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II: Pregnancy- Fetus Flashcards

1
Q

____ twins are at highest risk for Twin-Twin Transfusion Syndrome

A

Monochorionic; diamniotic

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2
Q

____ twins are at highest risk of entanglement of umbilical cords.

A

Monoamniotic

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3
Q

____ villi: cytotrophoblast core surrounded by syncytiotrophoblasts

A

Primary

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4
Q

____ villi: cytotrophoblasts contact decidua and invade through to the inner third of the myometrium

A

Anchoring

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5
Q

____ villi: extraembryonic mesoderm growing into the cytotrophoblast layer

A

Secondary

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6
Q

____ villi: majority of placental mass, responsible for nutrient exchange

A

Floating

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7
Q

____ villi: mesenchymal cell differentiation into blood vessels to form arteriocapillary network in the villous

A

Tertiary

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8
Q

_____ are specialized basic histones with disulfide bonds that compact sperm DNA

A

Protamines

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9
Q

______ do not express MHC molecules

A

Syncytiotrophoblasts

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10
Q

______ may downregulate immune function regionally

A

Cytotrophoblasts

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11
Q

______: morphological and biochemical differentiation of uterine stromal cells

A

Decidualization

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12
Q

______: process by which blastocyst escapes the zona pellucida

A

Hatching

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13
Q

______: trophectoderm cells of the blastocyst interdigitate with the luminal epithelium of the uterus

A

Apposition

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14
Q

___-zygote: majority of spontaneous twin pregnancies (70%)

A

di

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15
Q

An activated oocyte releases ___, to prevent polyspermy.

A

ZP3-F

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16
Q

Capacitated sperm can bind to the _______ and undergo the acrosomal reaction.

A

zona pellucida

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17
Q

Dizygotic twins are __-chorionic and __-amniotic.

A

di; di

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18
Q

Fertilization occurs _____ hours following ovulation.

A

12 to 24

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19
Q

HbF has a lower affinity for ______.

A

2,3-BPG

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20
Q

How can TTTS be diganosed?

A

Placental Injection Studies

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21
Q

Hyperemesis in the context of twin pregnancies can be attributed to higher levels of ___

A

hCG

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22
Q

Implantation occurs approximately ___ days following fertilization.

A

6

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23
Q

In the placental-fetal unit, which produces 17-hydroxyprogesterone?

A

Fetus

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24
Q

In the placental-fetal unit, which produces estrogens?

A

Placenta

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25
Q

In the placental-fetal unit, which produces progesterone?

A

Placenta

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26
Q

In TTTS, the ____ twin is at risk for developmental and growth defects

A

Donor

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27
Q

In TTTS, the ____ twin is at risk for fetal hydrops.

A

Recipient

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28
Q

Monozygotic twins dividing during days 0-3 are __-chorionic and __-amniotic

A

di; di

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29
Q

Monozygotic twins dividing during days 13+ are __-chorionic and __-amniotic

A

mono; mono; (Conjoined)

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30
Q

Monozygotic twins dividing during days 4-8 are __-chorionic and __-amniotic

A

mono; di

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31
Q

Monozygotic twins dividing during days 9-12 are __-chorionic and __-amniotic

A

mono; mono

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32
Q

Name the 4 stages of implantation.

A

Pre-Implantation; Apposition, Adhesion, Invasion

33
Q

Name the three most common causes of polyhydramnios.

A

Congenital abnormalities; Gestational diabetes; Hydrops

34
Q

Name the three stages of placental development.

A

Pre-lacunar; Lacunar/Trabecular; Villous Stage

35
Q

Name three treatments for TTTS.

A

Reduction Amniocentesis, Microseptostomy, Laser Ablation

36
Q

On day 5, the blastocyst escapes the ______.

A

Zona pellucida

37
Q

Oocyte-derived _____ reduces sperm protamines to decondense the sperm DNA and form the pronucleus.

A

Glutathione

38
Q

Sperm binding to the zona pellucida is mediated by ____.

39
Q

Sperm traverse the _____ to reach the zona pellucida

A

Cumulus oophorus/corona radiata

40
Q

Umbilical ____ carry deoxygenated blood.

41
Q

Umbilical ____ carry oxygenated blood.

42
Q

What is a potential medical treatment for ectopic pregnancy?

A

Methotrexate

43
Q

What is the composition of amniotic fluid early in pregnancy?

A

ultrafiltrate of maternal plasma

44
Q

What is the composition of amniotic fluid late in pregnancy?

A

Fetal urine (some lung secretions)

45
Q

What is the implication of untreated TTTS?

A

Mortality of at least one twin

46
Q

What is the most common cause of oligohydramnios?

A

rupture of membranes

47
Q

What is the normal value for normal concentration of sperm?

A

20 million per ml

48
Q

What is the normal value for normal morphology?

49
Q

What is the normal value for semen volume?

50
Q

What is the normal value for sperm motility?

51
Q

What is the predominant component of the zona pellucida?

A

Protein (70%)

52
Q

What protein mediates sperm-oocyte fusion?

53
Q

Which day of gestation? 4-8 cell embryo with the zona still present

54
Q

Which day of gestation? Appearance of inncer cell mass and outer cells that will comprise the future placenta

55
Q

Which day of gestation? Blastulation begins

56
Q

Which day of gestation? Two-cell embryo with symmetry and scant vacuoles

57
Q

Which enzymes does the fetus lack?

A

3-Beta-HSD, Aromatase

58
Q

Which enzymes does the placenta lack?

A

p450c17, 17-alpha-hydroxylase

59
Q

Which hormone promotes decidualization?

A

Progesterone

60
Q

Which pathology? Abdominal pain, vaginal bleeding, abnormally rising beta-hCG

A

Ectopic Pregnancy

61
Q

Which pathology? Impedes ability of baby to pass through cervix during delivery, can cause dangerous hemorrhage for mother and newborn

A

Placenta Previa

62
Q

Which pathology? Implantation near/on the cervix

A

Placenta Previa

63
Q

Which pathology? Implantation on a scarred region of uterine wall resulting in deep implantation; associated with previous C-section

A

Placenta Accreta

64
Q

Which pathology? Invasion through the uterine wall and into the abdominal cavity

A

Placenta Percreta

65
Q

Which pathology? Most common cause of maternal mortality during the first trimester of pregnancy

A

Ectopic Pregnancy

66
Q

Which pathology? Unblanced flow through connected vessels in the placenta

A

Twin Twin Transfusion Syndrome

67
Q

Which placental hormone? Controls maternal IGF-1 levels

68
Q

Which placental hormone? Increases maternal plasma glucose content to make nutrients available to the fetus

69
Q

Which placental hormone? Maintains corpus luteum

70
Q

Which placental hormone? Stimulates trophoblast differentiation into cytotrophoblasts and syncytiotrophoblasts

71
Q

Which stage of placental development? Appearance of chorionic villi

72
Q

Which stage of placental development? Cytotrophoblasts proliferate and invade adjacent maternal tissue

A

Pre-lacunar

73
Q

Which stage of placental development? Vacuoles appear in syncytiotrophoblasts that coalesce to form lacunae that contact endometrial capillaries

A

Lacunar/Trabecular

74
Q

Which steroids are produced by trophoblasts in high levels?

A

Estrogen, Progesterone

75
Q

Which TTTS treatment has a higher complication rate and involves direct visualization of communicating vessels

A

Laser Ablation

76
Q

Which TTTS treatment may increase risk of cord entanglement

A

Microseptostomy

77
Q

Which TTTS treatment may need to be repeated?

A

Reduction Amniocentesis

78
Q

Which type of twins? Thick dividing membrane with lambda sign on imaging

79
Q

Which type of twins? Thin dividing membrane with T-sign on imaging

Life Cycle (24 decks)

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