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D&T3 Exam 1 > Gesetational-carpenter > Flashcards

Gesetational-carpenter Flashcards

1
Q

Gestation Trophoblastic disease

Types of moles

A

Complete

Partial

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2
Q

Toxemia of pregnancy

Preeclampsia-eclampsia

Characterized by

A

Hypertension, proteinuria, deem

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3
Q

Toxemia of pregnancy

Preeclampsia-eclampsia

Most likely in…

A

Primiparas

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4
Q

Decidua

A

Outer boundary of myometrium

Maternal vessels originate and deliver blood to and from intervillous spaces

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5
Q

Disorders of early pregnancy

Ectopic pregnancy

MC site

A

Fallopian tube

Other sites-ovary, Cornu of uterus, abdomen

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6
Q

Gestation Trophoblastic disease

Types of moles

Partial

A

Some villi edematous

Triploid karyotype (69xxx,69xxy)–fertilization of egg with 2 sperm

Fetal parts may be seen

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7
Q

Toxemia of pregnancy

Pathogenesis

DIC

A

Results from dec uteroplacental perfusion

Leads to stimulation of vasoconstrictor substance

Activation of coagulation factors

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8
Q

Gestation Trophoblastic disease

Types of moles

Complete

A

All villi are edematous

90% have 46XX (all from sperm: paternal fertilization by 1 or 2 sperm of egg that has lost its chromosomes, sperm DNA duplicates)

No fetal parts

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9
Q

Placental infections and inflammations

Villitis

A

Inflammation in placental villi

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10
Q

Disorders of early pregnancy

Spontaneous abortion

Causes

A

Main cause: defective implantation and death of ovum or fetus in utero

Chromosomal abnormalities

Trauma

Infectious agents

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11
Q

Gestational Choriocarcinoma

Originates from…

A

Previous normal or abnormal pregnancy

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12
Q

Gestational Choriocarcinoma

Tx

A

Chemo

Some pts have subsequent normal pregnancies

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13
Q

Gestational Choriocarcinoma

Morphology

A

Soft fleshy whit-yellow masses

Not very large

Extensive necrosis

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14
Q

Placental infections and inflammations

Funisitis

A

Inflammation in umbilical cord

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15
Q

Pathway of infection

Ascending infection through birth canal

A

MC

Bacterial

Can cause premature rupture of membranes

Sexual intercourse can enhance ascending infection

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16
Q

Disorders of late pregnancy

Placenta Accreta

Placenta previa

Ass

A

Can occur in women with previous c section scar

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17
Q

Gestation Trophoblastic disease

Types of moles

Follow pts with

A

Quantitative HCG

Much higher with complete mole

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18
Q

Gestation Trophoblastic disease

Types of moles

With removal…

A

HCG dec

If not, evaluate for choriocarcinoma

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19
Q

Disorders of early pregnancy

Ectopic pregnancy

Predisposing factors

A

Most important-PID

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20
Q

Toxemia of pregnancy

Eclampsia

A

More severe for of toxemia

Seizures and DIC

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21
Q

Gestation Trophoblastic disease

Types of moles

Complete

Ass

A

Chorioca

1/40 cases results in choriocarcinoma

10% develop invasive mole

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22
Q

Twin placenta pic

A

Look at it in photos

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23
Q

Gestation Trophoblastic disease

Types of moles

Complete

Presentation

A

Uterine cavity filled with delicate friable mass (cystic grape like sturctures, see swollen edematous villi)

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24
Q

Toxemia of pregnancy

Pathogenesis

Placental ischemia

A

Abnormality in placentation

Shallow implantation

Residual vessels not adequate

25
Q

Gestational Choriocarcinoma

Microscopic

A

Proliferation of cytotrophoblasts and syncytiotrophoblasts

Can be very atypical with areas of anaplasia

26
Q

Gestation Trophoblastic disease

Types of moles

Clinical course

A

Pt presents with

Spontaneous abortion

Picked up by US

27
Q

Gestational Choriocarcinoma

Come from 3 things

A

50% hydatiform moles

25% previous abortions

25% normal pregnancies

28
Q

Twin-twin transfusion syndrome

Mostly in…

A

Monochorionic-monoamnionic placenta

29
Q

Gestation Trophoblastic disease

Hydatidiform Mole

Most likely to occur in…

A

Teen or 40-50s

30
Q

Toxemia of pregnancy

Clinical course

A

Starts after 32 wks

Hypertension, edema, proteinuria

Lead to headaches, visual disturbances, and shock

31
Q

Disorders of late pregnancy

Placenta Accreta

Possible sequel are

A

Postpartum hemorrrhage- can be life threatening and require hysterectomy

32
Q

Gestation Trophoblastic disease

Types of moles

Partial

Ass

A

Chorioca

Rare to have following chorio

33
Q

Gestation Trophoblastic disease

Types of moles

Partial

Presentation

A

With spontaneous abortion, will see focal areas of swollen chorionic villi

34
Q

Toxemia of pregnancy

Pathogenesis

Events

A

Placental ischemia

DIC

Hypertension

35
Q

Gestation Trophoblastic disease

Hydatidiform Mole

A

Cystic swelling of chorionic villi

Ass trophoblastic proliferation

36
Q

Gestation Trophoblastic disease

Invasive mole

A

Penetrates myometrium (may even perforate uterine wall

Locally destructive

Villi may embolize (liver, brain–not true mets)

37
Q

Toxemia of pregnancy

Placental morphology

A

Inc in infarctions

walls of vessels-fibrinoid necrosis

Thrombi and hemorrhage in liver kidney brain

38
Q

Placental infections and inflammations

Chorioamnionitis

A

Inflammation in fetal membranes

39
Q

Twin placenta

A

Two ova-dizygotic

One ova-monozygotic

40
Q

Gestation Trophoblastic disease

Hydatidiform Mole

Presentation

A

4th-5th month with uterus that measures larger than expected

If early US, then diagnosed early

41
Q

Disorders of late pregnancy

Placenta Accreta

Define

A

Adherence of placenta directly to myometrium due to partial or complete absence of decidua

42
Q

Disorders of late pregnancy

Placenta Accreta

Ass w

A

Placenta previa (placenta implants in lower uterine segment or cervix, causes antepartum bleeding and premature labor

43
Q

Gestational Choriocarcinoma

A

Malignant neoplasm of trophoblastic cells

44
Q

Differentiate mono and di placentas

A

Di-di= 2 chorionic fused, amnion on either side (dark line down center

Mono-di=amnion-no visible chorion

45
Q

Where fetal mother nutrient exchange takes place

A

Placental villi, where umbilical vessels branch and terminate

46
Q

Disorders of early pregnancy

Ectopic pregnancy

Define

A

Implantation of fetus in any site other than normal uterus

47
Q

Gestation Trophoblastic disease

Invasive mole

Clinical

A

Persistent elevation of HCG

Vagina bleeding

48
Q

Gestation Trophoblastic disease

Invasive mole

Tx

A

Responds well to chemo

Can result in uterine rupture and req hysterectomy

49
Q

Ectopic pregnancy

Presentation

A

Severe abdominal pain 6 wks after LMP

HCG will be elevated

Endometrial biopsy shows no chorionic villi

Rupture of tubal pregnancy=medical emergency

50
Q

3 types of placentas

Amnion

Chorion

A

Amnion-# of sacs
Chorion-# of placentas

Mono-di, di-di, mono-mono

Identical twins can be any 3

Later the split the more shared structures

51
Q

Twin-twin transfusion syndrome

Cause

A

Abnormal sharing of fetal circulations

Results in disparity of fetal circulations and may cause death of 1 or both fetuses

52
Q

Gestational Choriocarcinoma

Common mets

A

Lungs

Vagina

Liver

Kidney

53
Q

Gestational Choriocarcinoma

Clinical

A

Present irregular spotting after miscarriage, D&C, or normal pregnancy

Often has spread by time of diagnosis

54
Q

Toxemia of pregnancy

Clinical course

Only definitive therapy

A

Delivery

55
Q

Toxemia of pregnancy

Pathogenesis

Hypertension

A

Due to arterial vasoconstriction

56
Q

Pathway of infection

2 types

A

Ascending infection through birth canal

Hematogenous

57
Q

Disorders of early pregnancy

Ectopic pregnancy

Can cause

A

Hematosalpinx

58
Q

Pathway of INfection

Hematogenous

A

Can occur by spread of bacteria to placenta

Most often affects villi

D&T3 Exam 1 (19 decks)

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