diseases of pregnancy

Question 1

defiition of toxemia

Answer 1

pre-eclampsia (HTN and proteinuria and edema)

eclampsia (more severe, convulsions, DIC with organic lesions)

Question 2

etiology of toxemia

Answer 2

placental ischemia, abnormal placentation

Question 3

clinical presentation of toxemia

Answer 3

primiparas, last trimester

Question 4

therapy for toxemia

Answer 4

bedrest, anti-HTN, induction of labor

Question 5

most common site of an ectopic pregnancy

Answer 5

fallopian tubes - 90%

Question 6

predisposing factors for ectopic pregnancy

Answer 6

PID in 35-50%

Question 7

outcomes of ectopic

Answer 7

hemorrhage, rupture, spontaneous regression

Question 8

detection of ectopic

Answer 8

severe ab pain, hCG assay, ultrasound, laparscopy, endometrial biopsy (should lack chorionic villi)

Question 9

what are the three forms of hydatidiform moles?

Answer 9

complete, partial and invasive

Question 10

what are the clinical features of a complete h mole?

Answer 10

bleeding, uterus large for dates, hCG markedly elevated, vesicles on US

Question 11

gross features of complete h mole?

Answer 11

mass of grape like clusters

Question 12

mircoscopic features of complete h mole?

Answer 12

all villi show hydropic welling with trophoblastic proliferation

Question 13

cytogenetics of complete h mole

Answer 13

46XX or XY, empty egg fertilized by 1 or 2 sperm

Question 14

prognosis with curettage or complete h mole

Answer 14

10% develop invasive, 2.5% develop choriocarcinoma

Question 15

clinical features of a partial h mole

Answer 15

uterus not enlarged; hCG less elevated,

Question 16

gross features of a partial h mole

Answer 16

clinical dx is usually a missed abortion or spontaneous; may have fetal parts

Question 17

micro features of partial h mole

Answer 17

some villi enlarged, with focal trophoblastic proliferation

Question 18

cytogenetics

Answer 18

triploid, egg fertilized by two haploid or one diploid sperm

Question 19

prognosis of partial h mole with curettage

Answer 19

rarely progresses to choriocarcinoma

Question 20

definition of an invasive mole?

Answer 20

a mole which penetrates or perforates the uterine wall

Question 21

placental site trophoblastic tumor definition

Answer 21

rare malignant tumor of intermediate trophoblasts which invades the endomyometrium

Question 22

choriocarcrinoma precursor lesions

Answer 22

H mole 50%
abortion 25%
normal pregnancy 22%
ectopic pregnany <3%

Question 23

micro features of choriocarcinoma

Answer 23

malignant synctial and cytotrophoblasts (no villi), hemorrhagic

Question 24

spread of choriocarcinoma

Answer 24

direct spread, hemaatogenous mets which can be complicated by hemorrhages

Question 25

treatment

Answer 25

surgery and chemo

Question 26

prognosis

Answer 26

approaches 100%