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Penny - OB CH > Chapter 23 - The first trimester > Flashcards

Chapter 23 - The first trimester Flashcards

1
Q

complete expulsion or partial expulsion of the conceptus

A

Abortion

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2
Q

sonographic sign which describes appearance of ectopic pregnancy within FT

A

adnexal ring sign

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3
Q

wall of inner sac (amniotic cavity) that contains the embryo and amniotic fluid echogenic curvilinear structure that may be seen during 1st trimester within gestational sac

A

Amnion

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4
Q

cavity that contains simple appearing amniotic fluid and the developing embryo

A

amniotic cavity

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5
Q

an abnormal pregnancy in which there is no evidence of a fetal pole or yolk sac within the GS
-refereed to as blighted ovum

A

Anembryonic gestation

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6
Q

a condition of having abnormal number of chromosomes

A

Aneuploid

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7
Q

stage of conceptus that implants within the decidulaized endometrium

A

Blastocyst

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8
Q

low heart rate

A

Bradycardia

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9
Q

most malignanet form of gestation trophoblastic disease with possible metastatic to liver and lungs and vagina

A

choriocarcinoma

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10
Q

outer membrane of gestation that surround amnion and developing embryo

A

chorion

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11
Q

part of the chorion covered by chorionic villi that is the fetal contribution of the placenta

A

chorion frondosum

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12
Q

he space between the chorionic sac and amniotic sac that contains the secondary yolk sac; also referred to as the extraembryonic coelom

A

chorionic cavity

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13
Q

gestational sac

A

chorionic sac

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14
Q

fingerlike projections of gestational tissue that attach to the decidualized endometrium and allow transfer of nutrients from the mother to the fetus

A

chorionic villi

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15
Q

specialized cells within the ventricular system responsible for cerebrospinal fluid production

A

choroid plexus

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16
Q

e combination of a female ovum with a male sperm to produce a zygote also referred to as fertilization

A

Conception

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17
Q

physiologic ovarian cyst that develops after ovulation has occurred

A

corpus luteum cyst

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18
Q

the corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone

A

corpus luteum of pregnancy

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19
Q

the corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone

A

corpus luteum of pregnancy

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20
Q

the measurement of the embryo/fetus from the top of the head to the rump

A

CRL

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21
Q

the endometrial at the implantation site and the maternal contribution of the placenta

A

decidua basalis

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22
Q

the physiologic effect of the endometrium in the presence of a pregnancy

A

decidual reaction

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23
Q

the level of human chorionic gonadotropin beyond which an intrauterine pregnancy is consistently visible

A

Discriminatory zone

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24
Q

*Normal US appearance of decidua capsularis & decidua parietalis
*Separated by anechoic fluid-filled uterine cavity

A

double decidual sign

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25
Q

a sequela of preeclampsia in which uncontrollable maternal hypertension and proteinuria lead to maternal convulsions and possibly fetal and maternal death

A

eclampsia

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26
Q

term given to the developing fetus before 10 weeks gestation

A

embryo

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27
Q

-The death of an embryo before 10 weeks gestation

A

embryonic demise

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28
Q

-A double fold of dura mater located within midline of the brain

A

falx cerebri

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29
Q

the fingerlike extension of the fallopian tube located on the infundibulum

A

fimbria

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30
Q

-Localized, painless contractions of the myometrium in the gravid uterus that should resolve within 20-30 minutes

A

focal myometrial contraction

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31
Q

the way in which a pregnancy can be dated based on the first day of the last menstrual cycle also referred as menstrual age

A

gestational age

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32
Q

a disease associated with an abnormal proliferation of the trophoblastic cells during pregnancy; may also be referred to as molar pregnancy

A

gestation trophoblastic disease

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33
Q

the name for the dominant follicle prior to ovulation

A

Graafian follicle

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34
Q

the development of blood cells

A

Heamtopoiesis

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35
Q

co-existing ectopic and intrauterine pregnancies

A

heteropic pregnancy

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36
Q

-The most common form of gestational trophoblastic disease in which there is excessive growth of the placenta and high levels of human chorionic gonadotropin
-typically benign

A

hydatidiform mole

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37
Q

excessive vomitting during pregnancy

A

hyperemeis gravid arum

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38
Q

a bleed that occurs at the time in which the conceptus implants into the decidualized endometrium

A

implantation bleeding

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39
Q

distal segment of fallopian tube

A

infundibulum

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40
Q

Appearance of small gestational sac in uterine cavity surrounded by thickened, echogenic endometrium

A

intradecidual sign

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41
Q

a type of gestational trophoblastic disease in which a molar pregnancy invades into the myometrium and may also invade through the uterine wall and into the peritoneum

A

Invasive mole

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42
Q

early embryonic structures that will eventually give rise to the extremities

A

limb buds

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43
Q

the measurement of the gestational sac to obtain a gestational age; achieved by adding the measurements of the length width and height of the gestational sac and dividing by 3

A

mean sac diameter

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44
Q

a chemotherapy drug used to attack rapidly dividing cells like those seen in an early pregnancy; this drug is often used to manage ectopic pregnancy

A

methotrexate

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45
Q

the spontaneous end of a pregnancy before viability

A

miscarriage

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46
Q

Fetal demise with retained fetus

A

missed abortion

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47
Q

the developmental stage of the conceptus following the zygote

A

morula

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48
Q

the normal developmental stage when the midgut migrates into the base of the umbilical cord

A

physiologic bowel herniation

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49
Q

Pregnancy-induced maternal high blood pressure & excess protein in urine after 20 weeks gestation

A

preeclampsia

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50
Q

-The appearance of an abnormally shaped false gestational sac within the uterine cavity as a result of an ectopic pregnancy
-this often corresponds with the accumulation of blood and secretions within the uterine cavity

A

pseudogestional sac

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51
Q

the primary brain vesicle also referred to as the hindbrain become the cerebellum pons medulla oblongata and fourth ventricle

A

rhombencephalon

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52
Q

the structure responsible for early nutrient transfer to the embryo; the yolk sac seen during a sonographic examination of the early gestation

A

secondary yolk sac

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53
Q

a bleed between the endometrium and the gestational sac at the edge of the placenta

A

subchorionic hemorrhage

54
Q

having three sets of each chromosome or 69 total

55
Q

chromosomal aberration in which there is a third chromosome 18

A

trisomy 18 (Edwards syndrome)

56
Q

Chromosomal aberration in which there is third chromosome 21

A

Trisomy 21 (Down syndrome)

57
Q

the cells that surround the gestation that produce human chorionic gonadotropin

A

Trophoblastic cells

58
Q

a chromosomal aberration where one sex chromosome is absent; may also be referred to as monosomy X

A

Turner syndrome

59
Q

the structure that connects the developing embryo to the secondary yolk sac

A

vitelline duct

60
Q

he cell formed by the union of two gametes the first stage of a fertilized ovum

61
Q

What cells produce hCG

A

trophoblastic cells

62
Q

primary yolk sac regressresses during week ___

63
Q

the neural tube will become the fetal ____ and ___

A

head, spine

64
Q

In the 1st trimester _____ maintains the corpus luteum cyst

65
Q

hCG is detected in the maternal blood as early as ___ days menstrual age

66
Q

a gestational sac with TV sonography should be visualized between ____ and ____ mIU per mL

A

1,000, 2,000 discriminatory zone or level

67
Q

normal hcg levels will double every ____ hours in the 1st trimester

68
Q

will hCG rise or decline in complete molar pregnancy?

69
Q

The _____ ____ of the endometrium is essentially the first sonographically identifiable sign of a pregnancy. However, the first sign of a definitive sign of an IUP is the ____ ____ within the endometrium.

A

decimal reaction, gestational sac

70
Q

Sonographic identification of the decidua capsularis, decidua parietalis, and decidua basalis to differentiate a “pseudo sac” associated with ectopic pregnancies from a gestational sac

A

Double sac sign

71
Q

l+w+h of gestational sac and /3.
you can also add 30 to MSD meas (mm) for an estimate of gestational age in days.

A

MSD formular

72
Q

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

A

secondary yolk sac

73
Q

The gestational sac consists of two cavaties:

A

chorionic cavity , amniotic cavity

74
Q

what duct connects the yolk sac to the embryo?

A

vitelline duct

75
Q

The embryo will grow at a rate of ___mm per day

76
Q

The most accurate sonographic measurement of pregnancy is

77
Q

midgut herniation begins at week ___ and regresses at week ____

78
Q

The placenta is formed by the _____ ____ and the ____ _____

A

decidua basalis, chorion frondosum

79
Q

what are the most common abnormalities seen with NT?

A

trisomy 21, 18, Turner syndrome and congestive heart failure

80
Q

the NT optimally measured between ___ and ___ weeks ____ days when the CRL measures between ___ and ___ mm

A

11,13,6,45,84

81
Q

what is the maximum meas of NT?

82
Q

The most common location of an EUP is

A

ampullarf portion of the tube

83
Q

classic clinical triad of ectopic pregnancy

A

pain, vaginal bleeding, and a palpable abdominal pelvic mass

84
Q

which is more common, a complete or incomplete molar (GTD) pregnancy?

85
Q

are molar pregnancies typically benign or malignant?

A

benign, but do have malignant potential

86
Q

The most common forms of malignant GTD are

A

invasive mole, choriocarcinoma

87
Q

The most common sites of metastasis

A

lungs, liver and vagina

88
Q

The ovarian mass associated with molar pregnancy and elevated hCG is the ___ ____ cyst

A

theca lutein

89
Q

A ____ ____ or anembryonic gestation is diagnosed when there is no evidence of a fetal pole or yolk sac within the gestational sac

A

blighted ovum

90
Q

clinical findings of blighted ovum

A

vaginal bleeding, reduction of pregnancy symptoms, low hCG

91
Q

fibroids are stimulated by what hormone?

92
Q

the complete expulsion or partial expulsion of the conceptus

93
Q

what structure connects the embryo to the yolk sac?
vitelline duct
yolk stalk
amnion
chorionic stalk

94
Q

what is the name of the dominant follicle prior to ovulation?
Graafian
corpus luteum
morula
corpus albicans

95
Q

fertilization typically occurs within ______ after ovulation
40 hours
12 hours
24 hours
56 hours

96
Q

the most common site of fertilization is within the:
isthmus
fundus
cornu
ampulla

97
Q

with a normal pregnancy, the first structure noted within the decidualized endometrium is the:
yolk sac
chorionic sac
amniotic cavity
embryo

98
Q

the structure created by the union of sperm and egg is:
blastocyst
zygote
morula
ampulla

99
Q

the trophoblastic cells produce
estrogen
progesterone
FSH
hCG

100
Q

sonographically, a normal appearing 7-week IUP is identified. within the adnexa, an ovarian cystic structure with a thick, hyperechoic rim is also discovered. what does this ovarian mass most likely represent?
theca lutein cyst
corpus luteum cyst
corpus albicans
ectopic pregnancy

101
Q

what is the stage of the conceptus that implants within the decidualized endometrium?
blastocyst
morula
zygote
ovum

102
Q

another name for the chorionic sac is the:
chorionic cavity
extraembryonic coelom
amniotic sac
gestational sac

103
Q

what is often used to medically treat an ectopic pregnancy?
dilatation and curettage
dilatation and evacuation
open surgery
methotrexate

104
Q

what structure lies within the extraembryonic coelom?
gestational sac
embryo
yolk sac
amnion

105
Q

what hormone, produced by corpus luetum, maintains the thickened endometrium?
estrogen
progesterone
hCG
LH

106
Q

what is the most common form of GTD?
complete molar pregnancy
partial molar pregnancy
invasive mole
choriocarcinoma

107
Q

in the first trimester, normal hCG levels will:
double every 48 hours
triple every 24 hours
double every 24 hours
double every 12 hours

108
Q

compared with a normal IUP, the ectopic pregnancy will have a:
high hCG
low hCG
markedly elevated hCG
high AFP

109
Q

which of the following locations for an ecoptic pregnancy would be least likely?
isthmus
ampulla
ovary
interstitial

110
Q

the first sonographically identifiable sign of pregnancy is the:
amnion
yolk sac
decidual reaction
chorionic cavity

111
Q

the first structure noted within the gestational sac is the:
yolk sac
embryo
decidual reaction
chorionic sac

112
Q

NT measures are typically obtained between:
1 and 5 weeks
5 and 8 weeks
8 and 11 weeks
11 and 14 weeks

113
Q

the normal gestational sac will grow:
2mm per day
3mm per day
1cm per day
1mm per day

114
Q

during the 1st trimester US, you note a round, cystic structure within the fetal head. this most likely represents:
prosencephalon
mesencephalon
rhombencephalon
proencephalon

115
Q

the migration of the embryologic bowel into the base of the umbilical cord at 9 weeks is referred to as:
physiologic bowel herniation
pseudo-omphalocele
omphalocele
gastroschisis

116
Q

during a 12 week US, bilateral echogenic structures are noted within the lateral ventricles of the fetal cranium. these structures most likely represent:
cerebral tumors
cerebral hemorrhage
anencephalic remnants
choroid plexus

117
Q

he most common pelvic mass associated with pregnancy is the:
uterine leiomyoma
dermoid cyst
theca luteum cyst
corpus luteum cyst

118
Q

all of the following are associated with an abnormal NT except:
trisomy 21
trisomy 16
trisomy 18
Turner syndrome

119
Q

what hormone maintains the corpus luteum during pregnancy?
estrogen
progesterone
FSH
hCG

120
Q

the most common cause of pelvic pain with pregnancy is:
ectopic pregnancy
heterotopic pregnancy
missed abortion
molar pregnanc

121
Q

the most common location of an ectopic pregnancy is the:
ovary
interstitial
cornual
ampullary

122
Q

all of the following are contributing factors for an ectopic pregnancy except:
PID
assisted reproductive therapy
IUCD
advance paternal age

123
Q

all of the following are clincial features of an ectopic pregnancy except:
pain
vaginal bleeding
shoulder pain
adnexal ring

124
Q

in the early gestation, where is the secondary yolk sac located?
chorionic cavity
base of umbilical cord
embryonic cranium
amniotic cavity

125
Q

all of the following are sonographic findings consistent with ectopic pregnancy except:
decidual thickening
complex free fluid within the pelvis
bilateral, multiloculated ovarian cysts
complex adnexal mass separate from the ipsilateral ovary

126
Q

all of the following are consistent with a complete hydatidiform mole except:
heterogenous mass within endometrium
bilateral theca lutein cysts
hyperemesis gravidarum
low hCG

127
Q

malignant form of GTD is:
choriocarcinoma
hydatidiform mole
anembryonic
hydropic villi

128
Q

an US exam was performed on a pregnancy patient who complained of vaginal bleeding. sonographically, a crescent-shaped anechoic area is noted adjacent to the gestational sac. the gestational sac contained a 6week single live IUP. what is the most likely definition?
ectopic pregnancy
molar pregnancy
subchorionic hemorrhage
anembryonic gestation

129
Q

all of the folliwng would be associated with lower-than-normal hCG levels except:
ectopic pregnancy
molar pregnancy
blighted ovum
spontaneous abortion

130
Q

all of the following are clinical findings consistent with a complete molar pregnancy except:
vaginal bleeding
HTN
uterine enlargement
small for dates

131
Q

which of the following is most likely metastatic location for GTD?
rectum
pancreas
spleen
lungs

132
Q

all of the following may be sonographic findings in the presence of an ectopic pregnancy except:
pseudogestational sac
corpus luteum cyst
adnexal ring
low beta-hCG

Penny - OB CH (18 decks)

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