GTN/GTD

Question 1

Karyotype

Answer 1

Complete = 46, XX
Partial = 69, XXX or XXY

Question 2

Pathology

Answer 2

Complete = empty ovum + 1 sperm duplicates or 2 sperm fertilize
Partial = normal ovum fertilized by 2 sperm

Question 3

Trophoblastic proliferation

Answer 3

Complete = Diffuse
Partial = Focal

Question 4

Villous edema

Answer 4

Complete = widespread
Partial = focal

Question 5

Uterine size

Answer 5

Complete = large for dates
Partial = small for dates

Question 6

Initial hCG

Answer 6

Complete = > 100,000
Partial = < 100,000

Question 7

p57 staining

Answer 7

Complete = negative
Partial = Positive

Question 8

Risk of GTN

Answer 8

Complete = 15-20%
Partial = 1-5%

Question 9

Tx of non-metastatic GTN (invasive mole)

Answer 9

IM Methotrexate q1w

Question 10

Low risk GTN

Answer 10

IV Methotrexate qd x5d

Question 11

High risk GTN

Answer 11

EMACO (Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide, Vincristine [Oncovin])

Question 12

Placental site trophoblastic tumor

Answer 12

Hysterectomy

Question 13

Once you dx GTN, what is the next step?

Answer 13

CXR

Question 14

A GTN score of ___ = high risk

Answer 14

> 6

Question 15

What is the criteria of the following GTN scoring categories that = a score of 1…
Age?
Antecedent pregnancy?
Months b/w pregnancies?
Starting hCG?
Largest tumor size?
Number of mets?

Answer 15

Age: ≥40
Antecedent pregnancy: Abortion
Months b/w pregnancies: 4-6m
Starting hCG: 1k - 10k
Largest tumor size: 3-4cm
Number of mets: 1-4

Question 16

What criteria of the following GTN scoring categories = a score of 4…
Months b/w pregnancies?
Starting hCG?
Site of mets?
Number of mets?

Answer 16

Months b/w pregnancies: > 12m
Starting hCG: > 100k
Site of mets: Brain
Number of mets: > 8