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Repro 2 Midterm > Dobson: Pathology of the fallopian tube, ovary, and gestational trophoblastic disease > Flashcards

Dobson: Pathology of the fallopian tube, ovary, and gestational trophoblastic disease Flashcards

1
Q

What does adnexa mean?

A

-the parts adjoining an organ

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2
Q

What are the fallopian tubes formed from?

A
  • mullerian duct

- remnants of the wolffian duct form paratubal cysts!

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3
Q

What is the most common cause of Salpingitis?

A
  • N. Gonorrhea 60%

- chlamydia most of remainder

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4
Q

What will we see on imaging in salpingitis?

A

-tubo-ovarian abscess

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5
Q

Tuberculous salpingitis

A
  • rare in US
  • cause of infertility where endemic
  • multinucleated giant cells
  • Ziel neilson stain*
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6
Q

are fallopian tube tumors common

A
  • no!
  • B-9 adenomatoid tumor (mesothelial tumors)
  • primary adenocarcinoma of the fallopian tube
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7
Q

how does adenocarcinoma of fallopian tube present?

A
  • bleeding not related to cycle

- one of the rarest gynecologic cancers

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8
Q

What is PCOS combined clinically with?

A

-hyperandrogenism

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9
Q

are cystic follicles in ovary common?

A
  • hell yes
  • can be palpable, may cause pain
  • incidental finding
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10
Q

what is the outer part of the corpus luteum colored?

A

yellow!

-because it’s secreting a bunch of hormones

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11
Q

PCOS

A
  • multiple cysts (follicles that don’t mature)
  • hyperandrogenism
  • menstrual irregularities
  • chronic anovulation
  • decreased fertility
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12
Q

how is PCOS characterized?

A
  • obesity
  • DM type 2
  • Early atherosclerosis
  • lots of free estrone
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13
Q

PCOS symptoms

A
  • amenorrhea
  • acne
  • hirsutism or male pattern baldness
  • acanthosis nigricans
  • deepening voice
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14
Q

what are the 3 kinds of tumors that can come from the ovary?

A
  • Surface epithelial stromal tumors
  • sex cord stomal tumors
  • Germ cell tumors
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15
Q

which tumors are commonly bilateral?

A
  • serous tumors
  • clear cell
  • metastatic (duh)
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16
Q

what age do serous tumors usually present at?

A
  • younger

- 20-45

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17
Q

B-9 tumors morphology

A
  • smooth glistening cyst wall with no epithelial thickening or only small papillary projections
  • cilia present!
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18
Q

What do borderline tumors have?

A

-more complex growth patterns

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19
Q

Where do malignant tumors spread to?

A

-peritoneum and omentum

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20
Q

What is another good characteristic feature of serous tumors?

A

-PSAMMOMA BODIES!!!!

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21
Q

what is the outlook if the malignant tumors get to the peritoneum?

A

-terrible… they’lll die

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22
Q

What are some risk factors for serous ovarian tumors?

A
  • Nulliparity
  • FMH
  • Heritable mutations: BRCA1 and BRCA2
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23
Q

If we see psuedomyxoma peritonei, what do we think?

A

-appendiceal tumor

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24
Q

What is the presentation of ovarian epithelial tumors?

A

-most commonly lower abdominal pain and abdominal enlargement (tumor or ascites)

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25
Q

what tumor marker is useful for ovarian neoplasms?

A
  • CA-125

- look at it to track the treatment process

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26
Q

what is the karyotype of almost all teratomas?

A
  • normal!

- 46,XX

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27
Q

Which tumors are the only ones that will be secreting androgens?

A

-the granulosa and theca cell tumors

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28
Q

what will a child that has a granulosa cell tumor present wiht?

A

-precocious puberty!

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29
Q

How would an adult with a granulos cell tumor present?

A

-with endometrial issues!

30
Q

What is a Renke crystalloid charactieristic of?

A
  • Hilus cell tumors

- that is a pure leydig cell tumor

31
Q

When I say Call Exner bodies, you say….

A

Granulosa cell tumors

32
Q

What are Call Exner bodies?

A

-small, distinctive, glandlike structures filled with an acidophilic material

33
Q

What is it called when a GI tract tumor metastasizes to the ovary

A

-Krukenburg tumor!

34
Q

When is the peak incidence for a sertoli-leydig cell tumor?

A
  • 2nd and 3rd decades

- they are unilateral and may resemble granulosa cell tumors grossly

35
Q

What mutation is usually in sertoli-lerydig cell tumors?

A

-DICER1

36
Q

What is the cytotrophoblast?

A

-the cells that line the outer part of the embryo

37
Q

What is the syncitiotrophoblast?

A

-the part that anchors the embryo into the endometrium

38
Q

What is in the umbilical cord?

A
  • vein

- 2 arteries

39
Q

What is considered a miscarriage?

A

-preggo loss before 20 weeks of gestation

40
Q

What is the most common cause of spontaneous abortion?

A

-chromosomal abnormalities (turner syndrome 45,X)

41
Q

What is the vascular abnormality that causes sponateous abortion?

A

-Anti Phospholipid syndrome

42
Q

What are the Torch infections?

A
  • Toxoplasmosis
  • Rubella
  • CMV (owl eye nucleii)
  • Herpes
43
Q

Where is ectopic pregnancies usually located?

A

-the fallopian tube!

44
Q

What will show up on an ultrasound with an ectopic preggo?

A

-a “donut” sign

45
Q

What is considered a disorder of late preggo?

A

-20 weeks to the third trimester

46
Q

What is particularly common in second trimester losses?

A

-infections

47
Q

What is Twin-twin transfusion syndrome (TTTS)?

A
  • monochorionic twins
  • vascular anastomosis (usualy deep arteiovenous anastomosis
  • they steal blood from each other
48
Q

What is placenta previa?

A

-when the placenta is attached close to or covering the cervix…. this

49
Q

What do ppl with preeclampsia have?

A

-htn, edema, and proteinuria

50
Q

What is eclampsia then?

A

-pre eclampsia with a seizure

51
Q

what syndrome did we talk about with eclampsia?

A
  • HELLP syndrome

- Hemolysis, Elevated Liver enzymes, Low platelet counts (<100,000)

52
Q

What is more common in primiparas?

A

-preeclampsia

53
Q

Risk factors for Preeclampsia?

A
  • > 40
  • black
  • Fam hx
  • multiple gestation
  • Chronic renal disease
  • Chronic HTN
  • DM
  • clotting disorders
  • first prego
54
Q

When do the symptoms of preeclampsia disappear?

A

-after delivery of the placenta

55
Q

What is the thing that antagonizes VEGf which decreases maternal/placental angiogenesis?

A

-sFltl

56
Q

What inhibits TGF beta which decreases endothelial production of NO and vasoconstriction, htn, and tissue hypoperfusion?

A

-endoglin

57
Q

What is decreased in the hypercoagulable state associated with preeclampsia?

A
  • PGI2

- so great, now we get thrombi……..

58
Q

What organs are affects by preeclampsia?

A
  • placenta
  • liver
  • kidney
59
Q

What does the placenta look like in pre eclampsia?

A
  • infarcts
  • exaggerated ischemic changes
  • retroplacental hematomas
  • abnormal decidual vessels
60
Q

What do the liver lesions look like in preeclampsia?

A
  • irregular, focal, subcapsular, and intraparenchymal hemorrhages
  • fibrin thrombi in the portal capillaries and foci of hemorrhagic necrosis
61
Q

What are the gestational trophoblastic diseases?

A
  • hydatidiform mole
  • Invasive mole
  • choriocarcinoma
  • placental site trophoblastic tumor (PSTT)
62
Q

When is a hydatidiform mole diagnosed?

A
  • early in preggo (9 weeks)

- 2x as common in SE asia

63
Q

What does a complete mole look like?

A

-grapelike structures= edematous villi

64
Q

Which kind of mole (partial or complete) has formation of fetal tissue?

A
  • the partial mole

- that one has an X and Y chromosome

65
Q

What will be higher at nine weeks preggo with a mole?

A

-B-hCG

66
Q

What is an invasive mole?

A

-penetrates through uterine wall

67
Q

Choriocarcinoma

A
  • rapidly invasive malignant neoplasm of trophoblastic cells derived from a previously normal or abnormal pregnancy
  • uncommon
68
Q

Presentation of choriocarcinoma?

A
  • irregular vaginal bleeding
  • hCG usually very high
  • may present with mets to lung
69
Q

What is the results of chemotherapy in Choriocarcinoma?

A
  • amazing!

- nearly 100% remission and high rate of cures

70
Q

Placental site trophoblastic tumor?

A
  • Uncommon

- produce human placental lactogen hPL

71
Q

How does PSTT clinically present?

A
  • uterine mass with bleeding or amenorrhea
  • moderate HCG elevation
  • increase hPL
  • if localized, excellent prognosis

Repro 2 Midterm (9 decks)

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