Extras Flashcards
Fetal death is defined as death of a fetus:
- At 20 weeks or more of gest
* Weighing 500g or more
Mets ovarian carcinoma can be associated with:
Ascites
Peritoneal mets
Omental mets
Liver mets
Which masses are likely to be encountered with preg?
Fibroid
Dermoid cyst
Corpus luteal cyst
What is hypofibrinogenemia?
Deficiency in fibrinogen,
May be manifested by intravascular coagulation due to a demised fetus left in utero for more than 5 weeks
The biparietal diameter can be determined as early as
12 wks
Organogenesis is completed at:
8 weeks
How to determine age in weeks from a CRL measurement?
CRL (in cm) + 6.5 = weeks gest
Which conditions may cause a double ring sign of the fetal skull
DM Fetal demise Sickle cell anemia Rh isoimmunization Fetal distress Hydrops fetalis
The reason for shoulder pain in an ectopic preg is:
Intraperitoneal bleeding with diaphragmatic irritation
Approx how many days during the first 6 wks after conception does the hCG double?
2 days
20% of ectopic gestations demonstrate a pseudogestational sac
True
Cystic hygromas are associated with:
Elevated AFP
Turners syndrome
Describe omphalocele
Protrusion of abdominal contents that may contain bowel, liver, or spleen with herniation at the base of the umbilical cord.
Covered by a peritoneal sac covered w amnion
Describe gastroschisis
Normal insertion of the umbilical cord, not covered by membrane, herniates to the right side
Nonspecific signs of fetal death
Echoes in the amniotic fluid Absence of falx cerebri A decrease in BPD Double contour of the fetal head ( halo sign)
How long after fetal death can scalp edema be seen?
2-3 days
24-72 hrs
Sonographic Spaulding’s sign is:
Overlapping of the fetal cranium
Associated conditions with hydrocephalus
Meningomyelocele
TORCH
Aqueductal stenosis
Dandy walker symdrome
After evacuation of molar preg, how long does it take for hCG to return to normal range?
10-12 weeks
What percentage of molar preg results in choriocarcinoma?
3-20%
Where does choriocarcinoma mets to?
Liver, lungs, brain, bone, GI tract
Which country has greatest incidence of hydatidiform mole?
Japan
What is the reason of a CXR S/P hydatidiform mole treatment?
Mets evidence
PE
What distinguishes the small bowel from the large bowel
Valvulae conniventes (Folds of the small intestine)
The term pathogenic denotes:
The characteristics of a disease
Ovarian carcinomas usually mets to
Bowel
Accuracy of gest sac vol measurement as a means of estimating gest age is
Confidence limit of +/- 9 days
Long term effects of an IUGR born child
Speech defects
CNS abnormalities
Diminished intelligence
More frequent in male than female
Anomalies associated with IUGR
T21
T18
Potter’s syndrome
Neural tube defects
Ideal time for detecting spina bifida
17-18 weeks
Functions of the yolk sac
Hematopoiesis
Development of sex glands
Formation of digestive tube
Transfer of nutrients
The yolk sac that persists as a diverticulum of the ileum is known as:
Meckel’s diverticulum
Sonographic findings of a blighted ovum
"Tennis racquet" shape Disproportion between gest sac and UT size Failure of gest sac to grow Fragmentation of the sac Weak surrounding echoes 8 wks no embryo
Single umbilical artery is associated with:
Twins
DM
Congenital anomalies
Measurement of the umbilical vein diameter is a useful indicator of:
Rh isoimmunization
Double-ring sign aka halo sign is associated with:
Fetal demise Fetal distress Sickle cell anemia DM Rh isoimmunization Fetal anasarca Hydrops
Thickening of the placenta is associated with
Rh isoimmunization Multiple gestation Maternal heart disease DM Transplacental syphilis
Thinning of the placenta is associated with
IUGR
Placental insufficiency
Preeclampsia
Poly
Nagele’s rule
Mathematical methodology to estimate EDC
LMP + 7days- 3 months + 1 yr
Avg duration of preg
280 days
40 weeks
9 calendar months
10 lunar months
Ratio of HC to AC throughout preg
12-24 wks gest — head larger than abd
32-36 wks gest — head and abd are equal
36-40 wks gest — abd larger than head
What combo results in Rh isoimmunization?
Mother Rh- and father Rh+
Total malfusion of ductus paramesonephricus
Dedelphic uterus
Partial malfusion of ductus paramesonephricus
Bicornuate uterus
Minimal malfusion of ductus paramesonephricus
Septate uterus
Unilateral arrested development of paramesonephric duct
Uterus unicornis
Dysgerminoma
Malignant germ cell tumor of the ovary
Equal to seminoma of the testes
Uncommon tumor
Dermoid cyst
More common in younger females
Aka benign cystic teratoma
Most common benign germ cell tumor in the female
Mostly unilateral
Has hair, teeth, bone, fat
Tip of the iceberg sonographic appearance
Signs and symptoms of PID
Pelvic pain Fever Leukocytosis Rapid pulse Vaginal discharge Rebound tenderness
PID in IUD users is associated with
Actinomycosis (long term infection that causes sores or abscesses in the body’s soft tissue)
Most common location of dermoid cyst
Superior to uterine fundus
When is the recommended time to perform genetic amniocentesis?
16-19 weeks gest age
Time most accurate to measure FL in gest age
14-20
Reasons for amniocentesis
Sex determination
Genetic disorders
Fetal maturity
Hemolytic disease
Ifetal iliac crests can be depicted as early as
12 weeks
Normal rate of chest wall movements in utero
12-60 breathes per minute
How long after conception in a normal preg can hCG be detected
10 days
Method of terminating preg up to 12 wks menstrual age
Vacuum aspiration
Possible masses arising from post aspect of uterus may be confirmed by
Water enema with real time sonography
Stages of Squamous cell carcinoma of the cervix
0 carcinoma in situ 1A microinvasive 1B carcinoma confined to the cx 2 carcinoma extending beyond cx 2B lateral parametrial my involvement 3 distant mets
Methods of obtaining head circumference
Real time electronic caliper
Map measurer
Commercial computer measurement system
Formula HC= BPD + OFD/2.(Pi)
Urinary bladder of fetus is completely developed by
12 wks
Incompetent cervix is treated at how many weeks of gest
14-18 wks
By McDonald’s procedure
Or shiradkor
Neonate is considered growth retarded
When neonate weight is below the 10th percentile
Formula for AC
AC = (D1+D2) x 1.57
IPCKD
Autosomal recessive Occurs bilaterally Bilateral renal enlargement Occurs with Meckel's syndrome Incompatible w life
IMCKD
Autosomal dominant
Usually unilateral
Can be diagnosed before birth
Occurs in Meckel’s syndrome
Sonography can’t depict alopecia
True
Polyhydramnios
Fluid over 2,000 mL
Oligohydramnios
Fluid below 300 mL
Approximately 75% of twins are of the same sex
True
Cleft palate is associated with
Hypotelorism
Alobar holoprosencephaly
German measles in the first 12 wks gest may give birth to
Auditory defects
Patent ductus arteriosus of heart
Microcephaly
Kidneys can be depicted as early as
14 wks
Incidence of ovarian carcinoma in women in the US over 50 yrs of age is
33 per 100,000
Hydrops fetalis can be secondary to
Tumors obstructing venous return
Rh isoimmunization
Chorionic and amnion fuse approx
10-14 wks
Maternal conditions associated with increased incidence of fetal heart malformation
DM
Meds such as lithium
Placenta Previn occurs most commonly in
Multigravid patients
H/O C-section
H/O previous therapeutic abortion
Fetal arrythmias may be associated with
Malformed hearts
Maternal SLE
Maternal rheumatoid arthritis
The hydropic villi in pregnancy cannot be recognized until
After 14 wks
Amniocentesis is performed between 16-18 wks bc
The amniocentesis have the highest likelihood for successful harvesting of chromosomes
With anencephaly there is a 30 % chance of spinal dysraphism
True
What level of hCG can the gest sac be seen based on 2nd international reference
500 mIU/mL in transvaginal
Cumulus oophorus consists of
Oocyte
Cluster of granulosa cells that surround it
Muscles that form the boundaries of the true pelvis
Piriformis
Iliopsoas
Obturator
Gest age where the prox tib epiphyseal ossification center is seen
35 weeks
Cysterna magna is best seen at what week gest
15-28 weeks
In orienting the fetal heart which are the most important cardiac anatomy pieces to recognize
Foramen ovale
Moderator band
Eustachian valve function
Directs blood from IVC to Rt atrium to foramen ovale
What % of blood flow crosses the foramen ovale
60% or Rt atrial blood vol
Blood from pulmonary artery passing thru ductus arteriosus
90%
Crista dividens complex is associated with
Eustachian valve and foramen ovale
Moderator band should be scanned to confirm cardiac situs if foramen ovale is not seen
True
Use of doppler in fetal echo is not helpful in
Arrhythmia diagnosis
PI is
Pulsatility index
(A-B)/ mean
Normal waveform of umbilical artery
Triangular shaped
A/B ratio of umbilical artery in the 3rd trimester is less than
3.0
What is the pourcelot index
Resistivity index
(A-B)/A
Lateral uterine wall vessel Doppler in a normal pregnancy will be
Low pulsatility
High end diastolic frequencies
Ratio of uterine arcuate artery is less than___ after 26wks gets
2.6
