Pathology Flashcards
What’s the most common presentation of epispadia? What’s it commonly associated with?
The entire penile urethra is open along the entire shaft and is usually associated with bladder exstrophy (absence of the anterior bladder and abdominal wall.
What’s the difference between congenital phimosis and acquired phimosis? What’s paraphimosis?
Congenital phimosis is where the orifice of the prepuce maybe too narrow to allow retraction over the glans penis. Acquired is from infection or trauma
Paraphimosis is what happens when you force the prepuce over the glands and it strangulates and impedes outflow of blood.
A longitudinal vaginal septum is the result of what embryologically? What do you have a chance to win?
incomplete fusion of the mullein ducts resulting in a double vagina with a chance for a double cervix and uterus! called didelphys uterus.
The transverse vaginal septum is caused by what?
incomplete fusion of the mullerian ducts and urogenital sinus
What are some etiologies of cervical stenosis? What does it look like and lead to?
prior LEEP, or cone biopsy of the cervix
elongated ridged cervix w/o elasticity
may obstruct outflow (menses)
A bicornate uterus arise from what?
bicornate failure of degeneration of the mullerian duct walls
The neural folds move together and fuse during what week of embryologic development? What is created as a result of this fusion?
week 3
neural tube
What serum marker can help you to detect anencephaly or spina bifida?
AFP or MSAFP produced by the fetal liver. Elevated levels indicate a neural tube defect.
What does the spectrum of spina bifida include in the lumbar region?
Spina bifida occulta- dimple or hair (single vertebra fails to fuse)
Meningocele- CSF pouch
Meningomyelocele- CSF, dura, arachnoid, and cord
Rachischisis- spinal cord exposed to air-paralysis
Describe anencephaly in detail
Anterior neuropore fails to close around week 4. Presents with absent cranial vault and cerebral hemispheres. Characterized by the area cerebrovasculosa-mass of brain tissue and vasculature at the base of the skull. Frog eyes.
Where can a meningocele present?
Occiput, cervical, or lumbar regions. Sac is usually covered with skin and the apex is ulcerated.
What’s a menigoencephalocele and how is it different from a meningohydroencephalocele?
Diverticulum of CNS tissue and arachnoid extending through the occiput
Hydro-includes the ventricular cistern in this protrusion
Describe meningomyelocele in detail
Protrusion of dura, arachnoid and neural tissue from vertebral canal with trapped nerve roots of the cauda equina in a subcutaneous scar tissue. The cord appears flat and ribbon-like. Neurologic disfunction and infection lead to motor and sensory disfunction of the lower extremities in addition to bowel and bladder control.
On MRI you see a patient with an S shaped kinking and angulation of the upper cervical spinal cord from cerebellar herniation. The displacement of what superior structure would cause cranial nerve compression and stretching leading to difficulty swallowing, and vocal cord paralysis?
Medulla which will be displaced caudally when the cerebellum herniates through the foramen magnum.
Arnold-Chiari malformation (II)
Your patients serum levels in the first trimester show decreased HCG and PAPP-A. US follow up show nuchal translucency and impedance through the ductus venosus. Further testing shows a trisomy in chromosome 13. The fetus dies shortly after birth. What brain pathology would likely be present causing inter-hemispheric fissure absence?
Holoprosencephaly
Microcephalic brain
Interhemispheric fissure absent/horseshoe shaped
common ventricular chamber
