Gestational trophoblastic disease: GTN treatment: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gestational trophoblastic disease: GTN treatment

Sample item

A woman with post-molar gestational trophoblastic neoplasia has a FIGO prognostic score of 4. What is the treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Single-agent methotrexate or actinomycin D

Low-risk GTN (FIGO score 6 or below) is treated with single-agent methotrexate or actinomycin D with cure rates near 100 per cent. High-risk GTN (score 7 or above) is treated with multi-agent EMA-CO. Hysterectomy is considered if fertility is complete.

Option by option

  • A. Wertheim hysterectomy

    Wertheim hysterectomy is for cervical cancer.

  • B. Single-agent methotrexate or actinomycin D (correct)

    Correct. Score 6 or below is low risk and single-agent therapy suffices.

  • C. Radiotherapy to the pelvis

    Radiotherapy is not first-line for GTN.

  • D. EMA-CO multi-agent chemotherapy

    EMA-CO is for high-risk disease with a score of 7 or more.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Single-agent methotrexate or actinomycin D. Low-risk GTN (FIGO score 6 or below) is treated with single-agent methotrexate or actinomycin D with cure rates near 100 per cent.

Why is "Wertheim hysterectomy" not the answer?

Wertheim hysterectomy is for cervical cancer.

Why is "Radiotherapy to the pelvis" not the answer?

Radiotherapy is not first-line for GTN.

Why is "EMA-CO multi-agent chemotherapy" not the answer?

EMA-CO is for high-risk disease with a score of 7 or more.

What concept does this question test?

It tests Gestational trophoblastic disease: GTN treatment in OBG. High-risk GTN (score 7 or above) is treated with multi-agent EMA-CO. Hysterectomy is considered if fertility is complete.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gestational trophoblastic disease: GTN treatment?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.