GTD

Question 1

is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus which will fail to come to term.

Answer 1

Molar pregnancy

Question 2

types of trophoblast neoplasia (2)

Answer 2

1. molar- always gestational

2. non-molar can be non-gestational

Question 3

No villi
Non-gestational choriocarcinoma
Arise in ovary, testes, chest
Very, very rare 1:400,000 people

Answer 3

non-molar

Question 4

molar gestations occur due to

Answer 4

errors in fertilization or meiosis where there is abnormal paternal contribution to the zygote

Question 5

2 categories of molar gestations

Answer 5

complete or partial hydratidiform mole

Question 6

complete mole

Answer 6

uniparental (androgenetic)- when a single or double sperm combines with an egg that has lots its nuclear DNA

** single sperm reduplicates to form 46

Question 7

sperm that reduplicates what will be the genotype of the complete mole

Answer 7

XX or XY

**YY will not be observed

Question 8

complete mole have higher risk of developing into

Answer 8

choriocarcinoma

Question 9

partial mole

Answer 9

biparental- egg is fertilized by two sperm but the egg contains nucleus

*** common: XXY or with duplication XXXY

Question 10

paternal DNA preferentially makes extra-embryonic tissues/embryonic tissues while maternal DNA preferentially makes extra-embryonic tissues/embryonic tissues

Answer 10

paternal DNA preferentially makes extra-embryonic tissues while maternal DNA preferentially makes embryonic tissues

Question 11

Provides instructions for making a protein that is thought to play a role in inactivating genes based on which parent the copy of the gene came from

Thought to be involved in imprinting (inactivating) multiple maternal genes in egg cells (oocytes) that contribute to a developing embryo, ensuring that the genes will be inactive; the corresponding paternal genes are active.

Answer 11

NLRP7 Gene

Question 12

____is a kinase inhibitor involved in apoptosis
Only maternal allele is expressed
Paternal alleles are imprinted (inactivated)

Answer 12

p57

Question 13

_______ hydatidiform moles consist only of paternal DNA, and thus the cells lack p57 (tumor suppressor) expression as the gene is paternally imprinted (silenced).

Answer 13

Complete

Question 14

fetal development possible in partial hydatidiform mole

Answer 14

yep- have quite a few deformities and most are born dead

Question 15

Villi grossly identifiable, often >1cm in greatest dimension
All villi are vesicular
No fetal development
Excess tissue

Answer 15

complete hydatidiform mole

Question 16

Invasive mole
Choriocarcinoma
Placental site trophoblastic tumor (PSTT)
Epithelioid trophoblastic tumor (ETT

Answer 16

gestational trophoblastic neoplasia

Question 17

complete moles recurrence

Answer 17

20% invasive mole

Question 18

partial moles recurrence

Answer 18

1-5% invasive mole

Question 19

diagnosis of molar pregnancy

Answer 19

ultrasound- sensitivity 70-90%

Question 20

malignancy of trophoblast that present with bleeding and pre-eclampsia (toxemia) and it is widely metastatic

Answer 20

choriocarcinoma

Question 21

HcG is similar to

Answer 21

TSH- might present with hyperthyroidism during pregnancy

Question 22

GTD is not at all/ highly chemosensitive

Answer 22

highly chemosensitive

Question 23

2 most common medications used to treat molar pregnancies

Answer 23

1. methotrexate

2. Actinomycin-D (transcription inhibitor)

Question 24

faster fall of HcG after a complete molar pregnancy

Answer 24

less likely for a second molar pregnancy to occur

Question 25

Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG with large oligosaccharide side chains. Although hCG is produced by ___________ cells, hyperglycosylated hCG marks _________ cell. Hyperglycosylated hCG signals placental implantation.

Answer 25

Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG with large oligosaccharide side chains. Although hCG is produced by syncytiotrophoblast cells, hyperglycosylated hCG marks cytotrophoblast cell. Hyperglycosylated hCG signals placental implantation.

Question 26

IUD after molar pregnancy

Answer 26

do not insert due to soft uterus and increase risk of perforation