L71 Flashcards Preview

P&T Block 5 Renal > L71 > Flashcards

Flashcards in L71 Deck (35)
1

What are the 5 types of ovarian surface epithelial tumors? Which 2 can arise from endometriosis?

1. Serous
2. Mucinous
3. Endometrioid - endometriosis
4. Clear cell - endometriosis
5. Brenner/transitional

2

Explain the differences between benign, borderline, and malignant serous ovarian tumors

1. Benign = serous cystadenoma = simple, flat lining
2. Borderline = velvety, implants in abdomen as independent tumors (not mets)
3. Malignant = serous carcinoma, thick + shaggy

3

What is the name for a benign serous or mucinous ovarian tumor?

Serous or mucinous cystadenoma

4

What is the tumor progression pathway to get a low grade serous ovarian carcinoma?

Cystadenoma // endometriosis -> borderline -> low grade

5

What is the tumor progression pathway to get a high grade serous ovarian carcinoma? What are the genes involved?

Think BRCA 1/2 + p53
Inclusion cyst
High grade

6

Presentation of mucinous ovarian cancer

HUGE, most benign
"Bag jelly beans"

7

What is a pseudomyxoma peritonei

Bilat mucinous ovarian tumor as met from appendix mucinous tumor

8

For epithelial tumors, describe the role of:
Age
Cystic vs solid tumors
Bi vs unilat tumors
Those associated with endometrisois

OVARIAN SURFACE EPI TUMOR
1. Older = more likely to be malig
2. Benign - cystic, solid - malignant
3. Bilat more likely to be mets except serous
4. Endometrioid + clear cell associated with endometriosis

9

What is a Krukenberg tumor? Unil or bilat, histology

Diffuse gastric cancer - mets to the bilat ovaries
Histo: signet ring

10

Which type of ovarian tumor presents before 20 yo + unilateral

Ovaruan germ cell tumors

11

You can guess what a mature teratoma is - so what is an immature teratoma? Treat

Contains immature neuro tissue (brain)
High grade will need chemo regardless of resection b/c immature tissue indications malignant potential (vs mature teratoma = benign)

12

What is a dysgerminoma
Benign vs malignant
Uni or bilat
Enzyme elevated
Age
Prognosis

Ovarian "seminoma"
Malignancy of oocytes
Unilat
Young women: 20-30s
High LDH
Responds to treatment

13

Yolk sac tumor = endodermal sinus tumor
Age
Elevated in serum
Histo

Malignant tumor in GIRLS
High AFP (normally secreted by yolk sac)
Schiller Duval bodies = glomerulus-like

14

Name the 5 types of germ cell tumors

Teratoma (mature vs immature)
Dysgerminoma (oocytes)
Yolk sac tumor = endodermal sinus tumor
Choriocarcinoma (placental tissue)
Embryonal carcinoma = emybro like, large primitive cells

15

2 types of sex cord stromal tissues

Ganulosa-theca cell tumor
Sertoli-Leydig cell tumor

16

What is Meigs syndrome?

Ovarian tumor = fibroma
Hydrothorax
Ascities

17

Describe presentation of granulosa tumor

Makes E - signs of E excess
1. Early puberty
2. Bleeding out of cycle
3. Post-meno bleeding
Excess E likely to cause endometrial HYPERPLASIA + CARCINOMA

18

Serum + histo findings granulosa tumor

Inhibin = serum tumor marker
Coffee bean nuclei = Call Exner bodies

19

What is the normal vascular architecture of the umbilical cord?

2 arteries
1 vein
: o

20

What is oligohydramnios? What syndrome/sequence may result from prolonged/severe oligo?

Too little amniotic fluid
POTTER's sequence = no amniotic fluid to swallow = lung hypoplasia
- May be due to congenital lab of kidneys/UT
Characteristic facial appearance after being smooshed on placenta

21

What is meconium? How could this signal fetal insult?

Baby poop - should only happen around time of delivery
If green, distress that caused pooping is removed (umbilical cord spasm)

22

What is placenta previa + complication

Placenta implanted into lower segment of uterus - lies over cervix
Can't deliver through obstructed cervix - C section

23

What is placenta accreta + complication

Placenta into the myometrium - too tight
Hemorrhage -> may need to remove uterus at birth
Same idea, deeper invasion = placenta increta + percreta

24

What is twin twin transfusion syndrome

Anastimosis of the arteries so that one baby under profused (cause of death) and the other is over (dies CHF)

25

Name for infection of placenta vs membranes vs cord. Source?

Placenta = villitis
Membranes = chorioamnionitis
Cord = funisitis
Ascending infection via birth canal (duh none of these things exist if not pregnant)

26

What are you worried about with maternal infection of the placenta/membranes/cord

ToRCHES infections
Toxo
Rubella
CMV
HSV
Syphilis

27

Most common cause of rupture membranes

Infection

28

What is pre-eclampsia vs eclampsia?

Pre = HTN + proteinuria + edema
Defective formation in placental vasc bed -> less BF to placenta = hypoxia, premature birth
Eclampsia = + seizures, DIC

29

What disease did mom have if you see decidual vasculopathy aka fibrinoid necrosis and hemorrhagic infarct at delivery?

Pre/eclampsia

30

If mom comes in with pain + vaginal bleeding, what are you thinking? Biggest worry

Placental abruption!!! (b/c pain AND blood)
Worry still birth -> emergency delivery

31

How does a complete hydatidiform mole form?

2 sperm - no maternal chromosome in egg

32

How does partial hydatidiform mole form?

Maternal chromosome + 2 sperm fertilize
Triploid genetic material

33

Describe complete H mole
Genetics
Fetal tissue
Vilious edema
Trophoblastic prolif
Risk for choriocarcinoma

COMPLETE
Egg completely devoid mom's genes (incompat w/ life)
Complete absence fetal tissue
Completely edematous vili
Complete covering of those vili in blasts - secreted hCG
Completely at risk for choriocarcinoma

34

What does a complete H mole look like?

Bunch of grapes - may have some come out

35

What is choriocarcinoma? 2 ways you can get this tumor

Malignant
Tumor of blasts: syncytio + cytotropho = why high BhCG
From
1. Germ cell pathway - don't respond well to chemo
2. Gestation pathway (complete H mole) - yes chemo