Which one of the following states the diagnostic criteria for postmolar gestational trophoblastic neoplasia?
A rise of hCG levels of more than 10% for >3 values over 2 weeks' time
The correct answer is a rise in hCG of more than 10% across at least 3 values over 2 weeks. After molar evacuation, beta-hCG normally falls to undetectable levels within 8–12 weeks. FIGO criteria diagnose postmolar gestational trophoblastic neoplasia if any one holds: a plateau (within plus or minus 10%) across 4 values over 3 weeks (days 1, 7, 14, 21); a rise of more than 10% across 3 or more values over 2 weeks (days 1, 7, 14); persistently detectable hCG beyond 6 months; or histological choriocarcinoma or metastases. Treatment then follows the WHO prognostic score — single-agent methotrexate or actinomycin-D if 6 or less, EMA-CO if high risk.
The 5% rise over 4 values option errs on both the percentage and the value count — 4 values belong to the plateau criterion. The 15% figure is fabricated; no guideline uses it. The last option gets the rise right but stretches it to 4 weeks, which is not FIGO wording and would needlessly delay chemotherapy by a fortnight.
Key point: Memorise the pair — plateau: 4 values over 3 weeks; rise above 10%: 3 values over 2 weeks. Reliable contraception during follow-up prevents a new pregnancy confounding hCG monitoring.
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Important Questions from Neoplasms in Genital Tract
- Which one of the following is a protective factor for endometrial hyperplasia?
- Tumor marker of epithelial ovarian carcinoma is:
- The most common site of cervical cancer is:
- Which of the following are the vaccines for prevention of cervical cancer?
1. Cervarix
2. Gardasil
3. T-dap
4. Influenza
Select the correct answer using the code given below: - Consider the following statements regarding Carcinoma Cervix:
1. Clinical staging is done
2. Treatment if provided in stage I leads to survival rate of 80–90%
3. Surgery is preferred in young women with stage III disease
4. HPV virus is considered to be the causative agent
Which of the statements given above are correct?
