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OBGYN Pathology > Fetal Head/Brain > Flashcards

Fetal Head/Brain Flashcards

1
Q

Greater than _______ multiples of the median MSAFP is abnormal

A

2.5

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2
Q

What does MSAFP stand for?

A

Maternal
Serum
Alpha-FetoProtein

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3
Q

An elevated MSAFP of 2.5x the median suggests:

A

An open neural tube defect (NTD)

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4
Q

A ___________________ covering over an open neural tube defect allows excess ______ to enter maternal circulation.

A

Membranous covering

AFP

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5
Q

Increased fundal height raises suspicion of:

A

Polyhydramnios

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6
Q

Which bones are affected with a lemon shaped head?

A

Frontal bones of the skull

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7
Q

What shape head is associated with spina bifida?

A

Lemon

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8
Q

A flattened occiput and narrowed frontal part of the skull resembles a:

A

Strawberry

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9
Q

Strawberry shaped skull is associated with?

A

Trisomy 18

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10
Q

Brachiocephaly results in a what shaped head?

A

Rounded

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11
Q

Cephalic index >85%

A

Brachiocephaly

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12
Q

Brachiocephaly is associated with:

A

Chromosomal abnormalities and genetic syndromes

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13
Q

Cephalic index <70%

A

Dolichocephaly

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14
Q

Dolichocephaly is due to genetic abnormalities.

T/F

A

False, usually due to head molding in breech

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15
Q

What is characterized by excessive CSF in the cerebral ventricles?

A

Ventriculomegaly

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16
Q

Hydrocephalus is ventricular enlargement secondary to:

A

Increased intracranial pressure/head enlargement

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17
Q

Atria of lateral ventricles should not exceed:

A

10 mm

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18
Q

Examples of non communicating hydrocephalus

A

Aqueductal stenosis
Chiari II
Dandy Walker malformation

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19
Q

What is the most common intraventrivular obstruction?

A

Aqueductal stenosis

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20
Q

Where is the aqueduct of Sylvius located?

A

Between 3rd and 4th ventricles

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21
Q

What is chiari II associated with?

A

Spina bifida

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22
Q

What is a communicating hydrocephalus?

A

Arachnoid cyst

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23
Q

What may cause an overproduction of CSF that is considered a pathogenesis of ventriculomegaly?

A

Choroid plexus papilloma

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24
Q

Associated abnormalities with ventriculomegaly

A 
Spina bifida 
Dandy-Walker syndrome 
Encephalocele
Cardiac malformations
Renal malformations
Abnormal karyotypes
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25
Q

Sonographic findings associated with ventriculomegaly

A 
Polyhydramnios
Abnormal fetal lie
Hepatomegaly 
Fetal Ascites with associated infection
Meningomyelocele
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26
Q

Absence of skull and cerebral hemispheres

A

Anencephaly

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27
Q

Features seen with anencephaly

A

Bulging eyes
Macroglossia
Very short neck
Elevated AFP

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28
Q

With anencephaly, Face has what appearance?

A

Frog like

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29
Q

Other common findings with anencephaly

A

Polyhydramnios

Talipes (club foot)

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30
Q

How early can anencephaly of can be diagnosed?

A

12 weeks

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31
Q

Alobar Holoprosencephaly is the _________________ form of Holoprosencephaly.

A

Most severe

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32
Q

Dandy Walker malformation is a:

A

Congenital brain malformation in which there is enlargement of cisterna magna, agenesis of cerebellar vermis, and dilation of fourth ventricle

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33
Q

Dangling choroid sign is associated with:

A

Ventriculomegaly

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34
Q

Scaphocephaly is another name for:

A

Dolichocephaly

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35
Q

Gastroschisis is a herniation of abdominal contents that has a membrane covering it.
T/F

A

False

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36
Q

Holoprosencephaly is a group of brain abnormalities that has varying degrees of:

A

Fusion of lateral ventricles, absence of midline structures and associated facial anomalies

37
Q

Communicating hydrocephalus is an obstruction of cerebrospinal fluid from:

A

A source outside of the ventricular system like an arachnoid cyst

38
Q

Hydrocephalus refers to ventricular enlargement due to:

A

increased cranial pressure, caused by increased volume of CSF

39
Q

Fetal Hydrops must occur in at least:

A

2 body cavities

40
Q

What is the term for “smooth brain” where there is little/no gyri or sulci?

A

Lissencephaly

41
Q

Lobar Holoprosencephaly is the _____________ form of Holoprosencephaly.

A

Least severe

42
Q

What are some associations with Meckel-Gruber syndrome?

A

Microcephaly
Occipital encephalocele
Polydactyly
Polycystic kidneys

43
Q

Mega cisterna magna is when the CM measures larger than:

A

10 mm

44
Q

What is an anterior abdominal wall defect where there is a herniation of bowel and organs into base of umbilical cord?

A

Omphalocele

45
Q

Porencephaly is when a cyst, typically caused by intraparenchynal hemorrhage, communicates with:

A

A lateral ventricle

46
Q

Schizencephaly is a cerebral malformation associated with:

A

Development of fluid filled clefts

47
Q

Thanatophoric dysplasia is the most common lethal skeletal dysplasia characterized by:

A

Cloverleaf skull with frontal bossing and hydrocephalus

48
Q

Vein of Galen aneurysms are arteriovenous malformations associated with:

A

Congestive heart failure

49
Q

Cephalic index of less than _____ denotes Dolichocephaly and greater than _____ denotes Brachiocephaly.

A

70

85

50
Q

Ventriculomegaly is when the atria of the lateral ventricles measure greater than:

A

10 mm

51
Q

Anomaly associated with lemon shaped head

A

Chiari II malformation

Spina bifida

52
Q

Anomaly associated with a strawberry shaped head

A

Trisomy 18

53
Q

Anomaly associated with a cloverleaf shaped head

A

Thanatophoric dysplasia

54
Q

Anomaly associated with Microcephaly

A

TORCH/intrauterine infections
Trisomy 13 & 18, aneuploidy
Meckel-Gruber syndrome
Fetal alcohol syndrome

55
Q

Microcephaly appears as:

A

Small BPD
decreased HC/AC ratio
Poor cranial growth on serial scans
No dip between nose and forehead

56
Q

Macrocephaly is associated with:

A 
Hydrocephalus 
Hydranencephaly 
Intracranial tumors
Familial inheritance 
Beckwith-Wiedemann syndrome
57
Q

Cisterna magna should not measure less than:

A

2 mm

58
Q

The most common cause of non communicating hydrocephalus is:

A

Aqueductal stenosis

59
Q

Ventriculomegaly may be seen as a normal variant later in second trimester in ________ fetuses and fetuses _______ for gestational age.

A

Male

Large

60
Q

Holoprosencephaly has a strong association with:

A

Trisomy 13

61
Q

How many ventricles are typically seen with Holoprosencephaly?

A

1, a monoventricle

62
Q

Alobar Holoprosencephaly has Sonographic traits that show:

A 
Monoventricle
Fused echogenic thalami
Absence of falx, corpus callosum, CSP and interhemispheric fissure
Hypotelorism 
Cyclopia
Midline clefts
63
Q

Semilobar is associated with:

A

Cleft lip and palate

64
Q

Semilobar may have:

A

Partial development of falx and interhemispheric fissure

65
Q

Lobar Holoprosencephaly will have absence of:

A

Corpus callosum

CSP

66
Q

Dandy Walker variant is also known as:

A

Vermian hypoplasia

67
Q

Dandy walker complex refers to

A

Congenital malformations of posterior fossa, dysgenesis of cerebellar vermis

68
Q

When is the earliest vermian hypoplasia can be diagnosed?

A

After 18 weeks

69
Q

How often is dandy walker malformation associated with CNS abnormalities?

A

50-70%

70
Q

If cerebellar vermis is absent and the fourth ventricle is enlarged then ________ must be suspected.

A

Dandy Walker Malformation

71
Q

What is colpocephaly?

A

Disproportionate enlargement of occipital horns

72
Q

Ventricles may have what shape with agenesis of corpus callosum?

A

Tear drop shape

73
Q

Third ventricle will be _______ and ________ with agenesis of corpus callosum.

A

Elevated and dilated

74
Q

Porencephaly is most often unilateral.

T/F

A

True

75
Q

How can you tell the difference between an arachnoid cyst and a porencephalic cyst?

A

Arachnoid cysts will NOT communicate with the ventricular system

76
Q

Cranial meningocele includes:

A

Meninges and CSF

77
Q

Encephalocele contents include:

A

Brain tissue and CSF

78
Q

Where is the most common site for Encephaloceles?

A

Occipital

79
Q

Arnold Chiari II is displacement of :

A

Cerebellar vermis, fourth ventricle, and medulla oblangata through foramen magnum into upper cervical canal

80
Q

What causes Arnold Chiari II?

A

Traction on hindbrain

81
Q

What is Arnold Chiari II associated with?

A

Spina bifida

Tethered spinal cord

82
Q

Sono traits of Arnold Chiari II

A

Banana shaped cerebellum
Obliterated cisterna magna
Ventriculomegaly
Lemon shaped head

83
Q

Microcephaly must measure more than ____ standard deviations below normal.

A

3

84
Q

Agenesis of corpus callosum is associated with:

A 
Trisomy 18 & 13
Holoprosencephaly 
Median facial clefts
Dandy walker malformation 
Schizencephaly
Lissencephaly
85
Q

How can you confirm a vein of Galen aneurysm?

A

Using Doppler to demonstrate turbulence

86
Q

What’s the most common cause of Hydranencephaly?

A

Occlusion of carotid arteries in 1st/2nd trimester

87
Q

Hydranencephaly is the most severe degree of:

A

Porencephaly or brain destruction

88
Q

Hydranencephaly causes total or near total absence of cerebrum but _________________ remain intact.

A

Cranial vault
Thalami
Lower brain centers

89
Q

Hydranencephaly is difficult to distinguish from:

A

Severe hydrocephaly

OBGYN Pathology (10 decks)

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