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Obstetrics & Gynecolgy 1 > Mod 6 > Flashcards

Mod 6 Flashcards

1
Q

Mean sac diameter

A

MSD
Used when embryo is not identified
Used from 4-8 weeks

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2
Q

What do you measure in MSD

A

Length+width+height \ 3

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3
Q

What do you have to ensure you see when see the MSD

A

Double decidual reaction

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4
Q

Why is the MSD compared to the embryo

A

Useful in early diagnosis of oligohydraminos

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5
Q

What does oligohydraminos mean

A

Low fluid

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6
Q

What is the formula for calculating oligohydraminos

A

MSD(mm)-CRL(mm)

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7
Q

When is the oligohydraminos calculated and what does the calculation have to be less than for oligohyraminos to be suspected

A

5.5-9 weeks

<5mm

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8
Q

What is calculated/assessed in the 1st trimester scan

A

MSD
CRL
Nuchal lucency

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9
Q

How much does the gestational sac grow each day

A

1.1 mm / day

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10
Q

An EV scan should have what kind of MSD

A

8mm if yolk is seen

16mm if embyro is see

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11
Q

A transabdominal scan should have what MSD

A

8mm-yolk seen

16mm- embryo seen

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12
Q

When is a CRL used

A

Between 6 and 13 weeks

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13
Q

What is the most accurate measurement to predict gestational age +/- 3 days

A

CRL

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14
Q

Where do you measure on a CRL

A

Tip of the head to the end of the rump

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15
Q

What do you not include on a CRL

A

Yolk sac

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16
Q

What position should the fetus be in for a CRL and what position is the probe in

A

Neutral position

Probe is midline sag

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17
Q

What are the US findings with an ectopic

A 
No IUP
PUL (pregnancy of unknown location)
Free fluid in posterior cul de sac
Lt adnexal mass
Fetal pole identified in mass with FH seen
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18
Q

What does the free fluid in the posterior cul de sac indicate

A

Pregnancy has ruptured

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19
Q

What is the definition

A

A pregnancy that occurs outside the uterine cavity

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20
Q

What is the classical clinical triad

A
  1. Pain
  2. Bleeding
  3. Adnexal mass
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21
Q

What percentage of people present with these symptoms

A

45

22
Q

What are other presenting symptoms of ectopic pregnancy

A

Amenorrhea
Adnexal tenderness
Cervical tenderness

23
Q

When does ectopic pregnancies usually present

A

Between 5-8 weeks

24
Q

what are the risk factors that can result in ectopic pregnancies

A 
tubal surgery
pregnancy with an IUCD
PID
previous ectopic
endometriosis
chrons disease
previous appendicitis
25
Q

what is the risk of an ectopic presenting in the other tube after it presented in one

A

50%

26
Q

what does PID stand for

A

pelvic inflammatory disease

27
Q

where are the sites of ectopics

A 
fallopian tubes
cervix
interstitial segment of the tube
ovary
peritoneal cavity
28
Q

what percentage of ectopics occur in the ampulla

A

95%

29
Q

what are the most dangerous areas to have an ectopic

A

cervix

cornua areas

30
Q

what is another term for the cornua area

A

interstitial

31
Q

why is having an ectopic in the cornua area the most dangerous

A

it is one of the only areas in the body that wont coagulate

32
Q

why are the cornua area and cervix the most dangerous

A

high risk of hemorrage because they are highly vascular areas with little or no thickened endometrium for the embryo to burrow into

33
Q

what are the sonographic features of an ectopic

A

adnexal mass
free fluid
absence of an IUG or presents with a pseudo sac
may see a viable ectopic pregnancy instead of adnexal mass

34
Q

what is a viable ectopic

A

gestational sac seen with an embryo with a heart beat seen outside of the uterus
100% accurate for the diagnosis of an ectopic
may also indicate that the pregnancy has not yet ruptured

35
Q

should the menstrual history of that is given by the patient be trusted

A

not in this case, however knowing when the first pregnancy test was postitive is helpful

36
Q

what is common of the ß hCG levels

A

lower than normal but can still be in the same range

37
Q

what should happen to the ß hCG levels in a normal pregnancy but not with a ectopic pregnancy

A

levels should double every 2 days

38
Q

in early gestation, 5 weeks, what should happen to the levels of ß hCG in the blood work

A

should increase

39
Q

what would happen to ·ß hCG levels in the blood in the case of a spontaeous abortion

A

should decrease

40
Q

in the case of PID what should the ß hCG levels in the blood be

A

negative, not pregnant

41
Q

what is a heterotopic pregnancy

A

an interuterine pregnancy with a twin ectopic pregnancy

42
Q

what is the rarity of a heterotopic pregnancy

A

1/7000 incidences

43
Q

what did the ratio of heterotopic pregnacies use to be

A

1/40000

44
Q

why have the incidences of heterotopic pregnanices increased

A

due to ART

45
Q

what does ART mean

A

assisted reproductive technology

46
Q

what does a negative ultrasound result mean for ectopic and why

A

does not rule out ectopic as it may be too small recognize with sonography

47
Q

what must be done in a follow up to rule out ectopic

A

ev
ß hCG levels repeated every 2 days
scan repeated in one week

48
Q

what is the interstitial line sign

A

echogenic line extending from the endometrial canal up to the center of the interstitial sac or hemorrhagic mass

49
Q

what is the interstitial line sign help diagnosis

A

interstitial ectopic pregnancies

50
Q

gestational sacs must have a minimum of how many mm of what surrounding it

A

5mm of myometrium

Obstetrics & Gynecolgy 1 (8 decks)

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