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Radiology > O&G Imaging > Flashcards

O&G Imaging Flashcards

1
Q

Hypervascular mass within uterus and positive beta-HCG. Name 3 DDx

A

RPOC

Gestational trophoblastic disease

AVM (high flow velocities)

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2
Q

Maximal thickness of endometrium pre and post menopause?

A

Pre-menopause: up to 16 mm

Post menopause: up to 5 mm (7 mm if on HRT or tamoxifen)

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3
Q

Septate vs bicornuate uterus

A

Bicornuate less common, fundus divided and fertility is preserved

Septate more common, fundus intact and associated with infertility (needs surgical resection of septum)

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4
Q

Name 4 causes of echogenic fetal bowel in the 2nd trimester

A

Chromosomal anomalies (especially T21)

Intrauterine haemorrhage and fetal blood swallowing (placental abruption and amniocentesis)

TORCH infections

CF

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5
Q

Name 5 CNS anomalies associated with fetal ventriculomegaly

A

Aqueductal stenosis

Chiari malformation

Neural tube defect

Dandy-walker anomalies

Holoprosencephaly

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6
Q

Name 3 anomalies associated with NTD

A

Chromosomal anomalies: T18 most common

CNS anomalies: Chiari 2

Skeletal anomalies: DDH, clubfeet

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7
Q

Name 2 chromosomal anomalies associated with dysgenesis of the CC

A

T18

T13

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8
Q

Name 3 CNS anomalies associated with dysgenesis of the CC

A

Chiari II

Dandy-Walker

Holoprosencephaly

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9
Q

Name 4 intrauterine features of a Bochdalek hernia

A

Polyhydramnios

Large cystic mass in the chest

Deviated heart to the right

Absence of normal stomach bubble

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10
Q

Name 3 causes of fetal echogenic kidneys

A

ARPCKD

T13

Beckwith-Wiedemann syndrome

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11
Q

Name 3 causes of fetal anaemia

A

Haemolytic disease: Rh or ABO incompatibility

Fetal infections: Parvovirus B19

Haemoglobinopathies: thalassaemia

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12
Q

DCDA: dizygotic or monozygotic?

A

Accounts for all dizygotic twins

Accounts for 20-30% of monozygotic twins

Monozygotic twins can be MCDA (69%), DCDA (30%) or MCMA (1%)

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13
Q

Heterogeneous adnexal mass and enlarged, ill-defined uterus

A

Tubo-ovarian abscess

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14
Q

IVF and multiple cysts in left adnexa

A

NORMAL ovarian stimulation

OHSS: enlarged ovaries + bilateral large cysts + ascites/ pleural effusion

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15
Q

Name the 3 MR features of the normal cervix on T2

A

Endocervical canal: high signal

Fibrous stroma: low signal

Outer smooth muscle/ myometrium: intermediate signal

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16
Q

What is the incidence of ectopic pregnancy in the general population?

A

2% (1 in 50)

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17
Q

FIGO staging of cervical cancer

A

I: confined to uterus

II: parametrial but not pelvic wall/ lower third of vagina

IIIA: extends to pelvic wall/ lower third of vagina or hydronephrosis

IIIB: regional nodal mets

IVA: invades bladder/rectum or beyond pelvis

IVB: distant mets

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18
Q

What is the cut-off in pre-natal screening to suggest invasive testing?

A

1:300 risk

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19
Q

What favours mucinous over serous ovarian neoplasm?

A

Multi-cystic lesions (>20)

Uncommon to be bilateral (only 5%)

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20
Q

Acetabular angle in Down syndrome on antenatal US?

A

Reduced acetabular angles due to flattened acetabular roof

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21
Q

Turner syndrome and physeal fusion?

A

NORMAL skeletal maturation until age 15 years. Delayed fusion of physes after 20 years.

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22
Q

PUJ unilateral or bilateral?

A

Only 30% bilateral

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23
Q

Single placenta excludes dichorionic pregnancy?

A

FALSE: 2 separate placentas can fuse later.

Important to establish chorionicity in EARLY pregnancy.

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24
Q

Name the 5 main sub-types of ovarian epithelial tumours

A

Serous tumours (50%)- tubal

Mucinous tumours (30%)- cervix

Endometrioid tumours (20%)- endometrium

Clear cell tumours (5%)- Mullerian

Transitional cell tumours (Brenner)- 2%

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25
Q

Name 6 genetic risk factors for ovarian cancer

A

BRCA 1 and 2

Lynch syndrome (HNPCC)

Li-Fraumeni (p53 mutation)

Peutz-Jegher

Ataxia-Telangiectasia

K-Ras and HER-2 mutations

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26
Q

FIGO staging of ovarian cancer

A

Stage I: confined to ovaries

Stage II: limited to pelvis

Stage III: extra-pelvic or abdominal LN

Stage IV: spread to distant organs

27
Q

Name 2 features typical of serous ovarian tumours

A

Bilaterality

Concentric calcifications (psamomma bodies)

28
Q

Name 2 features of Brenner tumours

A

Most are benign

Most likely epithelial ovarian tumour to be solid

29
Q

Name 2 complications of ovarian teratomas

A

Torsion

Malignant transformation to SCC (1%)

30
Q

Name 2 monodermal (specialised teratomas)

A

Struma ovari (mature thyroid tissue- hyperthyroidism)

Ovarian carcinoid (GI tract tissue- carcinoid syndrome)

31
Q

Name 2 features of ovarian dysgerminoma

A

Unilateral and solid (all malignant)

Can produce beta-HCG

32
Q

Name 2 features of yolk-sac tumour

A

Predominantly solid and secretes AFP

Schiller-Duval body

33
Q

Name 2 features of ovarian choriocarcinoma

A

Secretes beta-HCG and highly aggressive

Identical to GTD but NOT responsive to Rx

34
Q

Name the main 3 sex-cord stromal tumours

A

Granulosa-theca cell: Call-Exner bodies and secrete oestrogen (precocious puberty in girls)

Fibroma-thecoma: solid, Meigs syndrome, Gorlin syndrome

Sertoli-Leydig: produce androgens (virilisation)

35
Q

What is the most common ovarian met?

A

Müllerian origin: uterus, fallopian tube, contralateral ovary

36
Q

Name the 2 types of cervical cancer

A

SCC (80%): arises at squamo-columnar junction

Adenocarcinoma (15%): arises from endocervical glandular epithelium. Not detected by pap-smear and poorer prognosis

37
Q

Top 3 locations of endometriosis

A

Ovaries

Uterine ligaments

Pouch of Douglas

38
Q

FIGO classification of endometrial carcinoma

A

Stage I: confined to uterine body

Stage II: body and cervix but not outside uterus

Stage III: outside uterus but within pelvis (IIIC nodes)

Stage IV: rectum or bladder (IVA) or distant mets (IVB)

39
Q

Name 4 features of type I endometrial carcinoma

A

Age 50

Risk factors: unopposed oestrogen, obesity, DM (endometrial hyperplasia)

Morphology: Endometrioid

Prognosis: Indolent- myometrial invasion and lymphatic spread

40
Q

Name 4 features of type II endometrial cancer

A

Age 70

Risk factors: endometrial atrophy (endometrial intraepithelial carcinoma)

Morphology: serous, clear cell and mixed müllerian tumour

Prognosis: Aggressive- intraperitoneal and lymphatic spread

41
Q

What is the incidence of molar pregnancy? Name 3 RF.

A

1:1000

Advanced maternal age

PHx of molar pregnancy or missed miscarriage

Asian ethnicity

42
Q

In utero exposure to DES and vaginal malignancy

A

Increased risk of clear cell adenocarcinoma (NOT SCC)

43
Q

Sequence of PID

A

Ascending infection from vagina

Acute suppurative salpingitis

Salpingo-oophoritis

Pyosalpinx followed by hydrosalpinx (long term)

44
Q

Name 2 features of CIN I on microscopy

A

Koilocytes (perinuclear vacuolation)

Indistinguishable from condyloma accumina

45
Q

What is Bowen disease?

A

SCC in situ (penis or vulva)

Strongly associated with HPV infection

46
Q

Fragile X

A

Mental retardation, long mandible, lax joints

Macro-orchidism and height BELOW average

Excessive repetition of CGG trinucleotide

47
Q

Endometrial polyps

A

Most commonly sessile

48
Q

4 main causes of choriocarcinoma

A

Following molar pregnancy (50%)

Post miscarriage (25%)

Post normal pregnancy (20%)

EP, genital teratomas (5%)

49
Q

Endometrial mass showing osteoid, cartilage and muscle on biopsy. Dx?

A

Endometrial carcinosarcoma (malignant mixed müllerian tumour)

50
Q

2 most common ovarian neoplasms arising from endometriosis

A

Endometrioid carcinoma

Clear cell carcinoma

51
Q

4 most common ovarian tumours to be bilateral

A

Serous tumours (60-70%)

Endometrioid tumours (40%)

Dermoid (10-15%)

Metastases (Krukenberg)

52
Q

Most common cause of jaundice or liver disease in pregnancy?

A

Cholestasis of pregnancy

53
Q

TTTS vs TRAPS (twin reversed arterial perfusion sequence)

A

TTTS: AV anastomosis

TRAPS: artery-to-artery anastomosis

54
Q

Most common ovarian tumours according to age?

A

Pre-menopause: S, M, E, C

Post-menopause: S, E, C, M

55
Q

Bilateral ovarian tumour- 2 most common

A

Serous cystic neoplasms

Endometrioid ovarian cancer

56
Q

Uterine leiomyoma

A

Monoclonal and no mitotic activity

Some can have chromosomal abnormalities

57
Q

Incidence of choriocarcinoma

A

0.5% partial mole

5% complete mole

58
Q

Granulosa cell tumour of ovary- histology and serum marker?

A

Call-Exner bodies

Inhibin is the serum marker

59
Q

Not associated with Meig syndrome?

A

Dysgerminoma

60
Q

Pleural effusion in Meig syndrome?

A

Right sided

61
Q

Name 3 ovarian tumours associated with Meig?

A

Fibroma-thecoma

Granulosa cell

Brenner

62
Q

Most common cause of vasa praevia?

A

Velamentous cord insertion (type 1)

63
Q

1st trimester screen (triple test)

A

NT

Beta-HCG

PAPP-A

Note: NBL used as an adjunct

64
Q

2nd trimester screen (quadruple test)

A

Beta hCG

AFP

Oestriol

US findings (NF, NBL, structural anomalies)

Radiology (16 decks)

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