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MFM Written Boards > Fetal Physiology and Anomalies > Flashcards

Fetal Physiology and Anomalies Flashcards

1
Q

Cyanotic CHD

A

Five Ts + 1-2-3-4-5

  • TA (one trunk)
  • TGA (switch of two great vessels)
  • Tricuspid atresia (tri-)
  • TOF (tetra-) [depending on whether pulmonary valve obstruction vs overt atresia)
  • TAPVR (five words)
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2
Q

CHD with normal 4CH

A

TOF (unless big VSD)

D-TGA

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3
Q

When treat fetal SVT?

A
  • > 1/3 of time in SVT
  • CHD
  • Hydrops
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4
Q

During which phase of lung development do CPAMs develop?

A

Pseudoglandular (7-17 wks)

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5
Q

What formula and what value for predicting CPAM prognosis (and whether to treat)?

A

CPAM volume ratio (CPAM lxwxh / HC) > 1.6 = bad prognosis

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6
Q

AF by gestational age

A 
8 weeks: 10 mL
12: 50
20: 400
22: 630
28: 770
Max @ 30-34 and plateau until 36-38 then begins to decline
41: 515 mL
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7
Q

Oligo/Poly by volume #s

A

Oligo < 300-500

Poly > 1500-2000 mL

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8
Q

Bladder tap with good prognosis

A

Na < 100
Cl < 90
Ca < 8
osmolality < 200

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9
Q

Probability sensitization

  • Without RhoGAM after 2nd pregnancy
  • With just postpartum RhoGAM
  • With postpartu mand 3rd tri RhoGAM
A

16%
1-2%
0.1-0.3%

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10
Q

99% of people’s platelet genotype is…

A

HPA 1a/1a

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11
Q

NAIT risk if mom HPA-1a neg (i.e. HPA-1b at all) and dad positive?

A

10%

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12
Q

Treatment of NAIT

A

IF high risk (e.g. previous sensitized neonate), steroids and IVIG 16-36 weeks

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13
Q

Omphalocele types and cardiac risk

A
  • Cephalic: pentalogy of Cantrell or epigastric omphalocele. 100% have cardiac
  • Lateral: classic with mid-abdomen defect. 10% cardiac.
  • Caudal: hypogastric omphalocele + bladder/cloacal exstrophy and low cardiac risk
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14
Q

Omphalocele syndrome (non-aneuploidy)

A

Beckwith Wiedemann, cloacal exstrophy, fibrochondrogenesis, Marshall-Smith, Meckel-Gruber

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15
Q

Omphalocele incidence with aneuploidies?

A

Trisomy 18 22%
Triploidy 13%
Trisomy 13 9%

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16
Q

MC complication omphalocele

A

PTB (26-65%)
IUGR 6-35%
C/S

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17
Q

When consider C/S for omphalocele?

A

“Giant” >=75% liver and defect > 5 cm

18
Q

Probability of HSV transmission primary, vaginal delivery vs recurrent?

A

50%, 3%

19
Q

Unique VZV findings in fetus?

A

Limb hypoplasia

20
Q

CMV infection stats

A

Of all susceptible moms, 3% convert during pregnancy.
Of all who convert (i.e. get infected), 30-40% infect fetus.
Of all infected fetus, 10% get severe complications i.e. 3% among those who converted.p

21
Q

Toxoplasmosis treatment

A

First tri spiramycin; thereafter pyrimethamine

22
Q

Complications malaria in pregnancy (P falciparum)

A
  • Growth restriction (13-70%)
  • Anemia 3-15%
  • LBW 8-14%
  • Infant mortality (3-8%)
23
Q

Gene mutation Achondroplasia

A

FGFR3

24
Q

Gene mutation Thanatophoric Dysplasia

A

FGFR3

25
Q

Gene mutation OI

A

COL1A1 or COL1A2

26
Q

Which among achondroplasia, thanatophoric, OI have poor cranial ossification / compressible cranium?

A

Achondroplasia type IA, OI. Thanatophoric has abnormally early ossification so get cloverleaf skull.

27
Q

U/S findings diagnostic of TAPS

A

PSV > 1.5 MoM donor twin and < 0.8 MoM in receiving

28
Q

Twin presentations v/v, v/non-v, non-v (A)

A

40% / 40% / 20%

29
Q

Increase fetal breathing?

Decrease it?

A
  • Increased by
    • Mom not “giving enough” O2: hypercarbia
    • Mom being amped: hyperoxemia, high BS, terbutaline, caffeine, indomethacin, feeding mom, fever
  • Decreased by
    • Depressants of variability: hypoglycemia, hypoxemia, steroids, magnesium, labor
30
Q

Macrosomia risk factors (in order top 5)

A
  • Previous macrosomia
    • High pre-pregnancy weight
    • Excess weight gain during pregnancy
    • Multiparity
    • Male
31
Q

Placenta alkaline phosphatase hot/cold labile/stable

A

Hot stable.

32
Q

What % of surfactant do lipids make up?

MC type of lipid in surfactant

A

Lipids (90%)

Phosphatidylcholine (50%) > PDG (15%).

33
Q

Which FLM test is NOT affected by blood?

A

PDG

34
Q

Which FLM test is NOT affected by meconium?

A

PDG

35
Q

What to do if get a “mature” for LBC w/ mec?
What to do if get a “mature” for L:S w/ mec?
What to do if get a “mature” for S:A w/ mec?

A

Valid.
Could be false (+).
Could be false (+). [Not necessarily mature]

36
Q

Which FLM affected by DM?

A

PDG (falsely “immature”; shows up later if poor DM control)

37
Q

Which FLM afected by oligo / poly?

A

LBC. False “mature” in oligo because high concentration. Poly opposite.

38
Q

Which FLM are affected by being taken from vagina?

A

LBC, PDG, L:S.

39
Q

Highest Sn/Sp among FLM tests?

A

S:A (96/58) but among now available PDG and L:S both 97/40.

40
Q

LBC test for FLM PPV/NPV

A

97/30

41
Q 
Which promote lung maturity? Which don't?
Androgens
Beta-agonist
Bombesin??
Epidermal GF
Estrogen
Insulin
PRL
Steroids
TRH
T3
TGF-alpha
TGF-bega
A
  • Promotes lung maturity
    * Steroids
    * TRH
    * T3
    * TGF-alpha
    * Epidermal GF
    * Estrogen
    * PRL
    * Beta-agonist
    * Bombesin??
    • Does NOT
      • Insulin
      • Androgens
      • TGF-beta
42
Q

PO2s of all the following

Uterine artery
Intervillous space
Umbilical vein
(Fetal) Right atrium
(Fetal) Right ventricle
Left atrium
Left ventricle
Umbilical artery
Uterine vein
A

In directional order: Uterine artery (72), IVS (30-35), Umb v (27), RA (30), RV (53), LA (70), LV (60), Umb a (19), Uterine v (48)

By rank: Uterine artery (72) > LA (70) > LV (60) > RV (53) > Uterine vein (48) > IVS (30-35) > RA (30) > Umbilical vein (27) > Umbilical artery (19).

MFM Written Boards (9 decks)

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