Gestational trophoblastic disease
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1. A 42-year-old woman has bleeding for 12 months following her third-term vaginal delivery. Uterine evacuation identifies choriocarcinoma on histological diagnosis. Ultrasound shows a 5-cm lesion in the myometrium and chest x-ray shows multiple (more than eight) lung nodules and serum beta hCG is 12045iu/lCorrectIncorrect
2. 44 year-old woman has a molar pregnancy evacuated uneventfully. The hCG decreases from a pre-evacuation value of 80 000 to 1000 IU/l 4 weeks after the evacuation but then persists at 1000 mIU/ml for 4 weeks. Clinical examination shows no abnormality or evidence of metastases. Ultrasound of the uterus shows a 2-cm lesion in the myometrium. Chest x-ray is normalCorrectIncorrect
3. Which one of the following factors is most likely to significantly increase the FIGO prognostic risk factor scoring for histologically diagnosed choriocarcinoma?CorrectIncorrect
4. Which one of the following factors is characteristically associated with partial hydatidiform mole?CorrectIncorrect
5. Which statement is correct in relation to histological examination of the products of conception (POC) in the diagnosis of gestational trophoblastic disease?CorrectIncorrect
6. Which statement is correct in relation to contraception and future pregnancy outcome for women whose last pregnancy was a complete or partial hydatidiform mole?CorrectIncorrect
7. Which one of the following is not an indication for chemotherapy for gestational trophoblastic disease in the UK?CorrectIncorrect
8. Women with partial or complete mole diagnosed is advised:CorrectIncorrect
9. A 38-year-old woman underwent a suction evacuation procedure following a diagnosis of a missed miscarriage 8 weeks ago. Histopathology results confirmed a molar pregnancy. She had a blood sample taken to assess serum HCG 2 days ago at her GP surgery, which was 500 iu/ml. She presents to you for her follow up appointment.
What is the most appropriate duration of follow up?CorrectIncorrect
10. A 36-year-old woman presents to her GP after a miscarriage with confirmation of gestational trophoblastic disease in the histology. Her HCG levels have not yet normalised and she was using combined oral contraceptive pills prior to her pregnancy. What is the most suitable contraceptive advice that you would offer her?CorrectIncorrect
11. A 42-year-old woman presents with hyperemesis and irregular vaginal bleeding. She had an ultrasound scan that showed snowstorm vesicular appearance. Her bHCG levels were 120,000 iu/l. Which one of the statements below are true?CorrectIncorrect
12. A 44-year-old para 2 presented for her fetal viability scan at 12 weeks. Ultrasound showed twin gestation with one live fetus and possibility of a coexistent complete mole. What advice will you offer her?CorrectIncorrect
13. A 23-year-woman had an ultrasound scan that was suggestive of a missed miscarriage. She underwent evacuation of the uterus and products of conception were sent for histology. The histology report confirmed that this had been a partial molar pregnancy.
What are the most likely genetic features of the partial molar pregnancy?CorrectIncorrect
14. What is the most common symptom in women who develop gestational trophoblastic disease after a miscarriage?CorrectIncorrect