Perinatal Pathology Flashcards
- disorders related to short gestation and low birth weight
- SIDS
- respiratory distress
- bacterial sepsis
causes of death under 1 yr of age
- accidents
- congenital malformations
- malignant neoplasms
- homicide
- diseases of heart
- influenze, pneumonia
causes of death, 1-4 years of age
- preterm, premature rupture of membranes prior to 37 WGA
- intrauterine infection
- structural abnormalieis of uterus, placenta
- multiple gestations
causes of prematurity and growth restriction
- chromosomal abnormalities
- congenital anomalies (Potter sequence)
- TORCH infections
fetal causes of prematurity and growth restriction
- cord abnormalities
- placental infarction, abruption
placental causes of prematurity
- leading cause of resp distress in newborns, now decreased because of artificial surfactant
- exofurg, infasurf, survanta
- increased alveolar surface tension, atelectasis, hypoxemia and CO2 retention
- acidosis, endothelial and epithelial damage
- hyaline membranes
neonatal respiratory distress syndrome
- complication of treatment of hyaline membrane disease
- squamous metaplasia, peribrochial and interstitial fibrosis, decrease in alveolar septation
bronchopulmonary dysplasia
- feeding intolerance, abdominal distention and blood stools after 8-10 days of age
- pneumatosis intestinalis, portal venous gas
necrotizing enterocolitis
- peaks at 2-4 months of age
- male predominance
- occurs during sleep period, Japan lowest and New Zealand highest
- rates in native americans and African americans are 2-7X higher
- history of mild upper respiratory tract infections, presumably viral
SIDS
- petechial hemorrhages most consistent finding, but they are agonal events
- triple risk model: underlying vulnerability, critical development period, extrinsic risks (smoking, sleeping prone, mild infection)
SIDS
-toxoplasma, rubella, CMV, herpes simplex, syphilis and HIV
TORCH infections
- due to group B strep, positive cultures an indication for C section
- more than one organism consered child abuse, Muchausen by proxy
perinatal sepsis
- mesencyhmal derivation
- often have primitive histo appearance
- abnormal embryogenesis common
- spontaneous regression and cytodifferentiation common
- familial or genetic pattern
pediatric tumors
- most common tumor of infancy
- derived from blood vesels
- skin- face, scalp
- spontaneous regression
- associated with VHL syndrome
hemangiomas
- mature, immature, malignant
- derived from pluripotent germ cells
- females > males
- sacrococcygeal the most common
- risk of malignant transformation is increased after 2 months of age
teratomas
- most common childhood cancer
- derived from immature white blood cells
- rapid onset
- anemia, bleeding, fever, weight loss
leukemia
-second most common cancer in children
-cell of origin variable, glial
-most involve cerebellum or brainstem
-increased intracranial pressure, headache, nausea, vomiting, blurred vision, dizzy
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central nervous system cancers
- derived from neuroectoderm
- 20% of brain tumors in children
- 17p deletion
medulloblastoma
- most common extracranial solid tumor of childhood
- neural crest origin
- parasympathetic ganglia or adrenal medulla
- large abdominal mass
- Homer wright pseudorosettes
- regress or cytodifferentiate
- skin papules
- N-myc, 17q, prognostic factors
neuroblastoma
- most common renal tumor in children
- derived from pluripotent embryonal renal cells
- presents w/ abdominal flank mass, pain, fever
- risk increased with WAGR and Denys drash syndrome, Beckwith Wiedemann, loss of imprinting
Wilms tumor
- germline deletion of 11p13
- aniridia, genital anomalies, mental retardation
WAGR syndrome
- dominant negative missense mutation of WT1
- gonadal dysgenesis, nephorpathy
Denys Drash syndrome
- malignant tumor of one or both eyes, derived from retinal cells
- occurs in children under the age of 4
- inherited mutation on chromosome 13
- prognosis excellent if no spread
retinoblastoma
- dervied from white blood cells
- risks: age, gender, family history, past EBV infection, immunosuppression
- Reed Sternberg cells
Hodgkin’s disease
- most common soft tissue sarcoma in children
- derived from embryonic skeletal muscle cells (Rhabdomyoblasts)
- head and neck, groin, abdomen, pelvis, arms, legs
- stain positive for muscle intermediate filament markers (desmin, myogenin)
rhabdomyosarcoma
bone and soft tissue sarcomas, CNS tumors, thyroid carcinomas, leukemias, lymphomas, have risk for?
secondary malignant neoplasms
