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Pathology/ICM-GYN Module > Gestational and trophoblastic diseases > Flashcards

Gestational and trophoblastic diseases Flashcards

1
Q

What is the placenta composed of?

A

chorionic villi

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2
Q

where does maternal blood enter the intervillous space?>

A

though endometrial arteries and circulates around the villi

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3
Q

What is the outer layer of the chorionic villi?

A

syncytiotrophoblast

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4
Q

what is the inner layer of the chorionic villi?

A

cytotrophoblast

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5
Q

what is spontaneous abortion classified as?

A

pregnancy loss before 20 weeks gestation

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6
Q

what are fetal causes of spontaneous abortion

A

aneuploidy
polyploidy
tranlocations

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7
Q

what are maternal causes of spontaneous abortion?

A 
luteal phase defect
diabetes (not controlled)
endocrine disorders
APLA
coagulapathies 
hypertension
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8
Q

what physical defects can cause spontaneous abortion

A

submucosal leiomyomas
uterine polyps
uterine malformations

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9
Q

what infections may cause spontaneous abortions?

A

toxoplasmosis
mycoplasma
listeria
viral infections

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10
Q

where do ectopic pregnancies usually occur

A

1fallopian tubes

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11
Q

what are risk factors for ectopic pregnancy?

A 
hx of PID 
hx of fallopian tube scarring (chronic follicular salpingitis)
appendicitis
endometriosis
prior surgery
IUD
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12
Q

Ectopic pregnancy signs and sx?

A

hemorrhagic shock

acute abdominal pain

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13
Q

how would you dx ectopic pregnancy

A

B-HCG
ultra sound
laparoscopy

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14
Q

If egg oops out of fimbriated end of tube what type of ectopic pregnancy is this?

A

abdominal etopic

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15
Q

what is hematosalpinx

A

blood in the fallopian tube most commonly caused by ectopic pregancy

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16
Q

What are copications of late pregnancy?

A

knots in umbilical cord-interruption of blood flow
ascending infections=chorioaminiotis can cause spent abortion
placental abruption

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17
Q

what is placenta previa?

A

plantation in lower uterine segment

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18
Q

how does placenta previa present?

A

third trimester bleeding

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19
Q

how must placenta previa be delivered?

A

though c-section

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20
Q

what is placenta abruption

A

separation of placenta from decide prior to delivery of fetus

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21
Q

how does placenta abrution present as

A

3rd trimester bleeding and fetal insufficiency

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22
Q

placent abruption is a common cause of _______

A

still birth

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23
Q

what is placenta accreta?

A

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

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24
Q

how does placenta accreta present?

A

with difficult delivery of placenta and post partum bleeding

requires hysterectomy

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25
what are risk factors for placenta accreta
prior placent previa | and history of c-section
26
what is placenta increta
(deep) (superficial) improper implantation of placenta into myometrium with little or no intervening decidua
27
what is placenta percreta
attachment of placenta through the myometrium
28
most ascending infections are.___
bacterial
29
what is chorioaminiotis
pin in membranes
30
what is funisitis
infection of the umbilical cord
31
what is acute villitis
bacteria in villi of the placenta
32
what is the px of preeclampsia?
hypertension edema proteinuria if ....headaches/visual disturbances...deliver
33
when do you get preeclampsia?
last trimester
34
how do you treat preeclampsia?
deliver | antihypertensives dont help
35
what is the DD of preeclampsia and how would you tell apart?
gestational hypertension (no proteinuria)
36
what is eclampsia
preeclampsia plus cns involment | convulsions->COMA
37
WHAT do patients with severe preeclampsia develop?
HELLP ``` Hemolysis Elevated Liver enzymes Low Platlets ```
38
What are the gestational trophoblastic diseases?
``` COMPLETE MOLE PARTIAL MOLE INVASIVE MOLE PALCENTAL SITE TROPHOBLASTIC TUMOR CHORIOCARCINOMA ```
39
what is a hydatidiform mole
Cystic swelling of chorionic villi
40
moles increase risk of ______
persistent trophoblastic disease choriocarcinoma spontaneous pregnancy lost
41
what is the clinical px of molar pregnancy?
spent pregnancy loss some people might have D/cutterage HCG will be high (faster then it should)
42
what is a complete mole
completely dad empty ovum | no fetal parts
43
how would a complete mole look histologically?
ALL villi enlarged and show edema
44
what gene would u see in complete mole?
p57(-)
45
what is a partial mole?
fertilization of one egg with 2 sperm 69,XXY or 92, XXXY\ fetal parts
46
what would gene you see in partial mole?
p57 (+)
47
how would a partial mole look histologically
not all villi enlarged | some show edema some don't
48
in which type of mole is there an increased risk of developing choriocarcinoma?
complete mole
49
in which type of mole is P57KIP2 gene transcribed?
partial
50
What is an invasive mole?
mole that penetrates or perforates the uterine wall | can lead to uterine rupture
51
which type of mole can benign mets (not true because it cannot grow in these areas)
invasive moles | with their hydronic villi
52
what is the clinical presentation of invasive mole?
vaginal bleeding irreglar uterine enlargement persistently high HCG
53
How do you treat an invasive mole?
chemotherapy
54
what is a choriocarincoma?
malignant neoplasm of trophoblastic cells
55
how can you get a choriocarcinoma?
arises from moles (50%) normal pregnancy (22%) abortions (25%) abnormal pregnancy/ectopic
56
how do you get the non-gestational type choriocarcinoma?
arise from germ cells in ovary or mediastinum
57
how invasive is choriocarcinoma?
rapidly invasive and mets all over | *usually mets to lung and bones at time of diagnosis)
58
how do you treat gestational choriocarcinoma?
gestational is very chemo sensitive 100% remission with chemo (vs. nongestational...worse prognosis)
59
how does choriocarcinoma present?
irregular vaginal spotting | really really really high levels of HCG
60
what is a placental site trophoblastic tumor
neoplastic proliferation of intermediate trophoblast
61
how does placental site trophoblastic tumor px?
uterine mass with abnormal bleeding or amenorrhea | mildly elevated HCG
62
where are intermediate trophoblast found?
implantation site chorionic plate placenta parenchyma placenta membranes
63
what is the prognosis for placental site trophoblastic tumor?
if localized =excellant prognosis | if advanced poor prognosis

Pathology/ICM-GYN Module (11 decks)

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