Dobson Gestational Pathology

Question 1

What are two specific common chromosomal anomalies leading to spontaneous abortion?

Answer 1

45 XO and trisomy 16

Question 2

Besides chromosomal anomalies, what are two other conditions that commonly lead to abortions?

Answer 2

Hypercoagulable states like antiphospholipid syndrome and infections.

Question 3

What is the most predisposing condition leading to ectopic pregnancy?

Answer 3

Chronic salpingitis secondary to PID.

Question 4

What are we trying to determine with hCG levels?

Answer 4

Whether or not there is a successful intrauterine pregnancy going on, a miscarriage, or an ectopic pregnancy.
Normally the hCG levels double every couple days with a normal pregnancy when it first begins.
Miscarriages, the hCG levels drop.
Ectopic pregnancies, the levels drop even further.

Question 5

What type of pathogen is almost always the cause of ascending infections leading to an abortion?

Answer 5

Bacterial

Question 6

5 conditions that lead to Uteroplacental vascular insufficiency?

Answer 6

Diabetes, HTN, mom has clot problems, smoking and cocaine and other drugs

Question 7

What is placental accreta, increta, and percreta?

Answer 7

Implantation into myometrium, further into myo, and placenta has gone through myometrium.

Question 8

What is going on with Twin Twin Transfusion syndrome?

Answer 8

Identical twins share the same placenta and abnormal blood connections form which leads to uneven blood flow to the babies. One baby is considered the donor and one is considered the recipient.

Question 9

Clinically, what is the sign for the donor and the recipient twin?

Answer 9

Donor doesn’t have enough amniotic fluid and becomes dehydrated and does grow as much.
Recipient has way too much amniotic fluid and gets really big and develops HTN.

Question 10

Biochemically, what is the problem going on that causes preeclampsia?

Answer 10

The remodeling of the placenta, necessary to meet the demands of pregnancy does not take place, so when things are really geared up in late pregnancy, the placenta actually becomes ischemic. This releases SFLT1 and endoglin to decrease angiogenesis much earlier than normal. Also, endoglin inhibits TGFbeta which may directly contribute to systemic VC.

Question 11

What is the reasoning behind HELLP syndrome due to preeclampsia?

Answer 11

Preeclampsia is associated with a hypercoagulable state for the lady

Question 12

You have to have 2 of the following 4 things to say we have hemolysis for HELLP?

Answer 12

Reduced hemoglobin
Low serum haptoglobin
High bilirubin
Abnormal peripheral smear

Question 13

What do we mean when we say elevated liver enzymes for HELLP syndrome?

Answer 13

Not only liver enzymes, but LDH and both need to be at least doubled.

Question 14

What value is considered low platelet count?

Answer 14

Less than 100k

Question 15

What are the two age groups more at risk for moles?

Answer 15

Teens and 40s

Question 16

What area of the world has a high risk for moles?

Answer 16

Southeast Asia

Question 17

What are the two lab values that are indicative of moles?

Answer 17

Elevated beta hCG and the rate of rise of hCG is way higher as well. BOTH.

Question 18

2 clinical signs of a choriocarcinoma?

Answer 18

Irregular vaginal bleeding and hCG very high.

Question 19

2 common places choriocarcinoma spreads to?

Answer 19

Lung and vagina

Question 20

What marker do trophoblastic tumors produce?

Answer 20

Human placental lactogen