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DMS 400 OB/GYN > Class 17: GI & GU Anomalies > Flashcards

Class 17: GI & GU Anomalies Flashcards

1
Q

what is bilateral renal agenesis?

A

no renals – not compatible with life

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2
Q

another name for bilateral renal agenesis?

A

potter syndrome

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3
Q

which part of the population does potter syndrome more commonly occur in?

A

males

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4
Q

what is the most severe GU anomaly?

A

bilateral renal agenesis

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5
Q

what weeks will severe oligohydramnios be seen with potter syndrome?

A

16-28 weeks

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6
Q

potter syndrome will lead to oligohydramnios, which will lead to __ ___

A

pulmonary hypoplasia

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7
Q

which part of pregnancy is directly related to the fetal production of urine?

A

2nd half of pregnancy

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8
Q

the following are secondary signs of which GU anomaly?
1. no UB
2. oligohydramnios
3. facial anomalies
4. clubfoot

A

potter syndrome

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9
Q

on US, what structures may mimic the renals? why?

A

adrenal glands – larger in the fetus

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10
Q

GU anomalies are associated with polyhydramnios. T/F?

A

false – oligohydramnios

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11
Q

with unilateral renal agenesis, everything in the fetus will look normal as long as there is no ___

A

obstruction

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12
Q

what is fetal hydronephrosis?

A

when the renal pelvis is dilated > 8 mm

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13
Q

what is the most common cause of fetal hydronephrosis?

A

UPJ obstruction

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14
Q

what is a frequent cause of UPJ obstruction?

A

double collecting system

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15
Q

which part of the population does posterior urethral valve syndrome more commonly occur in?

A

males

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16
Q

PUV is unilateral. T/F?

A

false

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17
Q

cause of PUV

A

extramembranous folds obstruct the distal fetal urethra

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18
Q

5 US appearances of PUV?

A
  1. keyhole sign (dilated urethra)
  2. enlarged UB
  3. thick UB wall
  4. hydroureters
  5. oligohydramnios
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19
Q

another name for prune belly triad?

A

eagle barrett syndrome

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20
Q

what part of the population does eagle barrett syndrome more commonly occur in?

A

97% males

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21
Q

3 signs of prune belly triad

A
  1. hypoplastic/agenesis of ABD musculature
  2. cryptoorchidism
  3. PUV & urinary ascites
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22
Q

why is eagle barrett syndrome called prune belly?

A

the abdomen of fetus is distended dt UB –> wrinkled when hydronephrosis is decompressed after birth

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23
Q

IPKD is autosomal recessive. T/F?

A

true

24
Q

4 types of IPKD?

A
  1. perinatal
  2. neonatal
  3. infantile
  4. juvenile
25
Q

what is perinatal IPKD?

A

when renals fail in the fetal period

26
Q

what is neonatal IPKD?

A

renals start failing in the 1st month of life – death in the 1st year

27
Q

what is infantile IPKD?

A

renals start failing within 3-6 months of life

28
Q

what is juvenile IPKD?

A

renal issues between 1-5 yo & there is less renal involvement

29
Q

why are the renals hyperechoic with IPKD?

A

many microscopic cysts give acoustic enhancement

30
Q

US appearance of IPKD?

A
  • bilateral enlarged homogenous hyperechoic kidneys
  • severe oligohydramnios
  • UB not seen
31
Q

what is the most common renal dysplasia?

A

multicystic dysplastic kidney

32
Q

multicystic dysplastic kidney is unilateral. T/F?

A

true

33
Q

is multicystic dysplastic kidney autosomal recessive or dominant?

A

dominant

34
Q

how do the lungs and amniotic fluid look with multicystic dysplastic kidney?

A

normal – one kidney is functioning properly

35
Q

associations of multicystic dysplastic kidney?

A

an abnormality with the contralateral kidney

36
Q

US appearance of multicystic dysplastic kidney?

A

many large anechoic cysts
largest cyst is not centered
malformed kidney shape

37
Q

differential dx of multicystic dysplastic kidney?

A

hydronephrosis (with frozen image)

38
Q

what is fetal hydrocele?

A

fluid around fetal testes

39
Q

GI tract abnormalities are associated with poly or oligohydramnios?

A

polyhydramnios

40
Q

what is duodenal atresia?

A

there is a blockage of the duodenal lumen, leading to dilation of duodenum & stomach, backing up amniotic fluid

41
Q

US appearance of duodenal atresia?

A

double bubble sign

42
Q

3 conditions duodenal atresia is associated with?

A
  1. VACTERL
  2. down’s syndrome (21)
  3. bowel malrotation (annular pancreas)
43
Q

definition of fetal hydrops?

A

excessive accumulation of clear, watery fluid in any tissues/cavities

44
Q

US signs for fetal hydrops? (AAPPPPHHS)

A

ascites
anasarca
pleural effusion
pulmonary effusion
polyhydramnios
placentamegaly
hepatosplenomegaly
hydropic umbilical cord
scalp edema

45
Q

2 types of fetal hydrops?

A
  1. non-immune fetal hydrops
  2. immune fetal hydrops
46
Q

most common cause of NIFH?

A

cardiovascular abnormalities

47
Q

2nd most common cause of NIFH?

A

chromosomal abnormalities

48
Q

the outcome for NIFH depends on ___

A

underlying causes

49
Q

what is the most common cause of IFH?

A

Rh disease/fetal blood incompatibility/Rh incompatible/rhizoimmunization

50
Q

are most people Rh+ or Rh-?

A

Rh+

51
Q

with Rh disease, mom has Rh_ & baby has Rh_

A

mom = Rh-
fetus = Rh+

52
Q

what happens with IFH

A

if there is a mixing of blood bw mom & fetus –> mom exposed to Rh antigen –> mom makes Ab against it –> attacks fetus RBC through placenta –> fetal anemia, CHF, hydrops

53
Q

5 effects to the fetus with IFH

A
  1. jaundice
  2. anemia
  3. brain damage
  4. heart failure
  5. death
54
Q

if the fetus has mild hemolytic disease, what is the treatment?

A

no prenatal tx needed

55
Q

if the fetus has moderate hemolytic disease, what is the tx?

A

1 prenatal transfusion & neonatal tx with multiple transfusions

56
Q

if the fetus has severe hemolytic disease, what is the tx?

A

multiple prenatal transfusions until 26-32 weeks
& aggressive neonatal tx

DMS 400 OB/GYN (21 decks)

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