GTN

Question 1

ASH FINAL Mnemonic (WHO prognostic system)

Answer 1

Age at diagnosis (>39?)
Site of Metastases (Esp Brain or liver)
HCG >100K? (Pretreatment)

Failed chemo?
Interval from diagnosis
Number of mets (>8?)
Antecedent pregnancy (prior term delivery?)
Large Tumor (>5cm?)

Question 2

FIGO classes:

Answer 2

I- elevated HCG and tumor confined to uterus
II- Tumor extends to adnexae or vagina only
III- Pulmonary mets
IV- Mets elsewhere

Question 3

Treatment for WHO score > or equal to 7?

Answer 3

EMACO

Etoposide, MTX, Actinomycin, Cyclophosphamide, Oncovorin (Vincristine)

Question 4

Diagnostic evaluation should include?

Answer 4

1) H&P
2) Labs: TFT, LFT, Type and screen. HCG, renal FTs
3) Pelvic US and CXR

Question 5

What kind of cysts are often seen with complete mole?

Answer 5

Theca lutein cysts

Question 6

Risk factors for GTN?

Answer 6

1- Asian/Native American
2- AMA
3- Very Young
4- Prior GTN/GTD