Gestational trophoblastic disease



Gestational trophoblastic disease



Gestational trophoblastic disease


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USMLE® Step 1 questions

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Gestational trophoblastic disease

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USMLE® Step 1 style questions USMLE

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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 shown below.  

 Reproduced from: Wikimedia Commons

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

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Gestational trophoblastic disease (GTD) is a group of tumors starting in the uterus's trophoblastic cells. Most cases of GTD occur during the first trimester of pregnancy, but it can also happen later. GTDs include partial and complete hydatidiform moles, gestational choriocarcinoma, placental site trophoblastic tumors, etc. Symptoms can include vaginal bleeding and pain, tiredness, and urination problems.


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