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RDS Test 1 > B8-021 CBCL IUGR > Flashcards

B8-021 CBCL IUGR Flashcards

1
Q

[…] signaling in the placenta integrates nutrient availability to regulate fetal growth

A

mTOR

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2
Q

medical conditions associated with placental insufficiency [3]

A

preeclampsia
chronic HTN
vascular disease (lupus)

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3
Q

how does disruption of uteroplacental contact cause placental insufficiency?

A

loss of contact between uterine wall and placenta –> reduced surface area for gas/nutrient exchange –> less fetal growth

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4
Q

how does disruption of typical morphology cause placental insufficiency?

A

gas/nutrient exchange affected by differing surface area

Examples:
too thick/thin = inefficient or hyperefficient
if cord placement is off, nutrients could take longer to reach fetus

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5
Q

in a normal placenta, how do trophoblasts remodel the spiral arteries for maximal blood delivery?

A

larger, allowing for high volume low pressure system

(also replace with fibrous tissue to limit vasoconstriction)

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6
Q

describe the deficient spiral artery remodeling occurring in preeclampsia

A

less depth of invasion

blood arrives with higher pressure, less volume, and pulsatility –> placental stress

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7
Q

histopathologic characteristics of severe/early placental insufficiency

A

fibrinoid deposits (injury to fetal villi)
syncytial knots (syncytiotrophoblast apoptosis)

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8
Q

the amount in maternal blood reflects the size of the footprint of the placenta on maternal wall

A

pregnancy associated plasma protein (PAPP-A)

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9
Q

decreased PAPP-A is a risk factor for

A

IUGR

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10
Q

pregnancy associated plasma protein (PAPP-A) is produced by […] cells

A

syncytiotrophoblast

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11
Q

AFP is produced by […] cells

A

fetal liver

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12
Q

used to screen for neural tube defects and abdominal wall defects

A

AFP

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13
Q

elevated AFP may signal [2]

A

leaky, damaged placenta
fetal malformations

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14
Q

elevated levels of DIA and hCG is a risk factor for

A

preeclampsia
IUGR

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15
Q

in animal models where undernutrition is created, the […] pathway creates downregulation of placental transporters prior to the reduction in fetal growth

A

mTOR

(decreased amino acid transport is a direct contribution to IUGR)

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16
Q

ways to measure placental insufficiency [4]

A

umbilical artery doppler
proteins in mother’s blood
morphology of placenta
uterine artery doppler

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17
Q

[symmetrical or asymmetrical IUGR]
early in gestation

A

symmetrical

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18
Q

[symmetrical or asymmetrical IUGR]
late in gestation

A

asymmetrical

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19
Q

[symmetrical or asymmetrical IUGR]
is more common

A

asymmetrical

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20
Q

[symmetrical or asymmetrical IUGR]
all measurements at antenatal scan are proportionally reduced

A

symmetrical

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21
Q

[symmetrical or asymmetrical IUGR]
abdominal circumference decreased
other measurements normal

A

asymmetrical

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22
Q

[symmetrical or asymmetrical IUGR]
caused by a genetic disorder or infection intrinsic to fetus

A

symmetrical

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23
Q

[symmetrical or asymmetrical IUGR]
caused by utero-placental insufficiency

A

asymmetrical

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24
Q

some physical features of IUGR babies at birth

A

absence of buccal fat
large head
loose, dry skin
thin umbilical cord
poor muscle mass

(basically signs of undernutrition)

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25
Q

short term complications of IUGR that are a consequence of being born preterm [2]

A

pulmonary hypertension
necrotizing enterocolitis

26
Q

short term complications of IUGR [3]

A

hypothermia
polycythemia
renal dysfunction

27
Q

signs of IUGR during pregnancy [4]

A

poor maternal weight gain
HTN
reduced fetal activity
abnormal fundal height

28
Q

fundal height that is […] or more behind dates requires US investigation

A

3 cm

29
Q

fundal height of normal pregnancy progresses at […] / week

A

1 cm

30
Q

IUGR is commonly known as EFW or AC being less than […]% for gestational age

A

10

31
Q

placentas with insufficiency will show obliteration of […]

A

terminal villi

(reduction of surface area in fetal capillary network)

32
Q

in placental insufficiency, umbilical doppler will show a reduction in blood flow during

A

diastole

(can even become absent or reversed in later stages)

33
Q

a AFI measure below […] cm on US is considered the threshold for oligohydramios

A

5

34
Q

[poly/oligo]hydramnios is seen with IUGR

A

oligo

35
Q

what are the limitations of using EFW and AC as defining measurements in the diagnosis of IUGR? [3]

A

intrinsic error of US

does not account for ethnicity/other characteristics that alter the typical curve

does not include doppler findings

36
Q

about […] of suspected IUGR fetuses are normal constitutional small fetuses

A

2/3

37
Q

placental cell-type primarily responsible for nutrient transport

A

syncytiotrophoblast

38
Q

clinical definition of IUGR

A

EFW <10%

39
Q

phase I of fetal growth is characterized by

A

hyperplasia

40
Q

process in pregnancy that is responsible for the transition of high pressure low blood flow to low pressure high blood flow system

A

spiral artery remodeling

41
Q

what pathway links nutrient availability to fetal growth?

A

mTOR

42
Q

an abnormal uterine artery doppler will show low blood flow from […] to […]

A

from mother to placenta

43
Q

clusters of nuclei from apoptotic syncytiotrophoblasts are called

A

syncytial knots

44
Q

[…] cells are in direct contact with maternal blood and interface with maternal uterine connective tissue

A

syncytiotrophoblast

45
Q

[…] cells lie underneath the syncytiotrophoblasts

A

cytotrophoblasts

46
Q

cytotrophoblasts differentiate and fuse into […]

A

syncytiotrophoblasts

47
Q

[…] cells form the uterine lining

A

decidual

48
Q

cells that form the placental barrier and line the outside of placental villi

A

syncytiotrophoblasts

49
Q

[…] can trigger premature placental aging

A

oxidative stress

(caused by inflammation or hypoxia)

50
Q

increases the bioavailability of IGF, which regulates placental development

A

PAPP-A

51
Q

[…] women have increased rates of babies SGA

A

short

52
Q

women who continue to smoke beyond […] weeks gestation have an increased risk for a baby of SGA

A

15 weeks

53
Q

fetal microcephaly, intracranial calcifications, and chorioretinitis

A

congenital toxoplasma

54
Q

MCA doppler measures bloodflow to the

A

fetal brain

55
Q

what would you expect to see on MCA doppler in FGR due to placental insufficiency?

A

increased diastolic flow

56
Q

what would you expect to see on umbilical artery doppler in FGR due to placental insufficiency?

A

decreased diastolic flow

57
Q

poor pregnancy […] can be non-pathological cause of SGA

A

dating

58
Q

what is the cause of hypoglycemia in IUGR infants?

A

decreased placental transfer of nutrients –> reduced supply

59
Q

an undernourished fetus will direct most of the blood flow to the […] [2]

A

heart
brain

60
Q

genetic aberration occurring in the trophoblast or in progenitor cells leading to abnormal placental development and IUGR

A

confined placental mosaicism

(only affects placenta; no genetic abnormalities seen in fetus)

RDS Test 1 (23 decks)

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