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Pathoma > Female Pathology: Gestational pathology > Flashcards

Female Pathology: Gestational pathology Flashcards

1
Q

what is ectopic pregnancy and what is the most common location

A
  • implantation of fertilized ovum at site other than uterine wall
  • lumen of fallopian tube
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2
Q

what is a key risk factor for ectopic pregnancy ?what can cause this risk factor

A

scarring

secondary to pelvic inflammatory disease or endometriosis

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3
Q

clinical presentation for ectopic pregnancy

A

lower quadrant abdominal pain few weeks after missed period

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4
Q

how is ectopic pregnancy treated? complications?

A

surgical emergency

- bleeding into fallopian tube (hematosalpinx) and rupture

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5
Q

what is spontaneous abortion

A

miscarriage of fetus occurring before 20 weeks gestation ( usually first trimester)

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6
Q

clinical symptoms of spontaneous abortion

A

vaginal bleeding
cramp-like pain
passage of fetal tissues

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7
Q

what are causes of spontaneous abortion

A
  • chromosomal anomalies ( trisomy 16)
  • hypercoagulable states ( antiphospholipid syndrome)
    congenital infection
  • exposure to teratogens ( especially first 2 weeks of embryogenesis)
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8
Q

what happens in baby is exposed to teratogens first 2 weeks of gestation

A

spontaneous abortion

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9
Q

what happens in baby is exposed to teratogens during weeks 3-8 of gestation

A

risk of organ malformation

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10
Q

what happens in baby is exposed to teratogens during months 3-9 of gestation

A

risk of organ hypoplasia

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11
Q

what is the most common cause of mental retardation in fetus

A

mental retardation

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12
Q

Alcohol to fetus can cause

A

facial abnormalities and microcephaly

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13
Q

Cocaine to fetus can cause

A

intrauterine growth retardation

placental abruption

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14
Q

Thalidomide to fetus can cause

A

limb defects

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15
Q

Cigarette smoking to fetus can cause

A

intrauterine growth retardation

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16
Q

Isotretinion to fetus can cause

A

spontaneous abortion

hearing and visual impairments

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17
Q

Tetracycline to fetus can cause

A

discolored teeth

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18
Q

Warfarin to fetus can cause

A

fetal bleeding

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19
Q

Phenytion to fetus can cause

A

digit hypoplasia

cleft lip/palate

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20
Q

what is placenta accreta

A

implantation of placenta in lower uterine segment

placenta overlies cervical os ( opening)

21
Q

clinical presentation of placenta accreta

A

third-trimester bleeding

22
Q

solution for placent accreat

A

requires delivery of fetus by cesarean section

23
Q

What is a common cause of still birth

A

placental abruption

24
Q

what is placental abruption

A

separation of placenta from decidua prior to delivery of fetus

25
Q

what is placenta accreta

A

improper implantation of placenta into myometrium with little or no intervening decidua

26
Q

clinical presentation of placenta accreta

A

difficult delivery of the placenta and postpartum bleeding

27
Q

If a patient has placenta accreta, what does she often require after

A

hysterectomy

28
Q

What is preeclampsia? when does it usually occur

A

pregnancy-induced hypertension, proteinuria, and edema

- usually 3rd trimester

29
Q

hypertension in preeclampsia can lead to what clinical symtpoms

A

headaches and visual abnormalities

30
Q

what is eclampisa

A

preeclampsia with seizures

31
Q

How is preeclampsia resolved

A

resolves after delivery

32
Q

what is HELLP?

A

preeclampsia with thrombotic microangiopathy involving the liver

  • Hemolysis
  • Elevated Liver enzymes
  • Low Platelets
33
Q

what would you do if your patient had either eclampisa or HELLP

A

immediate delivery

34
Q

sudden infant death syndrome?

A

death of a healthy infant ( 1month - 1year) without obvious cause

35
Q

when do you infants usually expire in sudden infant death syndrome

A

during sleep

36
Q

what are risk factors of sudden infant death syndrome

A

sleeping on stomach
exposure to cigarette smoke
prematurity

37
Q

what is hydatidiform mole

A

abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts

38
Q

what happens to the uterus and hormone levels in hydatidiform mole

A
  • uterus expands like normal pregnancy, but uterus is much larger
  • Beta-hCG much higher than expected for date of gestation
39
Q

when does hydatidiform mole present? what does it look like like?

A

second trimester as passage of grape-like masses through vaginal canal

40
Q

how is hydatidiform mole diagnoised

A
  • routine ultrasound in early first trimester
  • fetal heart sounds absent
  • ‘snowstrom’ appearance on ultrasound
41
Q

what is the genetics of partial hydatidiform mole

A

normal ovum fertilized by 2 sperm or
one sperm that duplicates chromosomes
69 chromosomes

42
Q

what is the genetics of complete hydatidiform mole

A

empty ovum fertilized by 2 sperm or
one sperm that duplicates chromosomes
46 chromosomes

43
Q

is fetal tissue present/absent in partial or complete hydatidiform mole

A

partial: present
complete: absent

44
Q

describe the villous edema in partial and complete hydatidiform mole

A

partial: some villi are hydropic, some normal
complete: most villi are hydropic

45
Q

describe the trophoblastic proliferation in partial and complete hydatidiform mole

A

partial: focal proliferation present around hydropic villi
complete: diffuse, circumferential proliferation around hydropic villi

46
Q

What is the risk of choriocarcinoma in partial and complete hydatidiform mole

A

partial: minimal
Complete: 2-3%

47
Q

how is hydatidiform mole treated? what need to be monitored and why

A

suction curettage
- subsequent Beta-hCH monitoring is important to ensure adequate mole removal and screen for development of choriocarcinoma

48
Q

Choriocarcinoma may arise as a complication of what

A

gestation ( spontaneous abortion, normal pregnancy, ro hydatidiform mole)
spontaneous germ cell tumor

49
Q

what type of choriocarcinomas respond well to chemotherapy

A

gestational pathway

- germ pathway do not respond well

Pathoma (38 decks)

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