Early Pregnancy

Question 1

what are the four Ps in the GP outline?

Answer 1

a- full term deliveries
b- preterm deliveries
c- miscarriages/abortions
d- living children

Question 2

what day post conception does implantation occur?

Answer 2

8-9 days post

Question 3

what is the sign that signals pregnancy on physical exam?

Answer 3

Chadwicks sign…bluish hue of the cervix

Question 4

what cells make the bHCG?

Answer 4

syncytiotrophoblast

Question 5

how much does bHCG increase every 48 hours?

Answer 5

100% increase every 48 hours

Question 6

what are bHCG levels 14 days after conception?

Answer 6

around 100 IU/L

Question 7

what level of progesterone signals a healthy pregnancy?

Answer 7

greater than 20

Question 8

what is first visible structure on ultrasound in pregnancy?

Answer 8

a yolk sac

Question 9

what is second sign of pregnancy on ultrasound?

Answer 9

fetal pole

Question 10

what is third sign of pregnancy on ultrasound?

Answer 10

fetal cardiac activity

Question 11

what gestational age should yolk sac be seen?

Answer 11

5 weeks

Question 12

what gestational age should fetal pole be seen?

Answer 12

6 week s

Question 13

what gestational age should cardiac activity be seen?

Answer 13

7 weeks

Question 14

what is most common cause of spontaneous abortion?

Answer 14

genetic…chromosomal anomalies

Question 15

what is most common genetic cause of spontaneous abortions?

Answer 15

aneuploidyy

Question 16

what is most common specific genetic error in abortion?

Answer 16

45X

Question 17

what is a missed AB?

Answer 17

silent SAB

Question 18

what is SAB?

Answer 18

spontaneous abortion

Question 19

what is a threatened AB?

Answer 19

bleeding with closed cervical os

Question 20

what is an inevitable AB?

Answer 20

bleeding with open cervical os

Question 21

what is an incomplete AB?

Answer 21

partial passage of pregnancy tissue

Question 22

what is septic AB?

Answer 22

sAB in presence of uterine infection

Question 23

what is medical therapy for SAB?

Answer 23

mifepristone and misoprostol

Question 24

what is surgical intervention for SAB?

Answer 24

D and C

Question 25

what is most common location of ectopic pregnancy?

Answer 25

ampulla of fallopian tube

Question 26

what is medical therapy for an ectopic pregnancy? ho does this work?

Answer 26

methotrexate....inhibits DHFR and purine synthesis so no DNA

Question 27

what is surgical option for ectopic preganncy?

Answer 27

salpingectomy and salpingostomy

Question 28

what will be super high in a molar pregnancy?

Answer 28

bHCG

Question 29

what does ultrasound look like in molar pregnancy?

Answer 29

lots of cysts in the uterus

Question 30

what does GTD stand for?

Answer 30

gestational trophoblastic disease

Question 31

what happens in GTD?

Answer 31

abnormal trophoblast proliferation and maturation and can be neoplastic

Question 32

what is the most common form of GTD?

Answer 32

hydatiform mole

Question 33

what are the two types of hydatiform moles? which is more common?

Answer 33

complete and partial...complete more common

Question 34

what are the three less common types of GTD?

Answer 34

invasive mole choriocarcinoma placental site trophoblastic tumor

Question 35

what does an invasive mole invade?

Answer 35

invades into the myometrium

Question 36

what can occur with an invasive mole?

Answer 36

can metastasize

Question 37

what is genetic makeup of a complete hydatiform mole?

Answer 37

46XX or 46XY

Question 38

will there be an embryo present in complete hydatiform mole?

Answer 38

no

Question 39

describe the tissue appearance in a complete hydatiform mole

Answer 39

diffusely hydropic villi with diffuse trophoblastic proliferation and atypia

Question 40

explain how genetic makeup is determined in complete hydatiform mole

Answer 40

sperm fertilizes an empty egg and them replicates to somehow make 46XX genome usually

Question 41

what is genetic makeup of partial hydatiform mole?

Answer 41

69XXX or 69XXY

Question 42

describe the appearance of partial hydatiform mole

Answer 42

focal hydropic villi with focal trophoblastic proliferation and atypia

Question 43

is embryo present in partial hydatiform mole?

Answer 43

yes

Question 44

explain how the genetics become in a partial hydatiform mole?

Answer 44

haploid egg fertilized by two sperm

Question 45

what happens to uterus in hydatiform moles?

Answer 45

get super big

Question 46

what is classic ultrasound appearanace of hydatiform moles?

Answer 46

snowstorm pattern

Question 47

what is there more of in hydatiform moles?

Answer 47

vaginal bleeding

Question 48

what is therapy for hydatiform moles?

Answer 48

D and C

Question 49

what should patients with hydatiform moles be followed for?

Answer 49

suspected malignancy

Question 50

what can you have in ovary with complete hydatiform moles?

Answer 50

theca lutein cysts

Question 51

what are signs of malignancy after removal of hydatifrom mole?

Answer 51

plateau of HCG increase in HCG

Question 52

what is hallmark of an invasive mole?

Answer 52

hemorrhage

Question 53

what is character of choriocarcinoma?

Answer 53

sheets of cyto and syncytiotrophoblasts without chorionic villi

Question 54

what happens a lot in choriocarcinoma?

Answer 54

metastasis

Question 55

is choriocarciinoma curable?

Answer 55

very curable...even metastes

Question 56

which of complete or partial mole has greater risk of becoming malignant or converting to choriocarcinoma?

Answer 56

complete