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Repro Week 4 > Early Pregnancy > Flashcards

Early Pregnancy Flashcards

1
Q

what are the four Ps in the GP outline?

A

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

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2
Q

what day post conception does implantation occur?

A

8-9 days post

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3
Q

what is the sign that signals pregnancy on physical exam?

A

Chadwicks sign…bluish hue of the cervix

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4
Q

what cells make the bHCG?

A

syncytiotrophoblast

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5
Q

how much does bHCG increase every 48 hours?

A

100% increase every 48 hours

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6
Q

what are bHCG levels 14 days after conception?

A

around 100 IU/L

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7
Q

what level of progesterone signals a healthy pregnancy?

A

greater than 20

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8
Q

what is first visible structure on ultrasound in pregnancy?

A

a yolk sac

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9
Q

what is second sign of pregnancy on ultrasound?

A

fetal pole

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10
Q

what is third sign of pregnancy on ultrasound?

A

fetal cardiac activity

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11
Q

what gestational age should yolk sac be seen?

A

5 weeks

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12
Q

what gestational age should fetal pole be seen?

A

6 week s

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13
Q

what gestational age should cardiac activity be seen?

A

7 weeks

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14
Q

what is most common cause of spontaneous abortion?

A

genetic…chromosomal anomalies

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15
Q

what is most common genetic cause of spontaneous abortions?

A

aneuploidyy

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16
Q

what is most common specific genetic error in abortion?

A

45X

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17
Q

what is a missed AB?

A

silent SAB

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18
Q

what is SAB?

A

spontaneous abortion

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19
Q

what is a threatened AB?

A

bleeding with closed cervical os

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20
Q

what is an inevitable AB?

A

bleeding with open cervical os

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21
Q

what is an incomplete AB?

A

partial passage of pregnancy tissue

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22
Q

what is septic AB?

A

sAB in presence of uterine infection

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23
Q

what is medical therapy for SAB?

A

mifepristone and misoprostol

24
Q

what is surgical intervention for SAB?

A

D and C

25
Q

what is most common location of ectopic pregnancy?

A

ampulla of fallopian tube

26
Q

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

A

methotrexate….inhibits DHFR and purine synthesis so no DNA

27
Q

what is surgical option for ectopic preganncy?

A

salpingectomy and salpingostomy

28
Q

what will be super high in a molar pregnancy?

A

bHCG

29
Q

what does ultrasound look like in molar pregnancy?

A

lots of cysts in the uterus

30
Q

what does GTD stand for?

A

gestational trophoblastic disease

31
Q

what happens in GTD?

A

abnormal trophoblast proliferation and maturation and can be neoplastic

32
Q

what is the most common form of GTD?

A

hydatiform mole

33
Q

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

A

complete and partial…complete more common

34
Q

what are the three less common types of GTD?

A

invasive mole
choriocarcinoma
placental site trophoblastic tumor

35
Q

what does an invasive mole invade?

A

invades into the myometrium

36
Q

what can occur with an invasive mole?

A

can metastasize

37
Q

what is genetic makeup of a complete hydatiform mole?

A

46XX or 46XY

38
Q

will there be an embryo present in complete hydatiform mole?

A

no

39
Q

describe the tissue appearance in a complete hydatiform mole

A

diffusely hydropic villi with diffuse trophoblastic proliferation and atypia

40
Q

explain how genetic makeup is determined in complete hydatiform mole

A

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

41
Q

what is genetic makeup of partial hydatiform mole?

A

69XXX or 69XXY

42
Q

describe the appearance of partial hydatiform mole

A

focal hydropic villi with focal trophoblastic proliferation and atypia

43
Q

is embryo present in partial hydatiform mole?

A

yes

44
Q

explain how the genetics become in a partial hydatiform mole?

A

haploid egg fertilized by two sperm

45
Q

what happens to uterus in hydatiform moles?

A

get super big

46
Q

what is classic ultrasound appearanace of hydatiform moles?

A

snowstorm pattern

47
Q

what is there more of in hydatiform moles?

A

vaginal bleeding

48
Q

what is therapy for hydatiform moles?

A

D and C

49
Q

what should patients with hydatiform moles be followed for?

A

suspected malignancy

50
Q

what can you have in ovary with complete hydatiform moles?

A

theca lutein cysts

51
Q

what are signs of malignancy after removal of hydatifrom mole?

A

plateau of HCG increase in HCG

52
Q

what is hallmark of an invasive mole?

A

hemorrhage

53
Q

what is character of choriocarcinoma?

A

sheets of cyto and syncytiotrophoblasts without chorionic villi

54
Q

what happens a lot in choriocarcinoma?

A

metastasis

55
Q

is choriocarciinoma curable?

A

very curable…even metastes

56
Q

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

A

complete

Repro Week 4 (8 decks)

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