Reproductive - Female Pathology Flashcards Preview

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Flashcards in Reproductive - Female Pathology Deck (76)
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61

Teratogen: thalidomide

limb defects

62

Teratogen: Cigarette smoke

intrauterine growth retardation

63

Teratogen: isotretinoin

spontaneous abortion, hearing/visual impairment

64

Teratogen: tetracycline

discolored teeth

65

Teratogen: warfarin

fetal bleeding

66

Teratogen: phenytoin

digit hypoplasia, cleft lip/palate

67

Preeclampsia

P: pregnancy-induced hypertension, proteinuria, edema, particularly in 3rd trimester (5% of pregnancies)

Headaches, visual abnormalities

M: abnormality of maternal-fetal vascular interface in placenta; resolves with delivery
placental ischemia from impaired vasodilation of spiral arteries, resulting increased vascular tone

Eclampsia - seizures (IV magnesium sulfate to prevent/treat seizures)

Risks: preexisting hypertension, diabetes, chronic renal, autoimmune disorders

Mortality: cerebral hemorrhage, ARDS

68

HELLP (preeclampsia)

Thrombotic microangiopathy involving liver

Hemolysis
Elevated liver enzymes
Low platelets

69

Sudden infant death syndrome

P: infant expires during sleep

M: death of infant (1m-1y) without obvious cause

Risk factors: cigarette smoke exposure, sleeping on stomach, prematurity

70

Hydatidiform mole

P: grape-like masses ("clusters of grapes", "honeycombed uterus") through vaginal canal in 2nd trimester/
or absent fetal heart sound; snowstorm appearance on ultrasound

abnormally large uterus, increased beta-hCG

Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts

Tx: dilatation and curettage
Subsequent beta-HCG monitoring for adequate mole removal and screen for choriocarcinoma

71

Partial hydatidiform mole

Normal ovum fertilized by two sperms (or one sperm duplicates)
69 chromosomes

Present fetal tissue
Some normal villi, focal proliferation

Minimal risk for choriocarcinoma

72

Complete hydatidiform mole

Empty ovum fertilized by 2 sperm (or 1 that duplicates)
46 chromosomes

Absent fetal tissue
Most villi are hydropic

Diffuse, circumferential proliferation around hydropic villi

2-3% risk for choriocarcinoma

73

2 Forms of Choriocarcinoma and Differences

Complication of gestation (spontaneous abortion, normal pregnancy, hydatidiform mole) or spontaneous germ cell tumor

Arising from gestation pathway responds well to chemotherapy.

Germ cell pathway does not respond well to chemotherapy.

74

Placenta previa

P: third-trimester bleeding (painless)

M: Implantation of placenta in lower uterine segment; placenta overlies cervical os (opening)

Often requires delivery by c-section (compress blood supply)

Risks: multiparity, prior C-section

75

Placental abruption (abruptio placentae)

P: third-trimester bleeding and fetal insufficiency; common cause of still birth

M: separation of placenta from decidua prior to delivery of fetus

May be associated with DIC
Risks: smoking, HTN, cocaine use

Life-threatening for both mother and fetus

76

Placenta accreta

P: difficult delivery of placenta and massive postpartum bleeding

M: Improper implantation of placenta into myometrium with little or no intervening decidua

Risks: prior C-sectio, inflammation, placenta previa

"accreta" = encased