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OB/GYN Scanning > Ectopic & GTD > Flashcards

Ectopic & GTD Flashcards

1
Q

What’s the risk of recurrence with ectopic pregnancy?

A

12-18%

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2
Q

What is the chance of an ectopic in the normal population?

A

1/8000

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3
Q

What is the chance of an ectopic in the fertiligy patient population?

A

1/1800

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4
Q

Where should you always look for an ectopic pregnancy?

A

morrison’s pouch

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5
Q

What is the ‘ring of fire’ sign?

A

Color doppler signal surrounding the gestational sac

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6
Q

What is the most common site for an ectopic implantation?

A

ampulla of the ovaduct

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7
Q

Adnexal implantation includes the…

A

isthmus, ampulla, fimbria, and interstitial areas.

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8
Q

Which is the most life-threatening of all ectopic gestations?

A

interstitial ectopic

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9
Q

This exists when the conceptus implants on any site within the uterus that is outside the endometrial cavity.

A

‘uterine’ ectopic pregnancy

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10
Q

‘Uterine’ ectopic pregnancy is suggested by a gestational sac that high in the fundus and NOT surrounded by at least ___ of myometrium in all planes.

A

5 mm

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11
Q

Cervical ectopics carry high ___ rates and attempts to evacuate the conceptus can cause ___.

A

morbidity and mortality, massive hemorrhage

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12
Q

Why might a woman with an ectopic pregnancy have pain in her shoulder?

A

because of intraperitoneal hemorrhage

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13
Q

This is a concomitant intrauterine implantation AND an extrauterine implantation.

A

heterotopic gestation

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14
Q

About when does an isthmus ectopic rupture?

A

6-8 weeks

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15
Q

About when does an ampullary ectopic rupture?

A

8-12 weeks

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16
Q

About when does an interstitial ectopic rupture?

A

12-16 weeks

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17
Q

This folic acid antagonist has been shown to destroy proliferating trophoblast and may be effective in small unruptured ectopics.

A

Methotrexate (MTX)

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18
Q

This physical sign is usually associated with intraperitoneal bleeding from hemorrhagic pancreatitis, ruptured abd aorta or ruptured ectopic.

A

Grey-Turner sign

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19
Q

What constitutes a Grey-Turner sign?

A

ecchymosis on the side of the abdomen

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20
Q

This is when the conceptus trophoblast layers proliferates and not the embryoblast; no embryo develops.

A

gestational trophoblastic disease

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21
Q

This abnormal fertilization process is a complication of pregnancy that is increased in older and very young women.

A

molar gestation

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22
Q

Name two clinical indicators of molar gestation.

A
  1. vaginal bleeding in the first or early second trimester

2. serum levels of beta-hCG are DRAMATICALLY elevated

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23
Q

T/F? Women with a molar pregnancy may experience hyperemesis, preeclampsia, and PIH.

A

true

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24
Q

T/F? Women with a molar pregnancy have AFP levels that are very high.

A

FALSE, very low

25
Q

T/F? Women with a molar pregnancy have a fundal height that is higher than dates.

A

true

26
Q

GTD affects how many pregnancies in the US?

A

1/1500 or 2000

27
Q

What is the characteric sonographic appearance of GTD?

A

the ‘snowstorm’, an echogenic mass containing cystic spaces

28
Q

This is the most common form of GTD.

A

Complete hydatidform mole

29
Q

How often does a complete mole happen in the US?

A

1:1500

30
Q

This is the most common form of GTD, occuring in 1/1500 and 5% risk of recurrence.

A

complete hydatidifom mole

31
Q

T/F? In a complete mole no identifiable fetal tissue is present.

A

true

32
Q

A complete mole occurs when sperm fertilizes an ___ ovum.

A

empty.

33
Q

A complete mole is completely ___ in origin.

A

paternal

34
Q

What are the risk factors for a complete mole?

A
  1. under 20 or over 40
  2. low economic status
  3. deficient in protein & folic acid
35
Q

T/F? In the 2nd trimester, a complete mole is hypervascular, with high velocity and low resistance.

A

FALSE, 1st trimester

36
Q

T/F? In the 1st trimester, a complete mole will present with unilateral theca lutein cysts.

A

FALSE, bilateral

37
Q

T/F? In the 2nd trimester, a complete mole has areas of necrosis.

A

true

38
Q

In complete moles, these are an ovarian response to excess hCG secretion by the GTN.

A

theca lutein cysts

39
Q

This form of GTD is commonly found to have 1 set of maternal chromosomes and 2 sets of paternal chromosomes.

A

Partial mole

40
Q

This GTD occurs when the mass contains a severely defective embryo and abnormal cells.

A

Partial mole

41
Q

What is a triploid karyotype?

A

Three sets of chromosomes

42
Q

A partial mole results when…

A

Two sperms fertilize a single ovum.

43
Q

Partial miles present with…

A
  1. Deformed gest. sac
  2. Growth restricted triploid fetus
  3. Large cystic placenta
  4. Similar to a missed abortion
44
Q

This GTD is similar to a partial mole but with a normal karyotype fetus.

A

Mole with coexisting normal fetus

45
Q

This condition most commonly follows GTD.

A

Persistent trophoblastic neoplasia (PTN)

46
Q

This is another phrase for PTN.

A

Recurrence of molar tissue

47
Q

This is the most common form of PTN.

A

Invasive mole

48
Q

This GTD penetrates the myometrium; may cause rupture and hemoperitoneum.

A

Invasive mole

49
Q

This is considered a malignant, non metastatic form of GTD.

A

Invasive mole

50
Q

What’s another term for invasive mole?

A

Chorioadenoma destruens

51
Q

This GTD presents as echogenic material that may extend into the myometrium with irregular sonolucent areas; ‘lights up like a Christmas tree’.

A

Invasive mole

52
Q

This form of GTD is considered malignant and metastatic.

A

Choriocarcinoma

53
Q

This form of GTD is very rare, 1:30,000 pregnancies.

A

Choriocarcinoma

54
Q

How many GTD pregnancies give rise to choriocarcinoma?

A

1:40

55
Q

The GTD that leads to vascular invasion, hemorrhage, and necrosis of the myometrium is…

A

Choriocarcinoma

56
Q

This GTD presents with an enlarged uterus with a vascular irregular complex mass.

A

Choriocarcinoma

57
Q

T/F? Choriocarcinoma presents in non pregnant patients with an elevated hCG.

A

True

58
Q

Patients with choriocarcinoma are often counseled to avoid pregnancy for at least ___ to minimize the risks.

A

One year

OB/GYN Scanning (14 decks)

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