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KEVIN BURANT IV > +Chapter 37 - Obstetric Ultrasound 2 > Flashcards

+Chapter 37 - Obstetric Ultrasound 2 Flashcards

1
Q

_________ are the most common solid pelvic masses encountered during pregnancy.

A

Uterine leiomyomas

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2
Q

_______ are the most common cystic pelvic masses found in pregnancy.

A

Corpus luteal cysts

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3
Q

_______ cysts form due to an exaggerated corpus luteum response to high levels of β-hCG.

A

Theca lutein

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4
Q

_______ is the single most common cause of a poor neonatal outcome.

A

Preterm delivery

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5
Q

The normal cervical length is ____ mm throughout gestation.

A

26 to 50 mm

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6
Q

______ is measured in sagittal plane between the internal os marked by a V-shaped notch and the external os marked by a triangular echodensity.

A

Cervical length

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7
Q

Dilation of the cervical canal greater than ___ mm is indicative of cervical incompetence.

A

Greater than 8 mm

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8
Q

Normal placenta is first apparent on US at about __ weeks as a focal thickening at the periphery of the gestational sac

A

8 weeks

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9
Q

Normal range of placental thickness

A

1 to 4 cm

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10
Q

_____ is present when part or all of the placenta covers the internal cervical os

A

Placenta previa

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11
Q

______ is present when placental blood vessels, or the umbilical cord, are adherent to the membranes that cover the cervix.

A

Vasa previa

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12
Q

________ is defined as the premature separation of a normally positioned placenta from the myometrium.

A

Placental abruption

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13
Q

_______ is an abnormal adherence of the placenta to the uterine wall

A

Placenta accreta

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14
Q

Invasion of the uterine wall by the placenta is referred to as ____
and
penetration of the uterine wall is _____.

A

placenta increta; placenta percreta

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15
Q

_______ is a benign vascular placental mass supplied by the fetal circulation. It is the most common tumor of the placenta.

A

Chorioangioma

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16
Q

Normal diameter of umbilical cord

A

1 to 2 cm

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17
Q

_______ is caused by the early (generally before 10 weeks GA) disruption of the amnion, enabling the fetus to enter the chorionic cavity.

A

Amniotic band syndrome

  • fetus becomes entangled in fibrous bands that develop within the chorionic cavity
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18
Q

_______ are membranous structures that project into the uterine cavity.

A

Uterine synechiae (amniotic sheets)

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19
Q

amniotic fluid index greater than 20 cm or

a single fluid pocket greater than 8 cm deep is strongly suggestive of ________.

A

polyhydramnios

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20
Q

A major complication of severe oligohydramnios is ______.

A

fetal lung immaturity

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21
Q

_______ results from shunting of blood from one twin to the other through vascular connections in the placenta.

A

Twin transfusion syndrome

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22
Q

A detailed US fetal anatomic survey performed at the optimum time of ______ weeks GA will detect the majority of serious structural birth defects.

A

18 to 22 weeks GA

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23
Q

In Down syndrome, pregnancy-associated plasma protein A (PAPP-A) is ___ and β-hCG is ____.

A

LOW; HIGH

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24
Q

____ refers to the normal echolucent space between the spine and the overlying skin at the back of the fetal neck.

A

Nuchal translucency

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25
Q

In the second trimester (19 to 24 weeks), a nuchal thickness measurement of ___ mm is abnormal.

A

≥6 mm

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26
Q

Second-trimester biochemical screening for fetal abnormalities currently includes four serum markers, the “quad test.”
These markers are ______.

A
  1. alpha-fetoprotein (AFP)
  2. hCG
  3. unconjugated estriol (uE3)
  4. inhibin A
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27
Q

Pregnancies with a fetus having Down syndrome show
____ levels of AFP and uE3 and
_____ levels of hCG and inhibin A.

A

low; elevated

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28
Q

In Trisomy 18, AFP, uE3, and hCG are all ____.

A

In Trisomy 18, AFP, uE3, and hCG are all LOW.

29
Q

______ is the most common chromosome abnormality, increasing in incidence and currently occurring in 1 of 500 births.

A

Trisomy 21 (Down syndrome)

30
Q

_______ is the second most common chromosome anomaly, occurring in 1 of 3000 births.

A

Trisomy 18

31
Q

Effective US screening for CNS anomalies can be performed by examination of three crucial axial planes through the fetal brain.
(Identify these three planes).

A
  1. transthalamic plane
  2. transventricular plane
  3. transcerebellar plane
32
Q

The normal cisterna magna measures ___ mm in width.

A

2 to 11 mm

33
Q

A small cisterna magna ( __ mm)
- suggests a Chiari II malformation,
but may also be seen with massive ventriculomegaly.

A large cisterna magna ( __ mm)
- may be a normal variant (mega-cisterna magna) or
indicate Dandy–Walker malformation, arachnoid cyst, or
cerebellar hypoplasia.

A

*small cisterna magna (<2 mm)
- suggests a Chiari II malformation,
but may also be seen with massive ventriculomegaly.

*large cisterna magna (>11 mm)
- may be a normal variant (mega-cisterna magna) or
indicate Dandy–Walker malformation, arachnoid cyst, or
cerebellar hypoplasia.

34
Q

The normal ventricular atrium does not exceed __ mm in width at any time during pregnancy.

A

does not exceed 10 mm

  • ventricular atrium is measured from its medial wall to its lateral wall
35
Q

The normal cisterna magna measures ___ mm throughout pregnancy.

A

2 to 11 mm

  • cisterna magna is measured from the vermis to the occiput
36
Q

3 US signs of ventriculomegaly

A
  1. diameter of the ventricular atrium greater than 10 mm
  2. separation of choroid plexus from the ventricular wall by greater than 3 mm
  3. “dangling choroid”
37
Q

The most common causes of ventriculomegaly in the fetus are

____.

A

Chiari II malformation and aqueductal stenosis

38
Q

_______ is the most common neural tube defect.

A

Anencephaly

39
Q

_______ are fluid- and/or brain tissue-filled sacs that protrude through a defect in the bony calvarium.

A

Cephaloceles

40
Q

______ refers to a spectrum of spinal abnormalities resulting from failure of the complete closure of the neural tube.

A

Spina bifida

41
Q

Spina Bifida ranges from
- simple nonfusion of the vertebral arches with intact skin
(___________),
- to protruding sacs containing only CSF skin
(___________),
- to sacs with spinal cord or nerve roots skin
(___________),
- and to a totally open spinal defect skin
(___________).

A

Spina Bifida ranges from
- simple nonfusion of the vertebral arches with intact skin
(spina bifida occulta),
- to protruding sacs containing only CSF
(meningocele),
- to sacs with spinal cord or nerve roots
(myelomeningocele),
- and to a totally open spinal defect
(myeloschisis).

42
Q

Spina bifida may occur anywhere in the spine but most often occurs in the _____.

A

lumbosacral region

43
Q

The “lemon sign” refers to __________, causing a lemon-shaped appearance to the head in the axial plane

The “banana sign” is produced by compression of the _______ into a banana shape.

A
  • “lemon sign” refers to bossing of the frontal bones, causing a lemon-shaped appearance to the head in the axial plane
  • “banana sign” is produced by compression of the cerebellar hemispheres into a banana shape.
44
Q

Hydranencephaly refers to total destruction of the cerebral cortex, believed to be caused by the occlusion of the _____.

A

internal carotid arteries

45
Q

Dandy–Walker malformation results from the maldevelopment of the ____.

A

roof of the fourth ventricle

46
Q

______ is a fluid collection in the fetal neck caused by failure of the lymphatic system to develop normal connections with the venous system in the neck.

A

Cystic hygroma

47
Q

_______ is a congenital hamartomatous lesion of the lung, usually affecting one lobe.

A

Cystic adenomatoid malformation

  • Type I lesions appear on US as single or multiple cysts larger than 2 cm size.
  • Type II lesions consist of multiple smaller cysts of uniform size less than 2 cm.
  • Type III lesions appear as echogenic solid masses because the cysts are microscopic
48
Q

_______ is a mass of lung tissue supplied by systemic arteries and separated from its normal bronchial and pulmonary vascular connections.

A

Pulmonary sequestration

  • Intralobar sequestrations (75%) are contained within the pleural covering of an otherwise normal lobe of the lung. Pulmonary venous drainage is maintained. US detection in the fetus is rare.
  • Extralobar sequestrations, although less common (25%), are much more frequently evident on fetal US. These are accessory lobes, contained within their own pleura, and supplied by both systemic arteries and veins.
49
Q

The apex of the normal heart is directed at the ___ at a 45° angle on the same side as the fetal stomach.

A

The apex of the normal heart is directed at the left anterior chest wall at a 45° angle on the same side as the fetal stomach.

Deviation from this position suggests a cardiac malformation or a thoracic mass.

50
Q

Swallowing begins at _____ weeks GA.

A

11 to 12 weeks GA

51
Q

By ____ weeks GA, the fluid-filled stomach is normally seen in the left upper quadrant of the fetal abdomen.

A

18 weeks GA

52
Q

______ is descriptive of fluid distension of the stomach and proximal duodenum.

A

Double bubble

  • Fluid distension of the duodenum is abnormal and indicative of duodenal atresia or stenosis, annular pancreas, or volvulus.
53
Q

Bowel obstruction is suggested by dilation of the small bowel of
______.

A

greater than 6 mm

54
Q

Small bowel is considered abnormally echogenic when its echogenicity is _____.

A

equal to or greater than that of adjacent bone

55
Q

The most common causes of hydronephrosis in the fetus are

_____ (3).

A
  1. ureteropelvic junction obstruction
  2. ectopic ureterocele
  3. posterior urethral valves
56
Q

3 definitive evidence of significant hydronephrosis in fetal kidney US.

A
  1. Dilation of the renal pelvis greater than 10-mm AP diameter or
  2. greater than 50% of the AP diameter of the kidney
    in axial section or
  3. unequivocal caliectasis
57
Q

Minimal dilatation of the renal pelvis is most often due to _____.

A

physiologic vesicoureteral reflux

  • that is normal during the second and the third trimesters
58
Q

A fluid-filled renal pelvis larger than ___ mm warrants attention because it may be a sonographic marker of aneuploidy (Down syndrome) or an early indicator of congenital urinary obstruction.

A

larger than 3 mm

59
Q

_______ kidney appears as multiple noncommunicating cysts of varying size.

A

Multi-cystic dysplastic kidney

  • Because affected kidneys do not function, bilateral multicystic dysplastic kidney is associated with severe oligohydramnios and is not compatible with life.
60
Q

Massive enlargement of both kidneys associated with oligohydramnios suggests _____.

A

autosomal recessive polycystic disease

61
Q

_______ results from a defect in the anterior abdominal wall nearly always on the right side of the umbilicus.

A

Gastroschisis

  • defect is usually 2 to 4 cm in size
  • Bowel herniates through the defect and floats freely in the amniotic fluid with no covering membrane
62
Q

______________ is a more serious abdominal wall defect.

- The defect is midline at the umbilicus with herniation of abdominal contents into the base of the umbilical cord

A

Omphalocele

  • Both liver and bowel are commonly present in the herniation
  • A membrane consisting of peritoneum and amnion covers the omphalocele
  • The umbilical cord inserts through the membrane
  • Associated anomalies are common
63
Q

A ratio of FL to foot length of less than 1 suggests a _____, whereas a ratio greater than 1 is usually associated with a _____.

A

A ratio of FL to foot length of less than 1 suggests a
*skeletal dysplasia,

whereas a ratio greater than 1 is usually associated with a *constitutionally small or growth-retarded fetus.

64
Q

______ is the most common lethal skeletal dysplasia.

A

Thanatophoric dwarfism

65
Q

_______ dysplasia is an autosomal dominant trait that is lethal in homozygous form and nonlethal in heterozygous form.

A

Achondroplastic dysplasia

  • Because at least one parent must have the condition, the US diagnosis is made on the basis of proximal limb shortening
66
Q

Osteogenesis imperfecta is a heterogenous group of disorders with both autosomal dominant and recessive inheritance patterns.
The hallmark of the disease is ______.

A

osteoporosis

  • this may manifest on US as diminished bone echogenicity
67
Q

Clenched hands with overlapping index fingers

A

trisomy 18

68
Q

Polydactyly with polycystic kidneys suggests ____.

“poly poly Mac”

A

Meckel–Gruber syndrome

69
Q

Hypoplasia of the middle phalanx of the fifth digit in association with femur and humerus shortening suggests ______.

A

Down syndrome

KEVIN BURANT IV (20 decks)

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