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D&T test 5 - Renal, Urogential > Class: Gestational pathology > Flashcards

Class: Gestational pathology Flashcards

1
Q

maternal component of placenta

A

decidua basalis

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2
Q

fetal component of placenta

A

chorion

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3
Q

What connects chorion to decidua basalis

A

chorionic villi

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4
Q

What is the outermost layer of the chorion (facing the mother)

A

syntiotrophoblast

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5
Q

What 2 things does the trophoblast secrete and what do thewy do

A

hCG, placental lactogen –> they supprt the placenta

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6
Q

How many veins/arteries are in the umbilical cord

A

2veins, 1 artery

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7
Q

define vasa previa

A

fetal Vessels running over (or very near) to the cervical os

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8
Q

what other condition is Vasa Previa associated with and define it

A

Associated with velamentous cord: vessels don’t insert properly = increased risk of rupture

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9
Q

Classic triad of sx of Vasa Previa

A

painless vaginal beleding
fetal bradycardia
membrane rupture

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10
Q

Tx for Vasa Previa

A

Emergency C-section . Could lead to fetal death!

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11
Q

what does “previa” mean

A

obstruction (in childbirth)

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12
Q

Placenta previa most Often occurs when?

A

> 20 weeks

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13
Q

risk factor for placenta previa

A

PRIOR c-SCETION

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14
Q

define Abruptio Placentae

A

premature detachment of the placenta from the uterine wall

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15
Q

Cause of abruptio placentae

A

bleeding between decidua and placenta–> separation

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16
Q

findings in placental abruption (4)

A

abrupt, painful bleeding
DIC
maternal shock
fetal distress (heart monitor)

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17
Q

Risk factors for placental abruption (4)

A

Proir placental abruption, cocaine, abdominal trauma, HTN

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18
Q

Define placenta acreta

A

defective decidua–> abnormal attachment and separation of placenta after delivery

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19
Q

Risk factors for placenta acreta (3) - really only need forst for class- the other 2 are from FA

A

prior C-section, inflammation, placenta previa

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20
Q

What are the 3 types of abnormal decidua –> abnormal placental implantiation and how are they defined?

A

pLACENTA AccRETA- placenta attaches to myometrium
Increta- invades myometrium
percreta - perforates myometrium - can perforate entire uterine wall

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21
Q

How is placent accreta dx?

A

prenatal US shows hazy interface between placenta and decidua

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22
Q

complication of placenta accreta

A

Sheehan syndomre

23
Q

defining finding in abruptio placentae (2)

A

fetal bradycardia, low maternal BP

24
Q

what is MC fetal cause of spontaneous abortion

A

chromosomal abnormality (50%)

25
Q

What are some common maternal risk factors for sponataneous abortion (5)

A

maternal age
weight extremes
DM, HTN
low folate

26
Q

What is the only population in which we treat asymptomatic bacteriuria,

A

Pregnant women

27
Q

Define Chorioamnionitis

A

infection of the chorion and amniotic fluid

28
Q

two findings in Chorioamnionitis

A

green/pyuric placenta

neutrophil infiltrate of chorion and amniotic fluid

29
Q

Presenting sx of Chorioamnionitis (1st one is the only important one)

A

maternal fever, uterine tenderness, maternal tachycardia, leukocytosis

30
Q

What condition –> highest risk for Chorioamnionitis

A

pre-term deliveries

31
Q

MC cause of Chorioamnionitis

A

Group B strep

32
Q

3 other causes of Chorioamnionitis (other than GBS)

A

PROM, PPROM
congenital infx (TORCH)
procedures (amniocentesis)

33
Q

How is Chorioamnionitis prevented (specifically)

A

swab for GBS at 37 weeks

34
Q

If mom has a fever, placenta looks cloudy, or baby does anything weird at all what is tx

A

ABX right away. send to NICU

35
Q

What can Chorioamnionitis cause in newborn

A

PNA, meningitis, sepsis

36
Q

Define PIH (pregnancy induced HTN) (3 criteria)

A

> 140/90 and
20 weeks gestation
no proteinuria or end-organ dmage

37
Q

5 drugs for HTN in pregnancy

A 
alpha-methyl dopa
clonidine
labetalol
Hydralazine
CCBs
38
Q

Define preeclampsia

A

widespread maternal endothelial dysfunciton–>new-onset HTN with either proteinuria or end-organ dysfunction > 20 weeks

39
Q

What does HELLP stand for

A

Hemolysis, Elevated Liver enzymes, Low Platelets

40
Q

what causes HELLP

A

preecclampsia endothelial dysfunction –> thrombosis–> microangiopathic hemolytic anemia, etc

41
Q

presentation of eclampsia (2 for mother, 1 for baby)

A

Tonic-clonic seizure or coma accompanied by fetal bradycardia

42
Q

tx for eclampsia (2)

A

IV magnesium Sulfate

immediate delivery

43
Q

molar pregnancies are an abnormality of what process

A

fertilization

44
Q

molar pregnancies are dt what cause?

A

excess paternal chromos

45
Q

What is the pathological thing in molar pregnancies?

A

cystic swelling of chorionic villi and proliferation of the chorionic epithelium (trophoblast only)

46
Q

3 associateions of Molar pregnancy

A

Hyperemesis gravidarum
Theca lutein cysts
Hyperthyroidism

47
Q

How many sets of genes and fetal parts present or not and why?: complete mole

A

two sets of genes 46XX, 46XY

no fetal parts becuase all paternal genetic info

48
Q

How many sets of genes and fetal parts present or not and why: partial mole

A

three sets of genes 69 XXY, 69 XYY, 69XXX

yes, fetal parts

49
Q

which type of molar pregnancy shows SUPER elevated hCG

A

complete

50
Q

which type of molar pregnancy shows snowstorm moles on US

A

complete

51
Q

which type of molar pregnancy MC progresses to choriocarcinoma

A

complete

52
Q

what causes Choriocarcinoma

A

persistent trophoblastic layer

53
Q

what 2 anaplastic cell types are found in Choriocarcinoma and what 1 structure is not found

A

Anaplastic cytotrophoblasts and syncytiotrophoblasts with no chorionic vili

54
Q

px for choriocarcinoma

A

highly treatbale

D&T test 5 - Renal, Urogential (27 decks)

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