Data interpretation Flashcards
What is a dermoid cyst
Similar to a teratoma but only has epidermal and dermal elements
What is a teratoma/mature teratoma
often has ecto/endo/meso elements.
Mature teratoma = has well differentiated elements from at least 2 germ cell layers - ecto/endo/meso. Developmentally mature skin with hair follacles, sweat glands, sometimes hair and other tissues.
How much of body weight is water?
60%
How much of body weight is plasma?
4%
How much of body weight is ICF and how much is ECF?
ICF = 40%
ECF = 20%
What is ultrasound frequency
> 20 kHz
In medical imaging it is between 2-15 MHz
Ultrasound appearance of miscarriage
1) mean gestation sack >/=25mm with no yolk sack
2) crown rump length >/=7mm with no fetal heart beat
USS appearance of complete molar pregnancy
snowstorm appearance = multiple anechoic areas within solid echos
bunch of grapes = represents hydropic swelling of the trophoblastic villi
USS appearance of partial mole
severe fetal abnormalities
abnormal gestation sack
enlarged placenta containing anechoic lesions
USS appearance of endometrioma
evidence of haemorrhagic debris - ground glass echos
diffuse homogenous low level echos
What are the normal FBS values
> 7.25 is normal
7.21-7.24 - borderline
<7.20 abnormal
Action if abnormal CTG and FBS is 7.26
Repeat in 1 hour if CTG remains abdnormal
Action if abnormal CTG and FBS is 7.21-7.24
Repeat in 30 minutes
Action if abnormal CTG and FBS is <7.20
Consider delivery
Indications for FBS
Abnormal CTG and cervix >3cm dilated
Acidosis suspected and cervix >3cm dilated
Contraindications for FBS
Maternal infection
Known coagulopathy of fetus
acute fetal compromise
prematurity <34 weeks
What are the main anion/cations intracellularly
ANION = phosphate
CATION = potassium
What are the main anion/cations extracellularly
ANION = chloride
CATION = sodium
Label these
vital capacity = volume if exhale all the way then inhale all the way
tidal volume = resting breath volume
inspiratory reserve = inspiratory capacity - tidal volume
What do each of these indicate: hepatitisB surface antigen, anti-hepBcore, anti-hepBsurface, IgM anti-Hbcore
hepatitisB surface antigen = current infection
anti-hepBcore = immunity due to past infection
anti-hepBsurface = immmunity due to vaccination
IgM anti-Hbcore = recent infection
Which 2 tests to be performed in all women struggling to conceive?
mid-luteal progesterone = should be >30. Antyhing <16 suggests anovulation
chlamydia screen
Features on USS of a functional cyst
Anechoic
thin walled
unilocular
>3cm diameter - otherwise is a follicle
no solid components
no colour flow
Describe the reassuring features of a CTG
Accellerations
No decellerations or early variable decellerations with no concerning characteristics for <90 minutes
Variability 5-25
HR 110-160
Describe the non-reassuring features of a CTG
Variable decellerations with no concerning characteristics for 90 minutes or more
OR
Variable decellerations for MORE than 30 minutes with concerning characteristics in <50% contractions
Variable decellerations for LESS than 30 minutes with concerning characteristics in >50% contractions
Late decellerations in >50% contractions for LESS than 30 minutes with no other evidence of maternal/fetal compromise
Variability <5 for 30-50 minutes OR >25 for 15-25 minutes
HR 100-109 OR 161-180
Abnormal features of CTG
HR <100 or >180
Variability <5 for >50 minutes OR >25 for >25 minutes
Late decellerations for >30 minutes
Variable decellerations with concerning characteristics for >30 minutes in >50% contractions
Acute bradycardia
Single prolonged decelleration lasting >3 minutes
Summarise B-rules and M-rules
B-rules: NA USS
- unilocular
- no blood flow
- presence of acoustic shadowing
- solid components where largest solid component <7mm
- smooth multilocular tumour where largest diameter <100mm
M-rules: IM BAP
- irregular solid tumour
- lots of blood flow
- at least 4 papillary structures
- Ascites
- Irregular multilocular tumour where largest diameter is >100mm
What should sperm PH be
> 7.2
How much sperm should be in 1 round of ejaculate
> 1.5ml
15 million per ml
What is normal sperm count/ml and per ejaculate
> 15mil/ml
> 39mil total
What is the normal % normal morphology in sperm
> 4%
What is the normal motility/progressive motility of sperm
motility >40%
progressive motility >32%
What is normal sperm vitality (total number of alive sperm)
> 58%
What do you do if sperm count abnormal
repeat in 3 months
What can steroids do to potassium
cause a mild hypokalaemia
What do you see on bloods of alcoholic
macrocytic anaemia
<B12
low urea due to impaired hepatic synthesis of urea
low platelets
low WCC
abrnomal LFTs
What to do if a scan does not reach miscarriage criteria
Repeat scan in 7 days
What would you expect to see with JVP in: heart failure, pericardial constriction, AF
right heart failure/overload - raised JVP
pericardial constriction - paradoxical JVP (kussmaul’s)
AF - absent A waves
What is the ideal ARTERIAL cord sample values following delivery
7.26-7.30
What frequency of USS is used for transabdominal USS
3-3.5 Mhz
What frequency of USS is used for transvaginal USS
5-7.5
What is pernicious anaemia.
Which molecule does it prevent from being absorbed?
Incidence?
Peak age?
Autoimmune destruction of parietal cells in the stomach which normally produce intrinsic factor. IF binds to B12 so that it can be absorbed.
1/10,000
60
What two tests are looked at to suggest menopause?
FSH >30 with a low progesterone
What two tests are looked at to suggest menopause?
FSH >30 with a low progesterone
What to do if in pregnancy there is protein in the urine?
What would the results tell you?
Organise a 24h urine collection to find out the total protein and protein:creatinine ratio
Results : total protein >300 mg = significant proteinuria
OR protein:creatitine ratio >30:1 mg/mmol
What is the USS appearance of MUCINOUS cystadenoma?
Multilocular
variable levels of echogenicity due to the difference in contents of the locules
thin walled septa
usually large
What is the USS appearance of SEROUS cystadenoma?
Unilocular
What is the threshold pH for adverse neurological outcomes in arterial cord sampling?
<7.10
When should mid-luteal progesterone be taken?
7 days before starting period so in 35 day cycle on day 28 or in 28 day cycle on day 21
