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OB/GYN I > Ch. 50 Abnormal 1st Trimester Pregnancy > Flashcards

Ch. 50 Abnormal 1st Trimester Pregnancy Flashcards

1
Q

The dominant structure seen in the embryonic cranium during the 1st trimester is the

A

choroid plexus

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2
Q

_____ is a congenital malformation of the brain and face caused by failure of the telecephalon to completely develop

A

holoprosencephaly

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3
Q

Ossification of the cranium is completed in the 1st trimester

A

false

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4
Q

If an embryonic cranial abnormality is suspected in the 1st trimester

A

the fetus is rescanned after 14 weeks

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5
Q

An echogenic mass in the base of the umbilical cord joining the embryonic abdomen at 10 weeks may be

A

Normal herniation of the gut outside the abdominal wall or omphalocele

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6
Q

Omphaloceles containing only bowel are easily diagnosed in the 1st trimester

A

false

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7
Q

Omphaloceles are associated with chromosomal anomalies

A

true

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8
Q

______ is one of the most common congenital defects seen in the 1st trimester

A

cystic hygroma

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9
Q

Can hydrocephalus be diagnosed in the 1st trimester of pregnancy

A

no, 14 weeks

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10
Q

Cystic hygroma is caused by abnormal development of the

A

lymphatic system

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11
Q

Cystic hygroma is associated with ______, especially when diagnosed in the 1st trimester

A

chromosomal abnormalities

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12
Q

_______ is the most common chromosomal abnormality that occurs in fetuses who are diagnosed with cystic hygroma in the 2nd or 3rd trimesters

A

turners syndrome

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13
Q

A cystic structure arising from the posterior fetal neck and upper thorax seen in the 1st trimester is most likely a

A

cystic hygroma

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14
Q

A nuchal translucency measurement of more than _____mm is always abnormal

A

2.5mm

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15
Q

The upper limit of normal for nuchal translucency _____ with increasing gestational age up to 14 weeks

A

increases

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16
Q

Nuchal translucency measurements should be performed with _____ imaging

A

TA or TV

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17
Q

The magnification of the image is not important when measuring nuchal translucency

A

false

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18
Q

_____ of fetuses with trisomy 21 will have abnormal nuchal translucency

A

70%

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19
Q

______ are associated with increased nuchal translucency, even if the karotype is normal

A

cardiac defects

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20
Q

Increased nuchal translucency is associated with which of the following

A

trisomy 13,18,21 and triploidy

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21
Q

______ is a gel like substance that surrounds and cushions the vessels of the umbilical cord

A

whartons jelly

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22
Q

If an umbilical cord cyst is seen in the late 2nd trimester, genetic analysis may be indicated

A

true

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23
Q

A common cause of 1st trimester vaginal bleeding is

A

ectopic pregnancy and retroplacental hematoma

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24
Q

_____ is caused by a separation of part of the placenta from the uterine wall

A

retroplacental hematoma

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25
Q

The larger the retroplacental hematoma is, the less likely it is that the pregnancy will be lost

A

false

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26
Q

The _____ is the most common ovarian mass seen in the 1st trimester of pregnancy

A

corpus luteum cyst

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27
Q

Corpus luteum cysts are usually not seen after _____ weeks

A

18

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28
Q

Ovarian cysts that persists into the 2nd or 3rd trimesters are at higher risk for

A

torsion

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29
Q

Why is it important to document the location of the placenta in relation to uterine fibroids

A

because they reduce the source of blood supply for the placenta if they are located beneath it

30
Q

Fibroids frequently grow during pregnancy due to

A

estrogen stimulation

31
Q

_____ may be mistaken for a fibroid

A

focal uterine contractions

32
Q

One of the most important diagnoses made by sonography is

A

ectopic pregnancy

33
Q

Why has the incidence of ectopic pregnancy increased in recent years

A

increase risk with PID, IUD, infertile patients and endometriosis

34
Q

The most common symptom of ectopic pregnancy is

A

acute pelvic pain

35
Q

The bleeding associated with ectopic pregnancy is caused by

A

invasion of the fallopian tube by trophoblastic tissue

36
Q

Sonographically, the absolute positive diagnosis of ectopic pregnancy is made by

A

identification of a gestational sac outside the uterus

37
Q

The most common site of ectopic pregnancy is

A

fallopian tube

38
Q

Why is it important for the sonographer to know which preparation or standard is used by the lab for quantitative HCG levels

A

because IRP numbers are twice 2IS at the same time of pregnancy

39
Q

A fluid collection often seen in the uterine cavity in cases of ectopic pregnancy is called a

A

pseudogestational sac

40
Q

How does the sonographer distinguish pseudogestational sac from intrauterine pregnancy

A

no fetal pole or yolk sac, filled with low level echoes, no trophblastic flow

41
Q

Doppler flow around a gestational sac is

A

low resistance and high velocity

42
Q

Flow pattern with low resistance and high velocity is referred to as

A

trophoblastic flow

43
Q

Mandy came to the emergency room complaining of severe pelvic pain. Bloodwork revealed a positive pregnancy test. Transvaginal sonography demonstrated an empty uterus, a right adnexal mass, and free fluid in the pelvis with a sand-like texture. No definite gestational sac was seen. What is most likely the diagnosis? What does the right adnexal mass represent? Why does the free fluid have echoes?

A

ectopic pregnancy, hematoma from ruptured tube, blood

44
Q

Which imaging method is used when imaging ectopic pregnancy

A

TA and TV

45
Q

Define heterotopic pregnancy

A

coexisting and intrauterine pregnancies

46
Q

`What treatments increase the risk of heterotopic pregnancy

A

in patients undergoing ovulation induction of IVF

47
Q

______ is the most dangerous type of ectopic pregnancy

A

cornual and interstitual

48
Q

Why is interstitial ectopic pregnancy so dangerous

A

tremendous blood supply and potential for hemorrhage upon rupture

49
Q

Define cervical pregnancy

A

gestational sac implants in cervix

50
Q

If the fetal heart rate in the 1st trimester is less than 90 bpm, the prognosis is poor

A

true

51
Q

If the MSD is _____ less than the CRL, oligohydramnios may be suspected

A

4mm

52
Q

Embryos with 1st trimester oligohydramnios always die

A

true

53
Q

Diagnosis of _____ requires serial sonograms

A

embryonic growth retardation

54
Q

Describe the sonographic appearance of complete abortion

A

reveals empty uterus with normal endo with no adnexal mass or free fluid

55
Q

Describe the sonographic appearance of incomplete abortion

A

thickened or irregular endometrial echos, may see fluid in endo, no heart tones

56
Q

What is another term for imcomplete abortion

A

missed abortion

57
Q

Define anembryonic pregnancy

A

blighted ovum, gest sac is present but no embryo develops

58
Q

Molar pregnancy is easily diagnosed in the 1st trimester

A

false

59
Q

The snowstorm or bunches of grapes appearance of molar pregnancy appears to be specific to the ____ trimester

A

2nd

60
Q

With molar pregnancy, HCG levels are ____ than expected

A

higher

61
Q

Why are serial HCG levels done after evacuation of a molar pregnancy

A

to ensure tropho tissue has been removed

62
Q

_____ refers to a group of tumors that arise from the chorionic villi of the placenta

A

gestational trophoblastic disease

63
Q

Abnormal proliferation of the trophoblast leads to

A

molar pregnancy

64
Q

_____ is the most common form of trophoblastic disease and is benign

A

hyatidiform mole

65
Q

Increased maternal age leads to a ____ risk for molar pregnancy

A

increased

66
Q

Previous history of molar pregnancy leads to a _____ risk for molar pregnancy

A

increased

67
Q

______ has only trophoblastic material and no fetal parts

A

complete molar pregnancy

68
Q

_____ occurs when a sperm fertilizes an ovum that contains no chromosomes

A

complete molar pregnancy

69
Q

______ are locally invasive but do not metastasize

A

invasive molar pregnancies

70
Q

______ is both locally invasive and will develop distant mets

A

choriocarcinoma

71
Q

What characteristics help the sonographer distinguish between hydropic degeneration of the placenta and molar pregnancy

A

HCG levels and presence of normal fetus

OB/GYN I (13 decks)

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