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OBGYN 20-24 > 20-24 > Flashcards

20-24 Flashcards

1
Q

A syndrome characterized by endometrial adhesions that typically occur as a result of scar formation after some types of uterine surgery

A

Asherman Syndrome

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2
Q

Cessation of menstruation with advanced age

A

Menopause/ climacteric

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3
Q

During menopause, follicles cease to mature, resulting in a considerable reduction in the amounts of :

A

estrogen, progesterone

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4
Q

The ovaries become more ______ during post-menopause and lack follicles.

A

echogenic

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5
Q

The decrease in estrogen by the ovaries has other physiologic consequences:

A

decrease in uterine size, mucosal layer begins to become atrophic, the vagina becomes smaller, breasts tend to accumulate more adipose or fat tissue

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6
Q

Patients undergoing menopause may also suffer from:

A

night sweats, mood changes, depression, dyspareunia, dysuria, and a decrease in libido.

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7
Q

Lack of circulating estrogen during and after menopause, there is a notable increase in risk for:

A

coronary heart disease and an increase threat for developing osteopenia and osteoporosis

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8
Q

_________ is often used to combat the reduction of estrogen circulating in the female body after menopause and to prevent post-menopausal symptoms

A

HRT - hormone replacement therapy

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9
Q

___________ has been shown to significantly reduce the risk of developing osteoporosis and coronary heart disease, with a possible reduction in the risk of developing colon cancer and Alzheimer’s disease

A

ERT estrogen replacement therapy

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10
Q

Unopposed ERT is not combined with :

A

progesterone therapy

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11
Q

Unopposed ERT has been shown to increase the risk of developing :

A

endometrial hyperplasia and endometrial carcinoma also could be an increased risk of developing breast cancer thromboembolism, hypertension, and possibly diabetes

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12
Q

What do physicians use to attempt to reduce the risks associated with unopposed ERT:

A

progesterone therapy, progestin therapy

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13
Q

the sonographic appearance of a pt on ERT and thickness of the endometrium are variable and comparable to:

A

premenopausal female

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14
Q

A common indication for postmenopausal ultrasound is:

A

postmenopausal bleeding

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15
Q

Complications that may lead to postmenopausal bleeding:

A

endometrial atrophy, uncontrolled HRT, endometrial hyperplasia, endometrial polyps, submucosal or intracavitary leiomyoma, endometrial carcinoma, and some ovarian tumors

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16
Q

Post-menopausal endometrial thickness measurement should not include:

A

adjacent hypoechoic myometrium and is considered accurate only when double-layer thickness measurement is performed without the inclusion of endometrial fluid

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17
Q

The post-menopausal bleeding patient’s endometrial thickness should not exceed

A

4-5 mm

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18
Q

If the measurement of the endometrium is less than 5 mm in the post-menopausal bleeding patient the bleeding is typically caused by

A

endometrial atrophy

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19
Q

The asymptomatic patient, post-menopausal patient, with no vaginal bleeding can have an endometrial thickness of up to :

A

8 mm

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20
Q

The most common cause of postmenopausal bleeding is :

A

endometrial atrophy

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21
Q

_______ results from the unopposed stimulation of estrogen on the endometrium.

A

Endometrial Hyperplasia

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22
Q

Sonographic appearance of endometrial hyperplasia

A

thickened echogenic endometrium, small cystic spaces within the endometrium

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23
Q

Clinical findings of endometrial hyperplasia

A

Abnormal uterine bleeding (any age), polycystic ovary syndrome, obesity, tamoxifen therapy

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24
Q

Most common female genital tract malignancy, with post-menopausal bleeding

A

endometrial carcinoma

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25
Q

Endometrial Carcinoma is most often in the form of :

A

adenocarcinoma

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26
Q

Adenocarcinoma and endometrial carcinoma have been linked with :

A

unopposed estrogen therapy, nulliparity, obesity, chronic anovulation, stein-Leventhal syndrome, estrogen-producing ovarian tumors, and the use of tamoxifen

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27
Q

Sonographic findings of endometrial carcinoma:

A

thickened endometrium, heterogeneous uterus, enlarged uterus with lobular contour, endometrial fluid, polypoid mass within the endometrium

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28
Q

_________ are small nodules of hyperplastic endometrial tissue that may cause abnormal vaginal bleeding

A

endometrial polyps

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29
Q

_______ is a breast cancer drug that inhibits the effects of estrogen on the breast.

A

tamoxifen

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30
Q

________ is the presence of intrauterine adhesions or synechiae within the uterine cavity that typically occur as a result of scar formation after uterine surgery, especially after a dilation and curettage

A

Asherman syndrome

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31
Q

Sonographic findings of Asherman Syndrome

A

Bright areas within the endometrium, sonohysterography findings include bright bands of tissue traversing the uterine cavity

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32
Q

______ an infection of the upper genital tract

A

Pelvic inflammatory disease

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33
Q

Inflammation of the fallopian tubes

A

salpingitis

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34
Q

Patients suffering from salpingitis from PID may present clinically with symptoms resembling :

A

cholecystitis

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35
Q

Pelvic infections such as chlamydia or gonorrhea can actually lead to perihepatic infection and the subsequent development of adhesions located between the liver and diaphragm this event is called:

A

Fitz-Hugh-Curtis syndrome

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36
Q

PID has been linked with infertility and:

A

ectopic pregnancy

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37
Q

Clinical findings of salpingitis

A

findings consistent with PID, pelvic tenderness, fever, leukocytosis

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38
Q

Sonographic appearance of salpingitis

A

Distended fallopian tube filled with echogenic material (pus) or anechoic fluid, Hyperemic flow within or around the affected fallopian tube depicted with color doppler, nodular, thickened wall of the fallopian tube

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39
Q

As PID progresses and reaches beyond the fallopian tubes, the ________ and ____ become involved

A

ovaries and peritoneum

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40
Q

As PID progresses; adhesions develop within the pelvis that leads to the fusion of the ovaries and dilated tubes a condition known as:

A

Tubo-ovarian complex

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41
Q

Further progression of tubo-ovarian complex leads to a :

A

tubo-ovarian abscess

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42
Q

Sonographic findings of tubo-ovarian complex

A

thickened, irregular endometrium, pyosalpinx or hydrosalpinx, cul-de-sac fluid, multicystic and solid complex adnexal masses, ovaries, and tubes recognized as distinct structures, but the ovaries will not be separated from the tube by pushing the vaginal probe

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43
Q

Sonographic findings of tubo-ovarian abscess

A

thickened, irregular endometrium, pyosalpinx or hydrosalpinx, cul-de-sac fluid, multicystic and solid complex adnexal mass(es), Complete loss of borders of all adnexal structures, and the development of a conglomerated adnexal (possibly bilateral) mass

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44
Q

What is termed the inability to conceive a child after 1 year of unprotected intercourse:

A

Infertility

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45
Q

Congenital uterine malformations often lead to:

A

Repeated abortions

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46
Q

________ is functional ectopic endometrial tissue located outside of the uterus.

A

Endometriosis

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47
Q

Implantation of ectopic endometrial tissue may be the result of endometrial tissue being passed through the :

A

Fallopian tubes during menstruation

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48
Q

Endometriosis can be located anywhere in the pelvis, the most common location is:

A

The ovaries

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49
Q

Hemorrhage of the ectopic endometrial tissue often occurs and results in:

A

Endometriomas

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50
Q

Typical age of diagnosis for endometriosis :

A

25-35

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51
Q

Common clinical findings of endometriosis:

A

Pelvic pain, dysparenunia, infertility.

May also have dysmenorrhea, menorrhagia, painful bowel movements, or be completely asymptomatic

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52
Q

AKA stein-leventhal syndrome

A

Polycystic ovary syndrome

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53
Q

PCOS is characterized by:

A

Amenorrhea, hirtuism, and obesity

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54
Q

PCOS has been cited as the most common cause of :

A

Androgen excess/hyperandrogenism

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55
Q

Established clinical criteria for PCOS diagnosis :

A

Oligo/anovulation, blood work indicative of hyperandrogenism, Sonographic findings consistent with PCOS

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56
Q

Sonographic appearance of PCOS

A

Often enlarged ovaries, contain multiple small follicles along periphery, “string of pearls” sign

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57
Q

For the imaging diagnosis of PCOS it has been suggested that one or both ovaries should contain:

A

12 or more follicles that measure between 2-9 mm, ovarian volume should not exceed 10mL

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58
Q

What can be used to evaluate the patency of the Fallopian tubes?

A

Hysterosalpingography, hysterosalpingsonography, or hysterosalpingo-contrast-sonography

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59
Q

When the endometrium does not develop appropriately in the luteal phase (as a result of reduced progesterone production by the ovary) is termed:

A

Luteal phase deficiency

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60
Q

Adhesions within the uterine cavity often cause:

A

Infertility or lead to recurrent early pregnancy loss

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61
Q

Sonographic findings of asherman syndrome

A

Bright areas within the endometrium, sonohystography findings include bright bands of tissue traversing the uterine cavity

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62
Q

Fibroids that are __________ or __________ in location may distort the endometrium, thus preventing implantation of products of conception.

A

Intracavitary/ submucosal

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63
Q

Clinical findings of leiomyoma

A

Pelvic pressure, menorrhagia, palpable abdominal mass, enlarged, bulky uterus, dysuria, constipation, infertility

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64
Q

With assisted reproductive technology (ART) what is usually done to increase follicular development in order to extract multiple oocytes

A

Ovarian stimulation

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65
Q

______________ requires that a mature ovum be extracted from the ovary, fertilization takes place outside of the body.

A

In vitro fertilization

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66
Q

In-vitro fertilization: 4-8 developing embryos are placed into the uterus by means of a:

A

Catheter

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67
Q

The means by which twins, triplets, quadruplets, and quintuplet pregnancies are reduced :

A

Selective reduction/multi fetal pregnancy reduction

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68
Q

A additional technique of ART where the fertilization takes places in the Fallopian tubes:

A

Gamete intrafallopain tube transfer (GIFT)

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69
Q

GIFT requires that ooccytes and sperm be placed in the Fallopian tube via:

A

Laparoscopy

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70
Q

Zygote intrafallopian tube transfer is a method that requires the zygote be inserted :

A

Into the Fallopian tube

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71
Q

Patients who are being treated with ART are at an increased risk for :

A

Ectopic pregnancy, multiple gestations, ovarian hyper stimulation syndrome

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72
Q

Stimulation of the ovaries by hormonal therapy:

A

Ovulation induction

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73
Q

Drug that is used to stimulate the pituitary gland to secrete increased amounts of FSH:

A

Clomid/ clomiphene citrate

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74
Q

Fertility drug which is a hormone extracted from the urine of post menopausal women:

A

Pergonal

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75
Q

Pergonal is a mixture of what?

A

FSH and luteinizing hormone

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76
Q

Pergonal is often given in conjunction with

A

hCG

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77
Q

Ovulation induction dramatically increases risk of:

A

Multiple gestations and OHS

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78
Q

During OHS ovaries ______ and can measure:

A

Enlarge

5-12 cm

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79
Q

With OHS the ovaries contain:

A

Multiple large follicles/ theca lutein cysts

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80
Q

_______ is administered as part of ovulation induction, and theca lutein cysts occur due to these high levels

A

hCG

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81
Q

__________ can occur due to the large theca lutein cysts, results in acute pelvic pain.

A

Ovarian torsion

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82
Q

In cases of severe OHS patients have :

A

Nausea, vomiting, abdominal distention, ovarian enlargement, electrolyte imbalance, and oligoria

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83
Q

Sonographic signs of OHS

A

Cystic enlargement > 5cm, ascites, possible pleural effusion

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84
Q

OHS can initiate :

A

Renal failure, thromboembolism, and acute respiratory distress syndrome

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85
Q

Reversible form of contraception

A

IUD or IUCD

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86
Q

Small plastic T shaped IUD that releases small amounts of progestin to impede implantation

A

Mirena

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87
Q

T-shaped IUD utilizes copper to inhibit sperm transport, or to prevent fertilization or transplantation

A

Paragard

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88
Q

IUDs should be located within what portion of the endometrium?

A

Fundal

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89
Q

Sonographic appearance of lippes loop IUD

A

5 equally spaced shadowing structures

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90
Q

IUDs that have the Sonographic finding of T-shape

A

Copper T, mirena, paragard

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91
Q

Sonographic appearance of the dalkon shield

A

Shadowing ovoid shape device

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92
Q

IUDs create posterior shadowing and have been described as producing an “_________________” on sonogram

A

Entrance and exit echo

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93
Q

If the IUD is not located in the endometrium then what should be explored ?

A

Existence of myometrial perforation

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94
Q

Patients that have an IUD perforated into the uterine wall will often complain of what?

A

Irregular or heavy bleeding and cramping

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95
Q

The use of IUDs has been linked with:

A

PID, ectopic pregnancy, and spontaneous abortions

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96
Q

Birth control pills produce an _________ cycle.

A

Anovulatory

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97
Q

Permanent form of birth control that uses small coils placed into the proximal isthmic segment of the Fallopian tubes

A

Easier device

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98
Q

Sonographically how will the essure device appear

A

Bilateral echogenic linear structures with proximal isthmic segments of the Fallopian tubes best seen in the transverse plane

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99
Q

Female sterilization in the form of ___________________ offers another permanent pregnancy prevention method

A

Tubal ligation

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100
Q

If a patient presents to ultrasound with hx of tubal ligation and a positive pregnancy test what should be suspected?

A

Ectopic pregnancy

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101
Q

A normal pregnancy lasts for:

A

9 months, 40 weeks, 280 days

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102
Q

In the early first trimester if TA imaging is used pt should have a :

A

Distended urinary bladder

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103
Q

When a patient is in their late 2nd or 3rd trimester the gravid uterus can compress on the maternal IVC causing :

A

supine hypotensive syndrome

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104
Q

______ denotes the number of times a woman has been pregnant.

A

gravidity

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105
Q

________ denotes the number of pregnancies that led to the birth of a fetus at or beyond 20 weeks or an infant who weighed at least 500g.

A

parity

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106
Q

In the 2nd trimester painless vaginal bleeding is most often associated with:

A

placenta previa

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107
Q

In the 2nd trimester painful vaginal bleeding may occur as a result of:

A

placental abruption

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108
Q

The triple screen consists of :

A

hCG, MSAFP, estriol

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109
Q

The quadruple screen consists of:

A

hCG, MSAFP, estriol, and inhibin A

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110
Q

Some medical institutions provide an earlier test than the customary triple screen performed between 11-14 weeks, what is this an analysis of?

A

hCG, pregnancy-associated plasma protein a PAPP-A, combined with fetal NT

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111
Q

A newer blood test is available, which is a type of cell-free fetal DNA testing. Can reveal gender and is also highly accurate in detecting chromosomal anomalies:

A

MaterniT21plus

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112
Q

Measurements that are obtained in the first trimester:

A

the yolk sac, gestational sac, CRL, NT

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113
Q

The purpose of a BPP is :

A

to investigate for signs of fetal hypoxia and to assess overall fetal wellbeing.

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114
Q

Standard Fetal Measurement for AC:

A

Measured in an axial plain, taken around the abdomen at the level of the umbilical vein and fetal stomach.

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115
Q

Standard Fetal measurement for HC:

A

Measured at the outer perimeter of the skull at the level of the 3rd ventricle, thalamus, CSP, and falx cerebri

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116
Q

Standard Fetal measurement for FL:

A

Measured at the long axis of the femoral shaft when the ultrasound beam is perpendicular to the shaft

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117
Q

Standard fetal measurement of BPD:

A

Measured from the outer edge of the proximal skull to the inner edge of the distal skull at the level of the 3rd ventricle, thalamus, CSP, and falx cerebri

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118
Q

A type of reverberation artifact caused by several small, highly reflective interfaces such as gas bubbles

A

comet tail artifact

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119
Q

Caused by attenuation of the sound beam:

A

shadowing

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120
Q

An artifact that appears as a solid streak or a chain of parallel bands radiating away from a structure:

A

ringdown

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121
Q

How long should one episode of breathing last during a fetal BPP in order to receive 2 points?

A

30s

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122
Q

How many fetal body movements must be visualized in order to receive 2 points?

A

3 or more gross body movements

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123
Q

_______ presentation is the most common fetal presentation.

A

cephalic

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124
Q

The most common pelvic mass associated with pregnancy is:

A

Corpus luteal cyst

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125
Q

Pregnant patients, who complain of RLQ could be suffering from?

A

acute appendicitis

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126
Q

_______________ is most often secondary to the large size of the uterus with subsequent transient asymptomatic obstruction of the ureters.

A

Hydronephrosis/ dilation of the renal collecting system

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127
Q

MSAFP will ________ with Anencephaly

A

increase

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128
Q

Edwards syndrome (trisomy 13) will decrease which triple/quadruple screenings/additional labs

A

hCG, estriol, MSAFP, inhibin A, and PAPP-A

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129
Q

Cephalocele will _______ MSAFP

A

increase

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130
Q

Trisomy 21 (down syndrome) will increase which labs:

A

hCG, inhibin A

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131
Q

MSAFP will _______ with gastroschisis

A

increase

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132
Q

Spina-bifida (meningocele or myelomeningocele) will cause MSAFP to:

A

increase

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133
Q

An ectopic pregnancy will show a decrease in which labs?

A

hCG, hematocrit

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134
Q

Turner syndrome will cause a decrease in which labs?

A

hCG with hydrops, MSAFP, estriol, inhibin A (with hydrops, PAPP-A

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135
Q

A mature ovum is released through ovulation at around day:

A

14

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136
Q

A sperm which can live up to _______ hours unites with the egg in the distal 1/3 fallopian tube

A

72 hours

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137
Q

Conception usually occurs within ________ after ovulation.

A

24 hours

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138
Q

The combination of the sperm and ovum produces a structure referred to as the:

A

zygote

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139
Q

The zygote undergoes rapid cellular division and eventually forms into a cluster of cells called:

A

morula

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140
Q

The morula continues to differentiate and form into a structure known as:

A

blastocyst

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141
Q

The outer tissue layer of the blastocyst is comprised of :

A

trophoblastic cells

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142
Q

The trophoblastic cells produce which pregnancy hormone?

A

hCG

143
Q

The inner part of the blastocyst will develop into:

A

embryo, amnion, umbilical cord, and primary and secondary yolk sacs

144
Q

The outer part of the trophoblastic tissue will develop into :

A

placenta and chorion

145
Q

On day ____ or ____ of the menstrual cycle, the blastocyst begins to implant into the decidualized endometrium at the level of the fundus.

A

20/21

146
Q

By how many days has complete implantation occurred:

A

28

147
Q

The implantation of the blastocyst within the endometrium may cause some women to experience vaginal bleeding, referred to as:

A

implantation bleeding

148
Q

Primary yolk sac regresses during which week:

A

4, and two separate membranes are formed

149
Q

When two separate membranes are formed from the primary yolk sac, the outer membrane represents:

A

chorionic sac/ gestational sac

150
Q

Within the gestational sac is the :

A

amnion or amniotic sac

151
Q

By the end of the 4th week, the ________ becomes wedged in between two membranes in an area called the chorionic cavity or extraembryonic coelom.

A

secondary yok sac

152
Q

The developing embryo is located between the yolk sac and the ______ at four weeks.

A

amnion

153
Q

When the developing embryo is located between the yolk sac and the amnion (at 4 weeks) _______ is formed.

A

alimentary canal

154
Q

The ______ will become the fetal head and spine.

A

neural tube

155
Q

The alimentary canal will become:

A

foregut, midgut, and hindgut

156
Q

The lab used to detect pregnancy:

A

hCG

157
Q

hCG is produced throughout pregnancy by the:

A

placenta

158
Q

In the first trimester what maintains the corpus luteum cyst of the ovary so that progesterone can continue to produce:

A

hCG

159
Q

hCG is detected in the maternal blood as early as:

A

23 days

160
Q

What is the earliest definitive sign of an IUP

A

Gestational sac

161
Q

The period given to describe the earliest sonographic detection of an IUP is termed the:

A

discriminatory zone

162
Q

Typically at 5 weeks, a _____ gestational sac will be seen

A

5mm

163
Q

Normal hCG levels double every ________

A

48 hours

164
Q

the _________ of the endometrium is essentially the first sonographically identifiable sign of pregnancy:

A

decidual reaction

165
Q

The decidual endometrium will appear:

A

thick and echogenic as a result of the continued production of progesterone

166
Q

Earliest gestational sac is seen: _______ and will grow at a rate of ______ per day

A

5 weeks/1mm

167
Q

The intradecidual sign can be misdiagnosed because it may resemble :

A

psuedogestational sac of an ectopic pregnancy

168
Q

The double sac sign denotes the typical appearance of the two distinct layers of the decidua:

A

decidua capsularis (inner) and decidua parietalis (outer layer)

169
Q

The space between the gestational sac and the amniotic sac, the location of the secondary yolk sac

A

chorionic cavity

170
Q

the decidualized tissue at the implantation site containing the chorionic villi, the fetal contribution of the placenta:

A

chorion frondosum

171
Q

The portion of the chorion that does not contain chorionic villi

A

chorion laeve

172
Q

Fingerlike extension of trophoblastic tissue that invades the decidualized endometrium

A

chorionic villi

173
Q

The endometrial tissue at the implantation site. The maternal contribution of the placenta:

A

decidua basalis

174
Q

The portion of the decidua opposite the uterine cavity, across from the decidua basalis:

A

decidua capsularis

175
Q

the decidualized tissue along the uterine cavity adjacent to the decidua basalis

A

decidua parietalis

176
Q

The earliest sonographic measurement that can be obtained to date the pregnancy:

A

gestational sac

177
Q

The gestational sac measurement can be used until there is a :

A

fetal pole

178
Q

By adding ____ to the MSD sonographers can obtain an estimate for the gestational age in days.

A

30

179
Q

An irregularly shaped gestational sac and MSD of > _____ that does not contain a fetal pole are both signs of potential pregnancy failure:

A

25

180
Q

The first structure seen with sonography within the gestational sac is the :

A

secondary yolk sac

181
Q

The yok sac produces ____ and plays an important role in angiogenesis and hematopoiesis during early development

A

AFP

182
Q

The yolk sac is connected to the embryo by the _____, aka omphalomesenteric duct.

A

vitelline duct

183
Q

The gestational sac consists of 2 cavities:

A

chorionic cavity and amniotic cavity

184
Q

The chorionic cavity lies between:

A

amnion and chorion

185
Q

The chorionic cavity contains:

A

yolk sac and fluid

186
Q

The amniotic cavity contains :

A

simple-appearing amniotic fluid and the developing embryo

187
Q

The amnion and chorion typically fuse around:

A

middle of the first trimester but may not be totally fused until 16 weeks gestation

188
Q

By week ____ the embryo can be seen located within the amniotic cavity adjacent to the yolk sac

A

6

189
Q

Sonographic documentation of heart activity being present between:

A

5 and 6 weeks

190
Q

Heart motion can be detected in a _____ mm embryo and with motion certainly evident within the ____ mm embryo

A

4/5

191
Q

Embryonic HR of _________ bpm between 5-6 weeks is normal

A

100-110

192
Q

The most accurate sonographic measurement of pregnancy is:

A

CRL

193
Q

Fetal limb buds are identified by:

A

7 weeks

194
Q

At 7 weeks ______ is proportionally larger than the body.

A

head

195
Q

Within the fetal head, a cystic structure may be noted - this most often represents: (7-8 wks)

A

rhombencephalon/hindbrain

196
Q

The rhombencephalon will eventually develop into the:

A

4th ventricle

197
Q

As early as 8 weeks, the _____ may be visualized in the upper abdomen.

A

stomach

198
Q

________ begins at 8 weeks, which marks the developmental stage when the midgut migrates into the base of the umbilical cord.

A

physiologic bowel herniation

199
Q

IF physiologic bowel herniation does not resolve by _____ weeks, a follow-up exam is warranted.

A

12 weeks

200
Q

The developing placenta may be noted at the _________ as a well-defined crescent-shaped homogeneous mass of tissue.

A

end of the first trimester

201
Q

The placenta is formed by the :

A

decidua basalis, the maternal contribution

chorion frondosum, the fetal contribution

202
Q

The term nuchal refers to the_____

A

neck

203
Q

the nuchal translucency is represented by a thin membrane along the __________ aspect of the fetal neck.

A

posterior

204
Q

The most common abnormalities associated with increased NT are:

A

trisomy 21, trisomy 18, Turner syndrome, and congestive heart failure

205
Q

The NT is optimally measured between:

A

11-13weeks and 6 days

when CRL measures between 45-84mm

206
Q

The fetus may be seen resting on the ______ and this should not be confused for a prominent NT

A

amnion

207
Q

The normal range of thickness of NT is based on the ___________, although most often a measurement of _____ between 11-13 weeks 6 days is considered abnormal.

A

gestational age; 3 mm

208
Q

It has been recognized with many down syndrome fetuses, the nasal bone is either ______ or _______ between 11-13 weeks.

A

hypoplastic or absent

209
Q

Visualizing the nasal bone separate from the overlying nasal skin will provide an _______ sign in the normal fetus.

A

equal

210
Q

The most common pelvic mass associated with pregnancy is:

A

ovarian corpus luteum cyst

211
Q

The corpus luteum of pregnancy is a _____ cyst that is maintained during the 1st trimester by ______, which is produced by the developing placenta.

A

functional; hCG

212
Q

The corpus luteum secretes ________ and thereby maintains the thickness of the endometrium

A

progesterone

213
Q

Typically the corpus luteum measures between :

A

2-3 cm

may continue to grow up to 10cm

214
Q

The circumferential rim of the corpus luteum typically produces what type of waveform:

A

low resistance spectral doppler

215
Q

The calipers during NT measurement must be placed ______ to the long axis of the fetus.

A

perpendicular

216
Q

An ectopic pregnancy is also referred to as:

A

extrauterine pregnancy EUP

217
Q

_______ is the most common cause of pelvic pain with a positive pregnancy test.

A

EUP

218
Q

The most common location for EUP is :

A

within the fallopian tube, the specifically ampullary portion of the tube

219
Q

Contributing factors for ectopic pregnancy:

A

previous ectopic, previous tubal surgery, hx of pelvic inflammatory disease, undergoing fertility treatment, previous or present use of an IUD, multiparity, advanced maternal age

220
Q

When a patient has a EUP and coexisting IUP it is termed:

A

heterotopic pregnancy

221
Q

The classic clinical triad of an EUP includes:

A

pain, vaginal bleeding and palp abdominal pelvic mass

222
Q

______ can be helpful in determining EUP because a normal IUP should double every 48 hours.

A

hCG

223
Q

___________ pregnancies are considered potentially life-threatening because the pregnancy may progress normally until a spontaneous rupture occurs.

A

interstitial

224
Q

__________ is a drug used to medically treat an EUP

A

methotrexate

225
Q

Sonographic findings of ectopic pregnancy:

A

the extrauterine gestational sac containing a yolk sac, adnexal ring sign, complex adnexal mass, a large amount of free fluid within the pelvis or in Morison pouch, complex free fluid could represent hemoperitoneum, pseudogestational sac, poor decidual reaction, an endometrial cavity containing blood

226
Q

Benign ________________ often referred to as molar pregnancy or hydatidiform mole, is a group of disorders that result from an abnormal combination of male and female gametes.

A

Gestational trophoblastic disease

227
Q

The most common form of the gestational trophoblastic disease:

A

complete molar pregnancy

228
Q

The most common forms of malignant GTD are:

A

invasive mole, choriocarcinoma

229
Q

(GTD) The most common sites of metastatic involvement are :

A

lugs, liver, and vagina

230
Q

Patients who present with a diagnosis of molar pregnancy are often referred for:

A

chest radiographs or other studies for further evaluation of metastasis

231
Q

Treatment for molar pregnancy:

A

D&C, hCG monitoring, hysterectomy, & possibly chemo

232
Q

Clinical findings of GTD

A

hyperemesis gravidarum,
markedly elevated hCG ( potentially higher than 100,000 mIU per mL),
heavy vaginal bleeding with possible passage of grape-like molar clusters,
hypertension,
uterine enlargement
hyperthyroidism

233
Q

Sonographic findings of complete molar pregnancy

A

complex mass within the uterus,
color doppler may reveal hypervascularity around the mass but not within it,
vesicular snow storm secondary to placental enlargement, multiple cysts replacing the placental tissue (hydropic chorionic villi),
bilateral ovarian theca lutein cysts

234
Q

Partial or incomplete molar pregnancy may be accompanied by a coexisting:

A

triploid fetus, parts of the fetus, or amnion

235
Q

With partial or incomplete molar pregnancy how will hCG present:

A

Normal, minimally elevated

236
Q

Invasive molar pregnancy invades:

A

the myometrium and may also invade through the uterine wall and into the peritoneum

237
Q

___________ is diagnosed when there is no evidence of a fetal pole or yolk sac within the gestational sac

A

blighted ovum/anembryonic gestation

238
Q

Clinical findings of Blighted ovum:

A

vaginal bleeding, reduction of pregnancy symptoms, low hCG

239
Q

_____________ is defined by the death of the embryo or fetus.

A

embryonic demise/fetal demise

240
Q

Cardiac activity should be detected in a pole that measures:

A

4-5mm

241
Q

The normal embryonic HR at 6 weeks is typically between

A

100-110

242
Q

absent cardiac activity when the CRL is below _______ is suspicious for pregnancy failure

A

7mm

243
Q

________ is essentially a bleed between the endometrium and the gestational sac.

A

subchorionic hemorrhage

244
Q

subchorionic hemorrhage results from the:

A

implantation of the fertilized ovum into the uterus with subsequent low-pressure bleeding or spotting.

245
Q

By ________ the neural plate the structure that will form the central nervous system has developed.

A

4.5

246
Q

The proper measurement of the lateral ventricle is taken at the :

A

atria

247
Q

Where are the mid cerebral arteries located in the circle of Willis

A

laterally - bilaterally

248
Q

The rhombencephalon aka:

A

hindbrain

249
Q

The skull consists of _______ cranial bones.

A

8

250
Q

Premature fusion of the sutures is termed:

A

craniosynostosis

251
Q

Craniosynostosis leads to :

A

an irregular shaped skull

252
Q

Spaces that exist between the forming fetal skull bones are referred to as:

A

fontanelles or soft spots

253
Q

The opening in the base of the cranium through which the spinal cord travels:

A

foramen magnum

254
Q

The brain can be divided into two main parts:

A

cerebrum and cerebellum

255
Q

The cerebral hemispheres are linked in the midline by the :

A

corpus callosum

256
Q

Three protective tissue layers that cover the brain and spinal cord are termed:

A

meninges

257
Q

The innermost layer of the meninges :

A

pia mater

258
Q

The middle layer of the meninges is the:

A

arachnoid membrane

259
Q

The dense, outermost layer of the meninges is the :

A

dura mater

260
Q

The corpus callosum should be completely intact between:

A

18-20 weeks

261
Q

The absence of all or part of the corpus callosum is termed:

A

agenesis of the corpus callosum

262
Q

The midline brain structure is located in the anterior portion of the brain between the frontal horns of the lateral ventricles. (box-shaped)

A

Cavum Septum pellucidum

263
Q

The ______ does not communicate with the ventricular system, and its absence is associated with multiple cerebral malformations.

A

CSP

264
Q

The two lobes of the thalamus are located on both sides of the:

A

3rd ventricle

265
Q

The thalamus should not be confused with the ____________________, which are more inferiorly positioned in the brain.

A

cerebral peduncles

266
Q

The ventricular system is composed of ____ ventricles, whose primary function is to provide cushioning for the brain.

A

4

267
Q

Each ventricle is lined by a membrane called the :

A

ependyma

268
Q

What is responsible for the production of cerebrospinal fluid in the fetus:

A

choroid plexus

269
Q

Each lateral ventricle communicates with the 3rd ventricle in the midline of the brain at the:

A

foreman Monro

270
Q

The third ventricle is located between:

A

the two lobes of the thalamus

271
Q

The third ventricle connects to the fourth ventricle inferiorly by means of a long tubelike structure called:

A

the aqueduct of sylvius/cerebral aqueduct

272
Q

The fourth ventricle is located ________ to the cerebellum.

A

anterior

273
Q

The two lateral apertures (in the fourth ventricle) are also referred to as:

A

foramina of luschka

274
Q

The foramina of luschka allow CSF to travel from the 4th ventricle to the:

A

subarachnoid space around the brain

275
Q

Another opening of the fourth ventricle, which is located midline and is the median aperture is also known as:

A

foramen of magendie

276
Q

Foramen of magendie alllows CSF to pass from the 4th ventricle to the _________________

A

cisterna magna and subarachnoid space

277
Q

CSF flows ________ and around the spinal cord

A

inferiorly

278
Q

____________ are responsible for the reabsorption of CSF into the venous system.

A

arachnoid granulations/arachnoid villi

279
Q

The cisterna magna, located in the _____ fossa of the cranium.

A

posterior

280
Q

The cerebellum is located in the ______ fossa of the cranium.

A

posterior

281
Q

The cerebellum consists of two hemispheres right and left that are coupled at the midline by the:

A

cerebellar vermis

282
Q

The normal cerebellum is what shape:

A

dumbbell or figure 8 shaped

283
Q

BPD measurement of the fetal head can be taken starting between:

A

13-14 weeks

284
Q

BPD is obtained in what plane:

A

axial

285
Q

What should be seen in the BPD/HC measurement

A

CSP, thalamus, and falx

286
Q

cephalic index =

A

BPD/OFD x 100

287
Q

Head shape that is considered round or short and wide.

A

brachycephalic

288
Q

The head shape that is elongated, narrow head:

A

dolichocephaly, scaphocephaly

289
Q

A cephalic index of less than _______ denotes a dolichocephalic shape.

A

75

290
Q

Cephalic index of more than ____ denotes brachiocephalic shape.

A

85

291
Q

The lateral ventricle is measured in the transaxial plane at the level of the :

A

atrium

292
Q

The calipers are placed at the level of the _____ of the choroid plexus for a measurement of the lateral ventricles.

A

glomus

293
Q

The normal lateral ventricle does not typically measure more than:

A

10mm

294
Q

Enlargement beyond 10 mm of the lateral ventricles is referred to as:

A

ventriculomegaly/ hydrocephalus

295
Q

The cerebellum grows at a rate of _____ per week between 14-21 weeks

A

1mm

296
Q

The depth of the cisterna magna should not measure more than

A

10 mm

297
Q

The depth of the cisterna magna should not measure less than:

A

2 mm

298
Q

Measurement of the cisterna magna more than 10 mm is consistent with :

A

mega cisterna magna and dandy-walker complex

299
Q

A measurement of the cisterna magna less than 2 mm is worrisome for:

A

Arnold-chiari II malformation

300
Q

The buildup of CSF within the ventricular system secondary to some type of obstruction:

A

obstructive hydrocephalus

301
Q

________ has been cited as the most common cranial abnormality.

A

ventriculomegaly

302
Q

____________ sign describes the echogenic choriod plexus hanging lump surrounded by CSF.

A

dangling choroid sign

303
Q

__________________ is apparent when the obstruction lies outside the ventricular system

A

communicating hydrocephalus

304
Q

_____________ is when the obstruction level is located within the ventricular system.

A

non-communicating hydrocephalus

305
Q

The most common cause of hydrocephalus in utero

A

aqueductal stenosis

306
Q

The cerebral aqueduct (aqueduct of Sylvius), is located between :

A

3rd and 4th ventricles

307
Q

An obstruction (stenosis) at the aqueduct of Sylvius would cause :

A

3rd ventricle and both lateral ventricles to expand - 4th ventricle remains normal.

308
Q

Fatal condition in which the entire cerebellum is replaced by a large sac containing CSF

A

hydranencephaly

309
Q

With hydranencephaly, there is no cerebral ______ present

A

mantle

310
Q

Midline brain anomaly that is associated with not only brain aberrations but also atypical facial structures.

A

holoprosencephaly

311
Q

3 types of holoprosencephaly

A

alobar, semilobar, and lobar

312
Q

With alobar holoprosencephaly the cortex can take on three basic shapes

A

pancake, cup, or ball

313
Q

The most severe form of holoprosencephaly :

A

alobar

314
Q

Alobar holoprosencephaly is diagnosed when there is the absence of:

A

corpus callosum, CSP, 3rd ventricle, intrahemispheric fissure, falx

315
Q

___________ or _________ is present in 50-70% of fetuses diagnosed with holoprosencephaly

A

Trisomy 13, patau syndrome

316
Q

Sonographic findings of alobar holoprosencephaly:

A

Horseshoe-shaped monoventricle, fused echogenic thalami, absence of the CSP, interhemispheric fissure, falx cerebri, corpus callosum, third ventricle, Normal cerebellum and brain stem

317
Q

Cerebellar vermis is either completely absent or hypoplastic, as a result, the tentorium, the structure that separates the cerebrum from the cerebellum, is elevated. This represents what malformation:

A

dandy-walker malformation

318
Q

Facial anomalies of alobar holoprosencephaly:

A

cyclopia, hypotelerism, proboscis, cleft lip, anophthalmia, cebocephaly

319
Q

If the cerebellar vermis is absent and the 4th ventricle is enlarged then _________ must be suspected

A

DWM - Dandy walker

320
Q

The corpus callosum is completely formed by:

A

18 weeks

321
Q

Most often if the corpus callosum is absent then:

A

the CSP will be as well

322
Q

In the normal brain, the sulci within the cerebrum typically travel _______ to the corpus callosum, but with agenesis of the corpus callosum, they tend to have a more ________ or radial arrangement. (spoke wheel pattern)

A

parallel/perpendicular

323
Q

Associated with the development of fluid-filled clefts within the cerebrum.

A

schizencephaly

324
Q

The Sonographic appearance of open lip schizencephaly is that of a cerebrum containing __________ clefts filled containing anechoic CSF.

A

gray matter lined

325
Q

A rare condition in which a cyst communicates with the ventricular system:

A

porencephaly

326
Q

Porencephaly can occur after the fetus has experienced _________ within one or both cerebral hemispheres.

A

hemorrhage

327
Q

Condition in which there are no gyri within the cerebral cortex

A

lissencephaly

328
Q

________ and ______ are the most common neural defects.

A

anencephaly and spina bifida

329
Q

________ in a woman’s diet significantly reduces the likelihood of her fetus developing a neural tube defect.

A

.4mg of folate

330
Q

______ is defined as the absence of the cranial vault above the bony orbits.

A

acrainia

331
Q

_______ is considered when there are no cerebral hemispheres present - where as _________ denotes a normal amount of cerebral tissue

A

anencephaly/ exencephaly

332
Q

Sonographic appearance of anencephaly:

A

froglike facies, bulging eyes, and absence of the cranial vault.

333
Q

Clinical findings of acrania/anencephaly:

A

elevated MSAFP

334
Q

Spina bifida may result in a mass protruding form the spine, this mass can be referred to as a __________ or ________.

A

meningocele/myelomeningocele

335
Q

Most common location of spina bifida is :

A

the distal lumbosacral region

336
Q

Frontal horns will be small and slitlike, whereas the occipital horns will be enlarged, this describes what condition of the fetal skull?

A

colpocephaly

337
Q

Sonographic signs of Arnold Chiari II malformation

A

lemon sign, banana sign, obliterated cisterna magna, colpocephaly, enlarged Massa intermedia, hydrocephalus, an open spinal defect

338
Q

protrusions of intracranial contents through a defect in the skull:

A

cephalocele

339
Q

The most common location for a cephalocele

A

occipital region

340
Q

what are the contents of a meningocele?

A

meninges only

341
Q

what are the contents of an encephalocele:

A

brain tissue only

342
Q

what are the contents of an encephalomeningocele

A

both meninges and brain tissue

343
Q

encephalomeningocystocele

A

meninges, brain tissue, and lateral ventrical

344
Q

Most common in utero infection:

A

cytomegalovirus

345
Q

Sonographic intracranial findings consistent with intrauterine infections:

A

are the calcifications around the ventricles and ventriculomegaly

346
Q

Most common intracranial tumor in utero:

A

teratoma

347
Q

Most common risk factor for fetal intrauterine intracranial hemorrhage :

A

maternal platelet disorders

348
Q

The normal cerebral circulation typically yields a _______ impedance doppler pattern, with the continuous forward flow throughout the cardiac cycle.

A

high

349
Q

Doppler of the _____ has been shown effective at evaluating for potential hypoxia.

A

MCA

350
Q

The resistance pattern of the MCA should be _____ than that of the umbilical artery

A

greater

351
Q

An arteriovenous malformation that occurs within the fetal brain:

A

Vein of Galen aneurysm

352
Q

Sonographic findings of a vein of Galen aneurysm :

A

large, anechoic mass within the midline of the cranium, when using color doppler will fill with turbulent venous and arterial flow

353
Q

Fetus suffering from the vein of Galen aneurysm will also have signs of :

A

hydrops and cardiomegaly

354
Q

Clinical findings of Vein of Galen Aneurysm: (neonatal)

A

congestive heart failure

OBGYN 20-24 (1 decks)

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