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ARRT (Ob/gyn US) > Chapter 23 The First Trimester > Flashcards

Chapter 23 The First Trimester Flashcards

1
Q

What is the most likely metastatic location for GTD?

A

Lungs

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2
Q

What is associated with a lower-than normal hCG level:

A
  • Ectopic pregnancy
  • Blighted ovum
  • Spontaneous abortion
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3
Q

A malignant form of GTD is:

A

Choriocarcinoma

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4
Q

Consistent with a complete hydatidiform mole:

A
  • Heterogenous mass within the endometrium
  • Bilateral theca lutein cysts
  • Hyperemesis gravidarum
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5
Q

In the early gestation, where is the secondary yolk sac location?

A

Chorionic cavity

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6
Q

Contributing factors for an ectopic pregnancy:

A
  • PID
  • Assisted reproductive therapy
  • IUCD
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7
Q

The structure created by the union of sperm and egg is the:

A

Zygote

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8
Q

The trophoblastic cells produce:

A

hCG

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9
Q

Another name for the chorionic sac is the:

A

Gestational sac

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10
Q

What is often used to medically treat an ectopic pregnancy?

A

Methotrexate

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11
Q

What structure lies within the extraembryonic coelim?

A

Yolk sac

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12
Q

What is the most common form of GTD?

A

Complete molar pregnancy

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13
Q

In the first trimester normal hCG levels will:

A

Double every 48 hours

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14
Q

What location for an ectopic pregnancy would be least likely?

A

Ovary

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15
Q

The first sonographically identifiable sign of pregnancy is the:

A

Decidual reaction

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16
Q

NT measures are typically obtained between:

A

11 and 14 weeks

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17
Q

The normal gestational sac will grow:

A

1mm per day

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18
Q

The most common pelvic mass associated with pregnancy is the:

A

Corpus luteum cyst

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19
Q

What hormone maintains the corpus luteum during pregnancy?

A

hCG

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20
Q

What is associated with an abnormal NT?

A
  • Trisomy 16
  • Trisomy 18
  • Turner syndrome
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21
Q

The most common location of an ectopic pregnancy is the:

A

Ampullary portion of the uterine tube

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22
Q

The most common cause of pelvic pain with pregnancy is:

A

Ectopic pregnancy

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23
Q

Fertilization typically occurs within ______after ovulation

A

24 hours

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24
Q

What is the name of the dominant follicle prior to ovulation?

A

Graafian

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25
Q

What structure connects the embryo to the yolk sac?

A

Vitelline duct

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26
Q

Compared with a normal IUP, the ectopic pregnancy will have a:

A

Low hCG

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27
Q

The first structure noted within the gestational sac is the:

A

Yolk sac

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28
Q

During a 12 week sonogram, bilateral echogenic structures are noted within the lateral ventricles of the fetal cranium. These structures most likely represents:

A

Choroid plexus

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29
Q

With a normal pregnancy the first structure noted within the decidualized endometrium is the:

A

Chorionic sac

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30
Q

What is the stage of the conceptus that implants within the decidualized endometrium?

A

Blastocyst

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31
Q

The migration of the embryologic bowel into the base of the umbilical cord at 9 weeks is referred to as:

A

Physiologic bowel herniation

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32
Q

During a first-trimester sonogram, you note a round, cystic structure within the fetal head. This most likely represents:

A

Rhombencephalon

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33
Q

What hormone, produced by the corpus luteum, maintains the thickened endometrium?

A

Progesterone

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34
Q

Normal hCG levels ______every 48 hours in the first trimester

35
Q

______is a bleed between the endometrium and the gastational sac

A

Subchorionic hemorrhage (perigestational hemorrhage)

36
Q

_____is coexisting ectopic and intrauterine pregnancies

A

Heterotopic pregnancy

37
Q

By 7 weeks, the bpm should be at least ______

38
Q

Treatment for GTD includes:

A
  • D&C
  • hCG monitioring
  • Hysterectomy
  • Possibly chemotherapy
39
Q

The alimentary canal will become the:

A
  • Foregut
  • Midgut
  • Hindgut
40
Q

The normal embryonic heart rate at 6 weeks is typically between _______

A

100 and 110 bpm

41
Q

The most common abnormalities associated with increased NT are:

A
  • Trisomy 21
  • Trisomy 18
  • Turner syndrome
  • Congestive heart failure
42
Q

The placenta is formed by the:

A

*Decidual basalis
*Maternal contribution of the placenta
*Chorion frondosum
*Fetal contribution

43
Q

The embryonic heart rate increases to ______by 9 weeks

44
Q

Embryonic heart rate is considered normal at _____between 5 and 6 weeks

A

100-110 bpm

45
Q

The embryo will grow at a rate of _____per day in the first trimester

46
Q

The _____contains simple-appearing amniotic fluid and the developing embryo

A

Amniotic cavity

47
Q

The chorionic cavity lies between the:

A

Amnion and chorion

48
Q

The gestational sac consists of two cavities:

A

*Chorionic cavity
*Amniotic cavity

49
Q

Conception usually occurs within ______after ovulation

50
Q

_____also referred to as fertilization, is the union of an ovum and a sperm

A

Conception

51
Q

The most common pelvic mass associated with pregnancy is the:

A

Ovarian corpus luteum cyst

52
Q

Fetal limb buds are readily identified by:

53
Q

hCG is detected in the maternal blood as early as:

A

23 days menstrual age

54
Q

The neural tube will become:

A

Fetal head and spine

55
Q

The inner part of the blastocyst will develop into the:

A

*Embryo
*Amnion
*Umbilical cord
*Primary and secondary yolk sac

56
Q

The outer part, the trophoblastic tissue, will develop into the:

A

Placenta and chorion

57
Q

The blastocyst makes these link with the maternal endometrium via small projections of tissue called:

A

Chorionic villi

58
Q

_____is associated with a poor prognosis and is often the first sonographic sign of an eminent embryologic demise

A

Bradycardia

59
Q

The thermal index, which is the amount of energy required to raise tissue temperature 1 Celsius, should be kept at:

60
Q

The _____will eventually develop into the fourth ventricle and several other essential brain structures

A

Rhombencephalon

61
Q

_____begins at 8 weeks, which marks the developmental stage when the midgut migrates into the base of the umbilical cord

A

Physiologic bowel herniation

62
Q

The combination of the sperm and ovum produces a structure referred to as the:

63
Q

The zygote undergoes rapid cellular division and eventually forms into a cluster of cells called the:

64
Q

The _____is visible during the latter half of the first trimester as a tortuous structure connecting the fetus to the developing placenta

A

Umbilical cord

65
Q

______is a group of disorders that result from an abnormal combination of male and female gametes

A

Benign gestational trophoblastic disease (GTD)

66
Q

_____is a chemotherapy drug used to attack rapidly dividing cells like those seen in an early pregnancy, used to manage ectopic pregnancies

A

Methotrexate

67
Q

______or______ is diagnosed when there is no evidence of a fetal pole or yolk sac within the gestational sac

A

*Blighted ovum
*Anembryonic gestation

68
Q

_____denotes the appearance of the small gestational sac in the uterine cavity surrounded by the thickened, echogenic endometrium

A

Intradecidual sign

69
Q

_______is the normal sonographic appearance of the decidua capsularis and decidua parietalis, separated by the anechoic fluid-fluid uterine cavity

A

Double decidual sign

70
Q

Clinical findings of molar pregnancy

A
  1. Hyperemesis gravidarum
  2. Markedly elevated hCG level
  3. Heavy vaginal bleeding
  4. Enlarged uterus
  5. Possible preeclampsia or eclampsia
  6. Hypertension and/or hyperthyroidism
71
Q

Clinical findings of partial molar pregnancy

A
  1. Normal physical exam
  2. Normal or slightly evaluated hCG level
  3. Smaller than normal uterus
  4. Possible vaginal bleeding
72
Q

Clinical findings of the corpus luteum of pregnancy

A
  1. Asymptomatic
  2. Pain associated with hemorrhage and enlargement of cyst
73
Q

Clinical findings of blighted ovum

A
  1. Vaginal bleeding
  2. Reduction of pregnancy symptoms
  3. Low hCG
74
Q

Clinical findings of embryonic or fetal demise

A
  1. Vaginal bleeding
  2. Small for dates
  3. Closed cervix
  4. Low (based on LMP) hCG
75
Q

Clinical findings of subchorionic hemorrhage

A
  1. Vaginal bleeding or spotting
  2. Uterine cramping
  3. Closed cervix
76
Q

Clinical findings of a uterine leiomyoma (with pregnancy)

A
  1. Positive pregnancy test
  2. Pelvic pressure
  3. Menorrhagia
  4. Palpable pelvic mass
  5. Enlarged, bulky uterus
  6. Urinary frequency
  7. Dysuria
  8. Constipation
77
Q

Sonographic findings of blighted ovum

A
  1. Large, irregular gestational sac without an embryo or yolk sac
  2. Absent or minimal gestational growth
  3. Poor decidual reaction
78
Q

Sonographic findings of embryonic or fetal demise

A
  1. No detection fetal heart activity in a pole that measures 4-5mm
  2. Irregular shaped fetus
  3. Irregular sized gestational sac
  4. Irregular appearing yolk sac
79
Q

Sonographic findings of subchorionic hemorrhage

A
  1. Crescent-shaped anechoic, echogenic, or hypoechoic area adjacent to the gestational sac
  2. May resemble a second gestational sac
80
Q

Sonographic findings of uterine leiomyoma

A
  1. Hypoechoic mass within the uterus
  2. Posterior shadowing
  3. Degenerating fibroids may have calcifications or cystic components
  4. Multiple fibroids appears as an enlarged, irregularly shaped, enlarged heterogeneous uterus
81
Q

Sonographic findings of partial molar pregnancy

A
  1. Complex mass within the uterus partially filling the uterine cavity adjacent to the gestational sac
  2. “Vesicular snowstorm appearance” secondary to placental enlargement
  3. Multiple, variable-sized cysts replacing the placental tissue (Hydropic chorionic villi)
  4. Triploid fetus
82
Q

Sonographic findings of the corpus luteum of pregnancy

A
  1. Simple cyst appearance
  2. A cyst with a thick, echogenic rim around it
  3. Hemorrhagic cyst appearance, including complex components or entire echogenic depending on the amounts of blood and stage of lysis
83
Q

Sonographic findings of complete molar pregnancy

A
  1. Complex mass within the uterus
  2. Color doppler may reveal hypervascularity around the mass but not within it
  3. “Vesicular snowstorm appearance” secondary to placental enlargement
  4. Multiple variable-sized cysts replacing the placental tissue
  5. Bilateral ovarian theca lutein cysts

ARRT (Ob/gyn US) (18 decks)

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