Pathoma: Gestational Pathology

Question 1

The most common site of ectopic pregnancy is ____________.

Answer 1

the fallopian tube

Question 2

What are risk factors for ectopic pregnancy?

Answer 2

Endometriosis, abdominal surgery, and PID

Question 3

The classic presentation of ectopic pregnancy is _____________.

Answer 3

lower-quadrant abdominal pain in a woman who’s missed a period

Question 4

Most spontaneous abortions are due to ______________.

Answer 4

chromosomal anomalies

Other causes are hypercoagulable states, infection, or toxin exposure.

Question 5

Typically, failure of organ development causes abortions between __________, while organ hypoplasia causes abortions after ___________.

Answer 5

week 3 and week 8; after the third month

Question 6

How is placenta previa treated?

Answer 6

Placenta previa usually indicates C-section. This is because the fetus will press on the placenta during labor and obstruct its own blood supply.

Question 7

What pathologic sign will you see in a patient with placental abruption?

Answer 7

Bleeding on the maternal surface of the placenta

Question 8

What is decidua?

Answer 8

Endometrium under the effects of progesterone

Question 9

Those with placenta accreta often require what treatment?

Answer 9

Hysterectomy because of uncontrollable bleeding

Question 10

What is the overall presentation of preeclampsia?

Answer 10

Edema, hypertension, and proteinuria in the third trimester

Question 11

Patients with _____________ may have fibrinoid necrosis in the vessels of the placenta.

Answer 11

preeclampsia

Question 12

What is eclampsia?

Answer 12

Preeclampsia with seizures

Question 13

Preeclampsia is thought to arise from ____________.

Answer 13

anomalies in the maternal-fetal vascular interface

Question 14

HELLP is an example of a _______________.

Answer 14

thrombotic microangiopathy

Question 15

What is HELLP?

Answer 15

Preeclampsia with Hemolysis, Elevated Liver enzymes, and Low Platelets

Question 16

Why do patients with HELLP get elevated liver transaminases?

Answer 16

The microangiopathic thrombosis occurs in the liver, which leads to ischemia.

Question 17

SIDS occurs during _______________.

Answer 17

one month to one year of age

Question 18

What are three risk factors for SIDS?

Answer 18

• Smoking
• Sleeping on stomach
• Prematurity

Question 19

What is the underlying idea of hydatidiform moles?

Answer 19

Instead of growing a baby you grow abnormal placental tissue.

Question 20

What happens to the uterus in hydatidiform moles?

Answer 20

It expands as if the woman is pregnant–actually bigger than normal.

Question 21

Histologically, the classic sign of hydatidiform moles is ________________.

Answer 21

edematous villi

Question 22

What lab suggests hydatidiform mole?

Answer 22

Elevated hCG

Question 23

Without prenatal care, what typically happens to hydatidiform moles?

Answer 23

During the second trimester, the woman will begin passing grape-like masses.

Question 24

The “snowstorm” appearance of hydatidiform moles appears on ______________.

Answer 24

ultrasound

Question 25

The risk of choriocarcinoma is greater in ___________ molar pregnancies.

Answer 25

complete

Question 26

Which type of molar pregnancy has more edematous villi?

Answer 26

Complete

“They’re COMPLETEly edematous.”

Question 27

In both types of molar pregnancy, there is proliferation of _______________.

Answer 27

the trophoblasts; in complete moles there is more proliferation, whereas in partial moles there is usually just proliferation on one side

Question 28

Fetal parts are present in ________________.

Answer 28

partial hydatidiform moles

Question 29

How are molar pregnancies treated?

Answer 29

D&C followed by monitoring of hCG levels (to ensure that all pieces were excised)

Question 30

What histologically defines choriocarcinoma?

Answer 30

Absence of villi –that is, only trophoblasts and syncytiotrophoblasts

Question 31

There are two paths to choriocarcinoma: gestational and germ cell. How are they clinically different?

Answer 31

Gestational choriocarcinomas typically respond to chemotherapy while germ cell ones do not.