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USMLE > Embryology and Devo > Flashcards

Embryology and Devo Flashcards

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USMLE® Step 1 flashcards
1
Q

Found at base of limbs. Anterior-posterior and CNS development. Mutation leads to holoprosencephaly

A

Sonic hedgehog gene

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2
Q

Produced at apical end of limbs at ectodermal ridge. Needed for dorsal-ventral axis organization.

A

Wnt-7

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3
Q

Produced at apical ectodermal ridge. Stimulates mitosis of mesoderm.

A

FGF

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4
Q

Segmental organization from cranium to caudum. Mutations cause appendages in wrong locations.

A

Hox

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5
Q

Codes for transcription factors

A

Hox

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6
Q

Which week does bilaminar disc (epiblast, hypoblast) form

A

Week 2

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7
Q

Gastrulation occurs

A

Week 3

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8
Q

Endoderm, mesoderm and ectoderm arise from

A

Epiblast primitive streak

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9
Q

Notochord arises from

A

Midline mesoderm

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10
Q

Neural plate arises from

A

Overlying ectoderm

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11
Q

Beginning of organogenesis and increased susceptibility to teratogens

A

Weeks 3-8

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12
Q

Ultrasound can see fetal heartbeat by

A

Week 6

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13
Q

Male female genitalia can be distinguished by

A

Week 10

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14
Q

Bones of skull are derived from

A

Neural crest

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15
Q

C cells of thyroid, chromaffin cells of adrenal medulla, melanocytes, pia and arachnoid, aorticopulmonary septum and endocardial cushions are derived from

A

Neural crest

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16
Q

Autonomic ganglia, DRG, cranial nerves and Schwann cells are derived from

A

Neural crest

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17
Q

Anal canal below pectinate, parotid, sweat and mammary glands, anterior pituitary lens of eye are derived from

A

Surface ectoderm

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18
Q

What induces formation of neuroectoderm (neural plate)

A

Notochord

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19
Q

Upper vagina, lymphatics, spleen, peritoneum, wall of gut tube, are derived from

A

mesoderm

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20
Q

Gut tube epithelium, most of urethra and lower vagina, lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells derived from

A

Endoderm

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21
Q

When does malformation occur

A

Weeks 3-8

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22
Q

A woman with vaginal clear cell adenocarcinoma or abnormal uterus likely had mother who consumed

A

Diethylstilbestrol

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23
Q

Absence of skin from the scalp is suggestive of which teratogen

A

Methimazole

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24
Q

Discolored teeth, inhibited bone growth suggest maternal use of

A

Tetracycline

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25
Q

Thalidomide use to tx leprosy or MM increases risk of what in fetus

A

Limb defects (“flipper” limbs)

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26
Q

Warfarin can cause what in fetus

A

bone deformities, fetal hemorrhage, abortion, olpthalmologic abnormalities

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27
Q

Can cause placental abruption, low birth weight, preterm birth, IUGR

A

Cocaine

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28
Q

Low birth weight, preterm labor, SIDS can occur due to maternal use of

A

cigarettes (smoking)

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29
Q

Cretinism results from

A

Lack or excess Iodine in maternal diet

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30
Q

Anal atresia to sirenomelia, congenital heart defects, neural tube defects and macrosomia are consequences of which maternal condition

A

Diabetes

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31
Q

Swofrdfish, shark, tilefish and king mackerel consumption increase risk of neurotoxicity in fetus due to

A

methylmercury

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32
Q

Fetal alcohol syndrome occurs due to failure of

A

Migration

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33
Q

Smooth philtrum, thin upper lip (vermilion border), small palpebral fissures (eye openings) and low set ears in baby indicate

A

Fetal alcohol syndrome

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34
Q

First to differentiate after fertilization

A

Trophoblast

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35
Q

Secretes beta-hCG after implantation

A

Synctiotrophoblast

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36
Q

Trophoblastic layer that facilitates exchange of nutrients and waste between mother and fetus

A

Synctiotrophoblast

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37
Q

Function of hCG

A

Maintain progesterone and sustain pregnancy

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38
Q

Failure of trophoblast to invade endometrium adequately can lead to

A

Pre-eclampsia

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39
Q

Dizygotic twins result from

A

2 separate eggs fertilized by two separate sperm (dichorionic, diamniotic)

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40
Q

What is the chorion

A

Outer layer of amniotic sac that attaches to endometrium and allows nutrient exchange between fetus and mother

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41
Q

What is the amnion

A

Inner layer of amniotic sac that protects developing fetus

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42
Q

Monozygotic twins that have two separate chorion and two separate amnion likely arose from

A

Cleavage at 2-cell stage

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43
Q

Monozygotic twins that share a chorion and have two separate amnion likely arose from

A

Cleave at morula stage (4-8 days)

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44
Q

Monozygotic twins that share one chorion and one placenta likely arose from

A

Blastocyst stage cleavage (8-12 days)

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45
Q

Conjoined twins result due to cleavage at which stage

A

> 13 days, formed embryonic disc

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46
Q

Monozygotic twins most commonly occur due to cleavage of

A

Morula (one chorion, two amnion)

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47
Q

Leading cause of intellectual disability in the US

A

Fetal alcohol syndrome

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48
Q

Inner layer of chorionic villi that produces cells

A

Cytotrophoblast

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49
Q

Outer layer of chorionic villi that synthesizes hCG stimulate progesterone secretion from corpus luteum during first semester. Lacks MHC I so will not be attacked by maternal immune system

A

Synctiotrophoblasts

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50
Q

Umbilical arteries and umbilical vein are derivatives of

A

allantois

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51
Q

How many umbilical arteries and veins

A

2 umbilical arteries (carry deoxygenated blood from fetus to mother), 1 umbilical vein (carry oxygenated blood from mother to fetal IVC)

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52
Q

Urine from umbilicus indicates

A

Patent urachus

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53
Q

Urachus is derived from

A

Allantois

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54
Q

Fluid-filled cavity between umbilicus and bladder that can lead to infection or adenocarcinoma

A

Urachal cyst (partial failure of urachus to obliterate)

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55
Q

Outpouching of bladder

A

Vesicourachal diverticulum (slight failure of urachus to obliterate)

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56
Q

Congenital persistence of urachus occurs due to errors in which week of devo?

A

3rd week

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57
Q

Meconium discharge from umbilicus

A

Vitelline fistula (vitelline duct fails to close)

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58
Q

Melena (dark poop with blood), hematochezia (vomit with blood), and abdominal pain in child. Tissue biopsy presents gastric or pancreatic tissue.

A

Meckel diverticulum (partial closure of vitelline duct)

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59
Q

Congenital persistence of vitelline duct (connects yolk sac to midgut lumen) occurs due to error in which week of devo?

A

7th week

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60
Q

Nerve associated with 1st arch

A

CN V2 and V3

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61
Q

Muscles associated with 1st arch

A

Muscles of mastication (Temporalis, masseter, anterior digastric, tympani)

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62
Q

Bones associated with 1st arch

A

Zygoma, Maxillary process, mandibular process, malleus and incus

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63
Q

Ectoderm associated with 1st arch

A

External auditory meatus

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64
Q

CN associated with 2nd arch

A

VII (Facial)

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65
Q

Muscles associated with 2nd arch

A

Muscles of facial expression, stapedius, stylohyoid

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66
Q

Bones associated with 2nd arch

A

Stapes, stylohyoid, lesser horn of hyoid, stylohyoid ligament

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67
Q

Artery associated with 1st arch

A

Maxillary artery (of ECA)

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68
Q

Artery associated with 2nd arch (

A

Stapedial and hyoid arteries

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69
Q

Lateral neck mass that doesn’t move upon swallowing is remnant of

A

Temporary cervical sinus of branchial clefts 2-4

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70
Q

Failure of NC derivatives of 1st and 2nd arches (deafness, micrognathia)

A

Treacher-Collins syndrome

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71
Q

Small jaw, glossoptosis, cleft palate, airway obstruction suggest

A

Pierre Robin Sequence (abnormal 1st and 2nd arch development)

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72
Q

Superior laryngeal nerve (swallowing) is derivative of which arch

A

4th

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73
Q

Aortic arch and proximal SCA are derivatives of which arch

A

4

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74
Q

Common carotid and proximal ICA are derivatives of which arch

A

3

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75
Q

CN IX is derivative of which arch

A

3

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76
Q

CN X is part of which arch

A

4 and 6

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77
Q

Recurrent laryngeal nerve (voice) is part of which arch

A

6

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78
Q

L: Proximal pulmonary artery and ductus arteriosus are part of which arch

A

6

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79
Q

Superior parathyroids are derived from which pouch

A

dorsal 4th

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80
Q

C cells of thyroid are derived from which pouch

A

Ventral 4th

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81
Q

Thymus is derived from which pouch

A

Ventral 3rd

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82
Q

Inferior parathyroids are derived from which pouch

A

Dorsal 3rd

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83
Q

Epithelial lining of palatine tonsils are derived from

A

2nd pouch

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84
Q

Middle ear, eustachian tube and mastoid air cells are derived from

A

1st branchial pouch

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85
Q

Clefts, Arches and Pouches represent which embryologic layers respectively

A

Ectoderm, mesoderm, endoderm

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86
Q

Lower portion of vagina develops from

A

Urogenital sinus

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87
Q

Failure of fusion of maxillary and medial nasal processes

A

Cleft lip

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88
Q

Failure of fusion of lateral palatine shelves

A

Cleft palate

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89
Q

Failure of fusion of lateral palatine shelves with nasal septum

A

Cleft Palate

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90
Q

Failure of fusion of lateral palatine shelves with median palatine shelf

A

Cleft palate

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91
Q

Mesonephros develops into

A

Ureter, epididymis and vas deference

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92
Q

Fallopian tubes, uterus and upper portion of vagina are derived from

A

paramesonephric duct

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93
Q

Mayer-Rokitansky-Kuster-Hauser syndrome is

A

Failure of Mullerian (paramesonephric) duct development. Primary amenorrhea in woman with secondary sexual characteristics

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94
Q

Seminal vesicles, epididymis, ejaculatory duct, ductus deferens (SEED) derived from

A

Mesonephric ducts

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95
Q

What is the Gartner duct

A

Remnant of mesonephric duct in females

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96
Q

Decreased fertility (woman has difficulty getting pregnant) due to a resorption defect of Mullerian duct implies

A

Septate uterus

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97
Q

Incomplete failure of Mullerian ducts

A

Bicornuate uterus

98
Q

Presents with recurrent miscarriages and multiple UTIs

A

Bicornuate uterus

99
Q

Complete failure of Mullerian ducts

A

Uterus didelphys

100
Q

Prostate gland arises from

A

Urogenital sinus

101
Q

Hormone that induces development of female external genitalia

A

Estrogen

102
Q

Hormone that induces formation of male external genitalia

A

DHT

103
Q

failure of urethral folds to fuse. Associated with inguinal hernia and cryptorchidism

A

Hypospadias

104
Q

Faulty positioning of genital tubercle. Associated with exstrophy of bladder

A

Epispadias

105
Q

Anchors testes to scrotum

A

Gubernaculum

106
Q

Forms tunica vaginalis

A

Processus vaginalus

107
Q

Forms ovarian ligament and round ligament of uterus

A

Gubernaculum

108
Q

Why are left varicoceles more common than right ones

A

Left spermatic vein enters left renal vein at 90 degree angle so there is more turbulent flow so greater pressure

109
Q

Lymphatic drainage of superior bladder, cervix and body of uterus

A

External iliac

110
Q

Lymph drainage of ovaries and testes

A

para-aortic

111
Q

Lymph drainage of distal vaginal/vulva/scrotum/distal anus

A

superficial inguinal

112
Q

Lymph drainage of glans penis

A

Deep inguinal

113
Q

Lymph drainage of prostate, cervix, corpus cavernosum, proximal vagina

A

internal iliac

114
Q

Which vessels are ligated during oophorectomy to avoid bleeding?

A

Ovarian vessels in Infundibulopelvic ligament (suspensory ligament of ovary)

115
Q

Infundibulopelvic ligament (suspensory ligament of ovary)

A

Connects ovaries to lateral pelvic wall

116
Q

Which structure is at risk of injury during ligation of ovarian vessels?

A

Ureter

117
Q

Cardinal ligament

A

Connects cervix to side wall of pelvis

118
Q

Which vessels are contained by cardinal ligament

A

Uterine vessels

119
Q

Which structure is at risk of injury during ligation of uterine vessels

A

Ureter

120
Q

Round ligament of uterus

A

Connects uterine fundus to labia majora

121
Q

What is the artery of Sampson

A

Anastamoses between ovarian and uterine vessels. Runs under Round ligament of Uterus

122
Q

Broad ligament

A

connects uterus, fallopian tubes, and ovaries to pelvic side wall

123
Q

Ovaries, fallopian tubes, round ligaments of uterus are contained in

A

Broad ligament

124
Q

Ovarian ligament

A

Connects medial pole of ovary to lateral uterus

125
Q

Pathway of sperm ejaculation (SEVEN UP)

A

Seminiferous tubules –> Epididymis –> Vas deferens –> Ejaculatory ducts –> Nothing –> Urethra –> Penis

126
Q

In a perineal straddle injury, which fascia is torn

A

Deep fascia of Buck

127
Q

In perineal straddle injury, where does urine escape into

A

superficial perineal space

128
Q

Posterior urethral injury where urine leaks into retropubic space occurs due to

A

Pelvic fractures

129
Q

Anterior urethral injuries occur due to

A

Straddle-type falls

130
Q

Erection occurs due to

A

PSNS of pelvic nerve: NO–> cGMP–> vasodilation

131
Q

Emission occurs due to

A

SNS of hypogastric nerve: NE –> intracellular Ca+2–> smooth muscle contraction–> anti-erectile

132
Q

Ejaculation occurs due to

A

visceral and somatic nerves of pudendal nerve

133
Q

Granulosa cell male homolog

A

Sertoli cell

134
Q

Theca cell male homolog

A

Leydig cell

135
Q

Sertoli cells regulate spermatogenesis in response to

A

FSH

136
Q

Sertoli cells secrete Inhibin B to

A

Inhibit FSH secretion

137
Q

Leydig cells secrete testosterone in response to

A

LH

138
Q

Carry aromatase to convert testosterone and androstendione to estrogen

A

Sertoli cells

139
Q

Form blood testis barrier

A

Sertoli cells

140
Q

Why do varicoceles lead to low sperm count?

A

Sertoli cells need cool temperatures to function

141
Q

When in process of sperm become haploid?

A

After meiosis I (secondary spermatocyte)

142
Q

What disinhibts lactation

A

drop in progesterone and estrogen after labor

143
Q

Appearance of breast bud indicates which stage of Tanner

A

Tanner Stage 2, thelarche

144
Q

Testicular enlargement begins in which Tanner Stage

A

2

145
Q

Breast “mound on mound” describes which Tanner stage?

A

Stage IV

146
Q

Penis size and length begins to increase in which Tanner stage

A

III

147
Q

Pines width/glans starts to increase in which stage?

A

Stage IV

148
Q

Define APGAR

A 
Appearance (blue or pink 0-2)
Pulse (0 - >100; 0-2)
Grimace (Cry and pull; 0-2)
Activity (movement; 0-2)
Respiration (strength of cry and breath; 0-2)
149
Q

Hormonal changes in menopause

A

Increased FSH/LH ratio, decreased estrogen, increased GnRH

150
Q

Amennorrhea for 12 months, decreased estrogen production, preceded by abnormal cycles for 4-5 years

A

Menopause

151
Q

Spike in which hormone levels is specific for Menopause?

A

FSH spike (due to loss of negative feedback due to decreased estrogen)

152
Q

hCG levels in ectopic/failing pregnancy, Edward syndrome and Patau syndrome

A

decreased

153
Q

hCG levels in hyatidiform moles, choriocarcinomas and Down syndrome

A

Increased

154
Q

Where is estrone produced

A

Adipose tissue via aromatase

155
Q

Where is estradiol produced

A

Ovary (primary follicles)

156
Q

Where is estriol produced

A

Placenta (pregnancy)

157
Q

Where are estrogen receptors expressed

A

Cytoplasm, translocate to nucleus when bound

158
Q

Stimulates endometrial gland secretions, spiral artery development, maintenance of pregnancy, decreases myometrial excitability, produces thick cervical mucus to trap sperm, increases body temperature, inhibits FSH and LH, prevents contractions, decreases ER expression, prevents endometrial hyperplasia

A

Progesterone

159
Q

Development of female sexual characteristics, female fat distribution, bone growth, follicle growth, increases myometrial excitability, upregulates ER, FSH, LH receptors, inhibition of FSH and LH and then LH surge, increases HDL, decreases LDL

A

Estrogen

160
Q

Young female presenting with unilateral painful cystic lesion along vaginal canal that produces mucus-like fluid likely has

A

Bartholin cyst

161
Q

3 places that HPV infects and how it appears

A

Vulva (genital warts 6 + 11), Vaginal canal, Cervix (16, 18, 31, 33); biopsy shows koilocytes (cells with raisin-like nuclei)

162
Q

How to classify low-risk vs high-risk HPV

A

DNA sequencing

163
Q

“Paper thin epidermis” with fibrosed or thickened dermis that presents as white patch (leukoplakia) in post-menopausal woman is

A

Lichen sclerosis (slight risk of squamous cell carcinoma)

164
Q

Leukoplakia with thick leathery vulvar skin is

A

Lichen simplex chronicus (no risk of squamous cell carcinoma)

165
Q

Which three conditions present with vulvar leukoplakia?

A

Lichens sclerosis, Lechen simplex chronicus, Vulvar carcinoma

166
Q

Woman who develops vulvar carcinoma in her 40s-50s likely was infected by

A

HPV 16, 18, 31, 33

167
Q

Woman who develops vulvar carcinoma in her 70s

A

non-HPV related

168
Q

Characterized by malignant epithelial cells in epidermis of vulva; presents as erythematous, pruritic, ulcerated vulvar skin

A

Extramammary Paget disease

169
Q

PAS+, keratin+ and S100-

A

Paget disease

170
Q

PAS-, Keratin-, S100+

A

Melanoma

171
Q

What is PAS a marker for?

A

Mucus (only epithelial cells make mucus)

172
Q

Important distinction between Paget disease of nipple vs vulva

A

Paget disease of nipple suggests cancer of breast. Paget dz of vulva does not indicate cancer

173
Q

Early in development, upper 2/3 of vagina and lower 1/3 of vagina are composed of

A

Upper: columnar epithelium
Lower: non-keratinizing squamous

174
Q

Persistance of columnar epithelium in upper vagina is tied to which teratogen

A

Maternal use of DES– vaginal adenosis

175
Q

“Grape like mass” protruding from vagina of 5yo girl is a malignant proliferation of what tissue

A

Mesenchyme, immature skeletal muscle

176
Q

Desmin and myogenin staining confirm

A

Embryonal rhabdomyosarcoma

177
Q

Lymph node spread of lower 1/3 vagina carcinoma

A

Superficial inguinal

178
Q

Lymph node spread of upper 2/3 vagina carcinoma

A

Iliac nodes

179
Q

Which part of cervix is most susceptible to HPV infection?

A

Transformation zone (point between endocervix and exocervix)

180
Q

HPV E6 protein function

A

Destroys p53

181
Q

HPV E7 protein function

A

destroys Rb

182
Q

90% of HPV is cleared by body. T/F?

A

True

183
Q

What are the four defining features of Cervical Intraepithelial neoplasia?

A

Koilocytic change, nuclear atypia, disordered cellular maturation, increased mitotic activity within cervical epithelium

184
Q

Key feature of invasive carcinoma

A

Dysplasia goes through basement membrane

185
Q

Most common type of cervical carcinoma

A

Squamous cell (80%)

186
Q

Why is postrenal failure the most common cause of death in women with cervical carcinoma?

A

Cancer can invade anterior wall and into bladder, block ureters, causing hydronephrosis and lead to postrenal failure

187
Q

Screening test and confirmatory test for cervical cancer

A

Pap smear for screen, colposcopy for confirmation

188
Q

HPV vaccine has antibodies against which strains?

A

6, 11, 16, 18

189
Q

A woman who develops amenorrhea after a D&C likely lost which cells

A

Basalis (regenerative layer of endometrium)– Asherman syndrome

190
Q

What are anovulatory cycles

A

Estrogen-driven proliferation phases without progesterone-driven secretory phases–> lead to abnormal cycles, heavy bleeding due to excessive endometrial growth
More common in menarche and menopause due changes in HPA

191
Q

What is the histologic diagnostic cell for chronic endometritis

A

Presence of plasma cells

192
Q

Why can Tamoxifen cause endometrial polyps?

A

Though it has anti-estrogenic effects on breast, has pro-estrogenic effects on endometrium

193
Q

Pain during menstruation, pelvic pain, and potential infertility can be caused by

A

Endometriosis

194
Q

Most common site of endometriosis

A

Ovary

195
Q

What is endometriosis?

A

Ectopic location of endometrial tissue and glands outside of uterus. Could be due to retrograde menstruation, abnormal development of Mullerian duct or lymphatic dissemination

196
Q

Postmenopausal bleeding in a woman with PCOS, obesity or HRT is likely due to

A

Endometrial hyperplasia from unopposed estrogen

197
Q

In a woman with postmenopausal bleeding, what is the most important indicator for progression to endometrial carcinoma?

A

Cellular atypia

198
Q

Three tumors that produce psammoma bodies

A

Mengingeomas, mesothelioma, papillary carcinoma of thyroid, Endometrial carcinoma serous type

199
Q

Two most common type of surface epithelial ovarian tumors

A

Serous and mucinous

200
Q

Single simple cyst with flat lining in woman in her 30s-40s suggests

A

Cyst adenoma (benign ovarian tumor)

201
Q

Complex cysts with thick, shaggy lining in postmenopausal woman. Bilaterality, suggests

A

Malignant cystadenocarcinoma

202
Q

Which type of ovarian carcinoma is increased in pts with BRCA1

A

Serous cystadenocarcinoma of ovary and fallopian tube

203
Q

Ovarian tumor with bladder-like (urothelial) epithlium is

A

Brenner tumor, usually benign

204
Q

Serum marker for surface epithelial ovarian tumor to monitor treatment

A

CA-125

205
Q

A 20-30 woman presenting with symptoms of hyperthyroidism and elevated thyroid levels but normal thyroid gland likely has

A

R Unilateral Teratoma

206
Q

Most common immature tissue in teratoma with malignant potential

A

Neural ectoderm

207
Q

Woman presenting with ovarian tumor, pleural effusion and ascites has

A

Fibroma Meigs syndrome (resolves with removal of tumor)

208
Q

Krukenberg tumor (Bilateral mets to ovary) is commonly from

A

Diffuse type gastric carcinoma (Signet cells)

209
Q

Pseudomyxoma peritonei mets to ovary likely originated in; presentation is “jelly belly” due to massive production of mucus in peritoneum

A

appendix

210
Q

What does third-trimester bleeding suggest

A

Placenta previa; requires CS

211
Q

Third trimester bleeding, painful contractions and fetal insufficiency suggest

A

Placental abruption (separation of placenta from decidua); common cause of stillbirth

212
Q

Presents with difficult delivery (delayed) of placenta and excessive postpartum bleeding (risk of hemorrhage)

A

Placenta accreta (implantation of placenta into myometrium)

213
Q

A woman with placenta accreta often requires

A

Hysterectomy

214
Q

Woman presenting with hypertension, proteinuria and edema in the third trimester (> 20 weeks) of pregnancy likely has

A

Pre-eclampsia

215
Q

Mechanism that causes pre-eclampsia

A

Decreased organ perfusion between placenta and uterus, leading to vasospasm and endothelial activation

216
Q

Best way to resolve preeclampsia

A

Deliver baby

217
Q

Define HELLP syndrome

A

Hemolysis, Elevated Liver enzymes, Low Platelets

Preeclampsia with thrombotic microangiopathy involving liver

218
Q

What is Eclampsia

A

Preeclampsia + seizures

219
Q

Uteroplacental ischemia–> oxidative stress–> activation of secondary mediators–>endothelial dysfunction, vasospasm, activation of coagulation-> widespread vasoconstriction–> hypoxic/ischemic damage to vascular beds is pathophysiology of

A

Preeclampsia

220
Q

What is seizure prophylaxis in a woman with preeclampsia

A

Magnesium sulfate

221
Q

How to reverse magnesium sulfate toxicity

A

Calcium gluconate

222
Q

Normal ovum fertilized by two sperm (or one that duplicates itself); 69 chromosomes

A

Partial mole

223
Q

Empty ovum fertilized by two sperm; 46 chromosomes

A

Complete mole

224
Q

Fetal tissue is present

A

Partial mole

225
Q

Fetal tissue is absent

A

Complete mole

226
Q

Some villi are hydropic, some are normal

A

Partial mole

227
Q

Most villi are hydropic (edematous)

A

Complete mole

228
Q

Focal proliferation of trophoblast

A

Partial mole

229
Q

Complete proliferation of trophoblast (“snowstorm” on US)

A

Complete mole

230
Q

Risk for choriocarcinoma is minimal

A

Partial mole

231
Q

Risk for choriocarcinoma is increased

A

Complete mole

232
Q

What are the two defining features of molar pregnancy

A

Uterus expands as pregnancy progresses but uterus is much larger than expected and beta-hCG is higher than expected for date of gestation

233
Q

When and how does molar pregnancy classically present in a woman without prenatal care?

A

Second trimester as passage of grape-like masses

234
Q

When and how is molar pregnancy diagnosed in woman with prenatal care

A

1st trimester via US; absent fetal heart sounds and “snowstorm” appearance

235
Q

Choriocarcinoma from gestation vs choriocarcinoma from GCT

A

Gestational responds to chemotherapy, GCT does not

236
Q

Woman who presents with elevated beta-hCG, shortness of breath, hemoptysis after giving birth may have

A

gestational choriocarcinoma

237
Q

Risk factors for placental abruption

A

Smoking, trauma, hypertension, preeclampsia and cocaine abuse

238
Q

4 Ts of postpartum hemorrhage

A

aTony, Trauma, Thrombin (coagulopathy), Tissue (retained prodcuts of conception)

239
Q

Too little amniotic fluid due to fetal inability to “pee”

A

Oligohydramnios (can cause Potter sequence)

240
Q

Too much amniotic fluid due to fetal inability to “swallow”

A

Polyhydramnios

241
Q

Hypertension <20 weeks of pregnancy suggests

A

Molar pregnancy

242
Q

Which phospholipid ratio assesses lung maturity/surfactant production?

A

Lecithin(dipalmitoylphosphatidylcholine)/sphingomyelin (>2 = mature)

USMLE (36 decks)

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