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P&T Block 5 Renal > L71 > Flashcards

L71 Flashcards

1
Q

What are the 5 types of ovarian surface epithelial tumors? Which 2 can arise from endometriosis?

A
  1. Serous
  2. Mucinous
  3. Endometrioid - endometriosis
  4. Clear cell - endometriosis
  5. Brenner/transitional
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2
Q

Explain the differences between benign, borderline, and malignant serous ovarian tumors

A
  1. Benign = serous cystadenoma = simple, flat lining
  2. Borderline = velvety, implants in abdomen as independent tumors (not mets)
  3. Malignant = serous carcinoma, thick + shaggy
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3
Q

What is the name for a benign serous or mucinous ovarian tumor?

A

Serous or mucinous cystadenoma

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4
Q

What is the tumor progression pathway to get a low grade serous ovarian carcinoma?

A

Cystadenoma // endometriosis -> borderline -> low grade

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5
Q

What is the tumor progression pathway to get a high grade serous ovarian carcinoma? What are the genes involved?

A

Think BRCA 1/2 + p53
Inclusion cyst
High grade

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6
Q

Presentation of mucinous ovarian cancer

A

HUGE, most benign

“Bag jelly beans”

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7
Q

What is a pseudomyxoma peritonei

A

Bilat mucinous ovarian tumor as met from appendix mucinous tumor

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8
Q 
For epithelial tumors, describe the role of:
Age
Cystic vs solid tumors
Bi vs unilat tumors
Those associated with endometrisois
A

OVARIAN SURFACE EPI TUMOR

  1. Older = more likely to be malig
  2. Benign - cystic, solid - malignant
  3. Bilat more likely to be mets except serous
  4. Endometrioid + clear cell associated with endometriosis
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9
Q

What is a Krukenberg tumor? Unil or bilat, histology

A

Diffuse gastric cancer - mets to the bilat ovaries

Histo: signet ring

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10
Q

Which type of ovarian tumor presents before 20 yo + unilateral

A

Ovaruan germ cell tumors

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11
Q

You can guess what a mature teratoma is - so what is an immature teratoma? Treat

A

Contains immature neuro tissue (brain)
High grade will need chemo regardless of resection b/c immature tissue indications malignant potential (vs mature teratoma = benign)

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12
Q 
What is a dysgerminoma
Benign vs malignant 
Uni or bilat
Enzyme elevated 
Age 
Prognosis
A 
Ovarian "seminoma"
Malignancy of oocytes 
Unilat
Young women: 20-30s
High LDH
Responds to treatment
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13
Q

Yolk sac tumor = endodermal sinus tumor
Age
Elevated in serum
Histo

A 
Malignant tumor in GIRLS
High AFP (normally secreted by yolk sac)
Schiller Duval bodies = glomerulus-like
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14
Q

Name the 5 types of germ cell tumors

A 
Teratoma (mature vs immature)
Dysgerminoma (oocytes)
Yolk sac tumor = endodermal sinus tumor 
Choriocarcinoma (placental tissue)
Embryonal carcinoma = emybro like, large primitive cells
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15
Q

2 types of sex cord stromal tissues

A

Ganulosa-theca cell tumor

Sertoli-Leydig cell tumor

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16
Q

What is Meigs syndrome?

A

Ovarian tumor = fibroma
Hydrothorax
Ascities

17
Q

Describe presentation of granulosa tumor

A 
Makes E - signs of E excess
1. Early puberty
2. Bleeding out of cycle
3. Post-meno bleeding
Excess E likely to cause endometrial HYPERPLASIA + CARCINOMA
18
Q

Serum + histo findings granulosa tumor

A

Inhibin = serum tumor marker

Coffee bean nuclei = Call Exner bodies

19
Q

What is the normal vascular architecture of the umbilical cord?

A

2 arteries
1 vein
: o

20
Q

What is oligohydramnios? What syndrome/sequence may result from prolonged/severe oligo?

A

Too little amniotic fluid
POTTER’s sequence = no amniotic fluid to swallow = lung hypoplasia
- May be due to congenital lab of kidneys/UT
Characteristic facial appearance after being smooshed on placenta

21
Q

What is meconium? How could this signal fetal insult?

A

Baby poop - should only happen around time of delivery

If green, distress that caused pooping is removed (umbilical cord spasm)

22
Q

What is placenta previa + complication

A

Placenta implanted into lower segment of uterus - lies over cervix
Can’t deliver through obstructed cervix - C section

23
Q

What is placenta accreta + complication

A

Placenta into the myometrium - too tight
Hemorrhage -> may need to remove uterus at birth
Same idea, deeper invasion = placenta increta + percreta

24
Q

What is twin twin transfusion syndrome

A

Anastimosis of the arteries so that one baby under profused (cause of death) and the other is over (dies CHF)

25
Q

Name for infection of placenta vs membranes vs cord. Source?

A

Placenta = villitis
Membranes = chorioamnionitis
Cord = funisitis
Ascending infection via birth canal (duh none of these things exist if not pregnant)

26
Q

What are you worried about with maternal infection of the placenta/membranes/cord

A 
ToRCHES infections
Toxo
Rubella
CMV
HSV
Syphilis
27
Q

Most common cause of rupture membranes

A

Infection

28
Q

What is pre-eclampsia vs eclampsia?

A

Pre = HTN + proteinuria + edema
Defective formation in placental vasc bed -> less BF to placenta = hypoxia, premature birth
Eclampsia = + seizures, DIC

29
Q

What disease did mom have if you see decidual vasculopathy aka fibrinoid necrosis and hemorrhagic infarct at delivery?

A

Pre/eclampsia

30
Q

If mom comes in with pain + vaginal bleeding, what are you thinking? Biggest worry

A

Placental abruption!!! (b/c pain AND blood)

Worry still birth -> emergency delivery

31
Q

How does a complete hydatidiform mole form?

A

2 sperm - no maternal chromosome in egg

32
Q

How does partial hydatidiform mole form?

A

Maternal chromosome + 2 sperm fertilize

Triploid genetic material

33
Q 
Describe complete H mole 
Genetics
Fetal tissue
Vilious edema
Trophoblastic prolif
Risk for choriocarcinoma
A

COMPLETE
Egg completely devoid mom’s genes (incompat w/ life)
Complete absence fetal tissue
Completely edematous vili
Complete covering of those vili in blasts - secreted hCG
Completely at risk for choriocarcinoma

34
Q

What does a complete H mole look like?

A

Bunch of grapes - may have some come out

35
Q

What is choriocarcinoma? 2 ways you can get this tumor

A

Malignant
Tumor of blasts: syncytio + cytotropho = why high BhCG
From
1. Germ cell pathway - don’t respond well to chemo
2. Gestation pathway (complete H mole) - yes chemo

P&T Block 5 Renal (30 decks)

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