Chapter 22 - Obstetric Sono overview Flashcards
inflammation of the appendix
Acute appendicitis
an estrogenic hormone produced by placenta
estriol
from an unknown region
idiopathic
a peptide hormone secreted by placenta during pregnancy
inhibin A
herniation of cranialor spinal meninges caused byan open cranialorspinaldefect
meninogecele
mass that results from spina bfida that contains spinal cord and meninges
myelomeningocele
anechoic space along posterior aspect of fetal neck
nuchal translucency
extreme paleness of skin
pallor
when the placenta covers or nearly covers the internal os of cervix
placenta previa
premature separation of the placenta from the uterine wall before the birth of the fetus
placental abruption
a protein that is produced by the placenta
pregnancy-associated plasma protein A
a maternal blood test that includes, analysis of HCG, AFP, estriol and inhibin A
quadruple screen
a reduction in blood return to maternal heart caused by gravid uterus compressing the maternal IVC
supine hypotensive syndrome
a maternal blood test that typically includes an analysis of HCG, AFP, estriol
Triple screen
A normal pregnancy typically lasts for ____months, __ weeks , ____ days
9 . 40 , 280
1-12 is considered what trimester
First
13-26 weeks is consider what trimester
second trimester
27-42 weeks is considered what trimester
3rd trimester
Fetal age can be determined by the _____
Last menstrual period
Patients in their 2nd and third trimester may suffer from this syndrome
Supine hypotensive syndrome
denotes the number of times a woman has been pregnant
Gravidity
Denotes the number of pregnancies that led to birth of a fetus at or beyond 20 weeks gestational age or an infant who weighs at least 500 g
Parity
pregnant more than once
multigravida
has given birth more than once
multiparous
has not given birth
nulliparous
first pregnancy
primigravida
has given birth once
primiparous
Triple screen can be done at
15-20 weeks
Triple screen can be done as early as __ weeks depending on medical facility
11-14 weeks
In the first trimester what are some reasons why a patient could present with vaginal bleeding?
Ectopic pregnancy, gestational trophoblastic disease, miscarriage, blighted ovum, embryonic demise, subchorionic hemorrhage
In the second trimester painless vaginal bleeding is often associated with what? What about painful vaginal bleeding?
Placenta previa, placenta abruption
Measurements obtained in the first trimester include what?
Yolk Sac, gestational Sac, Crown rump length, NT
The purpose of biophysical profile scoring is investigate for signs of what?
Fetal hypoxia
What is the highest possible score for a Biophysical profile
10
Where is the AC taken
level of the umbilical vein and fetal stomach
Where is the HC measured
Outer perimeter of the skull at the level of the third ventricle, thalamus, septum, pellucidum,falx cerebra
How should the ultrasound beam be with femur length?
Perpendicular to the shaft
How is the biparietal diameter measured?
Outer edge of proximal skull to Inner edge of distal skull at level of third ventricle, Thalamus, cavum septum pellucidum, falx cerebri
What is a normal score for thoracic movements?
2 points, at least one episode of stimulated fetal breathing lasting at least 30 seconds
What is the normal score for fetal movements?
2 points, at least three or more gross fetal movements
What is the normal score for fetal tone?
Two points, at least one flexion to extension of a limb or one hand opening and closing
What is the normal score for amniotic fluid?
Two points, at least one pocket of fluid that measures 2 cm in vertical diameter in two perpendicular planes
What is the normal score for non-stress test?
Two points, at least two fetal heart acceleration together with one fetal movement
Presentation of the fetus is determined by identifying the fetal anatomy that is closest to what
Internal OS of cervix
What is the most common fetal presentation?
Cephalic
A breech position can be further described as what?
Complete, incomplete, frank
What is complete breech
fetal legs are flexed at hips and there is a flexion of the knee
frank breech presentation is when
fetal buttocks are closest to the CX
What is footling breech
extension of at least one of the legs towards the cx
The most common pelvic mass associated with pregnancy is what
corpus luteum cyst
Abortion will have what triple screening finding
Decreased HCG
Anembryonic pregnancy will have what triple screen finding
Decreased HCG
Ancephaly will have what triple screen finding
increased MSAFP
Cephalocele will have what triple screen findings?
Increased MSAFP
Down syndrome trisomy 21 will have what triple screen finding?
Increase HCG, decrease estriol, decrease msafp, increase inhibin a, decrease Pappa
Ectopic pregnancy will have what triple screen finding?
Decrease HCG, decreased hematocrit with rupture
Edwards syndrome Trisomy 18 will have what triple screen findings?
Decrease estriol, decrease HCG, decrease msafp, decrease inhibin a, decrease Pappa
Gastroschisis will have what triple screen finding?
Increase MSAF
Molar pregnancy will have what triple screen finding?
Increase HCG
Omphalocele will have what triple screen finding
Increase MSAFP
Patau syndrome Trisomy 18 will have what triple screen finding
Increase MSAFP, increase Inhibin A
Spina bifida meningocele or myelomeningocele will have what triple screen finding?
Increase MSAFP
Triploidy will have what triple screen finding
Increase HCG with molar
Turner syndrom will have what triple screen finding
decreased HCG
Which of the following Is not part of the biophysics profile
A. fetal swallowing
B. flexion Of the limb
C. amniotic fluid
D. fetal breathing
A. fetal swallowing
for the normal biophysical profile, the amniotic fluid pocket should measure:
a. greater than 4 cm in two perpendicular planes
b. at least cm in two perpendicular planes
c. greater than 5 cm in two perpendicular planes
d. at least 3 cm in two perpendicular planes
B. at least 1 cm in two perpendicular planes
what is the term for the fetal presentation that is head down?
a. breech
b. crown
c. cephalic
d. vertical
Cephalic
fetal presentation is determined by identifying the fetal part that is closest to the:
a. placenta
b. external os of the cervix
c. maternal umbilicus
d. internal os of the cervix
D. internal os of cx
what is defined as the area located posterior to the broad ligaments and adjacent to the uterus, which contains the ovaries and fallopian tubes?
A.adnexa
B. paraovarian
C. pouch of Douglas
D. space of retzius
A. adnexa
all of the following may be visualized at the correct level of the head circumference except:
a. third ventricle
b. thalamus
c. cavum septum pellucidum
d. falx cerebelli
D. falx cerebelli
typically, with a miscarriage, the serum hCG value will be:
a. elevated
b. decreased
c. this laboratory finding is not helpful
d. unchanged
B. decreased
Typically, with anencephaly, the maternal serum alpha-fetoprotein value will be:
a. elevated
b. decreased
c. this laboratory finding is not helpful
d. unchanged
A. elevated
Typically, with gastroschisis, the maternal serum alpha-fetoprotein value will be:
a. elevated
b. decreased
c. this laboratory finding is not helpful
d. unchanged
A. elevated
the quadruple screen includes an analysis of all of the following except:
a. hCG
b. alphaFetoprotein
c. Inhibin A
d. PAPP-A
D
The reduction in blood return to the maternal heart caused by the gravid uterus compressing the maternal inferior vena cava describes: a. Edwards syndrome
b. Pulmonary obstructive syndrome
c. Supine hypotensive syndrome
d. Recumbent hypotensive syndrome
C.
which of the following would be the least likely indication for a first-trimester sonogram?
a. evaluate pelvic pain
b. define the cause of vaginal bleeding
c. gender identification
d. diagnosis of multiple gestations
C
all of the following would be an indication for a third-trimester sonogram except:
a. evaluate NT
b. evaluate fetal presentation
c. evaluate fetal growth
d. evaluate gestational age
A
What is described as the number of pregnancies in which the patient has given birth to a fetus at or beyond 20 weeks gestational age or an infant weighing more than 500g?
a. Gravidity
b. Parity
c. Primigravida
d. Primiparous
B parity
The number of pregnancies is defined as
a. Gravidity
b. parity
c. primigravida
d. primiparous
A. gravity
In the TPAL designation, the “L” refers to:
a. Living children
b. Lethal anomalies
c. Live births
d. Lost pregnancies
live births
The second trimester typically refers to weeks:
a. 12 through 26
b. 13 through 26
c. 10 through 28
d. 26 through 42
B. 13 through 26 weeks
the clinical manifestations of supine hypotensive syndrome include all of the following except:
a. proteinuria
b. tachycardia
c. nausea
d. pallor
A
Painless second trimester vaginal bleeding is most often associated with:
a. Placental abruption
b. Ectopic pregnancy
c. Miscarriage
d. Placenta previa
D. placenta previa
all of the following are observed during a biophysical profile except:
a. fetal tone
b. thoracic movement
c. fetal breathing
d. fetal circulation
D
which of the following would not be decreased in the presence of Edwards syndrome?
a. estriol
b. hCG
c. alpha-Fetoprotein
d. All would be decreased
D
all of the following are produced by the placenta except:
a. alpha-Fetoprotein
b. hCG
c. PAPP-A
d. Inhibin A
A
A myelomeningocele is associated with:
a. Down syndrome
b. Spina bifida
c. Edwards syndrome
d. Patau syndrome
B. spina bfida
The anechoic space along the posterior aspect of the fetal neck is the:
a. Nuchal fold
b. Nuchal cord
c. Nuchal translucency
d. Rhombencephalon
C. nuchal translucent
The premature separation of the placenta from the uterine wall before the birth of the fetus describes:
a. Placenta previa
b. Placental abruption
c. Ectopic cordis
d. Subchorionic hamartoma
placental abruption
Something that is idiopathic is said to be:
a. Caused by a functional abnormality
b. Related to fetal development
c. From an unknown cause
d. Found incidentally
from an unknown cause
which of the following forms of fetal presentation is the most common?
a. cephalic
b. complete breech
c. frank breech
d. transverse
A
Biophysical profile scoring is conducted:
a. Until the fetus cooperates
b. For 10 minutes
c. For 45 minutes
d. For 30 minutes
D. for 30 mins
What is the fetal presentation when the fetal buttocks are closest to the cervix referred to?
a. Footling breech
b. Frank breech
c. Complete breech
d. Transverse
b. frank breech
which of the following would not typically produce an elevation in hCG?
a. down syndrome
b. anembryonic pregnancy
c. triploidy
d. molar pregnancy
B
the triple screen typically includes an analysis of:
a. hCG, alpha-fetoprotein, and estriol
b. fetal NT, alpha-fetoprotein, and inhibin A
c. hCG, alph-fetoprotein, and inhibin A
d. hCG, alpha-fetoprotein, and PAPP-A
A
The dilation of the renal collecting system secondary to the obstruction of normal urine flow defines:
a. Nephrocalcinosis
b. Hydronephrosis
c. Renal calculi
d. Urinary stasis
B
The physiologic ovarian cyst that develops after ovulation has occurred is the:
a. Theca internal cyst
b. Graafian cyst
c. Corpus luteum cyst
d. Cystic teratoma
corpus luteum cyst
The protein that is produced by the yolk sac, fetal gastrointestinal tract, and the fetal liver is:
a. Alpha-fetoprotein
b. Human chorionic gonadotropin
c. Pregnancy-associated plasma protein A
d. Inhibin A
A
which of the following best describes the optimal instance to take the femur length measurement?
C. when the long axis of the femoral shaft is perpendicular to sound beam
the abdominal circumference should include all of the following except:
a. the fetal stomach
b. the fetal thoracic spine
c. the umbilical vein
d. the kidneys
D. the kidneys
which of the following artifacts is produced when the sound beam is barely attenuated through a fluid or a fluid-containing structure?
a. reverberation artifact
b. comet tail artifact
c. posterior shadowing
d. posterior enhancement
D.
which of the following artifacts is caused by attenuation of the sound beam?
a. reverberation artifact
b. comet tail artifact
c. posterior shadowing
d. posterior enhancement
C
which of the following would be least likely associated with an elevation in MSAFP?
a. anencephaly
b. turner syndrome
c. spina bifida
d. myelomeningocele
B
which of the following is also referred to as trisomy 13?
a. down syndrome
b. edwards syndrome
c. turner syndrome
d. patau syndrome
D
