Finals Deck Flashcards
_________ is the most common cystic lesion of the vagina; usually seen on the anterior lateral wall
Gartner’s duct cyst
Solid masses of the vagina are RARE; if seen ____________ is the most common
Adenocarcinoma
The most common finding in the cervix is the presence of ___________. Also called epithelial inclusion cyst.
Nabatean Cysts
_______ 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
Acquired condition with obstruction of the cervical canal
Cervical stenosis
What is the most common type of cervical cancer? {this affects women of menstrual age}
Squamous cell carcinoma
_______ are the most common GYN tumors occurring in approximately 20-30% of women over the age of 30; they are BENIGN.
Leiomyoma {or myomas}
Myomas are _______ dependent
Estrogen
What is the most common location of a leiomyoma?
Intramural {within the myometrium {middle layer}}
Another location {a small percentage} a leiomyoma can be is in the _______
Broad ligament
______ are the most common cause of uterine calcifications
Myomas
A less common cause for uterine calcifications are the _________ calcifications in the periphery of the uterus
Accurate artery calcification
A benign disease; invasion of the endometrial tissue that goes into the myometrium
Adenomyosis
Which is the most common form of adenomyosis? Diffuse or focal ??
Diffuse in the most common
Adenomyosis arises from the _______
Stratum basalis
Andenomyosis can sometimes be managed with hormone replacement therapy {T/F}
TRUE
Consist of a vascular plexus of arteries and veins without any intervening capillary network {most are teratogenic/acquired}
Uterine arteriovenous malformations {AVMs}
This develops from unstopped estrogen stimulation; it is the most common cause of abnormal uterine bleeding in pre and post menopausal women
Endometrial hyperplasia
These consist of hyper plastic over growth of glands, stroma, and blood vessels from the BASAL layer of the endometrium
Endometrial polyps
______ occurs most often in association with pelvic inflammatory disease {PID}
Endometritis
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
This is the most common gynecological malignancy in North America.
Endometrial carcinoma {adenocarcinoma is the most common type}
A thickened endometrium > than ___ to ___ mm {especially in post menopausal women} must be considered cancer until proven otherwise
Greater than 4 to 5 mm
Fluid collections within the uterus
Hydrometra
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 = _____
PI
Peak systole - end diastolic / peak systole= ___
RI
Benign= RI > ___, PI >____.
Benign= RI > .4, PI> 1
Malignancy= RI
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?
- early sexual contact
- multiple partners
- 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}
- hematoma
- dermoid
- ovarian neoplasm
- endometriosis
- 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 ?
- Ovarian hyperstimulation sydrome { seen with ascites/pleural effusion}
- Multiple gestations {30% of IVF patients}
- 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}
- standardize OB studies
- optimize detection of growth anomalies
- 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
