Molar Pregnancy Quiz:

This article provides information about molar pregnancy, a common reproductive health issue. However, the quiz format is for informational purposes only.

Please note:

• Information presented is for general knowledge only and should not be considered as a substitute for professional medical advice.

• It is recommended to consult with a healthcare specialist for accurate diagnosis and proper treatment.

• Self-diagnosing and self-treating can be harmful to your health.

—

1872. Choose the INCORRECT statement. The criteria for diagnosing high-risk molar pregnancy include:

A. Ovarian cyst > 6cm.

B. Uterus larger than gestational age.

C. E-hCG > 100,000mIU/mL.

D. Previous pregnancy was a miscarriage.

Answer: D

Explanation: A previous miscarriage is not a criterion for diagnosing high-risk molar pregnancy. The criteria for diagnosing high-risk molar pregnancy include:

• Ovarian cyst > 6cm.

• Uterus larger than gestational age.

• E-hCG > 100,000mIU/mL.

1873. Gestational trophoblastic disease includes:

A. Complete molar pregnancy.

B. Partial molar pregnancy.

C. Choriocarcinoma.

D. Invasive mole.

Answer: All of the above.

Explanation: Gestational trophoblastic disease is a group of malignant conditions of trophoblastic cells associated with pregnancy. These conditions include:

• Complete molar pregnancy: Occurs when an empty egg is fertilized by a sperm carrying a duplicated X chromosome.

• Partial molar pregnancy: Results from the union of one sperm and a normal egg, or one sperm and two empty eggs.

• Choriocarcinoma: A malignant tumor of trophoblastic cells, usually developing after the treatment of a molar pregnancy.

• Invasive mole: A malignant form of molar pregnancy that invades the uterine wall.

1874. In a partial molar pregnancy:

A. Trophoblastic tissues only occupy a portion of the uterine cavity.

B. There is always an ovarian cyst present.

C. Both normal placental tissue and trophoblastic tissues are present.

D. The risk is higher than in complete molar pregnancy.

Answer: C

Explanation: In a partial molar pregnancy, part of the uterine cavity contains normal placental tissue, while another part contains trophoblastic tissue.

1875. The most common clinical sign of molar pregnancy is:

A. Vaginal bleeding.

B. Uterus larger than gestational age.

C. Preeclampsia or eclampsia symptoms.

D. Pelvic pain.

Answer: A

Explanation: Vaginal bleeding is the most common clinical sign of molar pregnancy, typically bright red and heavier than usual.

1876. The percentage of benign outcomes after molar pregnancy evacuation is approximately:

A. 30%

B. 50%

C. 60%

D. 80%

Answer: D

Explanation: The percentage of benign outcomes after molar pregnancy evacuation is approximately 80%.

1877. The most definitive diagnostic sign of molar pregnancy is:

A. Uterus larger than gestational age.

B. Urinary hCG level > 20,000 frog units.

C. Visualization of trophoblastic tissue through the cervical opening.

D. Ultrasound image showing “snowstorm” appearance.

Answer: C

Explanation: Visualization of trophoblastic tissue through the cervical opening is the most definitive diagnostic sign of molar pregnancy.

1878. The highest relative risk of developing molar pregnancy is in women pregnant in the age range of:

A. 15-20

B. 25-30

C. 31-35

D. > 35

Answer: D

Explanation: The highest relative risk of developing molar pregnancy is in women pregnant over the age of 35.

1879. Which of the following statements about molar pregnancy is incorrect?

A. In complete molar pregnancy, the uterine height is usually larger than the gestational age.

B. The uterine consistency is usually firm.

C. Approximately 25% of molar pregnancies have bilateral ovarian cysts.

D. Hyperthyroidism occurs in 10% of molar pregnancies.

Answer: B

Explanation: The uterine consistency in molar pregnancy is usually soft, not firm.

1880. The necessary follow-up period after molar pregnancy evacuation is:

A. 3 months

B. 6 months

C. 10 months

D. 12 months

Answer: D

Explanation: After molar pregnancy evacuation, patients need to be followed up for 12 months to detect any complications early.

1881. Choose the most accurate statement about molar pregnancy:

A. It is due to excessive growth of connective tissue in the chorionic villi, causing the villi to swell.

B. It occurs due to rapid growth of trophoblastic cells, the chorionic villi lose their connective tissue and blood vessels, and swell into fluid-filled sacs.

C. It is a malignant condition of the chorionic villi.

D. It is caused by the fetus dying and disappearing, leaving only fluid in the fetal sac.

Answer: B

Explanation: Molar pregnancy occurs when trophoblastic cells grow rapidly, the chorionic villi lose their connective tissue and blood vessels, and swell into fluid-filled sacs.

1882. The following factors contribute to the risk of developing molar pregnancy. Which one is an exception?

A. Chromosomal abnormalities.

B. Genetic diseases.

C. Malnutrition and weakened immunity.

D. Frequent pregnancies with mothers under 20 years and over 40 years old.

Answer: B

Explanation: Genetic diseases are not a contributing factor to molar pregnancy. Factors that contribute to the risk of molar pregnancy include:

• Chromosomal abnormalities

• Malnutrition and weakened immunity

• Frequent pregnancies with mothers under 20 years and over 40 years old.

1883. Choose the incorrect statement about molar pregnancy:

A. Human placental lactogen (hPL) levels are usually abnormally high.

B. The histological feature is that the chorionic villi lack connective tissue and blood vessels.

C. The incidence in Southeast Asia is higher than in European countries.

D. One of the contributing factors is a protein-deficient diet.

Answer: A

Explanation: In molar pregnancy, hPL levels are usually lower than normal, not abnormally high.

1884. After complete molar evacuation, the hCG monitoring schedule until it becomes negative is:

A. hCG measured once a week.

B. hCG measured every two weeks.

C. hCG measured every three weeks.

D. hCG measured every four weeks.

Answer: A

Explanation: After complete molar evacuation, hCG needs to be measured once a week until it becomes negative.

1885. After molar evacuation, the possibility of malignant complications arises when hCG:

A. Decreases but does not return to negative.

B. Decreases and then increases again, excluding pregnancy.

C. Decreases to negative and then increases again, excluding pregnancy.

D. All of the above are correct.

Answer: D

Explanation: After molar evacuation, abnormal changes in hCG levels can indicate malignant complications, including:

• Decreases but does not return to negative.

• Decreases and then increases again, excluding pregnancy.

• Decreases to negative and then increases again, excluding pregnancy.

1886. Partial molar pregnancy is:

A. When trophoblastic tissue only occupies a part of the uterine cavity.

B. When normal placental tissue is present alongside trophoblastic tissue.

C. When trophoblastic tissue contains clear fluid in one part and blood in another.

D. When there is an ovarian cyst present with trophoblastic tissue.

Answer: B

Explanation: Partial molar pregnancy occurs when normal placental tissue is present alongside trophoblastic tissue.

1887. Choose the incorrect statement about the risk factors of molar pregnancy:

A. Poor socioeconomic conditions.

B. Age > 40 or < 20.

C. History of hypertension.

D. Folic acid deficient diet.

Answer: C

Explanation: A history of hypertension is not a risk factor for molar pregnancy. Risk factors for molar pregnancy include:

• Poor socioeconomic conditions.

• Age > 40 or < 20.

• Folic acid deficient diet.

1888. Molar pregnancy is diagnosed when the hCG level is:

A. Elevated to 10,000 international units.

B. Elevated to 50,000 international units.

C. Elevated to 40,000 international units.

D. Elevated to 30,000 international units.

Answer: B

Explanation: Molar pregnancy is diagnosed when the hCG level is elevated to over 50,000 international units.

1889. In molar pregnancy, the life-threatening complication for the patient is:

A. Mother’s fatigue due to severe nausea.

B. Excessive uterine distension.

C. Hemorrhage due to molar pregnancy evacuation.

D. Choriocarcinoma.

Answer: C

Explanation: The life-threatening complication for the patient in molar pregnancy is hemorrhage due to molar pregnancy evacuation.

1890. After molar evacuation, the most important factor for evaluating and predicting the patient’s outcome is:

A. hCG level.

B. Uterine volume.

C. Estradiol level.

D. Ovarian cyst.

Answer: A

Explanation: The hCG level is the most important factor for evaluating and predicting the patient’s outcome after molar evacuation.

1891. Gestational trophoblastic disease has the following characteristics, except:

A. It is an abnormal proliferation of trophoblasts associated with pregnancy.

B. It is mainly classified based on histopathological criteria.

C. According to histopathological classification, it includes molar pregnancy and gestational trophoblastic tumors.

D. The disease does not originate from small germ cells.

Answer: D

Explanation: Gestational trophoblastic disease originates from small germ cells.

1892. Choriocarcinoma is a primary tumor of:

A. Decidua.

B. Trophoblastic cells.

C. Uterine muscle.

D. Undifferentiated germ cells.

Answer: B

Explanation: Choriocarcinoma is a primary tumor of trophoblastic cells.

1893. Which of the following conditions is NOT a differential diagnosis for molar pregnancy with vaginal bleeding?

A. Threatened abortion.

B. Ectopic pregnancy.

C. Placenta previa.

D. Large fibroid with hemorrhage.

Answer: C

Explanation: Placenta previa is not a condition that needs to be differentiated from molar pregnancy with vaginal bleeding.

1894. Which of the following complications does NOT occur after molar evacuation?

A. Gestational trophoblastic neoplasia

B. Infection

C. Sheehan’s syndrome

D. Invasive mole

Answer: C

Explanation: Sheehan’s syndrome is a condition of pituitary insufficiency after childbirth, and it does not occur after molar evacuation.

1895. hCG is a basic test for follow-up and prognosis after molar evacuation. T/F

Answer: True

Explanation: hCG testing is a basic test for follow-up and prognosis after molar evacuation.

1896. hCG needs to be measured every 15 days after molar evacuation until it becomes negative. T/F

Answer: False

Explanation: After molar evacuation, hCG needs to be measured once a week until it becomes negative.

1897. Ovarian cysts usually do not disappear after molar evacuation. T/F

Answer: False

Explanation: Ovarian cysts usually disappear after molar evacuation.

1898. Molar pregnancy can be mistaken for:

A. Polyhydramnios. T/F

B. Multiple pregnancy. T/F

C. Threatened abortion. T/F

D. Placental abruption. T/F

E. Missed abortion. T/F

Answer:

A. False

B. True

C. True

D. False

E. True

Explanation:

• Molar pregnancy can be mistaken for multiple pregnancy due to similar symptoms of uterine enlargement.

• Molar pregnancy can be mistaken for threatened abortion due to similar symptoms of vaginal bleeding.

• Molar pregnancy can be mistaken for missed abortion due to similar symptoms of uterine enlargement but no fetal heart sounds.

1899. The common test used for follow-up after molar evacuation to detect choriocarcinoma is:

A. Complete blood count. T/F

B. Urine protein test. T/F

C. Chest X-ray. T/F

D. Urine hCG level. T/F

E. Uterine ultrasound. T/F

Answer:

A. False

B. False

C. True

D. True

E. True

Explanation:

• Chest X-ray can help detect early lung metastases of choriocarcinoma.

• Urine hCG level helps monitor the progression of the disease after molar evacuation.

• Uterine ultrasound can help detect early invasive mole.

1900. Molar pregnancy is a disease of the …(trophoblastic cells)…, caused by the degeneration of chorionic villi forming …(fluid-filled sacs)… that clump together like a bunch of grapes:

Answer:

• Molar pregnancy is a disease of the trophoblastic cells, caused by the degeneration of chorionic villi forming fluid-filled sacs that clump together like a bunch of grapes.

1901. According to histopathology, there are four types of molar pregnancy:

A. Complete molar pregnancy

B. …….(Partial molar pregnancy)

C. Benign molar pregnancy

D. ……..(Malignant molar pregnancy)

Answer:

A. Complete molar pregnancy

B. Partial molar pregnancy

C. Benign molar pregnancy

D. Malignant molar pregnancy

Explanation: According to histopathology, there are four types of molar pregnancy:

• Complete molar pregnancy

• Partial molar pregnancy

• Benign molar pregnancy

• Malignant molar pregnancy

1902. The common functional symptoms of molar pregnancy are:

A. Bleeding

B. …….(Severe nausea)

C. Feeling the abdomen enlarging rapidly

Answer:

A. Bleeding

B. Severe nausea

C. Feeling the abdomen enlarging rapidly

Explanation: Common functional symptoms of molar pregnancy include:

• Vaginal bleeding

• Severe nausea

• Feeling the abdomen enlarging rapidly

1903. Choose the INCORRECT statement. Clinical signs of molar pregnancy include:

A. High blood pressure.

B. Bilateral large, firm ovarian cysts.

C. Hyperthyroidism.

D. Uterus larger than gestational age.

Answer: B

Explanation: In molar pregnancy, bilateral ovarian cysts are usually large and soft, not firm.

1904. The purpose of classifying high-risk molar pregnancy is:

A. To perform evacuation if the patient still wants to maintain fertility.

B. To perform hysterectomy if the patient has enough children or is older.

C. To administer prophylactic chemotherapy.

D. To monitor beta hCG levels five times a week.

Answer: C

Explanation: The purpose of classifying high-risk molar pregnancy is to administer prophylactic chemotherapy.

1905. Prophylactic chemotherapy for high-risk molar pregnancy:

A. Use MTX alone.

B. Use MTX – FA.

C. Actinomycin D and MTX.

D. EMA

E. Cyclophosphamide

Answer: B

Explanation: Prophylactic chemotherapy for high-risk molar pregnancy typically involves using MTX – FA.

1906. Chest X-ray after molar evacuation is indicated:

A. One month after molar evacuation.

B. Once a month for the first three months.

C. Every three months.

D. Only indicated when hCG levels remain abnormally high.

Answer: D

Explanation: After molar evacuation, chest X-ray is only indicated when hCG levels remain abnormally high.

1907. The cause of the presence of ovarian cysts in molar pregnancy is:

A. Increased prolactin receptor.

B. Increased follicle-stimulating hormone.

C. Increased luteinizing hormone.

D. Increased chorionic gonadotropin.

Answer: D

Explanation: Increased chorionic gonadotropin is the cause of the presence of ovarian cysts in molar pregnancy.

1908. The diagnosis of complete molar pregnancy before evacuation is usually based on:

A. Abdominal X-ray.

B. Ultrasound.

C. CT scan.

D. MRI.

Answer: B

Explanation: The diagnosis of complete molar pregnancy before evacuation is usually based on ultrasound.

1909. The preferred treatment for a 25-year-old primipara with a uterine size of 16cm is:

A. Molar evacuation.

B. Induction of abortion using prostaglandins.

C. Suction evacuation.

D. Total hysterectomy.

Answer: C

Explanation: Suction evacuation is the preferred treatment for a 25-year-old primipara with a uterine size of 16cm.

1910. Which factor is NOT a high-risk factor after molar pregnancy?

A. Partial molar pregnancy.

B. Mother >40 years old.

C. HCG > 100,000mUI/ml.

D. Bilateral large ovarian cysts.

Answer: A

Explanation: Partial molar pregnancy is not a high-risk factor after molar pregnancy. High-risk factors after molar pregnancy include:

• Mother > 40 years old.

• HCG > 100,000mUI/ml.

• Bilateral large ovarian cysts.

1911. Which sign indicates a favorable outcome after molar evacuation?

A. Enlarged uterus, persistent ovarian cysts.

B. Vaginal metastasis.

C. Persistent vaginal bleeding after evacuation.

D. Rapid disappearance of HCG after 8 weeks.

Answer: D

Explanation: Rapid disappearance of HCG after 8 weeks indicates a favorable outcome after molar evacuation.

1912. Choose the incorrect statement about molar pregnancy:

A. Patients often experience severe and prolonged nausea.

B. Beta hCG levels > 100,000 IU.

C. Hyperthyroidism can occur.

D. Most cases will spontaneously miscarry around the 10th week.

Answer: D

Explanation: Molar pregnancies do not miscarry spontaneously; they typically require evacuation.

1913. Choose the most accurate management when a molar pregnancy is definitively diagnosed:

A. Perform molar evacuation with preparation, as early as possible.

B. Perform at a facility with surgical capabilities.

C. Send the evacuated tissue for pathological examination.

D. All of the above are correct.

Answer: D

Explanation: The most accurate management for definitively diagnosed molar pregnancy includes:

• Performing molar evacuation with preparation, as early as possible.

• Performing at a facility with surgical capabilities.

• Sending the evacuated tissue for pathological examination.

1914. In molar pregnancy, hysterectomy is considered when the patient has enough children and is:

A. Over 35 years old.

B. Over 40 years old.

C. Over 45 years old.

D. Over 50 years old.

Answer: B

Explanation: In molar pregnancy, hysterectomy is considered when the patient has enough children and is over 40 years old.

1915. Complete molar pregnancy is:

A. When trophoblastic tissue occupies the entire uterine cavity.

B. When trophoblastic tissue fills the uterine cavity and no placental tissue is present.

C. When most of the chorionic villi are transformed into fluid-filled sacs.

D. When trophoblastic tissue does not connect, sticking together to form a cluster.

Answer: B

Explanation: Complete molar pregnancy is when trophoblastic tissue fills the uterine cavity and no placental tissue is present.

1916. The histological structure of complete molar pregnancy is:

A. There is hydropic degeneration and edema of the chorionic villi stroma.

B. There is proliferation of trophoblastic epithelial cells.

C. There are no blood vessels in the villi, and the villi are degenerated.

D. There are no fetal and placental tissues.

Answer: D

Explanation: The histological structure of complete molar pregnancy is that there are no fetal and placental tissues.

1917. When performing molar evacuation, the specimen that needs to be sent for pathological examination is:

A. Trophoblastic tissue.

B. Placental tissue (if any).

C. Trophoblastic tissue mixed with blood clots.

D. Placental tissue and trophoblastic tissue.

Answer: D

Explanation: When performing molar evacuation, the specimen that needs to be sent for pathological examination is placental tissue and trophoblastic tissue.

1918. The time for measuring beta HCG levels to detect choriocarcinoma after molar evacuation is:

A. Two weeks after evacuation.

B. Four weeks after evacuation.

C. Six weeks after evacuation.

D. Eight weeks after evacuation.

Answer: D

Explanation: The time for measuring beta HCG levels to detect choriocarcinoma after molar evacuation is eight weeks after evacuation.

1919. The management for confirmed threatened molar pregnancy is:

A. Allow spontaneous evacuation.

B. Manual evacuation.

C. Evacuation with a sharp curette.

D. Evacuation with a vacuum aspirator.

Answer: D

Explanation: The management for confirmed threatened molar pregnancy is evacuation with a vacuum aspirator.

1920. After molar evacuation, the most important factor for predicting the outcome is:

A. hCG level progression.

B. Histopathological image of trophoblastic tissue.

C. Pregnandiol level.

D. Estriol level.

Answer: B

Explanation: After molar evacuation, the most important factor for predicting the outcome is the histopathological image of trophoblastic tissue.

1921. Molar pregnancy has the following characteristics, except:

A. It is often associated with abnormally high human placental lactogen (hPL) levels.

B. The histological characteristic is that the chorionic villi lack normal connective tissue and blood vessels.

C. The incidence is higher in Southeast Asian countries than in European countries.

D. It is related to chromosomal abnormalities.

Answer: A

Explanation: In molar pregnancy, hPL levels are usually lower than normal, not abnormally high.

1922. High-risk molar pregnancy is indicated when:

A. Severe nausea.

B. Vaginal bleeding.

C. Persistent ovarian cyst after evacuation.

D. Increased hCG levels before evacuation.

Answer: C

Explanation: A persistent ovarian cyst after evacuation is a sign of high-risk molar pregnancy.

1923. Invasive mole often occurs:

A. After ectopic pregnancy.

B. After vaginal delivery.

C. After miscarriage.

D. After molar pregnancy.

Answer: D

Explanation: Invasive mole often occurs after molar pregnancy.

1924. The main difference between choriocarcinoma and invasive mole in histological structure is:

A. There is hydropic degeneration and edema of the chorionic villi stroma.

B. Trophoblastic cells proliferate less, are localized, and less deformed.

C. Trophoblastic cells penetrate deeply into the uterine muscle and blood vessels, with no chorionic villi present.

D. There are deformed cells.

Answer: C

Explanation: The main difference between choriocarcinoma and invasive mole in histological structure is that trophoblastic cells penetrate deeply into the uterine muscle and blood vessels, with no chorionic villi present.

1925. The most common site of metastasis of choriocarcinoma is:

A. Vagina.

B. Lungs.

C. Liver.

D. Ovaries.

Answer: B

Explanation: The most common site of metastasis of choriocarcinoma is the lungs.

1926. Which of the following complications is most common after molar evacuation?

A. Infection.

B. Uterine perforation.

C. Progression to invasive mole.

D. Progression to choriocarcinoma.

Answer: B

Explanation: The most common complication after molar evacuation is uterine perforation.

1927. In molar pregnancy:

A. hCG is elevated and hPL is elevated.

B. hCG is elevated and hPL is decreased.

C. hCG is decreased and hPL is elevated.

D. hCG is decreased and hPL is decreased.

Answer: B

Explanation: In molar pregnancy, hCG is elevated and hPL is decreased.

1928. After evacuation, the uterus quickly decreases in size within 5-6 days. T/F

Answer: True

Explanation: After evacuation, the uterus quickly decreases in size within 5-6 days.

1929. hCG returns to normal levels around 12 weeks after evacuation. T/F

Answer: True

Explanation: hCG returns to normal levels around 12 weeks after evacuation.

1930. Molar pregnancy can cause the following complications:

A. Hemorrhage. T/F

B. Uterine perforation. T/F

C. Ovarian cyst torsion. T/F

D. Ruptured corpus luteum. T/F

E. Choriocarcinoma. T/F

Answer:

A. True

B. False

C. True

D. False

E. True

Explanation:

• Molar pregnancy can cause hemorrhage due to molar evacuation.

• Molar pregnancy does not cause uterine perforation, but evacuation can cause uterine perforation.

• Molar pregnancy can cause ovarian cyst torsion.

• Molar pregnancy does not cause ruptured corpus luteum.

• Molar pregnancy can cause choriocarcinoma (gestational trophoblastic neoplasia).

1931. Molar pregnancy should be differentiated from:

A. ….(Threatened abortion)…..

B. …..(Ectopic pregnancy)…..

C. ….(Missed abortion)…..

D. ….(Uterine fibroids)….

Answer:

A. Threatened abortion

B. Ectopic pregnancy

C. Missed abortion

D. Uterine fibroids

Explanation: Molar pregnancy should be differentiated from:

• Threatened abortion

• Ectopic pregnancy

• Missed abortion

• Uterine fibroids

1932. After molar evacuation, it is necessary to monitor:

A. …(Uterine involution)…

B. …(Vaginal bleeding)…

C. ….(Ovarian cysts, metastasis)…

Answer:

A. Uterine involution

B. Vaginal bleeding

C. Ovarian cysts, metastasis

Explanation: After molar evacuation, it is necessary to monitor:

• Uterine involution

• Vaginal bleeding

• Ovarian cysts, metastasis

1933. Choose the INCORRECT statement. Ovarian cysts are:

A. Functional cysts caused by hCG stimulation.

B. Can be aspirated by ultrasound or laparoscopy if they are large.

C. Only require medical treatment if they twist or rupture.

D. Usually return to normal size within 8-10 weeks.

Answer: C

Explanation: Ovarian cysts require surgical treatment if they twist or rupture, not just medical treatment.

1934. Choose the most accurate statement about molar pregnancy:

A. It is due to excessive growth of connective tissue in the chorionic villi, causing the villi to swell.

B. It is caused by rapid growth of trophoblastic cells, the chorionic villi lose their connective tissue and blood vessels, and swell into fluid-filled sacs.

C. It is due to congestion and increased blood vessel growth in the chorionic villi.

D. It is caused by the fetus dying and disappearing, leaving only fluid in the fetal sac.

Answer: B

Explanation: The most accurate statement about molar pregnancy is that it is caused by rapid growth of trophoblastic cells, the chorionic villi lose their connective tissue and blood vessels, and swell into fluid-filled sacs.

1935. Which of the following statements is incorrect when talking about molar pregnancy:

A. It originates from a pregnancy.

B. Most cases are a malignant form of trophoblastic cells from pregnancy.

C. Complications can include: toxemia, infection, and hemorrhage.

D. The incidence of choriocarcinoma is quite high, 20-25%.

Answer: B

Explanation: Molar pregnancy is not a malignant form of trophoblastic cells from pregnancy.

1936. Choose the correct answer regarding molar pregnancy:

A. Complete molar pregnancy is due to the union of two sperm with a normal egg.

B. Complete molar pregnancy is due to the fertilization of an empty egg by a sperm carrying a duplicated X