Gestational Pathology - Pathoma Flashcards

1
Q

What is the most common site for ectopic pregnancy?

A

lumen of fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the key risk factor for ectopic pregnancy?

A

Scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the classic presentation of ectopic pregnancy?

A

Lower quadrant abdominal pain weeks after missed period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does spontaneous miscarriage occur?

A

At 20 weeks or before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do spontaneous abortions present?

A

vaginal bleeding with crampy-like pain and passage of fetal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is spontaneous abortion usually due to? Other causes?

A

Most often due to chromosomal anomalies

Other causes: hypercoaguable states, congenital infection, and exposure to teratogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Placenta Previa?

A

implantation of placenta in the lower uterine segment => placenta overlies cervical os (“preview of placenta”) => requires delivery by c-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the typical presentation of Placenta Previa?

A

Third-trimester bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Placental Abruption?

A

Separation of placenta from decidua prior to delivery of fetus => common cause of still birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the typical presentation of Placental Abruption?

A

Third trimester bleeding and fetal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Placenta Accreta?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Placenta Accreta present?

A

Difficult delivery of the placenta and post-partum bleeding => often requires hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What condition is characterized by pregnancy-induced hypertension, proteinuria, and edema that typically arises in the third trimester?

A

Preeclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Preeclampsia due to?

A

Abnormality of maternal-fetal vascular interface in placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What finding may be present in the placenta if Preeclampsia was present?

A

Fibrinoid necrosis of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Eclampsia?

A

Preeclampsia + Seizures => mandates delivery

17
Q

What is HELLP Syndrome?

A

Preeclampsia with thrombotic microangiopathy involving the liver

18
Q

What does HELLP stand for in HELLP Syndrome?

A

Hemolysis, Elevated Liver enzymes, Low Platelets

19
Q

What do you call an abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts resulting in the uterus expanding as if normal pregnancy is present?

A

Hydatidiform Mole

=> grow placental tissue (villi) instead of baby :(

20
Q

What are four clinical signs of a growing Hydatidiform Mole versus normal pregnancy?

A
  1. Uterus will be larger than expected for gestational age
  2. beta-hCG will be higher than expected for gestational age
  3. Fetal heart sounds are absent
  4. “Snow-storm” appearance on ultrasound
21
Q

What is the classic presentation of a Hydatidiform Mole (if no prenatal care)?

A

Passage of grape-like masses through vaginal canal in “2nd trimester”

22
Q

What classifies a Hydatidiform Mole as complete?

A

Genetics => Empty ovum fertilized by two sperm (46 chromosomes)

Fetal tissue => Absent

Villous edema => Most villi are hyrdopic

Trophoblastic proliferation => Diffuse, circumferential proliferation around hydropic villi

Risk of choriocarcinoma => YES (2-3%)

23
Q

What classifies a Hydatidiform Mole as partial?

A

Genetics => Normal ovum fertilized by two sperm (69 chromosomes)

Fetal tissue => Present

Villous edema => Some villi are hyrdopic, and some are normal

Trophoblastic proliferation => Focal proliferation around hydropic villi

Risk of choriocarcinoma => Minimal

24
Q

What is the treatment for Hydatidiform Mole?

A

Dilation and Curettage

beta-hCG monitored to ensure adequate mole removal and to screen for development of choriocarcinoma

25
Which type of Choriocarcinoma responds well to chemotherapy? Germ cell pathway or Gestational pathway?
Choriocarcinoma that forms from the gestational pathway (i.e. hydatidiform mole)