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Pathology Flashcards

1
Q

Placenta: Umbilical Cord

A

2 Arteries & 1 Vein

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2
Q

Placenta: Codyledins

A

Anchors into endometrium– look to see if they are intact after delivery, if torn– parts of codyledin are left behind and can cause maternal bleeding.

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3
Q

Placenta 1st trimester

A

edematous chorionic vili, few syncytial knots, sparse vasculature, stroma separated by 2layers—outer syncytiotrophoblast & inner cytotrophoblast

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4
Q

Placenta 2nd Trimester

A

More vessels w/in chorionic villi, more syncytial knots, some fibrin (too much is path), less edematous, more cellular

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5
Q

Placenta: 3rd Trimester

A

small villi, w/ more vessels, thinned syncytio/cytotrophoblast

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6
Q

Spontaneous Abortion

A

<20wks—most are <12wks
Fetal Cause: CHROMOSOMAL abnormalities
Maternal Cause: luteal phase defect, uncontrolled diabetes or endocrine disorder, uterine defect—polyps, leiomyomas, malform,
*Listeria*, Toxo, Mycoplasma or viral

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7
Q

Ectopic Pregnancy

A

≈90% in Fallopian Tubes—*PID –> tube scarring*
MOST common cause of HEMATOSALPINX
NO decidual cells in tube for proper invasion/attachment/growth
Tube rupture–>massive intraperitoneal hemorrhage

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8
Q

Late Pregnancy Disorders

A

Constricting KNOTS or cord compression

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9
Q

True Knot vs. False Knot

A

true can be reduced

false can NOT be reduced

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10
Q

Cord Coiling

A

Degree of fetal activity and implantation site –higher placenta -> more twisting

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11
Q

Abruptio Placenta

A

RETROplacental hemorrhage, intravillous fibrin deposition

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12
Q

Other Late Pregnancy Disorders

A

Uteroplacental malperfusion, maternal vascular disease–preeclampsia, uteroplacental ischemia, IUGR

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13
Q

Placenta Acreta

A

Placenta attaches into myometrium–villi invade

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14
Q

Twin Placenta

A

Diamnionic Dichorionic

Diamnionic Monochorionic

Monamnionic monochorionic

If placental is fused look to see how many amniotic sacs there are.

Diamniontic: Amnion on boths sides of chorion

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15
Q

Twin-Twin Transfusion Syndrome:

A

monochorionic, vascular anastomoses that connects the twins’
circulation—1 twin gets better blood supply, death to 1 or both

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16
Q

Infections

Think BACTERIA!

A

Ascending Infection: Bacterial, Cloudy amniotic fluid w/ purulent exudate, neutrophils at chorion-amnion interface, vasculitis,

FUNICITIS—Wharton’s Jelly infected

Hematogenous: Acute VILLITIS—infection
along chorionic villi

17
Q

TORCH

A

Toxoplasmosis, Other, Rubella, CMV, HSV—

CHRONIC inflammatory infilitrates in chorionic villi, LYMPHOCYTIC infiltrate

18
Q

Preeclampsia

A

*HTN, Edema, & Proteinuria (>0.3)*f—LAST trimester
HTN caused by rxn to sperm
Eclampsia—convulsions

↑syncytial knots, accelerated vilous maturity, placental infarcts, ↑retroplacental hematomas, *fibrinoid necrosis* or atherosis of decidual vessels, liver lesions—hemorrhagic necrosis, kidney
lesions—mesangial hyperplasia, fibrin in glomeruli, brain hemorrhage

19
Q

Hydatidiform Mole

A

Cystic swelling of chorionic villi, variable trophoblastic proliferation, *↑risk of persistent invasive mole or choriocarcinoma*

Higher risk at Beginning & End of reproductive years
**Ovum LACKING MATERNAL chromosomes—PATERNAL 46 XX**
Androgenesis: 1 sperm duplicates genome

20
Q

Complete Mole

A

**Grape-like, swollen mass of chorionic villi**

Enlarged edematous viili & *Diffuse Trophoblast Hyperplasia*

21
Q

Partial Mole

A

Egg fertilized by 2 haploid PATERNAL chromosomes—DISPERMY *69 XXY*, maternal chromosomes PRESENT
Less edematous villi & trophoblastic proliferation
*NOT ↑ risk of choriocarcinoma but ↑risk of persistent molar dz*

22
Q

Invasive Mole

A

**MYOMETRIUM invasion by hydropic chorionic villi—proliferation of BOTH cyto- & syncytiotrophoblast**

Hyropic Villi—EMBOLIZE to lungs & brain

*Persistently ↑serum HCG*, vaginal bleeding, irregular uterine enlargement,
varying degrees of ovarian luteinization, responds well to chemo

23
Q

Choriocarcinoma

A

**Malignant TROPHOBLASTIC cells**
Does NOT produce chorionic villi, mixed proliferation of BOTH cyto- & syncytiotrophoblasts, lots of mitoses, invades myometrium, vessesl, lymphatics, etc,
from normal, abnl, ectopic pregnancy—retained tissue
RAPIDLY invasive, widely metastatic, respond well to chemo

*ISCHEMIC NECROSIS*, focal cystic softening,
extensive hemorrhage
Mets to: lungs, brain, bone marrow, liver & others

24
Q

Placental- Site Trophoblastic Tumor

A

**Neoplastic proliferation of EXTRAVILLOUS TROPHOBLASTS**
aka Intermediate Trophoblast
**Cyto- & Syncytiotrophoblasts on chorionic villi**—infiltrate ENDOMETRIRUM
50% preceded by NORMAL pregnancy—GOOD prognosis if localized
or <1yr to dx

Reproduction (14 decks)

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