II: Placental Pathology and Trisomies

Question 1

________ DNA is required for development of embryonic tissue

Answer 1

Maternal

Question 2

________ DNA is required for development of placental tissue

Answer 2

Paternal

Question 3

How is an intervillous thrombus diagnosed?

Answer 3

Kleihauer-Betke Test: HbF assay (>20% of fetoplacental circulation abnormal)

Question 4

How many sperm are typically involved in growth of a complete mole?

Answer 4

One

Question 5

p57kip2 is _____ expressed and _______ imprinted

Answer 5

Maternally; Paternally

Question 6

What is the nomenclature for pregnancies?

Answer 6

TPAL (Term, Premature, Aborted, Living)

Question 7

What management is indicated for a complete mole?

Answer 7

hCG level monitoring

Question 8

What type of staining can be used to demonstrate the type of mole?

Answer 8

p57kip2

Question 9

Which genetic anomaly? Abnormal fluid collection under skin, within abdomen, or within chest cavity

Answer 9

Fetal Hydrops

Question 10

Which genetic anomaly? Low AFP and estriol; high beta-hCG and inhibin

Answer 10

Trisomy 21

Question 11

Which genetic anomaly? Low AFT, estriol, beta-hCG; normal inhibin

Answer 11

Trisomy 18 (Edwards Syndrome)

Question 12

Which genetic anomaly? Micrognathia, Rocker-bottom feet, heart anomalies, renal fusion, omphalocele

Answer 12

Trisomy 18 (Edwards Syndrome)

Question 13

Which genetic anomaly? Polyhydramnios, fetal tachycardia, decreased fetal movement

Answer 13

Fetal Hydrops

Question 14

Which genetic anomaly? SGA, Round/flat flace with slanting palpebral fissures, duodenal atresia, ASD

Answer 14

Trisomy 21

Question 15

Which genetic anomaly? Short stature, webbing, cystic hygroma, gonadal hypoplasia, cardiac anomalies

Answer 15

Turner Syndrome

Question 16

Which genetic anomaly? Small for gestational age, polydactyly, facial defects, cutis aplasia, VSD, normal quad screen

Answer 16

Trisomy 13 (Patau Syndrome)

Question 17

Which pathology? Associated with fetal stress or maturity; can result in aspiration pneumonia or myonecrosis; associated with post-dates, low Apgars, neuro-developmental delay

Answer 17

Meconium

Question 18

Which pathology? Atherosis with foamy macrophages, widely spaced villi, large syncytial knots

Answer 18

Pre-eclampsia

Question 19

Which pathology? Detachment of placenta from decidual seat

Answer 19

Placental Abruption

Question 20

Which pathology? Failure of decidual formation, trophoblast invasion into myometrium

Answer 20

Placenta Accreta

Question 21

Which pathology? Feto-maternal hemorrhage, laminated appearance with lines of Zahn

Answer 21

Intervillous Thrombus

Question 22

Which pathology? Fibrin clot with rim of villous infarction, possible evidence of bleeding during pregnancy

Answer 22

Placental Abruption (Chronic)

Question 23

Which pathology? Group B strep infection of fetal membranes

Answer 23

Acute Chorioamnionitis

Question 24

Which pathology? Hemorrhagic, well-circumscribed nodule in uterus; proliferation of trophoblast and syncytiotrophoblasts in a biphasic pattern

Answer 24

Choriocarcinoma

Question 25

Which pathology? Intranuclear basophilic inclusions surrounded by a halo, often asymptomatic, may cause IUFD, IUGR, deafness

Answer 25

CMV placentitis

Question 26

Which pathology? Intravillous bleeding with bags of blood appearance

Answer 26

Placental Abruption (Acute)

Question 27

Which pathology? Lack of myometrial contractions after delivery

Answer 27

Post-Partum Hemorrhage

Question 28

Which pathology? Most common neoplasm of newborn

Answer 28

Sacrococcygeal Teratoma

Question 29

Which pathology? Neutrophils in fetal membranes, fever, leukocytosis, tachycardia, uterine tenderness

Answer 29

Acute Chorioamnionitis

Question 30

Which pathology? Placental invasion through uterine wall

Answer 30

Placenta Percreta

Question 31

Which pathology? Thin walled vessels with endothelium replaced by trophoblast, deposition of dense pink fibrinoid around vessels

Answer 31

Pre-eclampsia

Question 32

Which pathology? Vaginal bleeding, abdominal/back pain, rapid uterine contractions; risk factors: trauma, cocaine, clotting disorders

Answer 32

Placental Abruption

Question 33

Which type of mole? "grape-like vesicles" and "snowstorm" appearance

Answer 33

Complete

Question 34

Which type of mole? 20% may develop into persistent Gestational Trophoblastic Disease

Answer 34

Complete

Question 35

Which type of mole? Diandric

Answer 35

Both

Question 36

Which type of mole? Diploid

Answer 36

Complete

Question 37

Which type of mole? Do not recur or regress

Answer 37

Partial

Question 38

Which type of mole? Hydropic villi, circumferential trophoblast proliferation, central cisterns

Answer 38

Complete

Question 39

Which type of mole? Large cystic spaces with possible fetal tissue

Answer 39

Partial

Question 40

Which type of mole? P57kip2 mutation

Answer 40

Complete

Question 41

Which type of mole? Triploid

Answer 41

Partial