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Female/Male Reproductive > Exam 2 Review > Flashcards

Exam 2 Review Flashcards

1
Q

What are the general features of endometriosis?

A
  • Endometrial tissue that forms TUMOR-LIKE NODULES (foci) outside the uterus.
  • Foci composed of endometrial glands & stroma. (these glands respond to estrogenic stimulation & proliferate with the normal endometrium)

Note:
Ovarian endometriosis may present w/ large cystic lesions. The cysts are filled w/ red-brown fluid derived from decomposed blood = Chocolate Cyst.

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2
Q

Where are the common locations of Endometriosis?

A

OVARY, fallopian tube or on the pelvic peritoneum, but occasionally it may be found outside the pelvis, even on the umbilicus, appendix, and colon.
–Other locations (from pic): pouch of Douglas, vulva, bladder, abdomen

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3
Q

Who is more likely to get Endometriosis?

A

-20s-30s & 30-40
A disease of women of reproductive life (3rd and 4th decades)
- Women of higher socioeconomic groups

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4
Q

What is the most popular theory for the pathogenesis of Endometriosis?

A
  • Endometrial tissue is regurgitated during normal menstruation & instead of entering vagina, it is transferred upstream, it enters abdominal cavity thru fallopian tubes. The glands implant on the serosa of ovary or peritoneum.
  • Forms typical red-brown nodules or plaques. Most foci of endometriosis are located close to orifice of fallopian tubes which support this theory.
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5
Q

What are Leiomyomas (fibroids)?

-What % is benign/ malignant?

A

Benign tumors originating from the smooth muscle cells of the myometrium.

-98% are benign (leiomyomas), 1-2% are malignant (leiomyosarcomas)

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6
Q

Which tumors are the most common uterine tumors?

A
  • Leiomyomas
  • ~ 20% of all women of reproductive age have them (under influence of Estrogen, more common in African Americans).
  • They are small & clinically inapparent.
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7
Q

What are the 3 types of uterine fibroids?

A

1) Intramural: embedded within the myometrium
2) Subserosal: Occurs beneath covering serosa of the uterus
3) Submucosa: protrude into the endometrial cavity
* Associated w/ increase risk of miscarriage/infertility b/c decreases ability to implant into uterus

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8
Q

-What are the Risk factors for endometrial adenocarcinoma ?

A

1) Are taking exogenous estrogen in the form of pills or injections.
2) Have estrogen-producing tumors
3) Obese & form estrogen at an increased rate by fat tissue conversion.
- -DM (diabetes) and HTN (hypertension).
4) Are nulliparous or have early menarche & late menopause (related to longer exposure to estrogen)

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9
Q

What can reduce the risk of endometrial carcinoma, why?

A
  • Multiple pregnancies reduce because progesterone, (dominant pregnancy hormone) gives the endometrium long breaks from proliferation.
  • Estrogens stimulates proliferation of endometrial glands, (hyperplasias) which undergo malignant transformation.
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10
Q

Why does the beneficial risks of ESTROGEN outweigh the risks for carcinoma?

A
  • B/c endometrial cancer is detected early & treatment is successful.
  • “80% of all endometrial cancers are detected while the tumor is confined to the uterus, and affected women have an excellent prognosis.”
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11
Q

What is endometrial hyperplasia ?

A

-Caused by excessive Estrogenic stimulation of endometrium leading to cystic expansion & thickening of the entire endometrium w/ multi-layering of the endometrial glands with scant endometrial stroma.”

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12
Q

What are the 3 types of endometrial hyperplasia & percentages?

A

1) Simple Hyperplasia:
- When there is minimal glandular complexity and no cytologic atypia.
- (1% progression to carcinoma)

2) Complex Hyperplasia:
- When there is multilayering of the glands (complexity) w/ crowding, but still NO cytologic atypia.
- (3% may develop adenocarcinoma)

3) Atypical Hyperplasia:
Complexity to glands w/ crowding & there is cytologic atypia. The epi. cells are enlarged & hyperchromatic w/ high N/C.
-(25% of these cases progress to adenocarcinoma)

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13
Q
  • What type of cancer is endometrial adenocarcinoma?

- where does it originate from?

A
  • Most common malignant tumor of female genital tract. (50% of GYN malignancies)
  • Disease of older women (35 yo+)
  • Arises from epithelial cells lining the endometrial glands.
  • Tumor appears as fungating mass protruding into uterine lumen. The tissue is “friable” & soft b/c it consists of atypical glands w/ little tissue stroma.
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14
Q

What are the SYMPTOMS of endometrial adenocarcinoma?

What is TX?

A

-Most common symptoms: Vaginal bleeding that is spotting between 2 menstruations or as prolonged pronounced menstual bleeding (menorrhagia)

TX:

  • D&C (dilate cervix and scrape endometrium), -TAH-BSO (hysterectomy w/ or w/o ovaries),
  • lymph node removal of metastases
  • Radiation for advanced pt’s
  • Chemo for inoperable cases
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15
Q

-General features of ectopic pregnancy.

A
  • Implantation of the fetus in any other site than normal uterine location.
  • Most commonly the ovary, abdominal cavity & 95% occurring in fallopian tubes
  • The fertile zygote undergoes normal development w/ formation of placental tissue & amniotic sac.
  • Placenta poorly attached to wall of the tube, weakens it w/ the possibility of rupture & intraperitoneal hemorrhage.

-

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16
Q

Signs and Symptoms of Ectopic Pregnancy?

A

Signs/Symptoms:

  • Severe abdominal pain w/ rupture & possibility of shock w/ signs of an acute abdomen.
  • Pregnancy tests are positive

*****Aspiration of “fresh blood” from the pouch of Douglas (POSTERIOR FORNIX) denotes rupture.

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17
Q

What is helpful in the diagnosis of Ectopic Pregnancy?

A
  • An endometrial biopsy is helpful in diagnosis.
  • Absence of chorionic villi is consistent b/c villi are in the tube
  • Biopsy will show a decidual reaction of endometrium

***Ultrasound will show dilation of the fallopian tube.

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18
Q
  • ____________ pregnancies are ectopic ?

- Rapture occurs ________ after pregnancy.

A

-1/150
(1/400 die)

-2-6 weeks

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19
Q

-What is the most common cause of ectopic pregnancy ?

A

***Most common pathologic condition leading to ectopics is chronic salpingitis.

-Other factors: peritubal adhesions as from endometriosis, previous surgeries & leiomyomas.
The intratubal adhesion forms a barrier to normal passage of the zygote, so implants at the site of obstruction.

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20
Q

What are the two MOST common complications of chronic salpingitis from PID ?

A

1) Sterility (infertility): Risk rs increases w/ each Gonococcus infection, & caused by scarring of fallopian tubes, (occludes the lumen and prevents sperm from reaching the ovulated egg.)

2) Ectopic pregnancy: Increase w/ previous salpingitis.
Most common site for Ectopic being the fallopian tubes

  • Abscesses: may develop in the fallopian tubes, ovaries, or peritoneum
  • Peritonitis: bacteria may spread from ovaries & fallopian tubes.
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21
Q

Which female reproductive tract cancers are adenocarcinoma ?

A

-Tissues that are glandular = adenocarcinoma

***Uterus, Fallopian Tubes, & Ovaries are glandular so #1 cancer=adenocarcinomas

  • Endometrial Hyperplasia (Non-neo. Uter.)
  • Endometrial Polyps (Non-neo. Uter.)
  • Endometrial Adenocarcinoma (Neo. Uter.)
  • Tumors of fallopian tubes
  • Tumors of surface epithelium (Neo. Ovar.)
  • Serous Cystadenocarinoma
  • Solid Serous Cystadenocarcinoma
  • Mucinous Cystadenocarcinoma
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22
Q

Which female reproductive tract cancers are squamous cell?

A

-Tissues that squamous = squamous cell carcinoma

***Vulva, Vagina, & Cervix are squamous epithelium so #1 cancer=squamous cell carcinomas

*Pyometria (Non-neo. Uter.)

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23
Q

Endometrial Hyperplasia (Non-neo. Uterus)

adenocarcinoma or squamous cell carcinomas?

A

***adenocarcinoma
Caused by excessive estrogenic stimulation of the endometrium leading to cystic expansion of the entire endometrium with focal branching of the glands with scant endometrial stroma.

  • When there is minimal glandular complexity & no cytologic atypia, simple hyperplasia (1% progress to carcinoma)
  • When there is multilayering of the glands (complexity) with crowding, complex hyperplasia (3% may develop adenocarcinoma)
  • Atypical hyperplasia is when there is complexity to the glands with crowding and there is cytologic atypia. The epithelial cells are enlarged and hyperchromatic with high N/C ratios and prominent nucleoli.
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24
Q
  • Endometrial Polyps (Non-neo. Uterus.)

- adenocarcinoma or squamous cell carcinomas?

A
  • *adenocarcinoma
  • Benign, localized overgrowths that project from the endometrial surface into the endometrial cavity
  • Most arise in the fundus, usually solitary, and vary in size
  • Not believed to be pre-neoplastic, but up to 0.5% harbor adenocarcinomas.
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25
Q
  • Endometrial Adenocarcinoma (Neo. Uter.)

- adenocarcinoma or squamous cell carcinomas?

A

***adenocarcinoma

-Most common malignant tumor of the female genital tract, accounting for approx. 50% of all GYN malignancies

Common in:

  • Are taking exognous estrogen in the form of pills or injections
  • Have estrogen-producing tumors
  • obese & form estrogen at an increased rate by fat tissue conversion.
  • DM and HTN
  • Are nulliparous or have early menarche and late menopause
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26
Q

-Tumors of the fallopian tubes (Fall. Tubes ?

-
-adenocarcinoma or squamous cell carcinomas?

A
  • **adenocarcinoma
  • Rare, & attributable to the fact that epithelium of the fallopian tube does not shed cyclically, like endometrium. Also the muscularis is thin & has cells that don’t respond to estrogenic stimulation as do the myometrial cells.

-Adenocarcinomas are the most common lesion, and these tumors account for 1% of all GYN malignancies

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27
Q

What are the Tumors of surface epithelium (Neo. Ovary)?

-adenocarcinoma or squamous cell carcinomas?

A

1) Serous,
2) Mucinous
3) Brenner
4) Endometroid

-All tumors of the surface epithelium are either Adenomas or adenocarcinomas.

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28
Q

Which Tumors of surface epithelium (Neo. Ovary) are solid vs cystic?

A

Serous & Mucinous cystic.

Endometroid & Brenner = more solid.

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29
Q

Describe Serous and mucinous tumors (Tumors of surface epithelium (Neo. Ovary)?

  • Classified as what?
  • Which the most common form of surface tumors?
  • What is Pseudomyxoma Peritonei?
A
  • Classified as benign, borderline (potential), or malignant
  • Serous Tumors: (Serous Cystadenoma) Most common form of surface tumors
  • Mucinous Tumors : (Mucinous Cystadenoma) Are more often benign (7:1 ratio) and less commonly bilateral (10-30%)
  • usually filled with thick, yellowish or clear jelly-like material
  • If tumors rupture or the malignant tumors invade the peritoneum, the entire belly is filled w/ mucus. This is called Pseudomyxoma Peritonei.
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30
Q

Describe Endometroid and Brenner tumors (Tumors of surface epithelium (Neo. Ovary)?

A

Endometroid Tumors:
Solid tumors composed of glands that resemble endometrial glands

-Brenner Tumors:
Solid and characterized by a dense fibrous stroma with scattered nests of transitional epithelium

-Malignancies are Transitional Cell Carcinoma

31
Q

Describe Pyometria (Non-neo. Uterus) ?

A
  • Defined as pus in the endometrial cavity
  • Associated w/ any lesion that causes cervical stenosis, (tumor or scarring from surgical treatment of the cervix (conization of cervix)
  • Long-standing pyometria may be associated w/ rare chance of developing endometrial squamous cell carcinoma
32
Q

-Which tumors (4) are derived from the germ cells?

A

Germ Cell Epithelium Tumors:

1) Benign Cystic Teratoma (Dermoid Cyst)
- most common

2) Dysgerminoma
* * “Seminoma” (MEN)
- (Malignant)

3) Endodermal Sinus Tumor(marker: AFP)
* “Yolk Sac” Tumor in (MEN)
- (Malignant)

4) Choriocarcinoma(marker: β-HCG).
- (Malignant)

33
Q

Which tumors are derived from Surface Epithelium?

A

Surface Epithelium Tumors:

1) Serous: (most common) CYSTIC
- (Benign, borderline, malignant)

2) Mucinous:
Cystic
-(Benign, borderline, malignant)

  • Brenner
  • (Benign)
  • solid

3) Endometroid.
- (Malignant)
- solid

-Transitional Cell
(Malignant)

34
Q

What are Sex Cord Stromal Tumors and Markers?

A

Thecomas and Granulosa Cell Tumors→Estrogen

Sertoli-Leydig Cell Tumors→ Androgens/Testosterone
ovarian mass / endodermal sinus tumor= a-feto-protein ;

CA-125 cancer antigen
Beta HCG ovarian mass = chorio carcinoma

Note:
Thecoma (Benign)
Fibroma (Benign)
Granulosa (Malignant)
Sertoli-Leydig (Malignant)
35
Q

Ovarian tumors that secrete tumor marks or estrogens or androgens.

A

-Choriocarcinoma secrete HCG (histologically identical to placenta, endometrial or testicular lesions)

  • *Three variants of Sex Cord Stromal Tumors:
    1) Thecoma: Secrete Estrogen, cause menstrual irregularities & endometrial hyperplasia.

2) Granulosa Tumors: Produce estrogen cause menstrual irregularities. In young girls cause precocious puberty. In older women leads to breast or endometrial cancer.
3) Sertoli-Leydig Cell Tumors: Secrete androgens, cause virilization (deep voice, facial hair, male pattern baldness, hairy chest w/ hypertrophy of the clitoris)

36
Q

-Know the tissues and or organs where you can find choriocarcinoma

(Remember you can have it in ovary, testes (because a homologue of ovary), endometrium b/c pregnancy or abortion (primary not metastatic)

A
  • Gestational trophoblastic disease: ovarian germ cell tumor (trophoblastic cells)
  • Results in hemorrhagic nodules in placental bed, invades thru uterus wall & often implants into vagina, (solid or cystic)
  • Arises from: pre-existing complete hydatidiform mole (50%), placental tissue from abortion (25%), normal placenta after delivery (25%)
  • Worst germ cell tumor b/c at time of diagnosis tumor has typically already spread thru bloodstream to lungs & other organs (liver, brain, bones)
  • Placenta secrete beta-hCG → used as diagnostic marker and monitoring tumor recurrence after chemotherapy

Notes: -Men can get them too as teratocarcinomas

  • Histologically, identical to placenta, endometrial, or testicular lesions
  • Tx: chemo w/ Methotrexate. 80-100% survival if no metastases
37
Q
  1. What is a dermoid cyst and what is the other name for a dermoid cyst? What age group will you find it?
A
  • A Benign Cystic Teratoma. Presents as a cyst that is lined on the inside w/ hairy skin & wall contains other tissues, such as teeth, bone, & cartilage along w/ skin appendages, such as sweat & sebaceous glands that when the cyst is cut open, responsible for bad odor.
  • Most common is the Benign Cystic Teratoma = 95% of all Dermoid Cyst
  • Most common ovarian tumor in woman less than 25yrs
38
Q

What is the homologue tumor of the female dysgerminoma found in males?

A
  • Female→Male
  • Dysgerminoma→Seminoma
  • Endodermal Sinus Tumor→Yolk Sac Tumor

-“The ovarian counterpart of the male Seminoma, both macroscopically and microscopically. Grossly tumor is large, firm, w/ fleshy cut surface.”

-Dysgerminoma - It is an uncommon tumor, but makes up half of all malignant germ cell tumors.
Tx. is surgical. - occurs in childhood, all malignant, but only one-third are aggressive. Highly radiosensitive like Seminomas.

  • Endodermal Sinus Tumor- ovarian counterpart of the yolk sac tumor of the testes
  • produces Alpha fetoprotein (AFP)
39
Q

What is the most common of all GYN malignancies ?

A

-Endometrial Adenocarcinoma, most common malignant tumor of female tract accounting for ~ 50% of all GYN malignancies.

  • Ovarian cancer is the 2nd most common GYN cancer, but ranks FIRST for DEATHS caused by GYN cancer.
  • *****Causes more deaths than all other tumors of the reproductive tract.
40
Q

-Know what tumor of surface epithelium and type of tissue they mimic.

A

Serous Tumors = Fallopian Tube epithelium.

Mucinous Tumors mimic Endocervical epithelium.

Endometriod Tumors resemble Endometrial Glands.

Brenner Tumors mimic a modified Transitional epithelium.

41
Q

Surface Epithelial Tumors:

  • Vast majority of ovarian tumors are ________________
  • What is the Ab to a cancer antigen called?
A

-Hormonally non-functional

-CA-125 (tumor marker)
Detected in about 1/2 of the epi tumors that are confined to ovary, but 90% that have already spread.

42
Q

ALL malignant tumors are characterized by ___________ and ___________ both grossly (can see visually) and microscopically

A
  • hemorrhage

- necrosis

43
Q

Describe Serous Tumors

A

-MOST COMMON
-mimic fallopian tube epi
-consists of several cysts lumped together w/in common outer capsule
-60% benign, 15% borderline, 25% malignant
(60% malignant and 30% benign are bilateral)

  • Malignant form papillae or papillary projections filled w/ serous fluid, if becomes solid can have hemorrhage & necrosis
  • uncommon before puberty, seen older in life
44
Q

Describe Mucinous Tumors:

A

-mimic endocervical epithelium

  • commonly benign (7:1)
  • 10-30% bilateral
  • cavity of tumor filled with thick, yellowish or clear-jelly substance
  • if tumor is malignant or ruptures can cause Pseudomyxoma peritonei (invade the peritoneum and fill belly w/ mucus)
45
Q

Describe Brenner Tumors:

A
  • mimic urinary system epithelium, transitional cell carcinoma
  • solid & char by a dense fibrous stroma w/ nests of transitional epithelium
  • 2% of all neoplasms
  • stage III/IV = 8% 5 year survival rate
46
Q

Describe Endometrioid Tumors:

A
  • mimic endometrial glands, solid tumor w/ endometrial- like gland
  • can harbor benign endometriosis (15%)
  • 15 - 30% accompanied by carcinoma of the endometrium
47
Q

What do we call the Metastatic Gastric Cancer that specifically goes to the Ovaries as a metastatic disease ?

A

KRUKENBERG tumor:

  • Tumor of the GI tract, metastasizes to the ovaries.
  • The most common metastatic tumor being a stomach carcinoma that will tend to produce bilateral enlargement of ovaries.
  • (Metastatic Ovarian Tumors) These tumors have estrogen receptors which explains their metastasizing to the ovaries
48
Q

What does a woman usually first have before she has the chance of getting an ectopic pregnancy?

A

**Chronic salpingitis: The MOST COMMONN pathologic condition leading to ectopics is chronic salpingitis, b/c 95% of ectopic pregnancies occur in fallopian tubes.

-NUG: Other factors include peritubal adhesions from endometriosis, previous surgeries or leiomyomas

49
Q

What is a Hydatidiform Mole?

A

A placental abnormality marked by trophoblastic proliferation & hydropic degeneration of chorionic villi

50
Q

What is the MOST COMMON form of a hydatidiform mole ?

  • What is androgenesis?
  • What happens without maternal chromosomes?
A

THE COMPLETE MOLE:

  • The fetus cannot be identified in the amniotic sac.
  • Results from abnormal fertilization, where all of the chromosomes are PATERNAL in origin due to loss of maternal chromosomes from zygote at the time of fertilization.

Androgenesis = Paternal 23,X set of chromosomes re-duplicates to create 46 chromosomes.

-Without maternal chromosomes, embryo cannot develop, & placenta undergoes hydropic degeneration.

51
Q

Describe an Incomplete hydatidiform mole

A
  • Evolve from oocytes fertilized with 2 spermatozoa, therefore, cells have 69 chromosomes (1 maternal set, 2 paternal sets).
  • This combination is LETHAL, but embryo DOESN’T die immediately, so parts of embryo are found encased among the hydropically altered placental villi & normal placental tissue.
52
Q

What is the diagnosis of Hydatidiform Moles based on ?

A

-H. moles is RARE

-Based on enlarged uterus for
the corresponding, calculated duration of the pregnancy, without any signs of fetal movement.

  • Ultrasound is the best method for early detection. Look for Snowstorm Pattern with no fetal heartbeat or movement.
  • High serum & urine levels of hCG are typically found. They are aborted spontaneously mid-pregnancy.
  • It is important to remove all parts of abnormal placenta. Any remaining trophoblastic cells could give rise to malignant tumors.
53
Q

What is Wharton’s Jelly?

A
  • Mucous connective tissue in umbilical cord
  • Gelatenous substance of umbilical cord that provides insulation & protection
  • Also the site of umbilical cord stem cells.
54
Q

What is Meconium?

A
  • Fetal feces & first feces of newborns.

- Sticky, tarry, yucky

55
Q

What is Decidua?

A

-As the blastocyst implants, into the endometrium it stimulated the Decidual Reaction.

  • The cells of the endometrial stroma (fleshy endometrial tissue between glands of inner lining endometrium) accumulate lipids & glycogen, become plump, & are transformed into decidual cells.
  • This stroma thickens & becomes highly vascularized, & the endometrium is called DECIDUA & is READY for blastocyst implantation
56
Q

What are Meconium-Stained Placentas?

A
  • Green-colored staining of the fetal membranes that easily rinses off.
  • Found in 18% of placentas & occurs most commonly in placentas from pregnancies that are prolonged beyond 42nd wks of gestation.
  • Related to acute fetal hypoxia & distress, but this recently has been challenged.
  • Major complication of thick meconium is aspiration causing a fetal chemical pneumonitis
  • Histologically, there are meconium-laden macrophages w/in fetal membranes.
57
Q

Know the differences between placenta accreta, increta, and percreta based on the levels into the myometrium and beyond

A
  • Placenta Accreta: the attachment of the villi to the level of the myometrium without further invasion
  • Can result in uterine rupture, hemorrhage (due to fragments)
  • Placenta Increta: villi invade the underlying myometrium
  • Placenta Percreta: villi penetrate the full-thickness of the uterine wall
58
Q

Normal parameters of the placenta

A
  • ~ 22-24 cm in diameter, and 2.5-3.0 cm thick.
  • Weighs approximately 500 gms. (1 lb.)
  • The maternal surface is dark red/ maroon in color & divided into lobules or cotyledons. It is important that this structure be complete with no missing cotyledons.
  • The fetal surface is shiny, gray & translucent enough to see the color of underlying cotyledons. Fetal membranes (amnio-chorion) are gray, shiny, wrinkled & translucent.
59
Q

Normal parameters of the umbilical cord

A
  • At birth is pearly white, 1-2 cm in diameter, & 50-60cm long.
  • It is eccentrically positioned, & contains the right/left umbilical arteries, the left umbilical vein, & mucous connective tissue called Wharton’s Jelly.
  • The right/left umbilical arteries carry DEoxygenated blood from fetus to placenta. The umbilical vein carries oxygenated blood from placenta to fetus.

(Presence of 1 umbilical artery within cord is abnormal = cardiovascular abnormality)

60
Q

____________ carries the HIGHEST amount of oxygenated blood from the placenta to the fetus.

A

The UMBILICAL VEIN

61
Q

Normal parameters of the amniotic fluid ?

A
  • Amniotic fluid volume INCREASES thru the 7th month & DECREASES in the last 2 months.
  • At birth volume of amniotic fluid is around 1 liter. Rate of water exchange w/in the amniotic sac is 400-500 ml/hr.
  • The term fetus swallows 400ml of amniotic fluid & excretes 500ml of urine daily.
62
Q

What does the Amniotic fluid components contain?

A

-Electrolytes, carbohydrates, amino acids, lipids, proteins (hormones, enzymes,& alpha-fetoproteins), urea, creatinine, desquamated fetal cells, fetal urine & feces (meconium) & fetal lung liquids (lecithin & sphingomyelin), useful in fetal lung maturity.

  • Maternally derived water is similar to blood plasma (continually produced & constantly resorbed)
  • *L/S ratio - higher (2:1) correlates with lung maturity
63
Q

What are cotyledons and where would you expect to find them?

A
  • 15 to 30 divisions of placenta
  • found on the maternal side of placenta
  • consists of main stem of chorionic villus
  • cotyledons remaining in mother AFTER birth causes post-partum hemorrhaging
64
Q

Which hormone secreted from the placenta is known as the growth hormone for the fetus?

A

-Human Placental Lactogen (hPL):

protein hormone that induces lipolysis thus elevating free fatty acid content in mom

65
Q

What is the differenece between succenturiate placenta vs circumvallate placenta?

A

(Accessory) Succenturiate = EXTRA lobes

  • linked by thin chorionic tissue
  • No clinical importance, unless a portion of lobe is retained after birth - post-partum bleeding

Circumvallate = rolled & raised ring of fetal membrane
over fetal surface instead of edge of placenta (chorionic plate < basal plate).
-The blood vessels at chorionic plate stop at raised membranes & run deeper under membranes.
-Associated w/ Prematurity
Prenatal bleeding, Placental abruption or Multiplarity (more than on fetus)

66
Q

What is the Normal distribution of umbilical cord, how many arteries and veins?

A

-Wharton’s Jelly - mucous connective tissue

*3 vessels:
Left and right umbilical arteries:
Carry DE-oxygenated blood FROM fetus to placenta

Umbilical vein:
Carry oxygenated blood from placenta TO fetus

67
Q

What is the condition of amnion nodosa?

A
  • Numerous small, gray /yellow nodules on fetal surface of placenta, associated with:
  • **Oligohydramnios(low amount of amniotic fluid)

***Renal Agenesis (POTTERS SYNDROME) as a result of oligohydramnios (decrease amt of amniotic fluid, can leads to–>no endometrium cushion–>pulmonary disorder)

68
Q

What is the most common complication of a baby being born with amniotic fluid thick with meconium?

A

Aspiration causing fetal chemical pneumonitis

69
Q

What is acute chorioamnionitis and what organisms can cause this condition? What is the most common cause of chorioamnionitis?

A

Infection/Inflammation of fetal membranes (amnion & chorion) due to bacterial infections from:

  • Genital Mycoplasma species (M. hominis and U. urealyticum)
  • anaerobic Bacteroides group
  • Aerobe Group B Streptococcus, E. coli & Gardnerella vaginalis
  • Caused by premature rupture of amniochorionic membranes (PROM)
  • Amniontic fluid = cloudy and walls opaque, malodorous & edematous.
70
Q

What is funisitis?

A

Inflammation of umbilical cord caused by intrauterine infection; acute fetal inflammatory response

  • Signs/symptoms: Vasculitis of umbilical vessels, PMN infiltration after extension of Wharton’s jelly
  • Causes: meconium exposure, spread of chorioamnionitis, Candida, Actinomyces, HSV, Syphilis
  • Can be necrotizing (infiltration through vessel into Wharton’s Jelly), or peripheral (microabscesses on surface)
71
Q

–What tumor presents with pseudomyxoma peritonei

A

Mucinous cystic adenocarcinoma (NOT a serous tumor)

72
Q

–Which ovarian mass is same as the yolk sac tumor in the male?

A

Endodermal Sinus Tumor

  • Rich in AFP
  • Rare tumor that grows aggresive and rapid
  • Nodular tan-white firm masses
  • SEEN in children & young adults
73
Q

–Where are all the locations that can harbor choriocarcinoma

A

Placenta primarily. Also in endometria (ovaries) and testicles. It can metastasize to bone, liver and lungs.

74
Q

Which organ has estrogen receptors

A
  • Ovaries, breasts, and endometrium, 1-2% risk of cancer in those areas
  • Breast and Uterus are the main ones. The Brain, Bone, liver and heart also have estrogen receptors.

Female/Male Reproductive (3 decks)

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