Gestational Pathology

Question 1

what is ectopic pregnancy and what is the most common location

Answer 1

• implantation of fertilized ovum at site other than uterine wall
• ampulla of fallopian tube

Question 2

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

Answer 2

scarring

secondary to pelvic inflammatory disease or endometriosis

Question 3

clinical presentation for ectopic pregnancy

Answer 3

lower quadrant abdominal pain few weeks after missed period

Question 4

how is ectopic pregnancy treated? complications?

Answer 4

surgical emergency

- bleeding into fallopian tube (hematosalpinx) and rupture

Question 5

what is spontaneous abortion

Answer 5

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

Question 6

clinical symptoms of spontaneous abortion

Answer 6

vaginal bleeding
cramp-like pain
passage of fetal tissues

Question 7

what are causes of spontaneous abortion

Answer 7

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

Question 8

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

Answer 8

spontaneous abortion

Question 9

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

Answer 9

risk of organ malformation

Question 10

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

Answer 10

risk of organ hypoplasia

Question 11

what is the most common cause of mental retardation in a fetus

Answer 11

alcohol- can also cause facial abnormalities and microcephaly

Question 12

Cocaine to fetus can cause

Answer 12

intrauterine growth retardation

placental abruption

Question 13

Thalidomide to fetus can cause

Answer 13

limb defects

Question 14

Cigarette smoking to fetus can cause

Answer 14

intrauterine growth retardation

Question 15

Isotretinoin to fetus can cause

Answer 15

spontaneous abortion

hearing and visual impairments

Question 16

Tetracycline to fetus can cause

Answer 16

discolored teeth

Question 17

Warfarin to fetus can cause

Answer 17

fetal bleeding

Question 18

Phenytoin to fetus can cause

Answer 18

digit hypoplasia

cleft lip/palate

Question 19

what is placenta previa

Answer 19

implantation of placenta in lower uterine segment
placenta overlies cervical os ( opening)
-third trimester bleeding
-requires C section

Question 20

what is placental abruption

Answer 20

separation of placenta from decidua prior to delivery of fetus
-common cause of still birth

Question 21

what is placenta accreta

Answer 21

improper implantation of placenta into myometrium with little or no intervening decidua
-difficult delivery of the placenta and postpartum bleeding

Question 22

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

Answer 22

hysterectomy

Question 23

What is preeclampsia? when does it usually occur

Answer 23

pregnancy-induced hypertension, proteinuria, and edema

- usually 3rd trimester

Question 24

hypertension in preeclampsia can lead to what clinical symptoms

Answer 24

headaches and visual abnormalities

Question 25

what is eclampisa

Answer 25

preeclampsia with seizures

Question 26

How is preeclampsia resolved

Answer 26

resolves after delivery

Question 27

what is HELLP?

Answer 27

preeclampsia with thrombotic microangiopathy involving the liver

• Hemolysis
• Elevated Liver enzymes
• Low Platelets

Question 28

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

Answer 28

immediate delivery

Question 29

sudden infant death syndrome?

Answer 29

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

Question 30

when do you infants usually expire in sudden infant death syndrome

Answer 30

during sleep

Question 31

what are risk factors of sudden infant death syndrome

Answer 31

sleeping on stomach
exposure to cigarette smoke
prematurity

Question 32

what is hydatidiform mole

Answer 32

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

Question 33

what happens to the uterus and hormone levels in hydatidiform mole

Answer 33

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

Question 34

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

Answer 34

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

Question 35

how is hydatidiform mole diagnoised

Answer 35

• -‘snowstrom’ appearance on ultrasound in early first trimester
• fetal heart sounds absent

Question 36

what is the genetics of partial hydatidiform mole

Answer 36

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

Question 37

what is the genetics of complete hydatidiform mole

Answer 37

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

Question 38

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

Answer 38

partial: present
complete: absent

Question 39

describe the villous edema in partial and complete hydatidiform mole

Answer 39

partial: some villi are hydropic, some normal
complete: most villi are hydropic (edema)

Question 40

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

Answer 40

partial: minimal
Complete: 2-3%

Question 41

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

Answer 41

D&C
- subsequent Beta-hCH monitoring is important to ensure adequate mole removal and screen for development of choriocarcinoma

Question 42

Choriocarcinoma may arise as a complication of what

Answer 42

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