Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetric And Gynecology > MALIGNANT GESTATIONAL TROPHOBLASTIC DISEASE > Flashcards

MALIGNANT GESTATIONAL TROPHOBLASTIC DISEASE Flashcards

1
Q

What is the classification of malignant gestational trophoblastic neoplasia (GTN)?

A

Choriocarcinoma, persistent hydatidiform mole, invasive mole, and placental-site trophoblastic tumor (PSTT).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the risk factors for malignant GTD requiring chemotherapy.

A

Older age (≥40 years), preceding molar pregnancy, large tumor size (>5cm), high hCG levels (>10^5 miu/L), previous chemotherapy, and metastases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the role of the WHO prognostic scoring system in GTD?

A

It classifies GTD into low-risk (score 0-7) and high-risk (score >7) groups.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define choriocarcinoma.

A

A rapidly growing, invasive pregnancy-related tumor originating from trophoblast cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the histopathological findings in choriocarcinoma?

A

Dimorphic cytotrophoblast and syncytiotrophoblast populations, myometrial invasion, prominent necrosis, and hemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the FIGO anatomic staging for choriocarcinoma.

A

Stage 1: Uterine involvement; Stage 2: Vaginal metastases; Stage 3: Lung metastases; Stage 4: Distant metastases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the common clinical presentations of choriocarcinoma?

A

Irregular vaginal bleeding, metastatic symptoms (e.g., breathlessness, CNS disturbances, epigastric pain).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is choriocarcinoma diagnosed?

A

High β-hCG levels and persistent bleeding after pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the normal timeline for hCG to return to baseline after different pregnancy outcomes?

A

H. Mole: 84-100 days; Artificial abortion: 30 days; Spontaneous abortion: 19 days; Normal delivery: 12 days; Ectopic pregnancy: 8-9 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List the investigations necessary for GTN diagnosis and management.

A

FBC, RFT, LFT, HIV, CXR, USS, CT/MRI, brain imaging, and serial β-hCG levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the mainstay of treatment for GTN?

A

Chemotherapy is the primary treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name commonly used chemotherapy drugs for GTN.

A

Methotrexate, Actinomycin D, 5-Fluorouracil, Vincristine, Cyclophosphamide, Etoposide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What distinguishes low-risk from high-risk GTN?

A

Low-risk: Single-agent therapy; High-risk: Multi-agent therapy (EMA-CO regimen).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the principles of chemotherapy for GTN?

A

Low-risk patients receive single-agent; high-risk patients receive multi-agent therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the role of follow-up monitoring in GTN treatment?

A

Regular β-hCG monitoring and additional chemotherapy courses after normalization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is hCG follow-up critical after hysterectomy for GTN?

A

To detect and manage potential metastases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the surgical options for GTN management?

A

Hysterectomy, arterial ligation, embolization, and metastatic lesion removal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define an invasive mole.

A

A hydatidiform mole with villi penetrating deeply into the myometrium or blood vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the clinical features of an invasive mole?

A

Vaginal bleeding, intraperitoneal bleeding, uterine subinvolution, pelvic pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is an invasive mole diagnosed?

A

Persistent high β-hCG levels and imaging findings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What distinguishes an invasive mole from a choriocarcinoma?

A

Presence of villi distinguishes invasive mole from choriocarcinoma.

22
Q

What is the treatment for invasive moles?

A

Chemotherapy ± hysterectomy.

23
Q

Define placental-site trophoblastic tumor (PSTT).

A

A rare trophoblastic tumor predominantly composed of intermediate trophoblasts.

24
Q

How is PSTT diagnosed?

A

Persistent vaginal bleeding, low serum β-hCG (<10,000), histology.

25
Q

What is the treatment for PSTT?

A

Hysterectomy.

26
Q

What are the risk factors for developing an invasive mole?

A

History of complete hydatidiform mole, older age, high β-hCG levels.

27
Q

What is the significance of syncytiotrophoblast cells in GTD histology?

A

Their absence in PSTT histology.

28
Q

What are the metastatic symptoms associated with choriocarcinoma?

A

Hemoptysis, neurological symptoms, epigastric pain, jaundice.

29
Q

What is the survival rate for low-risk GTN treated with single-agent therapy?

A

Nearly 100%.

30
Q

Describe the EMA-CO regimen for high-risk GTN.

A

A multi-agent regimen combining etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine.

31
Q

How is hCG monitored during GTN treatment?

A

Monitored every 1-2 weeks until normalization and monthly for 1 year post-treatment.

32
Q

What is the role of hysterectomy in older patients with GTN?

A

To manage localized disease or excessive bleeding.

33
Q

What are the complications of untreated invasive moles?

A

Persistent hemorrhage, uterine perforation, distant metastases.

34
Q

What is the pathology of invasive moles?

A

Excessive trophoblastic proliferation with preserved villous pattern.

35
Q

How is PSTT different from other forms of GTD?

A

PSTT is locally invasive, indolent, and resistant to chemotherapy.

36
Q

What are the signs of metastasis in GTN?

A

Bluish vaginal nodules, CNS disturbances, lung symptoms.

37
Q

What is the importance of staging in GTN management?

A

Guides treatment and prognosis.

38
Q

How does age affect the prognosis of GTN?

A

Older age is associated with worse outcomes.

39
Q

Why is chemotherapy less effective in PSTT?

A

Due to its indolent nature and lower hCG production.

40
Q

What are the indications for selective arterial embolization in GTN?

A

To control localized bleeding.

41
Q

What are the adverse effects of GTN chemotherapy?

A

Bone marrow suppression, GI ulceration, liver/renal dysfunction.

42
Q

How is bleeding managed in patients with GTN?

A

Uterine artery embolization or hysterectomy.

43
Q

Why should conception be avoided for one year post-GTN treatment?

A

To allow for complete recovery and minimize recurrence risk.

44
Q

What are the features of chorioadenoma destruens?

A

Abnormal penetrativeness and extensive invasion by trophoblastic cells.

45
Q

How is persistent low-level hCG in PSTT managed?

A

Monitoring and hysterectomy if needed.

46
Q

What imaging techniques are used in GTN diagnosis?

A

Ultrasound, CT, MRI, and brain imaging.

47
Q

What is the role of β-hCG in GTN diagnosis and monitoring?

A

Essential for diagnosis, staging, treatment response, and follow-up.

48
Q

What percentage of complete hydatidiform moles become invasive?

A

Approximately 16%.

49
Q

Describe the presentation of metastatic nodules in GTN.

A

Bluish nodules filled with dark red blood.

50
Q

How is uterine subinvolution related to invasive moles?

A

It indicates incomplete uterine recovery, often linked to invasive mole.

Obstetric And Gynecology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions