AIIMS Raipur NO - 2019 (Shift-2)
Obstetrics & Gynaecology
Easy
In choriocarcinoma, levels of this hormone are high?
Appeared in: AIIMS Raipur NO - 2019 (Shift-2)
Explanation
- Choriocarcinoma is a malignant, trophoblastic cancer, meaning it arises from the cells that normally develop into the placenta.
- These trophoblastic cells are responsible for producing human chorionic gonadotropin (hCG) during pregnancy.
- Consequently, a choriocarcinoma secretes very high levels of hCG, making it a primary tumor marker for the disease.
- HCG levels are used for diagnosis, staging, monitoring treatment response, and detecting recurrence.
- Levels in choriocarcinoma can be extremely high, often over 100,000 mIU/mL, and should fall to non-pregnant levels after successful treatment.
Why Other Options Were Wrong
- Option A: Human chorionic somatomammotropin (hCS), also known as human placental lactogen (hPL), is a hormone produced by the placenta to modulate maternal metabolism, but it is not the specific tumor marker for choriocarcinoma.
- Option C: Human papillomavirus (HPV) is a virus, not a hormone. It is the primary cause of cervical cancer.
- Option D: Human leukocyte antigen (HLA) refers to a group of proteins on the surface of cells that help the immune system distinguish the body's own cells from foreign ones. They are not hormones and are not elevated in choriocarcinoma.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Tumor markers in gestational trophoblastic disease as background academic context rather than a clinical decision trigger.
- Nurses play a critical role in managing patients with choriocarcinoma by ensuring serial beta-hCG levels are drawn as scheduled (e.g., weekly until negative, then monthly) to monitor for remission or relapse.
- Patient education is vital. The nurse must explain the importance of strict, effective contraception (usually for 6-12 months post-remission) to prevent a new pregnancy, as rising hCG from a pregnancy would be indistinguishable from tumor recurrence.
- Nurses must monitor for signs of metastasis, which is common in choriocarcinoma. Key symptoms to watch for include coughing or hemoptysis (lung metastasis), headaches or seizures (brain metastasis), and abdominal pain (liver metastasis).
How to Approach the Question
- Identify the key terms in the question: 'choriocarcinoma' and 'hormone'.
- Recall that choriocarcinoma is a type of gestational trophoblastic disease, meaning it originates from placental trophoblast cells.
- Connect the cell of origin (trophoblast) to its primary hormonal product, which is human chorionic gonadotropin (hCG).
- Evaluate the options. Eliminate 'Human papilloma virus' as it is a virus, and 'Human leukocyte antigen' as it relates to the immune system.
- Differentiate between the two placental hormones listed: hCG and hCS. Remember that hCG is the specific and highly sensitive marker for trophoblastic tumors.
- Select the option that correctly identifies hCG as the elevated hormone.
Concept Tested & Keywords
- Concept Tested: Tumor markers in gestational trophoblastic disease
- Stem keywords: choriocarcinoma, hormone, high levels
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
Qx6KkzUcqSmh4dCjoFRDgu
Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1034-1036
E6 Obstetrics Williams p. 6
Practise the full AIIMS Raipur NO - 2019 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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