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OB/GYN REVIEW > First Trimester > Flashcards

First Trimester Flashcards

1
Q

What is a gamete?

A

male and female reproductive cells (ovum and sperm)

pg. E 82

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2
Q

What is a zygote?

A

sperm and ovum joined in infundibulum of fallopian tube

pg. E 82 O 353

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3
Q

What is a blastomere?

A

fertilized ovum that begins to divide loated in ampulla of fallopian tube
pg. E 83

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4
Q

What is a morula?

A

clusters of cells, 4 days after fertilization located in fallopian tube
pg. E 83 O 353

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5
Q

What is a blastocyst?

A

implants into endometrium 7 days after fertilization

pg. E 83 O 353

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6
Q

When does fertilization occur?

A

24-36 hours after ovulation

pg. E 83

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7
Q

What lines a blastocyst?

A

trophoblasts - which produce hCG

pg. E 83

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8
Q

What possibilities are there when hCG levels are higher than expected?

A

Further along than expected
Gestational trophoblastic disease
Multiple gestations
pg. E 83

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9
Q

What possibilities are there when hCG levels are lower than expected?

A 
Not as far along as suspected
Ectopic pregnancy
Embryonic demise
Abnormal IUP
pg. E 83
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10
Q

At what level is hCG when you can see a gestational sac TV?

A

1000 mIU/mL

pg. O 356

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11
Q

How often does hCG double and for how many weeks?

A

Doubles about every 2-3 days for the first 6-9 weeks

pg. E 83 O 356

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12
Q

When does the embryonic period end and the fetal period begin?

A

End of the 10th week

pg. E 84

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13
Q

What is the decidua basalis?

A

Maternal side of endometrium

pg. E 84

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14
Q

What does decidua mean?

A

Name for endometrium during pregnancy

pg. O 353

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15
Q

What is the decidua capsularis?

A

Fetal side of endometrium

pg. E 84 O 353

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16
Q

What is an amnion?

A

Extraembryonic membrane that lines the chorion
Contains fetus and amniotic fluid
pg. E 85 O 353

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17
Q

What is the chorion?

A

Outermost of fetal membranes
Fuses with amnion and not seen after 12-16 weeks
pg. E 85 O 353

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18
Q

When should a gestational sac be seen?

A

LMP > 5 weeks
hCG levels 1000-2000 mIu/mL
pg. E 86

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19
Q

What shape and location should a gestational sac be?

A

Round/oval/teardrop
W/in the endometrium towards the fundus
pg. E 86 O 357

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20
Q

What is a double decidua sign?

A

Thick hyperechoic rim surrounding a sonolucency, an IUP

pg. E 86 O 353

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21
Q

At what pace does a gestational sac grow?

A

1 mm/day

pg. E 86

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22
Q

A yolk sac should be present when the gestational sac is how many mm?

A

8 mm

pg. E 86 O 357

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23
Q

How is mean sac diameter calculated?

A

MSD =

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24
Q

How is the mean sac diameter calculated?

A

length + height + width / 3

pg. E 86 O 356

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25
Q

What is the chorion?

A

outermost of fetal membranes; shrinks by wks 12-16

pg. E 85 O 353

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26
Q

What is the amnion?

A

extraembryonic membrane that lines chorion and contains fetus
pg. E 85 O 353

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27
Q

When should a gestational sac be visualized?

A

hCG values 1000-2000
LMP > 5 wks
pg. E 86 O 359

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28
Q

What is the double decidua sign?

A

thick hyperechoic rim surrounding an IUP

pg. E 86 O353

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29
Q

When should a yolk sac be visualized?

A

5th gestational week (TV)
GS = 8 mm
pg. E 87 O 359

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30
Q

How should a yolk sac be measured?

A

inner to inner; < 6 mm

pg. E 87 O 358

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31
Q

When should an embryo be seen?

A

6th gestational week
GS = 16 mm
pg. E 87 O 359

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32
Q

What is a rhombencephalon?

A

Normal anechoic structure in the posterior brain seen between 8-11 weeks
pg. E 88

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33
Q

What is a complete abortion?

A

all products of conception expelled

pg. E 90 O 359

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34
Q

What are the clinical findings associated with a complete abortion?

A

bleeding, cramping, low hCG levels

pg. O 359

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35
Q

What is an incomplete abortion?

A

some products of conception are expelled while some remain in uterus
pg. E 90 O 360

36
Q

What are the clinical findings associated with an incomplete abortion?

A

asymptomatic, bleeding, cramping, hypotension

pg. O 360

37
Q

What are the sonographic findings of an incomplete abortion?

A

thickened endo with fluid, and possible gestational sac

pg. E 90 O 360

38
Q

What is a missed abortion?

A

Embryo without cardiac activity

pg. E 91

39
Q

What are the clinical symptoms of a missed abortion?

A

Asymptomatic, low hCG levels, brown vaginal discharge

pg. E 91

40
Q

What is an inevitable abortion?

A

gestational sac in cx
dilated cx
bleeding and cramping
pg. E 91

41
Q

What is a threatened abortion?

A

pregnancy may abort in future
patient usually has bleeding and cramping
pg. E 92

42
Q

What is another name for an anembryonic pregnancy?

A

blighted ovum

pg. E 92 O 359

43
Q

What is an anembryonic pregnancy?

A

the embryo fails to develop

pg. E 92 O 359

44
Q

What are the clinical signs of a blighted ovum?

A 
asymptomatic
hCG levels decline
small for dates
no fetal heart tones
pg. 359
45
Q

What are the sonographic findings of an anembryonic pregnancy?

A

large gestational sac
absent yolk sac, amnion, and embryo
pg. E 92 O 359

46
Q

What is a septic abortion?

A

abortion with non-sterile instruments resulting in infection of RPOC (retained products of conception)
pg. E 92

47
Q

What is an ectopic pregnancy?

A

pregnancy in an abnormal location

pg. E 93 O 360

48
Q

Where can an ectopic pregnancy be located?

A 
fallopian tube (most common: ampulla)
cervix
abdominal
abnormal UT position
pg. E 93 O 360
49
Q

What are the clinical findings of an ectopic pregnancy?

A 
pelvic pain
vaginal bleeding
palpable adnexal mass
low hCG levels
hypotension
cervical tenderness
pg. O 360
50
Q

What are the sonographic findings of an ectopic?

A 
no IUP
fluid in endo
"sliding sac sign" - can move GS with TV
unusual fetal presentation
free fluid
oligohydramnios
pg. E 94 O 360
51
Q

What is a heterotopic pregnancy?

A

extrauterine and intrauterine occuring at the same time

pg. E 94 O 360

52
Q

How can you distinguish an ectopic pregnancy from a corpus luteum?

A

“ring of fire” - Color Doppler surrounding gestational sac will show flow, corpus luteum will not
pg. E 95

53
Q

What is the most dangerous location for a ectopic pregnancy?

A

interstitial/cornua

pg. E 95

54
Q

What are the most common treatments for an ectopic pregnancy?

A

Methotrexate administration (MTX)
Laparoscopy
pg. E 95

55
Q

What is gestational trophoblastic disease (GTD)?

A

abnormal proliferation of the trophoblastic tissue

pg. E 96 O 360

56
Q

When does GTD typically occur?

A

during/after implantation of a fertilized ovum

pg. E 96

57
Q

Why might gestational trophoblastic disease occur?

A

Lack of chromosomes in ovum
Ovum fertilized by 2 sperm
pg. E 96

58
Q

What are the clinical findings of gestational trophoblastic disease?

A 
Enlarged UT
High hCG levels
Vaginal bleeding
Hyperemesis
No fetal heart tones
preeclampsia
pg. E 96 O 360
59
Q

What is a complete hydatidaform mole?

A

Most common form of trophoblastic disease
Chorionic villi are hydropic
no fetal tissue identified
pg. E 96

60
Q

What are the sonographic findings of a complete hydatidaform mole?

A 
enlarged UT
echogenic mass in endo
can be cystic in 2nd tri
hypervascular, low resistive flow
theca lutein cysts
pg. E 97
61
Q

What is a partial molar pregnancy?

A

one set of maternal chromosomes and 2 sets of paternal
triploidy
chorionic villi hydropic and normal
abnormal fetal tissue, but mild trophoblastic tissue
pg. E 97

62
Q

What are the sonographic findings of a partial mole?

A

deformed gestational sac
growth restricted fetus w/ triploidy
enlarged placenta with cystic areas
pg. E 97

63
Q

What is a molar pregnancy with a coexisting fetus?

A

2 conceptions. one in normal other is GTD
very rare
pg. E 97

64
Q

What are the sonographic findings of a molar pregnancy with a coexisting fetus?

A

Similar to partial, but placenta is identified
fetus is normal
pg. E 97

65
Q

What is persistent trophoblastic neoplasia (PTN)?

A

commonly follows GTD
can also occur after normal term delivery, spont. abortion or ectopic
hCG levels to not decline
pg. E 98

66
Q

What are the clinical findings of PTN?

A

hCG levels do not decline
vaginal bleeding
pg. E 98

67
Q

What are the types of PTN?

A

Invasive mole
Choriocarcinoma
pg. E 98

68
Q

What is another name for an invasive mole?

A

chorioadenoma destruens

pg. E 98

69
Q

What is an invasive mole?

A 
most common form of persistent trophoblastic disease
malignant, nonmetastatic
penetrates myometrium
can cause UT to rupture
pg. E 98
70
Q

What are the sonographic findings of an invasive mole?

A

echogenic material in endo and myometrium

irregular sonolucent areas surrounding trophoblastic tissue

71
Q

What is choriocarcinoma?

A

Rare
vascular invasion, hemorrhage, and necrosis of myometrium
malignant, metastatic
pg. E 98

72
Q

What are the sonographic findings of choriocarcinoma?

A

enlarged UT

irregular mass with vascularity

73
Q

What is psuedocyesis?

A

false pregnancy
psychological condition
pg. O 360

74
Q

What are the clinical signs of psuedocyesis?

A 
nausea/vomiting
abdominal distention
amenorrhea 
negative pregnancy test
pg. O 360
75
Q

What is a subchorionic hemorrhage?

A

low pressure bleed from implantation of blastocyst

pg. O 361

76
Q

What are the clinical findings of a subchorionic hemorrhage?

A

asymptomatic
vaginal spotting
pg. 361

77
Q

What is Fitz Hugh Curtis syndrome?

A

Inflammation of the peritoneum due to PID

Google

78
Q

What is the most common form of gestational trophoblastic disease?

A

Complete hydatidaform mole

79
Q

What is methotrexate used for?

A

Cause inovulation of early ectopic pregnancies and preserve fertility
URR Exam

80
Q

What causes nausea and vomiting in the first trimester?

A

Progesterone

URR Exam

81
Q

What hormone is responsible for stimulating the contraction of the Fallopian tubes to propel the egg toward the UT?

A

Estrogen

URR Exam

82
Q

At how many weeks is a gestational sac visualized?

A

4 weeks gestation

83
Q

At how many weeks is a yolk sac visualized?

A

5.5 weeks gestation

84
Q

What are chorionic villi formed from?

A

Trophoblastic cells

85
Q

Where is the yolk sac located?

A

Between amnion and chorion

OB/GYN REVIEW (16 decks)

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