Female Genital System Flashcards
(269 cards)
1
Q
germ cells become what in females
A
ovarian stroma/epithelium
2
Q
mullerian ducts become what in females
A
tubes
uterus
cervix
upper vagina
3
Q
urogenital sinus becomes what in females
A
lower vagina
external genitalia
4
Q
mesonephric ducts become what in females
A
they actually regress into nothing
5
Q
what is the round ligament
A
rope-like connective tissue that holds the uterus in place
6
Q
what is the broad ligament
A
broad sheet of connective tissue that holds the uterus in place
7
Q
what is the anterior cul-de-sac
A
space between the bladder and uterus
8
Q
what is the posterior cul-de-sac
A
space between the uterus and rectum
9
Q
which two infections cause cause infertility
A
chlamydia and neisseria gonorrhoeae
10
Q
what are the two infections of pre-term labor
A
ureaplasma urealyticum and mycoplasma hominis
11
Q
which three infections commonly cause discomfort of the reproductive tract
A
candida (yeast)
trichomonas (parasite)
gardnerella
12
Q
HSV most commonly affects which of the female reproductive organs
A
cervix (most common)
vagina
vulva (least common)
13
Q
HSV-1 most commonly causes which type of infection
A
oropharyngeal infection
14
Q
HSV-2 most commonly causes which type of infection
A
genital mucosa and skin
15
Q
what is the most common period of transmission of HSV
A
during the acute infection
16
Q
where does HSV establish a latent infection
A
regional lumbosacral nerve ganglia
17
Q
which two antiviral agents can shorten the length of HSV
A
acyclovir and famciclovir
18
Q
where is molluscum contagiosum most common
A
genital area
19
Q
what causes molluscum contagiosum
A
poxvirus
20
Q
which type of molluscum contagiosum is most prevelant
A
MCV-1
21
Q
which type of molluscum contagiosum is most often sexually transmitted
A
MCV-2
22
Q
who is most affected by molluscum contagiosum
A
young children between 2 and 12
23
Q
what is the main microscopic feature of molluscum contagiosum
A
handerson-patterson bodies
24
Q
in which condition would you see handerson-patterson bodies
A
molluscum contagiosum
25
which four conditions are associated with fungal infections of the female genital tract
diabetes mellitus
antibiotics
pregnancy
being immunocompromised
26
what is trichomonas vaginalis
large, flagellated ovoid protozoan that causes infection within 4 days to 4 weeks following sexual contact
27
what are four common symptoms of a trichomonas vaginalis infection
yellow, frothy discharge
discomfort
dysuria
dyspareunia
28
what is the characteristic appearance of the cervix in a trichomonas vaginalis infection
firey-red strawberry cervix
29
which three conditions cause cervicitis
gardnerella vaginalis
ureaplasma/mycoplasma
chlamydia trachomatis
30
what is pelvic inflammatory disease (PID)
inflammation that starts in the vulva and spreads upwards causing pain, fever, and discharge
31
which three organisms can cause pelvic inflammatory disease (PID)
neisseria gonorrhoeae
chlamydia
infections spread through lymphatics after delivery (ex. strep/staph)
32
what is the pelvic inflammatory disease (PID) sequela
acute infective stage:
-acute suppurative salpingitis
-salpingo-oophoritis
-tubo-ovarian abscesses
-pyosalpinx
chronic non-infective stage:
hydrosalpinx - infertility
33
what is seen microscopically in acute salpingitis from PID
dilated tube lumen with swelling and puss
34
what is seen microscopically in chronic salpingitis from PID
scarring and glandlike spaces
35
what are 5 acute complications of pelvic inflammatory disorder (PID)
ectopic pregnancy
pelvic pain
endocarditis
meningitis
intestinal obstruction
36
what are 5 chronic complications of pelvic inflammatory disorder (PID)
infertility
tubal obstruction
ectopic pregnancy
pelvic pain
intestinal obstruction
37
what important gland do you find in the vulva
bartholin's gland
38
what is the labia majora lined by
keratinized stratified squamous epithelium
39
what is a bartholin cyst
benign infection of the vulva caused by obstruction of the duct by an inflammatory process
40
how is a bartholin cyst treated
marsupialization (opened permanently) or excised
41
what is lichen sclerosus of the vulva
smooth white plaques or macules that produce a porcelain/parchment/cigarette paper surface of the vulva
42
what are three microscopic features of lichen sclerosus of the vulva
thinning of the epidermis
degeneration of basal epithelial cells
hyperkeratosis
43
what is squamous cell hyperplasia of the vulva
condition caused from rubbing or scratching of the skin
presents as leukoplakia
benign - not premalignant
44
what are two microscopic features of squamous cell hyperplasia of the vuvla
acanthosis and hyperkeratosis
45
what is condyloma acuminatum
papillomavirus induced, sexually transmitted genital wart
caused by HPV strains 6+11
benign
46
what are the four main types of benign exophytic vulva lesions
condyloma acuminatum
syphillitic condyloma latum
fibroepithelial polyps
vulvar squamous papillomas
47
what is a vulvar squamous papilloma
exophytic proliferation covered by nonkeratinized squamous epithelium
has an unknown etiology
48
what are the two main microscopic features of condyloma acuminatum
koilocytosis and perinuclear halos
49
who is mosted affect by vulvar intraepithelial neoplasia and vulvar carcinoma
women 60 and older
50
what is another name for vulvar intraepithelial neoplasia
bowens disease
51
the risk of vulvar intraepithelial neoplasia becoming cancerous is dependent on which two things
duration/extent of disease
immune status of the patient
52
what are the two groups of vulvar squamous cell carcinoma
basaloid and warty carcinoma
keratinizing squamous cell carcinoma
53
what are some features of vulvular basaloid and warty carcinomas
a less common type of vulvular squamous cell carcinoma
30% are HPV 16 related
mostly younger patients
considered vulvar intraepithelial neoplasia
54
what are some features of vulvular keratinizing squamous cell carcinoma
a more common type of squamous cell carcinoma
70% not HPV related
most common in older patients
55
once invasive vulvar squamous cell carcinoma develops, the risk of metastatic spread is linked to which three things
size of tumor
depth of invasion
involvement of lymphatic vessels
56
which size vulvar squamous cell carcinoma has the best prognosis
under 2 cm
57
what are the two types of vuvlar glandular neoplastic lesions
papillary hidradenoma
extramammary Paget disease
58
what is papillary hidradenoma
a type of vulvar glandular neoplastic lesion
mostly found on labia majora or interlabial folds
ulcerates
59
what is extramammary Paget disease of the vulva
a type of vulvar glandular neoplastic lesion
red, crusted map-like area usually on labia majora
not associated with underlying cancer
confined to epidermis
60
what is looked for to highlight the intraepidermal Paget cells in extramammary Paget disease
cytokertain 7
61
what is the most serious lesion of the vagina
squamous cell carcinoma
62
how can you tell the anterior aspect of the uterus from the posterior
anterior aspect: serosa does not extent as far and rounds off
posterior aspect: serosa extends farther down
63
what is an arcuate uterus
Müllerian duct anomaly where the uterus has a normal/very mildly abnormal septum shape
angle greater than 90 degrees
64
what is a septate uterus
deformity of the uterus where the septum divides the inner portion of the uterus
65
what is a bicornuate uterus
indentation in the fundus that's greater than 1 cm
caused by a non-fusion of Müllerian ducts
66
what differentiates a complete vs partial bicornuate uterus
partial: septum is confined to fundus region
complete: septum extends past fundus region
67
what is a didelphus uterus
Müllerian ducts don't fuse which leads to a double uterus with two cervices
68
what is a unicornuate uterus
small uterus with only one functioning fallopian tube
69
what is the most common type of unicornuate uterus
type B: no horn
70
what is vaginal adenosis
small patches of residual glandular epithelium in the vagina that may persist into adult life
71
what are Gartner duct cysts
cysts from wolffian (mesonephric) ducts on the lateral walls of the vagina
72
what are the three main types of benign tumors of the vagina
stromal tumors/polyps
leiomyomas
hemangiomas
73
what is the most common malignant tumor of the vagina
carcinoma from the cervix
74
what is vaginal embryonal rhabdomyosarcoma (sarcoma botryoides)
malignant vaginal tumor
appears as grape-like clusters
75
what are vaginal intraepithelial neoplasia and squamous cell carcinoma associated with
high-risk HPV infections
76
what is the greatest risk factor for vaginal intraepithelial neoplasia and squamous cell carcinoma of the vagina
previous carcinoma of the cervix or vulva
77
what is the most important thing for staging vaginal cancer
size and invasion through wall
78
lesions in the upper vagina tend to spread to which nodes
regional iliac nodes
79
lesions in the lower two thirds of the vagina tend to spread to which nodes
inguinal nodes
80
what is the junction between the cervix and cervical os called
squamocolumnar junction - moves upwards with time
81
what is squamous metaplasia of the cervix
replacement of glandular epithelium by advancing squamous epithelium
82
what is the transformation zone
area of cervix where the columnar epithelium abuts the squamous epithelium
83
estrogen produced by the ovary after puberty stimulates which two things
maturation of the cervical and vaginal squamous mucosa and formation of intracellular glycogen vacuoles in the squamous cells
84
why is glycogen important to vaginal cells
provides a substrate for vaginal aerobes and anaerobes
85
why are lactobacilli important
produce lactic acid to maintain a vaginal pH below 4.5
86
what is the normal cervical pH level
4.5 (slightly acidic)
87
what is an endocervical polyp
benign, exophytic growth within the endocervical canal
can cause spotting
88
what is the third most common cancer in women worldwide
cervical carcinoma - more than half are fatal
89
what is the most important factor in the development of cervical cancer
high-risk HPVs
90
which strain of HPV accounts for almost 60% of cervical cancer cases
HPV-16
91
which strain of HPV accounts for 10% of cervical cancer cases
HPV-18
92
which viral protein interferes with the tumor suppressor protein p53 and can contribute to cervical cancer
E6
93
which viral protein interferes with the tumor suppressor protein RB and can contribute to cervical cancer
E7
94
what is a low grade squamous intraepithelial lesion (LSIL) of the cervix
lesions of the cervix associated with HPV infection
most regress and do not progress to high grade (not premalignant)
95
LGSIL and HGSIL language is used for what
Pap smears
96
what is a high grade squamous intraepithelial lesion (HSIL) of the cervix
lesion that is caused by an HPV infection and it's ability to disregulate the normal cell cycle leading to things like increased cell proliferation
high risk for carcinoma
97
low grade squamous intraepithelial lesions are how many times more common than high grade
10 times more common
98
CIN (cervical intraepithelial neoplasia) language is used for what
describing results of a tissue biopsy (pathology/histo)
99
what is the proliferation marker looked for in squamous intraepithelial lesions
Ki-67
100
which cyclin-dependent kinase inhibitor characterizes high-risk HPV infections
p16
101
what is the average age for cervical carcinoma
45
102
what is the most common histological subtype of cervical carcinoma
squamous cell carcinoma
103
what is the second most common histological subtype of cervical carcinoma
adenocarcinoma
104
how does cervical carcinoma spread
by direct extension in:
-paracervical soft tissue
-bladder
-ureters
-rectum
-vagina
105
how can cervical cancer be prevented
HPV vaccines for young girls and boys up to 26
106
what are the two major components of the uterus
endometrium (glands in a stroma)
myometrium (smooth muscle)
107
what is the luteal phase
between ovulation and period (12-16 days)
108
how does the body prepare for ovulation
FSH stimulates the production of mature eggs
those mature eggs produce estrogen to thicken the endometrium and create fertile-cervical mucous
109
what is ovulation
rising estrogen and LH levels
LH causes follicle to rupture and release egg
typically day 14
110
what happens after ovulation
egg lives for 24 hours, sperm 3-4 days
progesterone produces more endometrial lining
follicle eventually shrinks and so does the lining
111
what rises when pregnancy occurs
HCG
112
which four things can cause dysfunctional uterine bleeding
endometriosis
polyps
leiomyomas
neoplasm
113
what is the most frequent cause of dysfunctional bleeding
anovulation (failure to ovulate)
114
what is anovulation
failure to ovulate
usually caused by hormonal imbalances (estrogen unopposed by progesterone)
115
when is anovulation most common
menarche (start of period) and perimenopausal period
116
anovulation is less commonly associated with which three things
endocrine disorders
ovarian lesions
metabolic disturbances
117
what is inadequate luteal phase
infertility associated with increased bleeding or amenorrhea
usually due to lack of progesterone production
118
which two organisms can cause acute endometritis
hemolytic strep and staph
119
what is the usual cause of acute endometritis
bacterial infections that arise after delivery or miscarriage
limited to stroma
120
how is acute endometritis treated
curettage and antibiotic therapy
121
chronic endometritis is associated with which four conditions
chronic pelvic inflammatory disease
retained gestational tissue
IUDs
tuberculosis
122
which plasma cells are seen in chronic endometritis cases
CD138 plasma cells
123
define endometriosis
ectopic endometrial tissue (glands and stroma) at a site outside of the uterus
124
what is the most common site for endometriosis
ovaries
125
what is the second and third most common sites for endometriosis
uterine ligaments and rectovaginal septum respectively
126
endometriosis mostly affects women of which age range
30-40 years of age
127
what are the four theories of endometriosis
1.) backwards flow of endometrium through tubes
2.) benign metastasis
3.) metaplasia of mesothelium
4.) stem cells become endometrial cells
128
what is the most common symptom of endometriosis
pelvic pain
129
endometriosis increases your risk for which two types of ovarian cancer by 3x
endometroid and clear cell ovarian cancers
130
what three main things does endometriosis cause
bleeding
fibrous adhesions
cystic ovaries (chocolate cysts)
131
what is adenomyosis
presence of endometrial tissue within the myometrium
132
what are 4 symptoms of adenomyosis
menometrorrhagia (irregular and heavy periods)
colicky dysmenorrhea (period pain)
pelvic pain
dyspareunia
133
what does adenomyosis look like grossly
nodularity
blood filled cysts
134
what are 3 conditions associated with endometrial hyperplasia
obesity
menopause
polycystic ovarian syndrome
135
what were the previous four categories of endometrial hyperplasia
simple w/o atypia
complex w/o atypia
simple atypical
complex atypical
136
what are the two current categories of endometrial hyperplasia
non-atypical
atypical (endometrial intraepithelial neoplasia)
137
23-48% of women with atypical endometrial hyperplasia are found to have what
carcinoma
138
which gene is mutated in 20% of endometrial hyperplasia cases
PTEN tumor supressor gene
139
what is the most common invasive cancer of the female genital tract
endometrial carcinoma - specifically endometrial adenocarcinoma
140
what is the most common type of endometrial carcinoma
type 1 (endometroid) carcinoma
141
what is type 1 (endometroid) carcinoma
well differentiated
mimic proliferative endometrial glands
arise from endometrial hyperplasia
142
type 1 (endometroid) carcinoma is associated with which 5 conditions
obesity
diabetes
hypertension
infertility
unopposed estrogen stimulation
143
which mutation is most commonly found in endometroid carcinomas
PTEN tumor supressor gene
144
how does a type 1 (endometroid) carcinoma spread
myometrial invasion followed by direct extension into things like the broad ligaments
145
what is the most important factor for staging malignant endometrial tumors
invasion, not size
145
which group establishes GYN malignancy staging
FIGO - International Federation of Gynecology and Obstetrics
146
what should you do with a malignant endometrial tumor
fix before you cut
tumors are very friable and you don't want to accidentally upstage the patient
147
what are the three main types of type 2 endometrial carcinoma
serous
clear cell
malignant mixed mullerian tumor
148
what is the age range for type 2 endometrial carcinoma
65-75 years of age
149
what is type 2 endometrial carcinoma
two main varients: serous and clear cell
arise in atropic uteri
poorly differentiated
fast growing
150
what is the most common type of type 2 endometrial carcinoma
serous carcinoma
151
which gene mutation is most common in serous (type 2) endometrial carcinoma
TP53
152
what is the treatment for endometrial carcinoma
surgery and radiation - good prognosis
153
what are endometrial malignant mixed mullerian tumors (MMMTs)
endometrial adenocarcinoma with malignant mesenchymal component
bulky and polypoid
154
what's another name for a malignant mixed mullerian tumor
carcinosarcoma
155
what are the four types of endothelial malignant mixed mullerian tumors (carcinosarcomas)
stromal sarcoma
leiomyosarcoma
rhabdomyosarcoma
chondrosarcoma
156
which three types of gene mutations are seen in malignant mixed mullerian tumors
PTEN
TP53
PIK3CA
157
what are the microscopic features of an endometrial malignant mixed mullerian tumor
malignant mesenchymal stroma in a biphasic pattern
158
who is most affected by malignant mixed mullerian tumors
postmenopausal women
159
what is an endometrial adenosarcoma
malignant endometrial polypoid growth
estrogen sensitive
affects 40-50 year olds
160
adenosarcomas mostly affect which age range of women
40-50 years of age
161
what are the two types of pure stroma neoplasms of the endometrium
benign stromal nodules
endometrial stromal sarcomas
162
endometerial stromal sarcomas are associated with which type of mutations
chromosomal translocations
163
which GYN condition would you see "worm-like plugs"
endometrial stromal sarcoma - caused by myometrial veins
164
what is the most common tumor in women
uterine leiomyoma
165
uterine leiomyomas are most commonly found in which layer of the uterus
myometrium
166
what are the three types of neoplastic disorders of the ovary
mullerian epithelium neoplasms
germ cell neoplasms
sex cord-stromal neoplasms
167
which gene mutation is unique to uterine smooth muscle tumors
MED12
168
what is the peak age range for a leiomyosarcoma
40 to 60 years of age
169
myometrial leiomyosarcomas metastasize most commonly to which four locations
lungs
bone
brain
abdominal cavity
170
how are leiomyosarcomas differentiated from leiomyomas
nuclear atypia
mitotic index
tumor necrosis
171
how are leiomyosarcomas staged
size and invasion
172
how are endometrial carcinomas staged
myometrial invasion/extension
173
suppurative salpingitis is most commonly caused by which two organisms
gonococcus or chlamydia
174
what are hydatids of Morgagni
paratubal cysts found at the fimbriated end or in the broad ligaments
175
what is an adenomatoid tumor (mesothelioma) of the fallopian tube
benign, subserosal nodules on the fallopian tube or in the mesosalpinx
176
how are fallopian tube tumors staged
T1 - tumor limited to fallopian tube
T2 - tumor involved one or both tubes with pelvic extension
177
where do ovarian cysts originate from
unruptured graafian follicles that have ruptured and immediately sealed
178
which type of ovarian cyst is present in the normal ovaries of women in reproductive age
luteal cysts (corpora lutea)
179
what is the other name for polycystic ovarian syndrome (PCOS)
stein leventhal syndrome
180
PCOS is associated with which three conditions
obesity
type 2 diabetes
premature atherosclerosis
181
women with PCOS are at a higher risk for which two conditions
endometrial hyperplasia and carcinoma
182
what is stromal hyperthecosis
disorder of ovarian stroma most often seen in postmenopausal women
bilateral, uniform enlargement of the ovary with a white-tan appearance
183
PCOS can often overlap with which condition
stromal hyperthecosis
184
what is theca lutein hyperplasia of pregnancy
condition where theca cells proliferate in the ovary during pregnancy
185
benign ovarian tumors mostly affect which age range of women
20-45 years of age
186
malignant ovarian tumors mostly affect which age range of women
45-65 years of age
187
ovarian tumors typically arise from which three ovarian components
surface/fallopian tube epithelium
germ cells
stromal cells
188
what is the most common type of ovarian cancer
serous cyst adenocarcinoma
189
which two things increase your risk for ovarian cancer
nulliparity (no children)
family history (BRCA1 and 2 mutations)
190
most primary ovarian neoplasms arise from what
mullerian epithelium
191
what are the three major histologic types of epithelial ovarian tumors
serous
mucinous
endometrioid
192
what are the three types of epithelial proliferation classifications of epithelial ovarian tumors
benign
borderline
malignant
193
what is a type 1 epithelial ovarian tumor
low-grade tumor that arise in association with borderline tumors or endometriosis
194
what is a type 2 epithelial ovarian tumor
high-grade serous carcinoma that arises from serous intraepithelial carcinoma
195
what is the most common malignancy of the ovary
serous tumor
196
what does a borderline serous epithelial ovarian tumor look like
increased number of papillary projections
197
what is the gross appearance of a malignant serous epithelial ovarian tumor
larger areas of solid or papillary tumor mass, irregularly, and nodularity of the capsule
198
the vast majority of mucinous epithelial ovarian tumors are which types
benign or borderline
199
mucinous epithelial ovarian tumors often have which gene mutation
KRAS
200
what differentiates a mucinous epithelial ovarian tumor from a serous epithelial ovarian tumor
rare surface involvement
unilateral
larger cystic masses
201
what is ovarian pseudomyxoma peritonei
type of mucinous ovarian cancer
characterized by: mucinous ascites, cystic peritoneal surfaces and adhesions
typically arises from the appendix but can start in the ovaries
202
what differentiates an endometrioid epithelial ovarian tumor from a mucinous or serous one
presence of tubular glands resembling benign or malignant endometrium
203
what is an ovarian cystadenofibroma
epithelial ovarian tumor
benign and multilocular with simple papillary processes
204
what is ovarian clear cell carcinoma
epithelial ovarian tumor in which the cells have a clear cytoplasm (looks like gestational endometrium)
205
what is a Brenner tumor
transitional cell ovarian tumor that is most commonly unilateral
has fibrous stroma that in rare cases can represent theca cells with hormonal activity
206
what is an important section to take in an ovarian teratoma
section of the pedicle because it has the highest chance of malignant transformation
207
what are the three categories of teratomas
mature (benign)
immature (malignant)
monodermal or highly specialized
208
immature or malignant ovarian teratomas often resemble what
embryonal and immature fetal tissue
209
what are the two most common types of ovarian germ cell tumors
struma ovarii and carcinoid
210
what is a struma ovarii
type of ovarian germ cell tumor composed of mature thyroid tissue
211
what is the ovarian counterpart of a testicular seminoma
ovarian dysgerminoma
212
dysgerminomas are most commonly seen in which age range of women
20-30 years of age
213
is a dysgerminoma malignant or benign
malignant
214
what is the gross appearance of an ovarian dysgerminoma
lobulated, flesh tumor with a yellow-tan or cream colored appearance
215
what is the microscopic appearance of an ovarian dysgerminoma
monomorphic cells arranged in diffused sheets separated by delicate fibrous septae
216
what is the second most common malignant ovarian tumor of germ cell origin
yolk sac tumor
217
in which condition do the tumor cells elaborate alpha-fetoprotein
yolk sac tumors
218
Schiller-duval bodies are seen in which condition
yolk sac tumors
219
what is a Schiller-duval body
glomerulus like structure composed of a central blood vessel enveloped by tumor cells
220
which type of germ cell ovarian tumor is highly aggresive
choriocarcinoma
221
what is an ovarian embryonal carcinoma
highly malignant germ cell tumor of primitive embryonal elements that is histologically like embryonal carcinoma arising in the testes
222
what is an ovarian polyembryoma
a malignant germ cell tumor containing embryoid bodies
223
what is a granulosa ovarian tumor
sex cord stromal tumor
unilateral and mostly occurs in postmenopausal women
yellow cut surface
224
in which condition would you see call-exner bodies
granulosa cell tumors
225
what is the peak age range for sertoli-leydig cell tumors
20-30 years of age
226
the most common metastatic ovarian tumors arise from which four structures
uterus
fallopian tubes
contralateral ovary
pelvic peritoneum
227
the most common extra mullerian tumors metastatic to the ovary are
breast
GI tract
228
what is a Krukenberg tumor
metastatic tumor of the ovary characterized by mucin producing, signet-ring cancer cells most often of gastric origin
229
what is unique about the placenta's vasculature
two umbilical arteries, one umbilical vein
230
define spontaneous abortion
miscarriage or pregnancy loss before 20 weeks of gestation
231
what percentage of pregnancies terminate in spontaneous abortion
10-15%
232
what is the most common location for an ectopic pregnancy
fallopian tube
233
what is associated with a twofold increase of ectopic pregnancies
IUD's
234
how are ruptures of tubal pregnancies diagnosed
through chorionic gonadotropin titers, pelvic sonography, and endometrial biopsies
235
what are the 5 disorders that occur in the third trimester of pregnancy
1.) interruption of umbilical cord blood flow
2.) ascending infection
3.) retroplacental hemorrhage
4.) disruption of the fetal vessels in terminal villi
5.) uteroplacental malperfusion
236
where would you find the decidua basalis
on the material side of the placenta covering the cotyledons
237
what is the name for twins with two separate placentas
dichorionic diamniotic
238
what is the name for twins that share one placental disc and are separated by a thin membrane
monochorionic diamnionic
239
what is the name for twins that share a placental disc and are not separated by a membrane
monochorionic monoamniotic
240
what is twin-twin transfusion syndrome
shunts between the arteriovenous anastomoses of twins can cause one twin to get more nutrients than the other
241
define placenta previa
placenta implants in the lower uterine segment or cervix
242
define complete placenta previa
placenta completely covers internal cervical os
243
define placenta accreta
absence of the decidua causes placenta to adhere to the uterine wall
244
define placenta increta
absence of the decidua causes placenta to adhere to myometrium
245
define placenta percreta
absence of the decidua causes placenta to invade through the uterine wall and sometimes into the bladder
246
what are the two pathways of infections of the placenta
1.) ascending through birth canal (most common)
2.) hematogenous (transplancental)
247
define preeclampsia
material endothelial dysfunction that presents with hypertension, edema, and proteinuria
248
who is most likely to be affected by preeclampsia
primipara women (those pregnant for the first time)
249
define HELLP
hemolytic anemia, elevated liver enzymes, and low platelets
250
HELLP is associated with what
preeclampsia
251
which three things cause contribute to preeclampsia
1.) abnormal placental vasculature
2.) endothelial dysfunction
3.) coagulation abnormalities
252
at which week is preeclampsia most common
week 34
253
what are the four main changes of the placenta seen in preeclampsia
1.) infarcts
2.) ischemic changes in villi
3.) retroplacental hematomas
4.) abnormal decidual vessels
254
define gestational trophoblastic disease
spectrum of tumors/conditions characterized by proliferation of placental tissue
255
what are the three major gestational trophoblastic disorders
1.) hydatidiform mole
2.) invasive mole
3.) placental site trophoblastic tumor
256
what is a hydatidiform mole
cystic swelling of chorionic villi with trophoblastic proliferation
common in teens and 50 year olds
257
what is a good indication of a hydatidiform mole
elevated HCG levels above those normal for pregnancy
258
how does a complete hydatidiform mole form
results from fertilization of an egg that has lost its females chromosomes
259
what is the risk percentage for developing choriocarcinoma from a complete hydatidiform mole
2.5%
260
how does a partial hydatidiform mole form
fertilization of an egg with two sperm - leads to a triploid zygote
261
are partial moles associated with choriocarcinoma
no
262
what is the morphology of a hydatidiform mole
friable mass made of cystic, grape-like structures made of swollen villi
263
grape-like clusters are seen in which GYN condition
hydatidiform mole
264
what is an invasive hydatidiform mole
villi penetrate the uterine wall
265
where can invasive hydatidiform moles metastasize to
lungs and brain
266
what are the two most common metastatic sites of ovarian choriocarcinomas
lungs (50%)
vagina (40%)
267
what is a placental site trophoblastic tumor (PSTT)
proliferations of extravillous trophoblasts that presents as a uterine mass
268
what is the incidence of gestational choriocarcinoma
1:20-30,0000
