Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive > PATH: Placenta > Flashcards

PATH: Placenta Flashcards

1
Q

What is the temporary organ connecting fetus and mother providing the equivalent of respiratory (and renal) services?

A

placenta

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

What is the membranous sac surrounding fetus containing serous fluid essential for fetal development?

A

amnion

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

What is the plate-shaped tissue under part of amniotic sac containing fetal blood vessels that branch into villi projecting into space filled with maternal blood?

A

chorion

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

What is the outer layer of blastocyst (from fertilized ovum) that implants in uterus and forms placenta?

A

trophoblast

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

What is the outer layer of placenta that normally peels off myometrium and sheds with placenta?

A

decidua

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

What are the syncytium of cells forming outer covering of chorionic villi, which thin out their cytoplasm and let their clumped nuclei hang off villi in “syncytial knots” to minimize diffusion barrier?

A

syncytiotrophoblast

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

What is the inner layer of the 1st trimester chorionic villi called?

A

cytotrophoblast layer

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

What is the outer layer of the 1st trimester chorionic villi called?

A

syncytiotrophoblast layer

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

How do third trimester chorionic villi differ from first trimester?

A

more blood vessels, less interstitium, thinner trophoblast covering

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

Where is a rupture of an ectopic pregnancy likely to occur?

A

lower abdominal cavity or pelvis (rather than into the uterus)

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

When someone presents with long-term bleeding 1 month after their LNMP, what should you think of?

A

spontaneous abortion

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

What test should you get in a person who has been bleeding for days?

A

hemoglobin

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

Why might a person who has been bleeding for days have a normal blood pressure?

A

they are young! young people will compensate for a tremendously long time with deceptively normal vital signs until they reach the compensatory limits of their young hearts and die in a flash.

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

If you expect your patient has a bleeding disorder like von Willebrand disease, what test can you use to screen?

A

partial thromboplastin time

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

When you see very young/ very old southeast Asian (Indonesian) pregnant women, what should you think of?

A

hydatidiform mole

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

What is a hydatidiform mole?

A

Abnormal gestations due to two sperm fertilizing one egg, or one or two sperm fertilizing an “empty egg” with absent or nonfunctional DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of moles are triploid?

A

partial moles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of moles are diploid?

A

complete moles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the pathological appearance of chorionic villi in hydatidiform moles?

A

Cystic swelling of chorionic villi makes them resemble grapes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which type of mole will get trophoblastic hyperplasia (all the way around the villi)?

A

complete moles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When are hydatidiform moles usually diagnosed?

A

Diagnosed at average of 8.5 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What findings are diagnostic of hydatidiform mole?

A

abnormal (snow storm) ultrasound showing diffuse villous enlargement and/or abnormally rapid and high elevation of beta human chorionic gonado-tropin (beta-HCG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you manage a hydatidiform mole?

A

curettage (scaping out the uterine contents) and monitoring beta-HCG to make sure it is all out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In someone with extreme blood loss (who has retained tons of salt in water to compensate), immediate blood transfusion via large bore catheters in all 4 limbs can kill a patient by what cause?

A

flash pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In what cases should a frozen section be performed?

A

only in cases that will change patient management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sudden onset of dyspnea during labor and delivery is a classic manifestation of what?

A

amniotic fluid embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can cause sudden death due to a cardiac arrhythmia and it causes pulmonary edema due to heart failure (that usually causes a gradual onset of dyspnea over minutes)?

A

peripartum cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The risk of a PE is increased by how much during pregnancy?

A

increased up to 50-fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How many pregnancies are complicated by pulmonary thromboembolism?

A

1 in 500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When do pregnant women get PE and why?

A

more commonly during & after delivery than before because that releases compression of the IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where do the majority of PEs come from?

A

deep vein thrombosis in left leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a life-threatening obstetric emergency due to acute cardio-pulmonary failure from pulmonary vasospasm, hypertension and right heart failure triggering pulmonary diffuse alveolar damage, sometimes with a second phase of DIC and hemorrhage?

A

amniotic fluid embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Why do amniotic fluid emboli occur?

A

fetal and amniotic elements entering maternal veins as decidua detaches and embolizing to lungs, which react with vasospasm, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Is amniotic fluid embolism fatal for babies?

A

not usually but around 20% die if their mothers die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

List the differential diagnosis for acute onset dyspnea during labor and deilvery.

A 
Pulmonary thromboembolism
Pulmonary edema (if pre-eclamptic)
Peripartum cardiomyopathy
Amniotic fluid embolism
Anxiety
Magnesium sulfate toxicity (if on magnesium sulfate for eclampsia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What race has the highest incidence of maternal death?

A

black women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the 5 leading causes of maternal death?

A 
thromboembolism (20%)
 hemorrhage (17%)
pre-eclampsia (16%)
 infection (13%)
cardiomyopathy (8%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Where is the most common site of ectopic pregnancies?

A

fallopian tube (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the most common cause of ectopic pregnancy?

A

scarring from previous infection of tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When and how does ectopic pregnancy usually present?

A

acute severe abdominal pain due to fallopian tube rupture and pelvic hemorrhage, about 6 weeks after last menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the most severe consequences of an ectopic pregnancy?

A

hemorrhagic shock, death

42
Q

What is a Spontaneous Abortion (Miscarriage)?

A

Pregnancy loss before 20 weeks

43
Q

True or False: spontaneous abortions are most common in older women.

A

TRUE: 11% in pregnancies of 20-24 year-olds to 51% in 40-44 year-olds

44
Q

What is the most common cause of spontaneous abortion in the first trimester?

A

GENETIC: half with chromosomal abnormalities

45
Q

What is the most common cause of spontaneous abortion in the second trimester?

A

INFECTIOUS (acute chorioamnionitis)

46
Q

What is the most common cause of spontaneous abortion in the third trimester?

A

VASCULAR (uteroplacental insufficiency, commonly associated with pre-eclampsia)

47
Q

What autoimmune disease is commonly associated with spontaneous abortion?

A

antiphospholipid syndrome

48
Q

What is : implantation in lower uterus or cervix, sometimes covering internal cervical os?

A

placenta previa

49
Q

What is: defective decidua, with adherence of villous tissue to myometrium?

A

placenta accreta (most common)

50
Q

What is: defective decidua, with penetration of villous tissue into myometrium?

A

placenta increta

51
Q

What is: defective decidua, with penetration of villous tissue through entire uterine wall?

A

placenta percreta (least common)

52
Q

True or false: all twins with Dichorionic diamniotic placentas are dizygotic?

A

false! 80% are dizygotic

53
Q

True or false: all twins with monochorionic

placentas are monozygotic?

A

true! if you share a placenta, you are identical

54
Q

In what type of placenta do you see twin-twin transfusion syndrome?

A

Monochorionic monoamniotic

55
Q

What is twin-twin transfusion syndrome?

A

unbalanced vascular anastomoses in monochorionic placentas can cause one twin to get too much blood and the other too little

56
Q

How might the “donor” twin in twin-twin transfusion syndrome affect its surroundings?

A

can send necrotic procoagulant material into the anastomoses threatening the life of the other twin and the mother

57
Q

List the common causes of placental infections.

A 
TORCH
	T for Toxoplasma gondii
	O for Other (syphilis, HIV, etc.)
	R for Rubella (German measles)
	C for Cytomegalovirus
	H for Herpes simplex virus
58
Q

How does acute chorioamnionitis (also called intra-amniotic infection) occur?

A

ascends from vagina

59
Q

What is the protozoan from cat feces that causes microcephaly, fever, rash, and seizures in neonates?

A

Toxoplasma gondii

60
Q

What infection is actually protracted intrapartum from maternal genital lesions, causes skin infection & worse in neonates, and is preventable with C section?

A

HSV

61
Q

What placental infection causes deafness, neurologic defects, and cardiac malformations in neonates?

A

rubella

62
Q

What is the most common transplacental infection

in US? What are the symptoms?

A

Cytomegalovirus (causes deafness, neurologic

defects in neonates)

63
Q

When do women with Acute Chorioamnionitis typically have rupture of membranes?

A

41% of women with premature rupture of membranes at <27 weeks

64
Q

Describe the stages of neutrophil movement in acute chorioamnionitis?

A

intervillous space–> chorion –> amnion –> fetal polys in chorionic blood vessels (fetal vasculitis where inflammation may lead to thrombosis)

65
Q

What is funisitis?

A

Exudate and congestion of cord (seen in placental infections)

66
Q

What is the characteristic pathology of placental infections?

A

Extensive tan (or green) exudate (and areas of congestion) on the amniotic surface with funisitis

67
Q

When you see the word INFLAMMATION, what should you automatically think?

A

pro-coagulant

68
Q

What is the major immune response to Acute Chorioamnionitis?

A

maternal neutrophiis

69
Q

What are the two major side effects of placental infeciton?

A

premature rupture of membranes and premature labor and delivery

70
Q

What is the causative agent of acute chorioamnionitis?

A

polymicrobial, with multiple vaginal flora bacteria

71
Q

What are the possible fetal implications of chorioamnionitis?

A

fetal sepsis, cerebral palsy, endometritis

72
Q

What normally occurs when trophoblast cells invade

myometrial spiral arteries?

A

destroy the smooth muscle cells in their walls and convert them from small caliber resistance vessels to large caliber capacitance vessels that accommodate vastly increased
blood flow later in gestation

73
Q

What is the name of the truncated form of VEGF receptor that acts as a decoy that is secreted by ischemic placenta in pre-eclampsia?

A

soluble fms-like tyrosine kinase 1 (sFlt-1)

74
Q

What is the name of the form of TGF-beta receptor that acts as a decoy that is secreted by ischemic placenta in pre-eclampsia?

A

soluble endoglin

75
Q

What are the roles of sFIt-1 and endoglin?

A

block VEGF and TGF mediated production of nitric oxide and prostacyclin, causing maternal hypertension, proteinuria and edema

76
Q

Why is preeclampsia a procoagulant state?

A

partly due to blockage of prostacyclin production and the production of proinflammatory cytokines like tumor
necrosis factor alpha (TNF-alpha)

77
Q

What is HELLP syndrome?

A

Hemolysis, Elevated Liver enzymes and Low Platelets

78
Q

What is eclampsia?

A

cerebral edema and seizures

79
Q

The changes that occur to the placental arteries by pre-eclampsia mirror what disease?

A

atherosclerosis

80
Q

What is the initial effect of ischemia on the development of chorionic villi (via preeclampsia)?

A

accelerated maturation that makes them more efficient at gas exchange, nutrient import and waste export, but when ischemia becomes more severe, it results in villous hypoplasia.

81
Q

What disease is characterized by: activation of platelets and clotting factors, creating fibrin red cell shredders in capillaries that causes hemolysis, platelet aggregation lowering the count, and thrombi in liver sinusoids that injure hepatocytes, who release their enzymes.

A

HELLP syndrome

82
Q

The liver injury of HELLP syndrome can progress to what problems?

A

necrosis, hemorrhage, even liver rupture

83
Q

What is the most common cause of Placental Ischemia and Infarction?

A

Pre-eclampsia

84
Q

How much ischemia of the placenta can the fetus tolerate?

A

the fetus can tolerate infarction of more than 50% of the placenta

85
Q

What are the repercussions of extensive ischemia of the placenta?

A

intrauterine growth restriction, neurologic injury and fetal demise

86
Q

What is an “invasive mole”?

A

a mole that persists after therapy and looks like a choriocarcinoma but has not metastasized

87
Q

What are the common sites of metastatic

choriocarcinoma?

A

brain, lung, liver, spleen and kidney

88
Q

How does a choriocarcinoma spread?

A

hematogenously (like a sarcoma)

89
Q

What is the most common first symptom of a choriocarcinoma?

A

uterine bleeding

90
Q

What is a word for a deficiency of amniotic fluid?

A

oligohydramnios

91
Q

What does oligohydramnios due to the infant?

A

sequence of compressive injuries to the fetus, but also pulmonary hypoplasia because the fetus needs to “breathe” for normal lung development, and absence of fetal “urine” in amniotic fluid due to fetal renal disease causes pulmonary hypoplasia incompatible with life after birth

92
Q

Describe some features of the oligohydramnios sequence.

A

Contractures of hands and feet (more severe deformation = clubfeet); Potter facies (flattened face, especially nose and ears)

93
Q

What is the name for a mechanical fibrotic lesion causing limb strictures or amputations?

A

Amniotic band

94
Q

What disease has: bleeding at the decidual-placental interface causing placental detachment before delivery of the fetus?

A

placenta abruption

95
Q

What is the immediate cause of placental abruption?

A

rupture of decidual blood vessels

96
Q

2/3 of placental abruptions lead to what?

A

retroplacental hematoma

97
Q

What percentage of retroplacental hematomas are due to placental abruptions?

A

2/3

98
Q

What are the 2 consequences of peripartum cardiomyopathy?

A

resolves spontaneously (in 1/3) or leads to dilated cardiomyopathy (in 2/3)

99
Q

Peripartum cardiomyopathy is most popular in what populations?

A

multiparous African-Americans

100
Q

How do you diagnose peripartum cardiomyopathy?

A

dilated cardiomyopathy without another cause 3 months before or after delivery

Reproductive (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions