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52 Cards in this Set
- Front
- Back
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What is Chorioamnionitis?
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Inflammatory response of the placenta/umbilical cord.
High cytokine levels cause baby reaction (premature birth). |
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What is Mosaica?
What can it cause? |
Genetic damage in only some of the cells.
When the baby's fine and the placenta isn't- must check סיסי שליה. Causes 2% of FGR. |
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What is MCC of death, ages 5-14?
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1. Accidents.
2. Tumors. |
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Of what source are most benign tumors in children?
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Mesenchymal.
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What is Lymphangiomas?
Lymphangioctasis? |
LymphAngiomas: Lymph vessels tumors. Can pressure organs and blood vessels.
LymphAngioctasis: dilations in lymph vessels. Don't spread furthers. |
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What are Myofibromas/Fyofibromatosis?
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Fibromas that contain muscle markers, like actin.
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What is the difference between adult fibrosarcoma and childhood fibrosarcoma?
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Childhood fibrosarcoma don't tend to recur after removed.
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Where do most congenital teratomas appear?
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Midline.
Sacrococcygeal: 40%. Can happen around thorax, cause hypoplasia of lungs. |
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What are the most common childhoost tumors?
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1. Leukemias.
2. Neuroblastomas. 3. Wilms tumor. |
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What is the definition of Blastoma?
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Malignant neoplasm of immature cells.
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What do childhood tumors look like, histologically?
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Small-round cell tumors.
Tissue looks embryonic. |
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Where does Neuroblastoma originate from?
What is its frequency? |
Neural crest.
Tend to mature/regress spontaneously (to ganglions/schwann cells). 50% in infants (<1y). |
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Which tissues does neuroblastoma usually affect?
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Adrenal
Sympathetic chains Metastasize rapidly. |
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What are the stages of Neuroblastoma?
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Stage 1: Restricted to adrenal, can be removed by surgery.
Stage 2: Restricted to adrenal, cannot be removed. Stage 3: Involved distant lymph nodes. Stage 4: Metastases. Stage 4S: Under 1y. Metastases to skin, liver and bone marrow- good prognosis. |
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What does neuroblastoma look like, histologically?
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Small-round cell tumor.
Pseudo-rosettes (Homer-wright). Stain for NSE. |
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What do Neuroblastomas secrete?
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Catcholamines- VMA/HMA.
No hypertension, though. |
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Factors that affect prognosis in neuroblastoma?
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N-myc amplification: good.
RTK receptors: indicates differentiation- good. Diploid: bad (better polyploid). Lack of CD44: indicates lack of adhesion- bad. MDR1: treatmant resistant- bad. |
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What do RB look like, histologically?
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Small-round cell tumor.
Pseudo-rosettes (Flexter-Wintersteiner). |
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What are the 3 main symptoms of Wilms tumor?
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1. Mass in abdomen.
2. Hematuria. 3. block in GI. |
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What are the MCC death in newborns?
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1. מומים.
2. Prematurity. 3. SIDS. 4. Accidents. |
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What is a מום?
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Morphological defect that exists at birth.
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When is something a minor anomaly, and when is it an anatomical variation?
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Over 4% of population- variation.
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What is a Malformation?
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מום על רקע גנטי.
Clubfoot Cleft lip/palate. Meningocele (only meninges). Meningomyocele (part of neural tube). |
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What is a Disruption?
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מום d/t event during development- genetically fine.
Deformation is a type of disruption, d/t MECHANICAL injury. |
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What is Oligohydramnios?
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Lack of amniotic fluid.
Can cause damage to facial morphology, clubfoot. Can cause lung injury: embryo must inhale amniotic fluid for their development. |
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What is a Field defect?
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Injury to one developmental field, that affects several systems.
holoprosencephaly: d/t trisomy 13. the brain doesn't develop into two hemispheres. Cyclopes, one ventricle in heart. |
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What is a syndrome?
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Several anomalies that appear together, and are (assumable) linked.
ie, chromosomal aberrations. |
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What is the most common syndrome?
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Down-syndrome.
(the only liveable autotrisomy) |
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What is:
Agenesis? Aplasia? Hypoplasia? Atresia? Dysplasia? |
Agenesis: Lack of organ.
Aplasia: Only sprouts of organ. Hypoplasia: Not enough cells. Atresia: Blockage in hollow organ. Dysplasia: Organ is created but it not organized or functional. |
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What happens during maternal diabetes?
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Embryo gets glucose, but not insulin (placents blocks it)- Hyperglycemic, large baby, underdeveloped lungs.
Hyperglycemia can cause מומים. |
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What are Homebox genes?
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A group of genes in charge of transcription control, involved in embryogenic development. Reserved in evolution.
HOX: Cause syndromes involving brain. Love vitamin A. PAX |
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When do you suspect chromosomal aberration?
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More than two מומים.
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Cause for prematurity?
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1. Preterm Premature Rupture of Membranes (PPROM)- 30%-40%.
2. Intrauterine infection- 25%. 3. Structural damage. 4. Many many babies. |
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What are the risks for Respiratory distress in the neonate?
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1. Prematurity (normal weight).
2. Male. 3. Diabetec mothers (insulin harms lung development). |
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What do you see in x-rays of Respiratory distress in the neonate?
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Ground glass, d/t insufficient entry of air.
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What is the cause for Respiratory distress in the neonate?
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insufficient surfactant.
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What is Respiratory distress in the neonate called in premature babies?
What does it look like? Treatment? |
Hyaline membrane disease.
Large, solid lungs. Thick, edematous alveoli walls. Lots of FIBRIN. Treat by surfactant and oxygen (not 100%). |
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What is one of the complications of Respiratory distress in the neonate?
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Bronchopulmonary dysplasia- after receving oxygen for more than 4 weeks, lung damage- some alveoli are fibrotic.
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What is Necrotizing enterocolitis?
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inflammation and necrosis, usually terminal ileum-cecum.
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How do you treat Necrotizing enterocolitis?
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Removal of problematic parts.
If there is fibrosis and adhesions- MUST operate, but better prognosis. |
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Causes of Necrotizing enterocolitis?
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Slight ischemia of colon, along with bacteria you get with oral feeding.
Mucous is more permeable, and bacteria get into colon walls and cause inflammation that leads to necrosis. |
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What is the cause for brain bleeding in premature babies?
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Ischemia- blood vessels around the ventricles are very thin, and the change in perfusion harms them.
Common. |
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What is SIDS (Suddent Infant Death Syndrome)?
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Sudden death of an infant under 1y, without explanation.
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What can you see in the autopsy of SIDS?
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Congestion, petechia, infections in respiratory tract, gliosis.
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What are the risk factors for SIDS?
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Male, prematurity, low birth weight, maternal smoking, hyperthermia, sleeping on stomach and sleeping on soft mattress.
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What are the risk factors for fetal growth retardation?
(can be seen in US by femur size) |
Maternal: smoking, hypertension, hypoglycemia (hyper makes large babies), drugs, רעלת הריון.
Fetus: Infections, chromosomal aberrations, מומים. Placenta: Insufficient blood supply. |
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What is hydrops fetalis?
What are the two types, and their causes? |
Edema everywhere.
Immune hydrops: Rh+ baby to Rh- mother. Non-immune: cardiovascular diseases, infections, multigestational, chromosomal aberrations. |
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What is Kernicterus?
What causes it? |
"yellow brain"- bilirubin (treat by ultraUV light).
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Where does gas exchange occur in the placenta?
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Trophoblast.
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What is Decidual vasculopathy?
What does it cause? |
Insufficient blood supply to the baby.
Causes asymmetric growth retardation. |
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What causes Decidual vasculopathy?
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Atherosis, fibrinoid necrosis, infarct, lack of physiological changes.
(infarct of 10% of placenta- FGR. 30%- death) |
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When do most ties in the umbilical cord are formed?
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During the 2nd trimester- fetus can move, but isn't too large.
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