Ovarian germ cell tumors Quiz: Ace Your Exams

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A 38-year-old primigravid woman comes to the office at 18 weeks gestation due to palpitations and pelvic pressure. She has been consistent with prenatal care. She is following a healthy diet and takes prenatal vitamins daily. She does not smoke or use alcohol or illicit drugs. Temperature is 37.5°C (99.5°F), pulse is 110/min, and blood pressure is 130/80 mmHg. On physical examination, the patient’s skin is moist and warm. Uterus size is consistent with 22 weeks of gestation. When the patient is holding her hands stretched, a mild tremor is noted. The thyroid gland is normal to palpation and nontender. Laboratory tests show hCG concentrations of 110,000 mIU/mL. TSH is 0.1 μU/mL. An abdominal ultrasound is obtained and shows a classic "Swiss cheese pattern," favoring the diagnosis of molar pregnancy, as demonstrated below:



Reproduced from: Wikimedia Commons

 Further evaluation would most likely reveal which of the following karyotypes?   

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