Chapter 28 - The fetal Gastrointestinal system Flashcards

1
Q

Fetal Biometric measurement made of the abdomen in the second and third trimesters; used in conjunction with other measurements to date the pregnancy and size of the fetus

A

Abdominal circumfrence

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2
Q

Q
Congenital maldevelopment of the rectum and absence of the anal opening

A

Anorectal atresia

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3
Q

Q
Excessive fluid in the peritoneal cavity

A

Ascites

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4
Q

The cystic dilation of the common bile duct

A

Choledochal cyst

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5
Q

Classic sonographic sign of duodenal atresia representing the stomach and proximal duodenum

A

Double bubble sign

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6
Q

Q
Congenital maldevelopment or absence of duodenum

A

Duodenal Atresia

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7
Q

Congenital absence of part of the esophagus

A

Esophageal atresia

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8
Q

Hernitation of abdominal contents through a right-sided, periumbilical abdominal wall defect

A

Gastroschisus

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9
Q

Q
A disease that leads to a functional bowel obstruction because of the lack of nerve cells within the colon wall

A

Hirchsprung disease

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10
Q

A fetus that is below the 10th percentile for gestational age (small for gestational age) and whose growth is impeded for some reason

A

Intrauterine Growth restriction

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11
Q

Fetal stool that is composed of fetal skin, hair, amniotic fluid, and bile

A

Meconium

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12
Q

An anterior abdominal wall defect where there is herniation of the fetal bowel and other abdominal organs into the base of the umbilical cord

A

Omphalocele

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13
Q

Q
A group of anomalies that includes an omphalocele, along with ectopic corgis, cleft sternum, anterior diaphragmatic defect, and pericardial defects

A

Penology of Cantrell

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14
Q

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

A

Physiologic Bowel herniation

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15
Q

An excessive amount of amniotic fluid for the gestational age

A

Polyhydroamnios

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16
Q

An abnormal connection between the esophagus and trachea

A

Tracheoesophageal Fistula

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17
Q

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

A

Turner syndrome

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18
Q

Acronym for associated anomalies; stands for vertebral anomalies, anal atresia, cardiac anomalies, tracheoesophageal fistula, or esophageal atresia, renal anomalies, and limb anomalies

A

VACTERL

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19
Q

when measuring the fetal abdominal circumference it should include:

A

-fetal stomach
-transverse spine
-umbilical vein

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20
Q

formula for abdominal circumference:

A

AC= 1.57 x (AD1 + AD2)

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21
Q

when polyhydramnios is detected, evaluate for signs of:

A

Duodenal or esophageal atresia

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22
Q

the esophagus and the trachea often for an abnormal connection known as:

A

tracheoesophageal fistula- associated w/ esophageal atresia 90% of time

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23
Q

associated anomalies in esophageal atresia: (5)

A

duodenal atresia
VACTERL association
down syndrome
intrauterine growth restriction
trisomy 18

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24
Q

sonographic findings of esophageal atresia: (3)

A
  1. small or absent stomach
  2. polyhydramnios
  3. intrauterine growth restriction
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25
Q

Duodenal atresia has a proven association with: (5)

A

-trisomy 21
-esophageal atresia
-VACTERL
-intrauterine growth restriction
-cardiac anomalies

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26
Q

sonographic findings of duodenal atresia: (3)

A
  1. “double bubble” sign (anechoic stomach and duodenum)
  2. polyhydramnios
  3. intrauterine growth restriction
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27
Q

in the fetus, the ____ lobe of the liver is larger than the _____ lobe

A

-Left
-Right

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28
Q

most common abnormality of the fetal liver:

A

Hepatomegaly

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29
Q

hepatomegaly may occur as a result of: (3)

A

intrauterine infections
fetal anemia
beckwith-wiedemann syndrome

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30
Q

choledochal cysts can lead to: (4)

A

cholangitis
portal hypertension
pancreatitis
liver failure

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31
Q

echogenicity of the small intestine should not be isoechoic to or greater than that of:

A

Fetal bone

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32
Q

transducer frequency plays a role in the diagnosis bowel- higher frequency transducer suggest echogenic bowel, the sonographer should:

A

decrease the frequency to less than or equal 5 MHz and decrease the overall gain

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33
Q

echogenic bowel has linked with: (5)

A

down syndrome
cystic fibrosis
growth restriction
fetal demise
congenital infections (such as cytomegalovirus and gastrointestinal obstructions)

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34
Q

obstruction of the fetal bowel most often occurs when there is a meconium plug causing the barrier, a condition referred to as:

A

Meconium plug

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35
Q

the most common type if colonic atresia that will lead to a bowel obstruction is:

A

anorectal atresia- (maldevelopment of rectum and anal opening causes dilation of bowel)

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36
Q

anorectal atresia may be linked with: (2)

A

VACTERL association and chromosomal abnormalities

37
Q

anorectal atresia will most often lead to:

A

the visualization of a dilated fetal rectum

38
Q

_________ and __________ are two of the most common ventral abdominal wall defects

A

gastroschisis and omphalocele

39
Q

if the fetus has an abdominal wall defect (opening in the abdomen), then a greater amount of _____ is allowed to pass into the maternal circulation

A

AFP

40
Q

elevated levels of ______ are found in the presence of omphalocele and gastroschisis

A

MSAFP

41
Q

clinical findings of gastroschisis: (1)

A
  1. elevated MSAFP
42
Q

sonographic findings of gastroschisis: (4)

A
  1. normal cord insertion
  2. periumbilical, right-sided mass
  3. recognizable loops of bowel outside the abdomen
  4. intrauterine growth restriction
43
Q

___ is often noted within an omphalocele

A

Ascites

44
Q

omphalocele has a more significant risk for heart defects and chromosomal anomalies than:

A

Gastroschisis

45
Q

anomalies linked with omphalocele: (4)

A

trisomy 18
trisomy 13
turner syndrome
beckwith-wiedemann syndrome

46
Q

clinical findings of omphalocele: (1)

A
  1. elevated MSAFP
47
Q

sonographic findings of omphalocele: (3)

A
  1. Midline abd mass at base of the umbilical cord that contains bowel, liver, other abd organs
  2. Abnormal cord insertion into this midline abd mass
  3. Multiple associated anomalies
48
Q

hepatomegaly would least likely be associated with:
a. beckwith-wiedemann syndrome
b. fetal anemia
c. intrauterine anemia
d. gastroschisis

A

D

49
Q

normally, physiologic bowel herniation resolves by:
a. 8 weeks
b. 10 weeks
c. 24 weeks
d. 12 weeks

A

D

50
Q

which of the following is most often associated with duodenal atresia?
a. trisomy 21
b. trisomy 18
c. trisomy 13
d. triploidy

A

A

51
Q

Hepatomegaly would be seen in conjunction with:
a. down syndrome
b. edwards syndrome
c. beckwith-wiedemann syndrome
d. hirschsprung disease

A

C

52
Q

pentalogy of cantrell includes all of the following findings except:
a. cardiovascular malformations
b. diaphragmatic malformations
c. omphalocele
d. gastroschisis

A

D

53
Q

an excessive amount of amniotic fluid is termed:
a. polyhydramnios
b. oligohydramnios
c. esophageal atresia
d. amniotic fluid index

A

A

54
Q

the most common abnormality of the fetal liver is:
a. gallstones
b. hepatocellular lymphadenopathy
c. cirrhosis
d. hepatomegaly

A

D

55
Q

congenital maldevelopment of the proximal portion of the small intestine is termed:
a. VACTERL association
b. esophageal atresia
c. duodenal atresia
d. jejunal atresia

A

C

56
Q

a functional bowel disorder within the fetus that is caused by the absence of intestinal nerves is found in:
a. gastroschisis
b. beckwith-wiedemann syndrome
c. omphalocele
d. Hirschsprung disease

A

D

57
Q

which of the following is associated with echogenic bowel?
a. fetal anemia
b. cystic fibrosis
c. radial ray syndrome
d. portal hypertension

A

B

58
Q

what chromosomal anomaly is associated with echogenic bowel?
a. trisomy 18
b. trisomy 13
c. trisomy 21
d. triploidy

A

C

59
Q

the herniation of the bowel into the base of the umbilical cord before 12 weeks is termed:
a. gastroschisis
b. omphalocele
c. hernia umbilicus
d. physiologic herniation

A

D

60
Q

all of the following are associated with omphalocele except:
a. trisomy 18
b. pentalogy of cantrell
c. intrauterine growth restriction
d. hirschsprung disease

A

D

61
Q

The fetal stomach should be visualized by:
a. 8 weeks
b. 14 weeks
c. 20 weeks
d. 18 weeks

A

B

62
Q

all of the following are associated with esophageal atresia except:
a. down syndrome
b VACTERAL association
c. edwards syndrome
d. oligohydramnios

A

D

63
Q

an abnormal connection between the esophagus and trachea is termed:
a. esophageal-duodenal herniation
b. double bubble sign
c. esophageal atresia
d. tracheoesophageal fistula

A

D

64
Q

in what location does gastroschisis occur more often?
a. left lateral of the cord insertion
b. right lateral to the cord insertion
c. just superior to the fetal bladder
d. base of the umbilical cord

A

B

65
Q

the congenital absence of part of the esophagus is termed:
a. duodenal atresia
b. VACTERAL association
c. down syndrome
d. esophageal atresia

A

D

66
Q

the “double bubble” sign is indicative of:
a. esophageal atresia
b. duodenal atresia
c. hydrocephalus
d. anorectal atresia

A

B

67
Q

all of the following are associated with gastroschisis except:
a. normal cord insertion
b. multiple chromosomal abnormalities
c. elevated MSAFP
d. periumbilical mass

A

B

68
Q

Which of the following laboratory values would be significant in the detection of an abdominal wall defect?
a. MSAFP
b. human chorionic gonadotropin
c. maternal serum amylase
d. estradiol

A

A

69
Q

what is an inherited disorder in which mucus secreting organs such as the lungs, pancreas, and other digestive organs produce thick and sticky secretions instead of normal secretions?
a. hirschsprung disease
b. cystic fibrosis
c. multiple sclerosis
d. turner syndorme

A

B

70
Q

what is an inherited disorder in which mucus secreting organs such as the lungs, pancreas, and other digestive organs produce thick and sticky secretions instead of normal secretions?
a. hirschsprung disease
b. cystic fibrosis
c. multiple sclerosis
d. turner syndorme

A

B

71
Q

what organ(s) produces amniotic fluid after 12 weeks?
a. fetal liver and the spleen
b. fetal intestines and lungs
c. fetal intestines and the liver
d. fetal kidneys

A

D

72
Q

an omphalocele is associated with all of the following except:
a. pentalogy of cantrell
b. trisomy 18
c. patau syndrome
d. meconium aspiration syndrome

A

D

73
Q

duodenal atresia and esophageal atresia are associated with:
a. oligohydramnios
b. polyhydramnios
c. normal amniotoic fluid index
d. anhydramnios

A

B

74
Q

the fetal guy develops at the end of the fifth menstrual week and can be divided onto all of the following except:
a. midgut
b. foregut
c. centralgut
d. hindgut

A

C

75
Q

Intrauterine growth restriction is defined as:
a. a small-for-dates fetus
b. a fetus that falls below the 10th percentile for gestational age
c. a fetus that is immunocompromised and has decreased umbilical cord doppler ratios for gestational age
d. a fetus that fall below the fifth percentile for gestational age

A

B

76
Q

which of the following best describes a choledochal cyst?
a. it is the cystic dilatation of the common bile duct
b. it is the herniation of the abdominal contents into the umbilical cord
c. it is the congenital absence of the cystic duct
d. it is the inflammation of the biliary tree caused by extrinsic obstruction

A

A

77
Q

Fetal stool is termed
A. place
B. Meconium
C. Laguna
D. Lanugo

A

B

78
Q

All of the following are associated with omphalocele except :
a. normal cord insertion
b. multiple chromosomal abnormalities
c. elevated MSAFP
d. periumbilical mass

A

A

79
Q

An omphalocele may contain:
A. fetal liver
B. ascites
C. fetal colon
D. all above

A

D

80
Q

the congenital maldevelopment of the rectum and absence of anal opening is termed:
a. jejunal atresia
b. intussusception
c. anorectal atresia
d. duodenal atresia

A

c

81
Q

all of the following are associated with duodenal atresia except:
a. trisomy 21
b. esophageal atresia
c. VACTERAL association
d. turner syndrome

A

D

82
Q

Which of the following would be least likely associated with an elevated MSAFP
A. Pentagoly of Cantrell
B. anorectal atresia
C. Gastrochsis
D. Omphalocele

A

a

83
Q

Which of the following would be least likely associated with an elevated MSAFP
A. Pentagoly of Cantrell
B. anorectal atresia
C. Gastrochsis
D. Omphalocele

A

b

84
Q

Which of the following is considered to be the most common type of colonic atresia?
A. duodenal atresia
B. jejunal atresia
C. anorectal atresia
D. intussuusception

A

C

85
Q

Fecal meconium typically consits of all of the following except
A. skin
B. hair
C. bile
D. blood

A

D

86
Q

Which of the following would be most likely associated with an excessive amount of amniotic fluid?
A. duodenal atresia
B. hepatomegaly
C. bilateral renal genesis
D. physiologic bowel herniation

A

A

87
Q

Which of the following would be most likely associated with oligohydramnios
A. duodenal atresia
B. hepatomegaly
C. bilateral renal agenesis
D. physiologic bowel herniation

A

c

88
Q

The majority of amniotic fluid is composed of
A. fetal blood
B. fetal serous fluid
C. maternal serious fluid
D. fetal urine

A

D

89
Q

All of the following are sonographic findings of esophageal atresia except
A. absent stomach
B. polyhydramnios
C. macrosomia
D. IUGR

A

C