Molar Pregnancy Quiz

Molar Pregnancy Quiz

Below are some multiple-choice questions about molar pregnancy:

1. Which statement is INCORRECT about the criteria for diagnosing high-risk molar pregnancy?

A. Ovarian cyst > 6cm.

B. Uterus larger than gestational age.

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

D. Previous pregnancy with fetal demise.

Answer: D

2. Gestational trophoblastic disease includes:

A. Complete molar pregnancy.

B. Partial molar pregnancy.

C. Choriocarcinoma.

D. Invasive molar pregnancy.

Answer: All of the above.

3. In partial molar pregnancy:

A. Molar tissue only occupies a portion of the uterine cavity.

B. There is always an ovarian cyst.

C. Both normal placental tissue and molar tissue are present.

D. The risk is higher than complete molar pregnancy.

Answer: C

4. Partial molar pregnancy is:

A. When molar cysts occupy only a portion of the uterine cavity.

B. When normal placental tissue is present alongside the molar cysts.

C. Some molar cysts contain thin fluid, while others contain blood.

D. When the molar pregnancy is accompanied by an ovarian cyst.

Answer: B

5. The most common clinical symptom of molar pregnancy is:

A. Vaginal bleeding.

B. Uterus larger than gestational age.

C. Signs of preeclampsia/eclampsia.

D. Pelvic pain.

Answer: A

6. The rate of benign progression after molar evacuation is approximately:

A. 30%

B. 50%

C. 60%

D. 80%

Answer: D

7. The most definitive diagnostic feature of molar pregnancy is:

A. Uterus larger than gestational age.

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

C. Visualizing molar cysts through the cervical os.

D. Ultrasound showing a “snowstorm” appearance.

Answer: C

8. The highest relative risk of molar pregnancy occurs in pregnant women aged:

A. 15 – 20

B. 25 – 30

C. 31 – 35

D. > 35

Answer: D

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

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

B. Uterine consistency is usually firm.

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

D. Hyperthyroidism occurs in 10% of molar pregnancies.

Answer: B

10. The time required for follow-up after molar evacuation:

A. 3 months

B. 6 months

C. 10 months

D. 12 months

Answer: D

11. Which of the following is the most accurate statement about molar pregnancy?

A. Due to excessive connective tissue growth in the chorionic villi, causing the villi to swell.

B. Due to the rapid proliferation of trophoblasts, the chorionic villi lack connective tissue and blood vessels, swelling into fluid-filled cysts.

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

D. Due to fetal demise and degeneration, leaving only fluid in the amniotic sac.

Answer: B

12. The following factors are all favorable for molar pregnancy, except:

A. Chromosomal abnormalities.

B. Genetic diseases.

C. Malnutrition, impaired immunity.

D. Multiple births, close births when maternal age < 20 and > 40.

Answer: B

13. Which statement is incorrect about molar pregnancy?

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

B. Histologically, chorionic villi lack connective tissue and blood vessels.

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

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

Answer: A

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

A. hCG quantification once a week.

B. hCG quantification every 2 weeks.

C. hCG quantification every 3 weeks.

D. hCG quantification every 4 weeks.

Answer: A

15. After molar evacuation, there is a risk of malignant transformation when hCG levels:

A. Decrease but do not return to normal.

B. Decrease and then increase again, excluding pregnancy.

C. Decrease to normal and then increase again, excluding pregnancy.

D. All of the above.

Answer: D

16. Partial molar pregnancy is:

A. When molar tissue occupies only 1 part of the uterine cavity.

B. When normal placental tissue is present alongside the molar cysts.

C. Some molar cysts contain thin fluid, while others contain blood.

D. When the molar pregnancy is accompanied by an ovarian cyst.

Answer: B

17. Which of the following is an incorrect statement about the risk factors for molar pregnancy?

A. Poor socioeconomic conditions.

B. Age > 40 or < 20.

C. History of hypertension.

D. Folic acid deficiency in the diet.

Answer: C

18. Diagnosis of molar pregnancy when quantifying EHCG:

A. Elevated to 10,000 IU.

B. Elevated to 50,000 IU.

C. Elevated to 40,000 IU.

D. Elevated to 30,000 IU.

Answer: B

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

A. Maternal fatigue due to severe nausea.

B. Excessive uterine distension.

C. Hemorrhage due to molar evacuation.

D. Choriocarcinoma.

Answer: C

20. After molar evacuation, the most important factor for assessing and prognosticating the patient is:

A. hCG levels.

B. Uterine volume.

C. Estradiol levels.

D. Ovarian cysts.

Answer: A

21. The following are characteristics of gestational trophoblastic disease, except:

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

B. The classification is primarily based on histopathological criteria.

C. According to the pathological classification, the disease includes molar pregnancy and trophoblastic tumors of gestational origin.

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

Answer: D

22. Choriocarcinoma is a primary tumor of:

A. Decidua.

B. Trophoblasts.

C. Myometrium.

D. Undifferentiated germ cells.

Answer: B

23. Which of the following conditions is INCORRECT when differentiating from molar pregnancy with bleeding?

A. Threatened abortion

B. Ectopic pregnancy

C. Placenta previa

D. Large fibroid with bleeding

Answer: C

24. The following complications do not occur after molar evacuation:

A. Choriocarcinoma.

B. Infection.

C. Sheehan’s syndrome.

D. Invasive molar pregnancy.

Answer: C

25. hCG is a fundamental test for monitoring and prognosticating after molar evacuation. TRUE/FALSE

Answer: TRUE

26. hCG needs to be done every 15 days after molar evacuation until it becomes negative. TRUE/FALSE

Answer: FALSE

27. Ovarian cysts usually do not disappear after molar evacuation. TRUE/FALSE

Answer: FALSE

28. Molar pregnancy can be mistaken for:

A. Polyhydramnios. TRUE/FALSE

B. Multiple pregnancy. TRUE/FALSE

C. Threatened abortion. TRUE/FALSE

D. Abruptio placentae. TRUE/FALSE

E. Missed abortion. TRUE/FALSE

Answer: A. FALSE

B. TRUE

C. TRUE

D. FALSE

E. TRUE

29. The tests commonly used to monitor after molar evacuation to detect Choriocarcinoma complications are:

A. Complete blood count. TRUE/FALSE

B. Urine protein quantification. TRUE/FALSE

C. Chest X-ray. TRUE/FALSE

D. Urinary hCG quantification. TRUE/FALSE

E. Uterine ultrasound. TRUE/FALSE

Answer: A. FALSE

B. FALSE

C. TRUE

D. TRUE

E. TRUE

30. Molar pregnancy is a disease of…(trophoblasts)…, due to the degeneration of chorionic villi forming…(fluid-filled cysts)… that cling together like a bunch of grapes:

Answer: Molar pregnancy is a disease of trophoblasts, due to the degeneration of chorionic villi forming fluid-filled cysts that cling together like a bunch of grapes.

31. According to pathological anatomy, there are 4 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

32. Common functional symptoms in molar pregnancy include:

A. Bleeding

B. …..(Hyperemesis gravidarum)

C. Feeling the abdomen enlarge quickly

Answer: A. Bleeding

B. Hyperemesis gravidarum

C. Feeling the abdomen enlarge quickly

33. Which of the following statements is INCORRECT? Clinical symptoms of molar pregnancy include:

A. Hypertension.

B. Bilateral enlarged, solid ovarian cysts.

C. Hyperthyroidism.

D. Uterus larger than gestational age.

Answer: B

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

A. To evacuate the molar tissue if the patient wants to preserve her reproductive ability.

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

C. To administer prophylactic chemotherapy.

D. To monitor beta hCG levels 5 times a day.

Answer: C

35. 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

36. After molar evacuation, chest X-rays need to be performed:

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

37. The reason for the appearance of ovarian cysts in molar pregnancy:

A. Increased prolactin receptor.

B. Increased follicle-stimulating hormone.

C. Increased luteinizing hormone.

D. Increased chorionic gonadotropin.

Answer: D

38. 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

39. The preferred treatment for molar pregnancy in a 25-year-old woman with a first pregnancy and a uterine size of 16cm.

A. Molar evacuation.

B. Induced abortion with Prostaglandin.

C. Molar aspiration.

D. Total hysterectomy.

Answer: C

40. Which of the following is NOT a high-risk factor after molar pregnancy?

A. Partial molar pregnancy.

B. Maternal age > 40 years.

C. HCG > 100,000mUI/ml.

D. Bilateral large ovarian cysts.

Answer: A

41. Which of the following is a sign of good progression after molar evacuation?

A. Enlarged uterus, persistent ovarian cysts.

B. Appearance of vaginal metastasis.

C. Persistent bleeding after molar evacuation.

D. Rapid disappearance of hCG after 8 weeks.

Answer: D

42. Which statement is incorrect about molar pregnancy?

A. Patients often experience severe and prolonged nausea.

B. Beta hCG levels > 100,000 IU.

C. Hyperthyroidism may occur.

D. Most will spontaneously abort around the 10th week.

Answer: D

43. Which of the following is the most correct management when a molar pregnancy is definitively diagnosed?

A. Molar evacuation with preparation, as soon as possible.

B. Perform at a facility with surgical capabilities.

C. Send the evacuated tissue for pathological examination.

D. All of the above.

Answer: D

44. Hysterectomy is considered for molar pregnancy 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

45. Complete molar pregnancy is:

A. When molar tissue occupies the entire uterine cavity.

B. When molar cysts occupy the entire uterine cavity and no placental tissue is seen.

C. When most of the chorionic villi become fluid-filled sacs.

D. When the molar cysts are not connected, and they cling together to form a cluster.

Answer: B

46. The histological structure of complete molar pregnancy is:

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

B. There is hyperplasia of trophoblastic epithelium.

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

D. There is no fetal tissue and chorionic villi.

Answer: D

47. When evacuating a molar pregnancy, the specimen that needs to be sent for pathological examination is:

A. Molar cysts.

B. Placental tissue (if present).

C. Molar cysts mixed with blood clots.

D. Placental tissue and molar cysts.

Answer: D

48. The time for quantifying beta hCG to detect Choriocarcinoma complications after molar evacuation:

A. 2 weeks after molar evacuation.

B. 4 weeks after molar evacuation.

C. 6 weeks after molar evacuation.

D. 8 weeks after molar evacuation.

Answer: D

49. Management when a threatened molar pregnancy is diagnosed is:

A. Allow the pregnancy to terminate naturally.

B. Manual evacuation.

C. Evacuate the molar pregnancy with a curette.

D. Evacuate the molar pregnancy with a vacuum aspirator.

Answer: D

50. After evacuating a molar pregnancy, the most important factor for prognostication is:

A. The course of hCG levels.

B. The histological appearance of the molar tissue.

C. Pregnanediol levels.

D. Estriol levels.

Answer: B

51. Molar pregnancy has the following characteristics, except:

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

B. Histologically, the chorionic villi lack normal connective tissue and blood vessels.

C. The incidence is higher in Southeast Asia than in Europe.

D. It is associated with chromosomal abnormalities.

Answer: A

52. Molar pregnancy is considered high-risk when there are signs of:

A. Hyperemesis gravidarum.

B. Vaginal bleeding.

C. Persistent ovarian cysts after molar evacuation.

D. Increased hCG levels before molar evacuation.

Answer: C

53. Invasive molar pregnancy usually occurs:

A. After ectopic pregnancy.

B. After vaginal delivery.

C. After miscarriage.

D. After molar pregnancy.

Answer: D

54. The main difference between choriocarcinoma and invasive molar pregnancy in terms of histological structure is:

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

B. Trophoblastic proliferation is less, localized, and less deformed.

C. There is an image of trophoblasts invading the myometrium and blood vessels without chorionic villi.

D. There are deformed cells.

Answer: C

55. The most common site of metastasis for choriocarcinoma is:

A. Vagina.

B. Lungs.

C. Liver.

D. Ovaries.

Answer: B

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

A. Infection.

B. Uterine perforation.

C. Transformation into invasive molar pregnancy.

D. Transformation into choriocarcinoma.

Answer: B

57. In cases of molar pregnancy:

A. hCG and hPL are elevated.

B. hCG is elevated and hPL is reduced.

C. hCG is reduced and hPL is elevated.

D. hCG and hPL are reduced.

Answer: B

58. The uterus rapidly reduces in size within 5-6 days after molar evacuation. TRUE/FALSE

Answer: TRUE

59. hCG returns to normal approximately 12 weeks after molar evacuation. TRUE/FALSE

Answer: TRUE

60. Molar pregnancy can lead to the following complications:

A. Hemorrhage. TRUE/FALSE

B. Uterine perforation. TRUE/FALSE

C. Ovarian cyst torsion. TRUE/FALSE

D. Corpus luteum rupture. TRUE/FALSE

E. Choriocarcinoma. TRUE/FALSE

Answer: A. TRUE

B. FALSE

C. TRUE

D. FALSE

E. TRUE

61. Molar pregnancy needs to be differentiated from:

A. ….(Threatened abortion)…..

B. …..(Ectopic pregnancy)…..

C. ….(Missed abortion)…..

D. ….(Uterine fibroid)….

Answer: A. Threatened abortion

B. Ectopic pregnancy

C. Missed abortion

D. Uterine fibroid

62. After molar evacuation, the following needs to be monitored:

A. …(Uterine involution)…

B. …(Vaginal bleeding)…

C. ….(Ovarian cysts, metastases)…

Answer: A. Uterine involution

B. Vaginal bleeding

C. Ovarian cysts, metastases

63. Which of the following statements is INCORRECT? Ovarian cysts are:

A. Functional cysts stimulated by hCG.

B. Can be aspirated via ultrasound or laparoscopy if large.

C. Only need medical treatment if they are twisted or ruptured.

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

Answer: C

64. Which of the following is the most accurate statement about molar pregnancy?

A. Due to excessive connective tissue growth in the chorionic villi, causing the villi to swell.

B. Due to the rapid proliferation of trophoblasts, the chorionic villi lack connective tissue and blood vessels, swelling into fluid-filled cysts.

C. Due to congestion and increased blood vessel growth in the chorionic villi.

D. Due to fetal demise and degeneration, leaving only fluid in the amniotic sac.

Answer: B

65. Which of the following statements is incorrect when talking about molar pregnancy?

A. It is a disease that originates from pregnancy.

B. For the most part, it is a malignant form of gestational trophoblastic disease.

C. It can have complications: preeclampsia, infection, hemorrhage.

D. The incidence of complications leading to choriocarcinoma is quite high at 20-25%.

Answer: B

66. Which of the following is the correct answer regarding molar pregnancy?

A. Complete molar pregnancy results from the fusion of 2 sperm with one normal ovum.

B. Complete molar pregnancy results from the fertilization of a non-nucleated ovum with one sperm containing a duplicated X chromosome.

C. The XX karyotype of complete molar pregnancy originates 50% from the father and 50% from the mother.

D. 94% of complete molar pregnancies have an XY sex chromosome.

Answer: B

67. When comparing urinary Estrogen levels in normal pregnancy and molar pregnancy, we see:

A. Estrone, Estradiol, and Estriol are all lower in molar pregnancy than in normal pregnancy.

B. Estrone, Estradiol, and Estriol are all higher in molar pregnancy than in normal pregnancy.

C. Estrone, Estradiol are higher in molar pregnancy than in normal pregnancy – Estriol is the opposite.

D. Estrone, Estradiol are lower in molar pregnancy than in normal pregnancy – Estriol is the opposite.

Answer: A

Note:

• This article is for informational purposes only and does not substitute for medical advice.

• Consult with a gynecologist for accurate diagnosis and treatment.

• It is important to follow up regularly after molar evacuation to detect complications early.