B8-013 Histology/Immunology of Pregnancy

Question 1

a benign form of gestational trophoblast disease

nonviable fertilized ovum implants and develops a placenta-derived tumor

Answer 1

hydatidiform mole

Question 2

“snowstorm” on ultrasound

“clusters of grapes”

Answer 2

hydatidiform mole

Question 3

is a complete or partial hydatidiform mole more likely to progress to cancer?

Answer 3

complete

Question 4

usually results from duplication of the haploid genome of a single sperm
or
fertilization by 2 sperm occurring in an ovum that has lost maternal chromosomes

Answer 4

complete hydatidiform mole

Question 5

most commonly enucleated egg + single sperm that duplicates its DNA

Answer 5

complete hydatidiform mole

Question 6

usually results from fertilization of an apparently normal ovum by 2 sperm

Answer 6

partial hydatidiform mole

Question 7

is a complete or partial hydatidiform mole associated with a uterus larger than normal for gestational age?

Answer 7

complete

Question 8

is a complete or partial hydatidiform mole associated with extremely elevated hCG?

Answer 8

complete

Question 9

[complete or partial mole]
46 XX or 46 XY

Answer 9

complete

Question 10

[complete or partial mole]
69XXX, 69 XXY, 69 XYY

Answer 10

partial

Question 11

[complete or partial mole]
2 sperm + 1 normal egg

Answer 11

partial

Question 12

attachment of placenta over internal cervical os

Answer 12

placenta previa

Question 13

presents with painless vaginal bleeding in third trimester

Answer 13

placenta previa

Question 14

risk factors for abnormal positioning of the placenta [2]

Answer 14

prior endometrial damage
uterine scarring

Question 15

edge of placenta is less than 2 cm from internal os

Answer 15

low lying placenta

Question 16

edge of placenta is more than 2 cm from the internal os

Answer 16

normal

Question 17

can a patient have a vaginal delivery with a placenta previa?

Answer 17

no

Question 18

can a patient have a vaginal delivery with a low lying placenta?

Answer 18

yes typically

Question 19

placenta attaches too strongly or invades too deeply into the wall of the uterus

Answer 19

invasive placenta

Question 20

placenta attaches too strongly to the muscular layer of the uterine wall, but does not invade

Answer 20

placenta acreta

Question 21

placenta invades into myometrium

Answer 21

placenta increta

Question 22

placenta invades through the full thickness of the uterine wall and can attach to adjacent organs in the abdomen

Answer 22

placenta percreta

Question 23

presents with difficulty separating placenta from uterus after fetal delivery
severe postpartum hemorrhage on attempted removal

Answer 23

invasive placenta spectrum

Question 24

first immunologic phase is a […] state

Answer 24

pro-inflammatory

(vascular remodeling, cellular invasion, tissue repair: contributes to morning sickness)

Question 25

second immunologic phase is a [...] state

Answer 25

anti-inflammatory (rapid fetal growth and development)

Question 26

third immunologic phase is a [...] state

Answer 26

inflammatory (immune cells move into myometrium, uterine contractions, delivery)

Question 27

[...] cells are characterized with poor cytotoxic function in a healthy pregnancy

Answer 27

uterine NKs | tamps down immune response to "non-self" tissue

Question 28

markers of uNKs

Answer 28

CD56 CD16

Question 29

characterized by deficient remodeling of the spiral arteries

Answer 29

preeclampsia

Question 30

cells that remove dying trophoblast play a key role in preventing release of paternal antigens, limiting maternal immune response

Answer 30

macrophages

Question 31

[...] cells maintain self tolerance

Answer 31

T-regulatory cells

Question 32

pro-inflammatory T cells that protect from microbes

Answer 32

Th 17

Question 33

infection can impact the balance of proinflammatory and anti-inflammatory cell types causing [...] in the first trimester, or [...] in the third trimester

Answer 33

infection can impact the balance of proinflammatory and anti-inflammatory cell types causing [miscarriage] in the first trimester, or [preterm labor] in the third trimester

Question 34

recurrent pregnancy loss is [...] or more consecutive, spontaneous pregnancy losses

Answer 34

3

Question 35

treatment for anti-phospholipid syndrome

Answer 35

lovenox low dose aspirin

Question 36

laboratory findings of lupus anticoagulant, anticardiolipin, anti-B2 glycoprotein 1

Answer 36

anti-phospholipid syndrome

Question 37

patients with pre-existing [...] tend to have worse symptoms during pregnancy and are at a high risk of preeclampsia

Answer 37

lupus

Question 38

previous [...] is a risk factor for placenta previa

Answer 38

cesarean delivery (and AMA)

Question 39

painless vaginal bleeding in the third trimester

Answer 39

placenta previa

Question 40

antiphospholipid syndrome is associated with repeat

Answer 40

miscarriages

Question 41

vaginal bleeding, back pain, contractions

Answer 41

placental abruption

Question 42

maintains luteal progesterone production until placental progesterone production is initiated

Answer 42

hCG

Question 43

elevated bp in late pregnancy proteinuria headache

Answer 43

preeclampsia

Question 44

excessive [...] cell invasion causes placenta accreta

Answer 44

trophoblast

Question 45

usually asymptomatic if not found early in pregnancy via US, it is found at delivery

Answer 45

placenta accreta

Question 46

elevated hCG no fetal tissue vaginal bleeding

Answer 46

molar pregnancy

Question 47

placenta with grape-like cystic structures

Answer 47

molar pregnancy

Question 48

excessive trophoblast invasion through the uterine wall

Answer 48

placenta percreta

Question 49

in IVF, the blastocyst must be transplanted back to the uterus during a receptive window of the [...] phase

Answer 49

secretory

Question 50

spiral arteries are remodeled by [...] after implantation

Answer 50

trophoblasts

Question 51

implantation occurs during the [...] phase

Answer 51

secretory

Question 52

peak estradiol secretion occurs during the [...] phase

Answer 52

proliferative