COMLEX Level 1 Placenta Accreta Quiz

Questions and Answers

What is failure to deliver the placenta within 30 minutes of birth called?

Placenta accreta

What are the risk factors of placental accreta spectrum?

History of c-section, history of uterine procedures, placental previa

What are the types of placenta accreta spectrum?

Placenta accreta, placenta increta, placenta percreta

What condition is characterized by secondary amenorrhea following a D&C?

Asherman syndrome Signup and view all the answers

What are the causes of secondary amenorrhea?

Hypothalamic, pituitary, ovarian, uterine, and other causes Signup and view all the answers

Match the disease with its corresponding histology:

Abscent stratum basalis in an endometrial biopsy = Asherman syndrome Benign keratinocytes within the epidermis = Imperforate hymen Enlarged ovaries with multiple cystic follicles = Polycystic ovary syndrome Hyperplasia of lactotroph cells within the anterior pituitary = Prolactinoma Numerous corpora albicans and a fibrotic cortex = Atrophic ovary Signup and view all the answers

What is characterized by severe anemia in infants with symptoms such as webbed neck and macrocytic anemia?

Diamond-Blackfan anemia Signup and view all the answers

What is the treatment for Diamond-Blackfan anemia?

Corticosteroids, transfusion, hematopoietic stem cell transplant Signup and view all the answers

What defect leads to Diamond-Blackfan anemia?

Defect in erythropoiesis Signup and view all the answers

List three causes of megaloblastic macrocytic anemias.

B12 deficiency, folate deficiency, orotic aciduria Signup and view all the answers

List four causes of nonmegaloblastic macrocytic anemias.

Diamond-Blackfan anemia, alcohol use, liver disease, thyroid disease Signup and view all the answers

What is a common cause of normocytic anemia in young children?

Aplastic anemia Signup and view all the answers

What condition is characterized by an autosomal recessive defect in DNA repair mechanisms?

Fanconi anemia Signup and view all the answers

What results from a defect in uridine monophosphate synthase and causes megaloblastic macrocytic anemia?

Orotic aciduria Signup and view all the answers

What causes megaloblastic macrocytic anemia with hypersegmented neutrophils?

Vitamin B12 deficiency Signup and view all the answers

What are common causes of macrocytic anemia in young children?

Orotic aciduria, Diamond-Blackfan anemia Signup and view all the answers

What conditions are associated with microcytic anemia in young children?

Lead poisoning, sideroblastic anemia, thalassemias Signup and view all the answers

What are some causes of normocytic anemia in young children?

Aplastic anemia, hereditary spherocytosis, leukemia Signup and view all the answers

Study Notes

Placenta Accreta

Defined as failure to deliver the placenta within 30 minutes of birth, leading to potential complications.
Manual extraction can cause uncontrollable bleeding and retention of placental tissue.
Emergent hysterectomy may be necessary due to severe hemorrhaging.
The condition involves placental villi attaching to the myometrium surface.

Risk Factors for Placenta Accreta Spectrum

History of cesarean section (c-section) increases risk.
Previous uterine procedures, including dilation, curettage, myomectomy, and uterine ablation, are significant factors.
Presence of placental previa also raises the likelihood of developing this spectrum.

Placenta Accreta Spectrum Components

Placenta Accreta: Villi attach superficially to the myometrium.
Placenta Increta: Villi penetrate deeper into the myometrium.
Placenta Precreta: Villi invade through the myometrium to the uterine serosa or surrounding organs.

Asherman Syndrome

Characterized by secondary amenorrhea after dilation and curettage (D&C).
Results from trauma to the stratum basalis, leading to its absence in the endometrium.

Etiology of Secondary Amenorrhea

Hypothalamic issues: Functional hypothalamic amenorrhea.
Pituitary causes: Hyperprolactinemia, empty sella syndrome, and Sheehan syndrome.
Ovarian disorders: Polycystic ovary syndrome and premature ovarian failure.
Uterine condition: Asherman syndrome.
Other contributing factors include congenital adrenal hyperplasia, hypothyroidism, and adrenal tumors.

Histology and Associated Diseases

Absent stratum basalis: Asherman syndrome.
Benign keratinocytes: Indicative of imperforate hymen.
Enlarged ovaries: Found in polycystic ovary syndrome.
Hyperplasia of lactotroph cells: Seen in prolactinoma.
Corpora albicans and fibrotic cortex: Suggests atrophic ovary.

Diamond-Blackfan Anemia

Diagnosed in infants with a male predominance.
Most prevalent in Caucasian populations, presenting with symptoms of anemia like pallor and fatigue.
Notable features include webbed neck, cleft palate, and triphalangeal thumbs.
Associated with macrocytic anemia that is nonmegaloblastic, showing decreased reticulocyte count and normal leukocytes and platelets.
Bone marrow biopsy demonstrates absence of erythroid precursors.

Treatment Options for Diamond-Blackfan Anemia

Corticosteroids are standard treatment.
Blood transfusions may be necessary.
Hematopoietic stem cell transplant can be indicated.

Pure Red Cell Aplasia (PRCA)

Associated with defects in erythropoiesis leading to Diamond-Blackfan anemia.
Bone marrow erythroblasts undergo premature apoptosis due to mutations affecting ribosomal protein synthesis, resulting in TP53 activation.

Types of Macrocytic Anemia

Megaloblastic: Includes B12 deficiency, folate deficiency, and orotic aciduria.
Nonmegaloblastic: Includes Diamond-Blackfan anemia, alcohol use, liver disease, and thyroid disease.

Aplastic Anemia

Characterized as normocytic anemia potentially due to viral infections, radiation, medications, or toxins.
Presents with pancytopenia, including anemia, thrombocytopenia, and leukopenia.

Fanconi Anemia

An autosomal recessive disorder involving DNA repair defects.
Can present with either normocytic or macrocytic anemia and also causes pancytopenia.

Orotic Aciduria

Another autosomal recessive condition with a defect in UMP synthase leading to elevated orotic acid and failure to thrive.
Presents with delayed development and megaloblastic macrocytic anemia unresponsive to folate and B12 supplementation.

Vitamin B12 Deficiency Anemia

Results in megaloblastic macrocytic anemia with the presence of hypersegmented neutrophils.
Causes include a vegan diet, pernicious anemia, gastrectomy, gastric bypass, and ileal diseases such as Crohn's.

Anemia in Young Children

Microcytic Anemias: Lead poisoning, sideroblastic anemia, thalassemias.
Normocytic Anemias: Aplastic anemia, hereditary spherocytosis, leukemia, microangiopathic hemolytic anemia, pyruvate kinase deficiency, Rh incompatibility, sickle-cell anemia.
Macrocytic Anemias: Orotic aciduria and Diamond-Blackfan anemia.

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Description

Test your knowledge on placenta accreta and its related risk factors with this quiz designed for COMLEX Level 1 preparation. Understand the critical definitions and implications of failure to deliver the placenta. Prepare effectively for your medical exams!