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pathology > Gestation and Breast > Flashcards

Gestation and Breast Flashcards

1
Q

Implantation if fertilised ovum at site other than the uterine wall

A

Ectopic pregnancy

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2
Q

What is the most common site of ectopic pregnancy

A

Lumen of the Fallopian tube

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3
Q

What is the key risk factor for ectopic pregnancy

A

Pelvic inflammation disease and endometriosis

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4
Q

Presents with lower quadrant pain weeks after missed period and is a sergical emergency

A

Ectopic pregnancy

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5
Q

Miscarriage of fetus (20 weeks before gestation)
Pretty common and occurs in about 1/4 of pregnancies
Presents as vaginal pain bleeding and passage of feral tissue

A

Spontaneous abortion

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6
Q

What are the causes of spontaneous abortions

A

Most often due to chromosomal anomalies, also hyper coagulable state seen in lupus or congenital infection and teratogens

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7
Q

Implantation of placenta in lower uterine segment
Placenta overlies cervical
Requeuires deliver by C-section and presents as 3rd trimester bleeding

A

Placenta previa

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8
Q

Separation of placenta from decidua prior to delivery of fetus
Common cause of still birth
Causes 3rd trimester bleeding and feral insufficiency

A

Placental abruption

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9
Q

Improper implantation of placenta in to myometrium with little to no decidua
Presents with difficult delivery of placenta because placenta is stuck and post parturition bleeding

A

Placenta Accreta

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10
Q
  • Abnormal eonception characterised by swollen and edmematous villi with proliferation of trophoblasts
  • uterus expands as if it’s a normal pregnancy is present, but uterus will be bigger than normal and B-hcg (Human chorionic gonadotropin) is more than normal.
A

Hydatidiform mole

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11
Q

Hydatidiform mole without prenatal care

A

Classically presents in 2nd trimester, passage of grape like masses through the vaginal canal
(The large Edematous villi is what is passing)

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12
Q

Hydatidiform mole with prenatal care

A

Diagnosed by routine USG, fetal heart sounds are absent

SNOW STORM appearance on USG

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13
Q

Hydatidiform mole can be classified in to 2

A

Complete mole and partial mole

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14
Q

Is Hydatidiform mole caused by the father or the mother?

A

It is caused by the father
- when two sperms come in molar pregnancy so all genetic material is from the father)
(Complete mole -> completely from the dad)

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15
Q

No fetal tissue, since it is a complete mole all villi are edematous and complete proliferation of trophoblasts, in complete mole, B-HCG is way higher and complete has complete risk for chriocsrcinoma 2-3%

A

Complete mole (empty ovum with 2 sperms)

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16
Q

Normal ovum fertilised by two sperm (69 chrom) feral tissue is “partially”present some villi are edematous (hydropic) and focal proliferation of trophoblasts around hydropic villi also minimal risk of choriocarcinoma

A

Partial mole

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17
Q

•Proliferation of trophoblasts, villi are absent

  • May arise as a complication of gestation or spontaneous germ cell tumour
  • Gestational pathway responds well to chemotherapy-> can be due to molar pregnancy, spontaneous abortion or normal pregnancy
  • Germ cell parhway doesn’t respond well to chemotherapy
A

Choriocarcinoma

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18
Q

What is breast derived from

A

Skin

19
Q

What is the functional unit of the breast

A

Terminal duct lobule unit

20
Q

The breast has two epithelial layers what are they

A

Luminal and myoepithelial

21
Q

Milk out side of lactation

A

Galactorrhea

22
Q

What causes galactorrhea

A

Nipple stimulation
Prolactioma
Drugs

23
Q
  • warm erythematous breast with purlent discharge
  • due to S aureus infection due to breastfeeding
  • treat with drainage and dicloxacillin
A

Acute mastitis

24
Q
  • Inflammation of subareolar ducts in smokers (vitamin A deficiency in specialised cells)
  • subareolar mass and nipple retraction
A

Periductal mastitis

25
Q

Subareolar dilation due to inflammation
Green brown nipple discharge and plasma cells in biopsy
Classically in multiparous(giving birth to more than 1 child), post menopausal women

A

Mammary duct ectasia (dilation)

26
Q

Happens in the breast usually due to trauma, shows as a mass or calcification, and on biopsy it shows necrotic fat with giant cells

A

Fat necrosis

27
Q
  • no invasion of breast so no mass

- detected as calcification in mammography

A

Ductal carcinoma in situ DCIS

28
Q

What’s the most important type DCIS

A

comedo type -> high grade nuclei and central necrosis and dysplastic calci

29
Q

What is pager disease

A

When DCIS. Reaches skin of nipple

30
Q

What is the most common invasive breast carcinoma

A

Invasive ductal carcinoma

31
Q

Presents with rock hard mass with sharp borders
It invades through the basement membrane
Duct like structures in desmoplastic stroma on biopsy

A

Invasive ductal carcinoma

32
Q

What are the subtypes of Invasive ductal carcinoma

A

Tubular
mucinous
Inflammatory (looks like acute mastitis) -> p’uedu orange
Medullary (Braca1) -> in sheets

33
Q

What is a good distinguishing method for Invasive ductal carcinoma

A

Number of myoepithelial cells

34
Q
  • no invasion
  • no mass or calcification so discovered incidently
  • has dyscohesive cells (separated) since they lack E cadherin
  • treat with Tamoxifen(antiestrogenic agent)
  • risk factor if malignant cancer
A

Lobular carcinoma in situ (LCIS)

35
Q
  • invade in single files, not stuck ( NO E CADHERIN)
  • prognosis by TNM - M most important factor but not many patients so for breast N is the most
  • SENTINAL LYMPH NODE BIOPSY IS ISED TO assess the ancillary lymph nodes
  • predictive factors - ER, PR, HER2 / neu genes
A

Invasive lobar carcinoma

36
Q

BRCA 1

A

Breast and ovarian carcinoma

37
Q

BRCA 2

A

Breast Carcinoma and breast in males

38
Q
  • most common premenopause
  • blue domed appearance, lump in outer breast
  • benign and doesn’t increase cancer risk
A

Fibrotic changes in the breast

39
Q

What fibrotic changes increase cancer risk

A

Ductal hyperplasia, atypical hyperplasia and sclerosing adenosis

40
Q

Does apocrine metaplasia increase cancer risk

A

No

41
Q
  • papillary lesion with bloody discharge
  • lesion has both epithelium types
  • most common cause of discharge
  • similar to papillary carcinoma except for not having myoepithelium and is more seen in post menopausal
A

Intraductal papilloma

42
Q
  • Most common benign breast tumor
  • Well circumscribed, mobile and marble like
  • Has no risk
  • estrogen sensitive
A

Fibroadenoma

43
Q
  • fibroadenoma like with some differences
  • extra fibrous so it has leaflike projections
  • more seen in post menopausal
  • can be malignant
A

Phyllodes tumour

pathology (15 decks)

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