2nd/3rd trimester pathology P1 (37%) Flashcards
you are evaluating the heart on a 28 week fetus. a single large trunk vessel exits the heart and the pulmonary artery appears to branch from it instead of from the right ventricle. these findings describe:
a. partial anomalous pulmonary venous return
b. total anomalous pulmonary venous return
c. double outlet left ventricle
d. truncus arteriosus
d
truncus arteriosus refers to a single large outflow tract with malalignment VSD. type 1 occurs when the pulmonary artery arises from the trunk vessel after it exits the heart. there are 4 types of truncus with type 1 being the most common
while scanning a 21 week fetus you identify splaying of cerebellar lobes with absence of the cerebellar vermis. the 13mm cisterna magna is anechoic and the 4th ventricle is dilated. these findings are most consistent with:
a. schizencephaly
b. hydranencephaly
c. trisomy 13
d. dandy walker malformation
d
sonographic appearance of DWM:
cystic dilation of the 4th ventricle that expands into posterior fossa
>10mm CM
splayed cerebellar lobs, small or absent vermis
ventriculomegaly or hydrocephalus
polyhydramnios
what is the most commonly identified fetal chest mass
a. congenital cystic adenomatoid malformation (CCAM)
b. cardiac sarcoma
c. diaphragmatic hernia (digestive tract segment above the diaphragm
d. pulmonary sequestration
a
congenital cystic adenomatoid malformation (CCAM) is the most common chest mass identified in a fetus. CCAM is the overgrowth of terminal bronchioles into a multicystic mass of pulmonary tissue. the cysts can be classified as microcystic or macrocystic. the cysts communicate with each other and bronchial tree
which of the following conditions is the most common cause of hydronephrosis in a fetus
a. bladder exstrophy
b. aqueductal stenosis
c. ureteropelvic junction obstruction
d. posterior urethral valves
c
UPL obstruction is the most common cause of renal hydronephrosis in a fetus
which of the following is least likely to be associated with placental abruption
a. smoking
b. fibroids
c. placental lakes
d. cocaine use
c
placental abruption can be associated with abdominal trauma, smoking, fibroids and drug use. placental lakes are a normal finding
while scanning a 22wk fetus you identify normal long bones in the lower extremities but the feet are very small with shortened tarsals and metatarsals. which of the following of the terms describes this isolated finding
a. rhizomelia
b. acromelia
c. phocomelia
d. clinodactyly
b
acromelia refers to the shortening of the most distal portion (hand, foot) of an extremity
the most common cardiac defect seen with trisomy 21 is
a. patent ductus arteriosus
b. AV canal defect of AVSD
c. ventricular septal defect
d. atrial septal defect
b
trisomy 21 commonly seen with an AVSD, which is a complex congenital defect. the atrioventricular canal defect is a combination of an ostium primum ASD and an inlet VSD
while performing a scan on a 21 week fetus you identify ectopia cordis, club foot and an asymmetric cleft lip/palate. which of the following is the most likely cause of these findings
a. tetralogy of fallot
b. amniotic band sequence
c. pentalogy of cantrell
d. patau syndrome
b
an asymmetric facial cleft is commonly caused by amniotic band sequence. other structural abnormalities can be identified such as omphalocele ectopia cordis and skeletal anomalies (club foot). symmetric clefting is more commonly related to congenital/chromosomal anomalies
when evaluating the abdominal circumference of a 30 week fetus you note that the umbilical vein curves to the left toward the stomach and the gallbladder is medial to the vein. the AC measurement and the skin thickness are normal. these findings are most suggestive of
a. normal anatomy
b. persistent right umbilical vein
c. situs inversus
d. absent ductus venosus
b
persistent right umbilical vein occurs when the right umbilical/portal vein remains open normally the left side remains open. in normal anatomy the umbilical vein curves to the right towards the liver nd the gallbladder is lateral to the vein. with PRUV the umbilical vein curves to the left towards the stomach and the gallbladder is medial to the vein. if situs inversus is present the stomach would be on the right
what is the most common cause for a shift of cardiac axis/position
a. diaphragmatic hernia
b. ectopia cordis
c. chromosomal anomalies
d. congenital cystic adenomatoid malformation
a
a diaphragmatic hernia is the most common reason for shift of cardiac axis/position
a velamentous cord insertion is associated with all of the following except
a. vasa previa
b. IUGR
c. complete molar pregnancy
d. placental abruption
c
there is no fetus (or umbilical cord) in a complete molar pregnancy
you are performing a 4 week follow up on twins that should be 14 weeks. on todays exam there is only a single normal fetus present and an irregular anechoic area adjacent to the normal sac. the patient has not experienced any bleeding. what most likely explains these findings
a. stuck twin syndrome
b. twin to twin transfusion
c. parabolic twin
d. vanishing twin syndrome
d
vanishing twin syndrome; embryonic demise of one fetus in a multiple pregnancy; occurs later in the 1st trimester or in the fist few weeks of the second trimester. failure of sac growth or a sac with irregular contour and margination. remaining twin is usually not affected as the other fetus is resorbed
ebstein anomaly is defined as
a. abnormal placement of the tricuspid valve more inferiorly into the apex of the right ventricle
b. abnormal placement of the tricuspid valve more inferiorly into the apex of the left ventricle
c. abnormal placement of the mitral and tricuspid valves more inferiorly into the apex of the ventricles
d. abnormal placement of the mitral valve more inferiorly into the apex of the left ventricle
a
ebstein anomaly refers to abnormal placement of the tricuspid valve more inferior in the apex of the right ventricle. this causes an enlarged right atrium and small right ventricle
