GTD

Question 1

What is the initial workup after diagnosis of malignant GTN?

Answer 1

CBC, CMP, coags, blood type, quantitative HCG, CT chest, abdomen, and pelvis, and brain CT or MRI

Question 2

How is malignant GTN treated?

Answer 2

Stage 1 and stage 2/3 with score < 7 - methotrexate or actinomycin D
Stage 4 or stage 2/3 with score >= y - etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine

Question 3

Which types of malignant GTN are treated with hysterectomy?

Answer 3

Placental-site trophoblastic tumors and epithelioid trophoblastic tumors

Question 4

What are the components of WHO risk scoring for malignant GTN?

Answer 4

Age
Pretreatment HCG
# of metastatic sites
Largest tumor size
Interval since prior pregnancy
Type of prior pregnancy

Question 5

What are risk factors for GTD?

Answer 5

Extremes of age
Prior history
Prior unsuccessful pregnancies
COC pill use
Asian and Native American descent

Question 6

Karyotype of a complete mole

Answer 6

46,XX or XY

Question 7

Karyotype of a partial mole

Answer 7

69,XXX or 69,XXY

Question 8

What is the chance of postmolar malignant sequelae with a molar pregnancy?

Answer 8

Complete - 15%

Partial - 4-6%