Pathology [Repro] Flashcards
Diagnose: male, testicular atrophy, eunuchoid body shape, tall stature, long extremities, gynecomastia, female hair distribution +/- developmental delay
Klinefelter’s syndrome
What are the characteristic lab findings in Klinefelter’s syndrome?
Increased: LH, FSH, oestrogen
Decreased: inhibin, testosterone
What genetic abnormalities are associated with Klinefelter’s syndrome?
XXY
Diagnose: female, short stature, ovarian dysgenesis (streak ovaries), shield chest, bicuspid aortic valve, webbed neck, coarctation of aorta, horshoe kidney, dysgerminonma, lymphedema
Turner syndrome
What are the characteristic lab findings in Turner syndrome?
Increased: LF, FSH
Decreased: estrogen
What are the characteristic histo-path findings of Turner syndrome?
No Barr bodies
What genetic abnormalities are associated with Turner syndrome?
XO
Diagnose: male, tall stature, severe acne, antisocial behavior
Double Y syndrome
What genetic abnormalities are associated with Double Y syndrome?
XYY
What is the etiology of female pseudo-hermaphroditism?
Excessive exposure to androgens during gestation
What are the characteristic signs and symptoms of female pseudo-hermaphroditism?
Ovaries present, external genitalia virilized or ambiguous
What are the characteristic signs and symptoms of male pseudo-hermaphroditism?
Testes present, external genitalia female or ambigious
What are the characteristic signs and symptoms of true hermaphroditism?
Both ovarian and testicular tissue present, ambiguous genitalia
What is the etiology of androgen insensitivity syndrome?
Defect in andogen receptor
Diagnose: female external genitalia, rudimentary vagina, internal testes, scant sexual hair
Androgen insensitivity syndrome
What are the characteristic lab findings in androgen insensitivity syndrome?
Increased: testosterone, LH, estrogen
What genetic abnormalities are associated with androgen insensitivity syndrome?
46, XY i.e. normal male
What are the characteristic lab findings in primary hypogonadism?
Increased: LH
Decreased: testosterone
What are the characteristic lab findings in hypogonadotropic hypogonadism?
Decreased: LH, testosterone
What are the characteristic lab findings in testosterone-secreting tumor?
Increased: testosterone
Decreased: LH
What are the characteristic lab findings in exogenous steroid use?
Increased: testosterone
Decreased: LH
What is the etiology of Kallmann syndrome?
Defective migration of GnRH cells
Diagnose: anosmia, lack of secondary sex characteristics
Kallmann syndrome
What are the characteristic lab findings in Kallmann syndrome?
Decreased: GnRH, FSH, LH, testosterone, sperm count
What is the etiology of complete hydatiform mole?
2 sperm + 1 empty egg
What is the pathogenesis of complete hydatiform mole?
Cystic swelling of chorionic villi and proliferation of chorionic epithelium
What are the characteristic signs and symptoms of complete hydatiform mole?
abnormal vaginal bleeding
What are the characteristic lab findings in complete hydatiform mole?
increased: β-hCG
What are the characteristic imaging findings in complete hydatiform mole?
Ultrasound: snowstorm uterus
What are the characteristic gross pathology findings of complete hydatiform mole?
Abnormally enlarged, honeycombed or cluster of grapes uterus
What are some possible complications of complete hydatiform mole?
Most common precursor of choriocarcinoma, uterine rupture
What is the treatment for complete hydatiform mole?
D&C, methotrexate
What is the etiology of partial hydatiform mole?
2 sperm + 1 egg
What is the pathogenesis of partial hydatiform mole?
Cystic swelling of chorionic villi and proliferation of chorionic epithelium
What are the characteristic signs and symptoms of partial hydatiform mole?
Abnormal vaginal bleeding
What are the characteristic lab findings in partial hydatiform mole?
Increased: β-hCG
What are the characteristic gross pathology findings of partial hydatiform mole?
“Honeycombed” or “cluster of grapes” uterus
What is the treatment for partial hydatiform mole?
D&C, methotrexate
What genetic abnormalities are associated with partial hydatiform mole?
69, XXX; 69, XXY; 69, XYY
What are some possible complications of partial hydatiform mole?
Most common precursor of choriocarcinoma, uterine rupture
What is the etiology of preeclampsia/eclampsia?
Placental ischemia secondary to high maternal vascular tone
Diagnose: gestational: headache, blurred vision, abdominal pain, edema, AMS, hyperreflexia, +/- seizures
Preeclampsia/eclampsia
What are the characteristic lab findings in preeclampsia/eclampsia?
Increased: hyperuricemia
Decreased: thrombocytopenia
What is the treatment for preeclampsia/eclampsia?
- Delivery ASAP
- Until then, bed rest, treatment of HTN
- IV magnesium sulfate to prevent/treat seizures
What are the risk factors for preeclampsia/eclampsia?
HTN, DM, renal disease, autoimmune disorders
What are some possible complications of preeclampsia/eclampsia?
HELLP syndrome
What is the etiology of HELLP syndrome?
Variant/complication of preeclampsia/eclampsia
What are the characteristic lab findings in HELLP syndrome?
Haemolysis
Increased: liver enzymes
Decreased: platelets
What are the characteristic signs and symptoms of abruptio placentae?
Painful bleeding in 3rd trimester
What is the prognosis for abruptio placentae?
Life-threatening for fetus and mother
What are the risk factors for abruptio placentae?
Smoking, HTN, cocaine
What are some possible complications of abruptio placentae?
DIC
What is the etiology of placenta accreta?
Placenta invades beyond decidua and attaches to myometrium
What are the characteristic signs and symptoms of placenta accreta?
Massive maternal bleeding at delivery
What are the risk factors for placenta accreta?
Prior C-section, prior placenta previa
What is the etiology of placenta previa?
Placenta attaches near or over internal cervical os
What are the characteristic signs and symptoms of placenta previa?
Painless vaginal bleeding during any trimester
What are the risk factors for placenta previa?
Multiparity, prior C-section
What are some possible complications of retained placental tissue?
Postpartum hemorrhage or infection
What is the etiology of ectopic pregnancy?
Zygote implants outside of uterus, usually fallopian tubes
Diagnose: sudden onset abdominal pain, amenorrhea
Ectopic pregnancy
What are the characteristic lab findings in ectopic pregnancy?
Decreased: hCG (compared to expected)
What are the characteristic imaging findings in ectopic pregnancy?
Ultrasound: visible mass
What are the characteristic histo-path findings of ectopic pregnancy?
Endometrium has decidua basalis but no chorionic villi
What are the risk factors for ectopic pregnancy?
PID, hx infertility, ruptured appendix, prior tubal surgery (scar)
What is the etiology of polyhydramnios?
Inability to swallow amniotic fluid
What are the risk factors for polyhydramnios?
Oesophageal or duodenal atresia, anencephaly
What is the physical defect in polyhydramnios?
>1.5 L amniotic fluid
What are the risk factors for oligohydramnios?
Placental insufficiency, bilateral renal agenesis, posterior urethral valve
What are some possible complications of oligohydramnios?
Potter’s sequence
What is the etiology of cervical dysplasia/squamous cell carcinoma?
HPV 16, 18
What are the characteristic histo-path findings of cervical dysplasia/squamous cell carcinoma?
Koilocytes (enlarged, hyperchromatic epithelial cells) on Pap smear.
(normal left, abnormal right)
What are some possible complications of cervical dysplasia/squamous cell carcinoma?
May progress to invasive carcinoma
What are the risk factors for cervical dysplasia/squamous cell carcinoma?
Multiple sexual partners, smoking, early age of first intercourse, HIV infection
What is the etiology of endometritis?
Retained tissue/foreign body in uterus
What is the pathogenesis of endometritis?
Infection and inflammation of endometrium
What is the treatment for endometritis?
Gentamycin + clindamycin +/- ampicillin
What is the etiology of endometriosis?
Retrograde menstrual flow
Diagnose: cyclic menstrual bleeding from non-uterine site, severe menstrual-related pain, painful intercourse, infertility
Endometriosis
What are the characteristic gross pathology findings of endometriosis?
Blood-filled “chocolate cysts”
What is the treatment for endometriosis?
OCP, NSAIDs, leuprolide, danazol
What are the characteristic imaging findings in endometriosis?
Uterus is normal sized
What is the etiology of adenomyosis?
Non-neoplastic endometrial tissue within myometrium
What are the characteristic signs and symptoms of adenomyosis?
Menorrhagia, dysmenorrhea, pelvic pain
What are the characteristic imaging findings in adenomyosis?
Uterus is enlarged
What is the treatment for adenomyosis?
Hysterectomy
What is the etiology of endometrial hyperplasia?
Usually excess estrogen stimulation
What are the risk factors for endometrial hyperplasia?
Anovulatory cycles, hormone replacement therapy, PCOS, granulosa cell tumor
What are some possible complications of endometrial hyperplasia?
Increased risk for endometrial carcinoma
What are the characteristic signs and symptoms of endometrial hyperplasia?
Postmenopausal vaginal bleeding
What are the characteristic signs and symptoms of endometrial carcinoma?
Postmenopausal vaginal bleeding
What are the risk factors for endometrial carcinoma?
Oestrogen without progestin, obesity, DM, HTN, nulliparity, late menopause
What populations are most at risk for endometrial carcinoma?
55-65 years
What are the characteristic signs and symptoms of leiomyoma (fibroid)?
Asymptomatic, abnormal uterine bleeding, miscarriage
What are the characteristic histo-path findings of leiomyoma (fibroid)?
Well-demarcated edges, whorled smooth muscle bundles
What populations are most at risk for leiomyoma (fibroid)?
20-40 years, black race
What is the prognosis for leiomyoma (fibroid)?
Good, does NOT progress to leiomyosarcoma
What are the characteristic histo-path findings of leiomyosarcoma?
Areas of necrosis and hemorrhage
What are the characteristic gross pathology findings of leiomyosarcoma?
Bulky, irregluar shape, may protrude from cervix