W01_08 Pediatric Pathology

Question 1

define developmental age

Answer 1

age from date of fertilization to intrauterine death or live birth

Question 2

define gestational age

Answer 2

age from first day of mother’s last menstrual period to expulsion/removal of conceptus

Question 3

if the baby dies in utero at 19 weeks, but the mother delivers stillbirth at 37 weeks, what’s the developmental age? gestational age?

Answer 3

developmental age: 19 weeks.

gestational age: 37 weeks

Question 4

define embryonal period

Answer 4

period of organ development

0-8 weeks

Question 5

define fetal period

Answer 5

9 weeks to birth

Question 6

define perinatal period

Answer 6

from 28 wks (GA) to 1 week post partum

Question 7

define spontaneous abortion

Answer 7

loss of conception prior to the period of viability

Question 8

define stillbirth

Answer 8

late fetal death before COMPLETE expulsion or removal of the fetus from the mother

Question 9

what are legal definitions of stillbirths?

Answer 9

fetus > 20 weeks (GA) or fetus > 500g;

no sign of life in the delivered fetus

Question 10

define maceration

Answer 10

softening and degenerative changes in the fetus, as a result of death of the fetus and retention in utero

Question 11

what’s the biggest cause of spontaneous abortion?

Answer 11

chromosomal abnormalities (accounts for 50%)

Question 12

what’s the second biggest cause of spontaneous abortion?

Answer 12

luteal phase deficiency.
note that progesterone usually primes the endometrium for implantation. so when the corpus luteum doesn’t produce enough, it’s a spontaneous abortion

Question 13

ectopic pregnancies usually implant where?

Answer 13

fallopian tube (90%)

Question 14

what are two predisposing conditions to ectopic pregnancies?

Answer 14

PID,
IUD usage (linked to PID)

Question 15

what are some maternal illnesses that contribute to greater risk of sponatenous abortion?

Answer 15

diabetes mellitus;
systemic lupus erythematosus;
antiphospholipid antibody syndrome;
materna hypertension;
alcohol/cocaine abuse

Question 16

what issues of the placenta can cause spontaneous abortion?

Answer 16

chorioamnionitis;
villus of unknown etiology;
decidual vasculopathy;
placental abruption;
multiple placental infarcts

Question 17

note: canadian rates of stillbirth is 4.5/1000

Answer 17

ok

Question 18

note: intrauterine asphyxia makes up a large part of stillbirth issues. what are signs of this?

Answer 18

thoracic petechiae, visceral congestion, hypoxic-ischemia injury, meconium discharge

Question 19

hypoxic-ischemic encephalopathy (HIE) is seen as a result of what?

Answer 19

intrauterine asphyxiation

Question 20

what’s eclampsia?

Answer 20

a disorder of a pregnant woman involving high blood pressure, neuro signs (coma, seizures)

Question 21

what’s HELLP syndrome?

Answer 21

Hemolysis;
Elevated Liver enzymes;
Low Platelets

Question 22

what are some maternal associations with toxemia?

Answer 22

maternal age < 20;
elderly primigravida;
multigravida;
hypertension;
smoking > 3 cigs/day;
poor pregnancy weight gain

Question 23

what are clinical symptoms of placental abruption?

Answer 23

uterine contractions;
abdominal and uterine pain;
vaginal hemorrhage

Question 24

note: cord prolapse can cause hypoxia if it’s squeezed off during birth

Answer 24

ok

Question 25

what’s the most dangerous type of twin placenta?

Answer 25

monochorionic twin placentae, as this can allow shared circulation - twin-twin transfusion;
note in monoamniotic placenta, there can be cord entanglement

Question 26

what’s the kleihauer-betke test?

Answer 26

estimate the volume of hemoglobin F in the mother. fetal death can occur if volume is 20-50% of the infant volume

Question 27

what are two major routes of intrauterine infection?

Answer 27

maternal hematogenous,
ascending amniotic;
also: direct from endometrium, ascending decidual, iatrogenic

Question 28

what bacteria can cause acute chorioamnionitis?

Answer 28

normal vaginal flora,
chlamydia,
ureaplasma urealyticum,
mycoplasma hominis,
gardnerella vaginalis

Question 29

note: blood borne infection can cause chronic villitus in the placenta

Answer 29

ok

Question 30

what are the TORCH organisms

Answer 30

toxoplasmosis,
other (syphillis),
rubella,
cytomegalovirus,
herpes simplex 2

Question 31

which trimester poses the greatest risk of congenital rubella?

Answer 31

1st;

can cause: growth restriction, microcephaly, deafness, cataracts, CHD

Question 32

what’s fetal hydrops?

Answer 32

accumulation of extravascular fluid due to a variety of etiologies