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OB/GYN II > Ch. 35, 36 & 61 > Flashcards

Ch. 35, 36 & 61 Flashcards

1
Q

With transvaginal scanning, the fetal heartbeat can be detected at _______ weeks

A

4-5

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2
Q

With transvaginal scanning, detailed anatomy and screening for defects is done in the ________

A

2nd-3rd trimesters

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3
Q

About _______ infants are born each year with congenital heart defects

A

30,000

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4
Q

Fetal echocardiography may be done after _____ with the optimum time of _______

A

14-16 weeks, 18-22 weeks

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5
Q

What is a fetal echocardiogram

A

focused ultrasound on the fetal heart, targeted sonogram done by trained personnel for specific indications

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6
Q

Details of fetal heart anatomy are better seen as gestation progresses

A

true

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7
Q

Doppler imaging of the fetal heart may be done without any concern about risk of bioeffects at all

A

false

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8
Q

There is no special training needed for a sonographer to do fetal echocardiograms

A

false

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9
Q

If a fetus has severe genetic abnormalities what is the usual outcome of the pregnancy

A

spontaneous abortion

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10
Q

The ______ system is the first fetal organ system to function

A

cardiovascular

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11
Q

By the end of the _____ week circulation of blood has begun

A

3rd

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12
Q

Blood formation in the embryo begins in the ______ week

A

5th

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13
Q

The space between the primitive atria and primitive ventricles is called the

A

AV canal

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14
Q

Endocardial cushions grow to divide the AV canal into _______ and ________

A

right, left halves

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15
Q

Truncal cushions are formed by _______ cells that migrate from the _______

A

neurocrest, hind brain

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16
Q

Why is it possible for most of the fetal blood to bypass the fetal lungs

A

foramen ovale, oxygenation occurs in the placenta and lungs aren’t used yet

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17
Q

List the 3 fetal circulatory structures that are no longer needed after birth and what they become

A

foramen ovale, ductus venosus, ductus arteriosus/arch

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18
Q

Define brachycardia

A

heart rate <100 bpm

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19
Q

Define tachycardia

A

heart rate >200 bpm

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20
Q

List the fetal risk factors that are associated with an increased likelihood for congenital heart defects

A

IUGR, cardiac arrhythmias, abnormal amniocentesis indicating a trisomy, abnormal amniotic fluid collections, abnormal heart rate, thickened nuchal translucency, hydrops fetalis, renal and GI anomalies, single umbilical artery

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21
Q

List the maternal risk factors that are associated with an increased likelihood for congenital heart defects

A

previous occurrence of CHD in siblings or parents, untreated diabetes, lupus, drug use, alcohol use, smoking, hypertension

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22
Q

List the Familial risk factors that are associated with an increased likelihood for congenital heart defects

A

genetic syndromes, presence of CHD in previous sibling

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23
Q

Why would a fetus whose mother has lupus be more likely to have bradycardia

A

due to heart block and pericardial effusion caused by the connective tissue disorder

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24
Q

Why is a broad band transducer preferred for fetal echocardiography

A

creates more detailed images

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25
Q

How can a transvaginal probe be used for fetal echocardiography

A

used when fetus is in transverse lie, easily angled toward heart, higher frequency means more detailed images

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26
Q

Why would cineloop be useful for fetal echocardiography

A

frame-by-frame analysis

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27
Q

______ is used to create a tracing of heart motion over time. This is used to evaluate ____ and _____ motion, opening and closing of ______ and ______ size

A

M-mode, wall, septal, valves, chamber

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28
Q

If the fetal heart beats 3 times/second what is the heart rate

A

180 bpm

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29
Q

Color doppler is useful for detecting ______ and ______ in blood flow

A

direction, turbulence

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30
Q

Why is 3D fetal echocardiography not better than 2D

A

decrease image clarity

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31
Q

What should the fetal echocardiographer document before targeting the fetal heart

A

position of fetus, stomach, aorta, IVC, location of apex, position of placenta, BPD, FL

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32
Q

List the anatomy that can be seen and evaluated from the four chamber view of the heart

A

RA, RV, tricuspid valve, LA, LV, mitral valve, interventricular septum, interatrial septum, foramen ovale, pulmonary veins as they enter LA, pulmonic valve

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33
Q

In the fetus, the foramen ovale opens into the _____ atrium

A

left

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34
Q

The ______ is a faint echogenic structure that can be seen in the right ventricle

A

moderator band

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35
Q

The tricuspid valve is located just ________ to the mitral valve

A

inferior

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36
Q

Which pulmonary vein is NOT seen in the four chamber view

A

right lower vein

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37
Q

What measurements of the fetal heart are done in the 4 chamber view

A

right/left ventricular width measurements, IVS thickness, atrium width valves

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38
Q

Why is it important to only use one focal zone when doing fetal echocardiography

A

increases frame rate

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39
Q

How does the sonographer differentiate the aortic arch from the ductus arteriosus

A

aortic arch has 3 vessels/branches looks like candy cane, ductus arteriosus has no branches and looks like a hockey stick

40
Q

To reach the five chamber view, the transducer is angled ______ from the four chamber view

A

anterior (up)

41
Q

The pulmonary artery is normally _____ and _______ to the aorta

A

anterior, left

42
Q

What cardiac structures are imaged in the five chamber view

A

LA, LV, mitral valve, LVOT, aortic root

43
Q

What cardiac structures are imaged in the LVOT view

A

rt & lt ventricles, LA, aortic valve, ascending aorta, IVS

44
Q

What does the sonographer assess to the long axis view to evaluate for membranous VSD

A

continuing of right IVS with anterior wall of the aortic root

45
Q

If there is no VSD seen on fetal echo, does that guarantee that there isn’t one? Why or why not

A

No, VSD must be 5-10mm, half of aortic diameter

46
Q

The pulmonary artery is a little _____ at its origin than the aorta

A

wider

47
Q

What is a tricuspid aortic valve

A

3 cusps with or without eccentric closure

48
Q

How does tricuspid valve dhow up on fetal echo

A

fish mouth appearance

49
Q

What vessel is evaluated in the hockey stick view? Will this view be possible in the normal child or adult

A

ductus arteriosus, no

50
Q

What are the 3 most common types of congenital heart defects

A

ASD, VSD, pulmonary stenosis

51
Q

Why are ASDs difficult to recognize in fetal life

A

foramen ovale remains open until after birth, when pressure change between right and left atrium forcing foramen to close completely

52
Q

If the flap of the foramen ovale is too long, what can happen to the fetal heart rhythm. Why?

A

can cause fetal arrhythmias, flap is touching lateral wall of atrium agitating the SA node in the right atrium

53
Q

Atrioventricular septal defect is a defect of the

A

endocardial cushions

54
Q

Atrioventricular septal defects affect the valves as well as the septum

A

true

55
Q

_________ is a defect with a single, free-floating valve leaflet that stretches across both ventricles across a VSD

A

complete atrioventricular septal defect

56
Q

What is a common atria

A

complete absence of the interartial septum, atria completely fill through systole and diastole

57
Q

In the 4 chamber view of the fetal heart, the left ventricle is enlarged/dilated. The right ventricle is very hypoplastic. There is no movement seen at the tricuspid valve annulus and a VSD is present. What is the probable diagnosis

A

tricuspid atresia

58
Q

_______ is the abnormal displacement of the septal leaflet of the tricuspid valve into the right ventricle

A

ebsteins anomaly

59
Q

________ is the most common form of cyanotic heart disease

A

tetralogy of fallot

60
Q

What is the cyanotic heart disease

A

pulmonary stenosis causes baby to turn blue, prevents oxygenation of blood

61
Q

List the 4 characteristic findings of tetralogy of fallot

A

rt ventricular hypertrophy, large VSD, overriding aorta, pulmonary stenosis

62
Q

Define double outlet right ventricle

A

both great vessels arising from right side of the heart, aorta is directed more to the right ventricle than to the left

63
Q

In a fetal echo, the mitral valve orifice is echogenic and thick and the valve doesn’t move. The left ventricle is hypoplastic and the ventricular wall is thick. What is the likely diagnosis

A

mitral valve atresia, hypoplastic left heart, mitral stenosis

64
Q

Mitral regurgitation is a normal finding in the fetus

A

false

65
Q

In cases of congenital aortic stenosis, what happens to the left ventricle? Why?

A

LVOT dilates (blocked), fluid overload occurs and ventricle can’t empty

66
Q

Define coarctation of the aorta

A

narrowing of the arch

67
Q

Coarctation of the aorta is almost always an isolated defect

A

false

68
Q

Hypoplastic Left Heart syndrome may be caused by premature closing of the foramen ovale

A

true

69
Q

Define transposition of the great arteries (vessels). What causes it?

A

abnormal condition when aorta is connected to RV and pulmonary artery is connected to the LV, abnormal completion of the loop in emnryology

70
Q

________ is a condition in which the right atrium is connected to the morphologic left ventricle and the left atrium is connected to the morphologic right ventricle. List two conditions that this anomaly is associated with

A

corrected transposition of the great vessel, malposition of the heart and situs inversus

71
Q

_______ occurs when the contotruncus fails to separate into the aorta and pulmonary trunk. Is this anomaly easily seen on fetal echo

A

persistent truncus arteriosus, yes

72
Q

_______ is an anomaly where the two atria connect to only one ventricle

A

single ventricle, 3 chamber heart

73
Q

Define cardiomyopathy

A

disease of the myocardium

74
Q

List two causes of cardiomyopathy

A

bacterial infection, hereditary and metabolic syndrome

75
Q

_________ occurs when the pulmonary veins do not drain into the left atrium. The prognosis is ______

A

total anomalous, poor

76
Q

Cardiac tumors are common

A

false

77
Q

The majority of cardiac tumors are malignant

A

false

78
Q

All cardiac tumors are benign

A

false

79
Q

List two cardiac findings associated with asplenia syndrome

A

transposition of great vessels, single ventricle, ASD, AVSD, pulmonary atresia, dextrocardia, double outlet right ventricle

80
Q

Asplenia is more common in males than in females

A

true

81
Q

List two cardiac findings with polysplenia syndrome

A

ASD, AVSD, transposition of the great vessels, dextrocardia, double outlet right ventricle

82
Q

_______ is an anomaly where the heart is located outside the chest wall

A

ectopic cordis

83
Q

Premature atrial or ventricular contractions occur when the electrical impulse is generated _______ the SA node

A

outside

84
Q

What mode is helpful in documenting fetal arrhythmias

A

M mode

85
Q

A benign tumor of the heart associated with tuberous sclerosis is

A

rhabdomyomas

86
Q

Which abnormality is a fetal cardiac arrhythmia caused by extra systoles and ectopic beats

A

ectopic premature atrial and ventricular contractions

87
Q

Failure of the leaflets to close completely, allowing blood to leak backward into the left atrium is called ______ regurgitation

A

mitral

88
Q

A discrete or long-segment narrowing in the aortic arch, usually at the level of the left subclavian artery near the insertion of the ductus arteriosus, is called

A

coarctation of the aorta

89
Q

A disease of the myocardial muscle layer of the heart that causes the heart to dilate secondary to regurgitation and also affects cardiac function is

A

cardiomyopathy

90
Q

In which of the following congenital heart lesions does only one great artery arise from the base of the heart

A

truncus arteriosus

91
Q

What cardiac structures are imaged in the short axis view (RVOT)

A

RA, RV, tricuspid valve, pulmonic valve, MPA anterior to aorta and bifurcation of right and left pulmonary artery, aortic valve, aortic root

92
Q

With the addition of cardiac outflow tract views ______ of CHD can be detected

A

85-90%

93
Q

What are the 4 characteristics of tetralogy of fallot

A

rt ventricular hypertrophy, VSD-large, overiding aorta, pulmonary stenosis

94
Q

_______ is typically a unilateral condition characterized by replacement of normal lung parenchyma by abnormal tissue which includes cysts

A

congenital cystic adenomatoid malformation CCAM

95
Q

Which CCAM type is one or more large cysts >2cm

A

type 1

96
Q

Which CCAM type is multiple small cysts <1-2cm

A

type 2

97
Q

Which CCAM type is multiple small cysts-too small to be seen by ultrasound beam so lung appears hyperechoic

A

type 3

OB/GYN II (13 decks)

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