Moles

Question 1

Complete mole

Answer 1

Double sperm (full chrom)
-good fertilisation, bad egg 
--> will grow fast 
-look for signs and symptoms of molar pregnancy growing too fast 
-size/date discrepancies
-bleeding 
-bhcg high 
-hyperthyroidism 
-hyperemesis gravidarum
-grape like mass 
-adnexal mass (simple cyst)
DX - transvaginal US - Snowstorm pattern
Tx - suction curretage 

f/u - bhcg each year while being on OCP for 12 years

worries about choriocarcinoma if it becomes invasive disease

Question 2

Incomplete mole

Answer 2

one egg + two sperm

• abnormal genetic compliment
• good egg, fertilisation

Patient - same as complete mole, treatment, follow up - same as complete mole

Invasive
-rise in hcg on orla contraception –> choriocarcinoma

Question 3

choriocarcinoma

Answer 3

Chorio
path - gestational contents trophoblastic neoplasia
pt; bhcg
-can occur after miscariage, molar and nomral pregnancy
-dx - transvaginal US
biopsy - cuttage
-CT imaging - because can go to lungs and brain
surgical and chemo

-MAC - methotrexate, actimycin D, cyclophamide