Finals Deck Flashcards by Alex Mcgahee

_________ is the most common cystic lesion of the vagina; usually seen on the anterior lateral wall

Gartner’s duct cyst

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Solid masses of the vagina are RARE; if seen ____________ is the most common

Adenocarcinoma

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The most common finding in the cervix is the presence of ___________. Also called epithelial inclusion cyst.

Nabatean Cysts

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_______ arise from hyperplastic protrusions of the epithelium of the endocervix or the ectocervix. These are usually seen in middle aged women, with irregular bleeding, and chronic inflammation being the most likely factor.

Cervical polyps

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Acquired condition with obstruction of the cervical canal

Cervical stenosis

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What is the most common type of cervical cancer? {this affects women of menstrual age}

Squamous cell carcinoma

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_______ are the most common GYN tumors occurring in approximately 20-30% of women over the age of 30; they are BENIGN.

Leiomyoma {or myomas}

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Myomas are _______ dependent

Estrogen

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What is the most common location of a leiomyoma?

Intramural {within the myometrium {middle layer}}

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Another location {a small percentage} a leiomyoma can be is in the _______

Broad ligament

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______ are the most common cause of uterine calcifications

Myomas

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A less common cause for uterine calcifications are the _________ calcifications in the periphery of the uterus

Accurate artery calcification

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A benign disease; invasion of the endometrial tissue that goes into the myometrium

Adenomyosis

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Which is the most common form of adenomyosis? Diffuse or focal ??

Diffuse in the most common

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Adenomyosis arises from the _______

Stratum basalis

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Andenomyosis can sometimes be managed with hormone replacement therapy {T/F}

TRUE

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Consist of a vascular plexus of arteries and veins without any intervening capillary network {most are teratogenic/acquired}

Uterine arteriovenous malformations {AVMs}

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This develops from unstopped estrogen stimulation; it is the most common cause of abnormal uterine bleeding in pre and post menopausal women

Endometrial hyperplasia

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These consist of hyper plastic over growth of glands, stroma, and blood vessels from the BASAL layer of the endometrium

Endometrial polyps

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______ occurs most often in association with pelvic inflammatory disease {PID}

Endometritis

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A partial or complete obliteration of the endometrial cavity this is caused by adherence of uterine walls from scaring which causes fibrous adhesions or synechiae; this can obliterate the endometrium

Asherman’s syndrome

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This is the most common gynecological malignancy in North America.

Endometrial carcinoma {adenocarcinoma is the most common type}

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A thickened endometrium > than ___ to ___ mm {especially in post menopausal women} must be considered cancer until proven otherwise

Greater than 4 to 5 mm

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Fluid collections within the uterus

Hydrometra

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Adenomyosis can be MANAGED with _______

Hormone replacement therapy

The normal ovary is homogeneous in texture with a central Echogenic medulla. {T/F}

TRUE

An ovary with a volume of 2X larger than the other is considered _________

Abnormal

Peak systolic - end diastolic / the mean velocity = _____

Peak systole - end diastolic / peak systole= ___

Benign= RI > ___, PI >____.

Benign= RI > .4, PI> 1

Malignancy= RI

Most common cause of ovarian enlargement; most cysts measure

Functional cyst

Forms when a mature follicle fails to ovulate or inovulate

Follicular cyst

What is the most common adnexal mass in pregnancy?

Corpus luteum cyst {which secretes estrogen and progestrone}

The "ring of fire" is a sonographic finding of a ________

Corpus luteum cyst

Polycyclic ovarian syndrome is a ______ disorder

Endocrine

Ovarian hyerstimulation sydrome is seen with ascites {T/F}

TRUE

This condition is ALWAYS bilateral , with a rounded shape, and characterized by tiny cysts around the periphery - "string of pearls"

PCOS

Paraovarian cysts arise from the _______

Broad ligament {located @ the terminal portion of the Fallopian tube} *** MUST DEMONSTRATE AN IPSILATERAL OVARY SEPARATE FROM THE CYST

Garners duct cyst are located in the ______

Broad ligament

Localized tumor of endometrial tissue

Endometrioma {chocolate cyst}

The ___ ovary is 3 times more likely to torse than the ____

The RIGHT ovary is 3 times more likely to torse than the left

``` Ovarian tumor stages: stage I: _____ stage II: ____ Stage III: ______ Stage IV: ______ ```

Stage I: limited to ovaries Stage II: limited to pelvis Stage III: involvement above the pelvic brim Stage IV: Spread throughout the peritoneal cavity

Brenner - transitional cell is associated with _______ syndrome

Meig's syndrome

Most common benign ovarian tumor

Dermoid {also called cystic teratoma or mature teratoma}

What is described as "tip of the iceberg" sign Sonographically ?

Dermoid tumor

______ tumors occur mainly in adolescents; this is the most common ovarian malignancy in this age group

Germ cell tumors

Benign solid tumor + ascites + hydrothorax / pleural effusion=

Meig's sydrnome

Thecomas are very ____

Rare {1%}

A vaginal cuff is seen in hysterectomy patients after surgery; the upper size limit of a normal cuff is ____ cm

2 cm

rare but most common malignant germ cell

Dysgerminoma

Meig's syndrome is accosiated with what two things?

brenner and fibroma

tumor primarily from the GI tract {primarily stomach} ; this drops mets to the ovaries

Kruckenburg tumor

endometriosis occurs most commonly in two forms: _____ of the uterus and ____ of the adnexa

adenomyosis - of the uterus | endometriosis - of the adnexa

Most commonly, PID is caused by sexually transmitted disease including ____ and _____ {this travels via the mucosa}

Gonorrhea and chladymia

risk factors for PID include what three factors?

1. early sexual contact 2. multiple partners 3. History of sexually transmitted dieases

Perihepatic inflammation ascending from a pelvic infection

Fitz-Hugh-cutis syndrome

Fitz- hugh curtis sydrome = _____ pain + _____

RUQ pain and PID

Differential diagnosis for fitz hugh curtis {5}

1. hematoma 2. dermoid 3. ovarian neoplasm 4. endometriosis 5. ectopic pregnancy

Infection that involves the fallopian tubes and the ovaries. Complex mass with peptations, irregular margins, and internal echoes; usually in the cul-de-sac

Tuba-Ovarian abscess

Fluid filled bowel may mimic what ?

Hydrosalpinx

Sonographic finding for Tuba-Ovarian abscess :

complex cul-de-sac mass the distorts pelvic anatomy

With ACUTE salpingitis that walls are ______ | With hydrosalpinx the walls are ____

* THICK | * THIN

Tubo ovarian abscess is associated with what syndrome?

Fitz hugh curtis

inflammation of the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera

Peritonitis

The more common form of endometriosis is the ______ form

external

Internal endometriosis occurs within the uterus and is referred to as ______

adenomyosis

What is the most common form of endometriosis | {diffuse /localized}

DIFFUSED

The localized form of endometriosis consists of a discrete mass known as a ______ {or chocolate cyst}

Endometrioma

It is estimated that infertility affects __ out of __ couples in america

1 out of 7

What is the best method to determine cervical length in a non gravid patient?

Hysterosalpingography

Diameter less than ___ mm may indicate cervical stenosis

1 mm

Luteal phase deficiency is not enough ____

progesterone

Septate uterus is highly associated with infertility {T/F}

TRUE

T-shaped uterus is caused by ______ exposure in utero

Diethylstilbestrol {DES}

What is the main reason to look at the fallopian tubes?

assess patency

What is used to evaluate the endometrial cavity for polyps, fibroid, ect.

SIS

A dominant follicle grows at a rate of __-__mm per day until it reaches 2.2 cm

2-3 mm

Corpus lute secretes what ?

progesterone

What are three associated findings with PCOS {along with inhibiting growth of follicles}

Oligomenorhea, hirsutism, and obesity

cyst measuring greater that ____ cm or ___mm could interfere with ovarian stimulation

1.5 cm or 15 mm

Ovulation induction therapy is monitored with endovaginal documentation of all follicles measuring greater than __ cm

1 cm

Ovulation is determined by ____ and ______

Follicle size and serum estradiol level

Normal endometrial response is increasing thickness from _-_ mm up to _-_ mm

2-3 mm up to 12-14 mm

What is the necessary thickness of the endometrium to achieve pregnancy ?

6 mm

Optical placement of the embryos is within ___ cm of the apex of the ____ of the uterus

2cm of the apex of the funds of the uterus

With GIFT { gamete intrafallopian tube transfer} fertilization takes place where?

within the women body

With ZIFT { zygote intrafallopian tube transfer} fertilized ova are injected through a laparoscope into the fimbriated ends of the fimbria {T/F}

TRUE

What are the three complications associated with reproductive technology ?

1. Ovarian hyperstimulation sydrome { seen with ascites/pleural effusion} 2. Multiple gestations {30% of IVF patients} 3. Ectopic or heterotopic pregnancy

both Intrauterine pregnancy and ectopic pregnancy are referred to as ..

heterotopic

The purpose of having national guidelines for OB exams is to... {3}

1. standardize OB studies 2. optimize detection of growth anomalies 3. detect fetal anomalies

Trimesters : 1st = 2nd = 3rd =

1st = 0-12 2nd = 13 - 26 3rd = 27 - 42 > 42 = post term

Nagele's rule : EDD= LNMP=

EDD= LNMP - 3 months + 7 days LNMP= EDD + 3 months - 7 day

____ % of pregnant women in the US will have an OB ultrasound

65%

What are the two major bioeffects of US?

Thermal - rise in temp | Cavitation - production and collapse of gass filled bubble

Embryo seen at __ weeks with transvaginal ultrasound

4 weeks

Amniotic fluid is produced by the ___ in the 1st trimester

placenta

Cervix measurement is usually _-_ cm long

3-4 cm

Overly distended bladder may mimic what ?

Placenta previa

At what level is the BPD measured?

The level of the thalamus, the cavum septi pellucidum, midline falx {outer to inner}

Femur length is measured ______ to the sound beam

perpendicular

Abdomen circumference is measured at the level of the ____, ____, and _____

stomach umbilical vein {hockey stick } Portal sinus

age of embryo stated as time from day of conception

embryonic age (conception age)

length of pregnancy defined in the United States as number of weeks from first day of last normal menstrual period (LNMP)

gestational (menstrual) age

structure lined by the chorion that normally implants within the uterine decidua and contains the developing embryo

gestational sac

placental implantation encroaches upon the lower uterine segment; if the placenta presents first in late pregnancy, bleeding is inevitable

placenta previa

12 days after conception considered a _____

zygote

considered a fetus > than ___ weeks

12 weeks

Considered ____ from implantation to 9-10 weeks

embryo

Fertilization occurs within the ____ portion of the fallopian tube

Distal portion

Blastocyst enters the uterus 4-5 days ____ fertilization

AFTER

Implantation is completed within ___ days POST fertilization

12 days

What is referred to as the outer cell mass made up mostly of placental tissue ?

trophoblast

What is referred to as the inner cell mass made up mostly of fetal tissue ?

embryo blast

The fusion of the chorion and amnion occurs between __ - __ weeks

16-17 weeks

The embryonic phase is between __ - __ weeks

4-10 weeks

Initial heart beat __ to __ weeks

5 1/2 to 6 weeks

What is the 1st structure seen within the gestational sac?

secondary yolk sac

If secondary yolk sac persists it is referred to as

Mickels diverticulum

CRL measures ___ mm by the end of the 10th week

35 mm

HCG { should double every 2-3 days} ; GS and hCG increases proportionally until __ menstrual weeks

8 menstrual weeks

HCG peaks at __-__ weeks then declines - the GS continues to grow

8-10 weeks

In transabdominal scanning, a normal GS can be consistently demonstrated when the beta hCG level is _____ mlU/ mL or greater

1800 mlU/mL

GS grows at a rate of __ mm per day

1 mm per day

Mean sac diameter > than 12 mm = visible ____ | Mean sac diameter > than 18 mm = visible ____

> 12 mm Visible YS | > 18 mm visible embryo