Class 6: GTD

Question 1

what is GTD caused by?

Answer 1

GTD is caused by abnormal proliferation of trophoblastic disease due to abnormal karyotype

Question 2

what is another name for trophoblastic tissue?

Answer 2

placental tissue

Question 3

2 functions of trophoblasts?

Answer 3

1. produce HCG
2. make chorionic villi

Question 4

3 types of GTD

Answer 4

1. hydatidiform mole
2. invasive mole
3. choriocarcinoma

Question 5

which form of GTD is benign?

Answer 5

hydatidiform mole

Question 6

which form(s) of GTD are malignant

Answer 6

invasive mole & choriocarcinoma

Question 7

another name for invasive mole?

Answer 7

chorioadenoma destruens

Question 8

what type of trophoblastic disease is nongestational?

Answer 8

testicular & ovarian choriocarcinoma

Question 9

hydatidiform mole & choriocarcinoma are more commonly in which parts of the world?

Answer 9

far east asia & africa

Question 10

what ages are more at risk for GTD?

Answer 10

<20 yo & >40yo

Question 11

what blood types are more at risk for GTD?

Answer 11

type A & AB

Question 12

besides age & blood type, what other factors increase the risk for GTD?

Answer 12

1. socioeconomic
2. previous molar pregnancy
3. multiple sexual partners
4. BC pills

Question 13

2 types of benign hydatidiform mole?

Answer 13

1. complete molar pregnancy
2. partial/incomplete molar pregnancy

Question 14

what is the most common type of GTD?

Answer 14

complete hydatidiform mole

Question 15

2 types of complete molar pregnancy?

Answer 15

1. fertilization of 1 defective ovum by 1 sperm that duplicates
2. fertilization of 1 defective ovum by 2 sperm

Question 16

2 types of incomplete molar pregnancy?

Answer 16

1. fertilization of 1 normal ovum by 2 sperm
2. fertilization of 1 normal ovum by 1 sperm with diploid set

Question 17

how many chromosomes are in a complete hydatidiform mole?

Answer 17

46 chromosomes

Question 18

how many chromosomes are in an incomplete hydatidiform?

Answer 18

69 chromosoomes

Question 19

which type of hydatidiform molar pregnancy has no fetal parts?

Answer 19

complete

Question 20

which type of hydatidiform molar pregnancy has high malignant potential?

Answer 20

complete

Question 21

which type of hydatidiform molar pregnancy has high malignant potential?

Answer 21

complete

Question 22

___ cysts are found in 20-35% of patients with molar pregnancy

Answer 22

theca lutein

Question 23

lab value related to theca lutein cysts?

Answer 23

high HCG

Question 24

how long can theca lutein cysts stay in the uterus after evacuation of molar pregnancy?

Answer 24

2-4 months

Question 25

MC S&S of GTD

Answer 25

irregular vaginal bleeding during pregnancy; possible discharge of mole

Question 26

size of the uterus in GTD?

Answer 26

large for date

Question 27

hyperemesis & preeclampsia are common symptoms of GTD. T/F?

Answer 27

true

Question 28

HCG levels are ___ times higher with GTD than with a normal pregnancy

Answer 28

3x

Question 29

how long does HCG continue to rise with GTD?

Answer 29

100 days from LMP

Question 30

the 2nd trimester US appearance of GTD is nonspecific. T/F?

Answer 30

false -- 1st trimester is nonspecific findings

Question 31

what type of pattern can molar pregnancy take on in the 2nd tri?

Answer 31

snow flake/lacey pattern

Question 32

molar pregnancy in 2nd trimester can look like a ___ mass with ___ areas that represent the chorionic villi

Answer 32

soft tissue mass with anechoic areas

Question 33

invasive mole is a malignant metastatic type of GTD. T/F?

Answer 33

false -- nonmetastatic

Question 34

when is invasive mole suspected?

Answer 34

when HCG levels remain high even when molar pregnancy is evacuated

Question 35

choriocarcinoma is an aggressive form of GTD. T/F?

Answer 35

true

Question 36

what percentage of benign molar pregnancies turn into choriocarcinoma?

Answer 36

2-5%

Question 37

what percentage of benign molar pregnancies turn into invasive mole?

Answer 37

15-18%

Question 38

where can choriocarcinoma mets to? (6)

Answer 38

lungs, brain, pelvis, lower GI, liver, urinary tract

Question 39

4 treatments to molar pregnancy

Answer 39

1. D&C 2. BC pills for 1 year after evacuation 3. HCG tests 4. other (depends on stage)