CREOG quizzes

Question 1

Omphalocele

Answer 1

ventral wall defect; frequency 1/5000 to 1/10000
Midline defect and the abdominal contents are covered by a membrane. The umbilical cord inserts to the base of the defect (gastroschisis is to the right of the midline)
Omphalocele has worse prognosis, 50% are assoc. with major anatomic or genetic anomalies. karyotype is indicated

Question 2

Anencephaly

Answer 2

Open NTD; Frequency: 1 in 1000
Possible teratogens: folic acid deficiency, heat, irradiation, alcohol abuse, aminopterin, valproic acid, maternal obesity.
Recurrence risk :2-3%; it can be reduced 60% if 4 mg of folic acid are taken during pregnancy
Low risk women should take 0.4 mg folic acid

Question 3

NTDs

Answer 3

Occur in 1 to 2 pregnancies per 1000 in the US; 50-55% are spina bifida, 45-50% anencephaly, <5% encephaloceles
Ultrasound findings of spina bifida:
-lemon sign (90% of cases less than 24 wks)
-banana sign
-ventriculomegaly

Question 4

Cystic hygroma

Answer 4

It is caused by failure of the lymphatic system to establish proper connection to the jugular venous system. It is most commonly associated with 45, X (turner syndrome).
If associated with fetal hydrops prognosis is very poor.
Recurrence risk <1%

Question 5

Echogenic bowel

Answer 5

• Cystic fibrosis
• Congenital CMV
• Down syndrome
• Aspiration of Blood
• *When this is found pt should be offered amniocentesis.

Question 6

Duodenal atresia

Answer 6

Double bubble sign and polyhydramnios

**Pt should be offered amniocentesis

Question 7

Placental Abruption

Answer 7

RF: HTN, uterine anomalies, smoking, high parity, increased maternal age, PPROM, trauma, multiple gestation

Question 8

Hyperemesis Gravidarum

Answer 8

DDx: Pancreatitis, PUD, hepatitis, cholelithiasis, hyperthyroidism

Question 9

Eduardo Porro

Answer 9

performed the 1st cesarean hysterectomy where both the mother and infant survived in 1878

Question 10

Kerr incision

Answer 10

low transverse uterine incision;

Question 11

Moderator Band

Answer 11

thickening of the interventricular septum at the level of the apex;

Question 12

Holoprosencephaly

Answer 12

Abnormality of the embryonic forebrain; 3 forms:

• Alobar- worst prognosis
• lobar- best prognosis
• Semilobar

Question 13

Piper Forceps

Answer 13

most appropriate instrument for delivery of the after coming head of a breech presentation

Question 14

Simpson Forceps

Answer 14

better for molded heads

Question 15

Tucker-Mclean Forceps

Answer 15

better for un-molded heads

Question 16

Twin peak sign

Answer 16

Di-Di placentation

Question 17

Kronig incision

Answer 17

low vertical incision
- primarily used when a cesarean hysterectomy is planned or for delivery of a pre-term non-frank breech presentation when the lower uterine segment is poorly developed

Question 18

Classical incision

Answer 18

should be used for a transverse lie back down as well as lower segment myoma, higher order multiple gestation, fetal anomaly

Question 19

Congenital cystic adenomatoid malformation of the lung

Answer 19

hamartoma characterized by overgrowth of terminal bronchioles.
Assoc. with polyhydramnios and non-immune hydrops

Question 20

Chorioangioma

Answer 20

vascular tumor of the placenta; it can cause hydrops fetalis

Question 21

sacrococcygeal teratoma

Answer 21

differentiated from a neural tube defect by the complex appearance of the tumor and identification of an intact bony vertebral column.
Cx: fetal hydrops

Question 22

Echogenic intracardiac focus

Answer 22

90% are located in the left ventricle

Question 23

Thanatophoric Dysplasia

Answer 23

severe skeletal disorder characterized by extremely short limbs and folds of redundant skin on the arms and legs. Other features: narrow chest, short ribs, underdeveloped lungs, enlarged head.
Type I- presence of curved thigh bones and flattened bones of the spine (platyspondyly).
Type II- straight thigh bones and a cloverleaf skull
They result from mutations in FGFR3 gene; autosomal dominant disorder

Question 24

Tetralogy of Fallot

Answer 24

fx: relatively large R ventricle, large ventricular septal defect, enlarged aortic orifice

Question 25

Listeria Monocytogenes

Answer 25

aerobic and facultative anaerobic gram positive bacillus
contaminants: deli meats, hot dogs, cheeses, smoked seafood and pates
Presentation: flu like illness with fever, headache, myalgias and upper respiratory systems
Incubation period: 11-70 days
Fetal sequelae: premature birth, neonatal infection, death
Tx: ampicillin 2 g IV q4hrs (tx for 2 wks if bacteremic)

Question 26

Conjoined twins

Answer 26

Incidence: 1:50,000

Incomplete embryonic division occurs 13-15 days after conception.

Question 27

Thoracophagus conjoined twins

Answer 27

fetuses have a common sternum, diaphragm, upper abdominal wall, liver, pericardium and GI tract.

Question 28

Heterotopic pregnancy

Answer 28

Incidence- 1:30,000