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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
Name 6 genetic risk factors for ovarian cancer
BRCA 1 and 2 Lynch syndrome (HNPCC) Li-Fraumeni (p53 mutation) Peutz-Jegher Ataxia-Telangiectasia K-Ras and HER-2 mutations
26
FIGO staging of ovarian cancer
Stage I: confined to ovaries Stage II: limited to pelvis Stage III: extra-pelvic or abdominal LN Stage IV: spread to distant organs
27
Name 2 features typical of serous ovarian tumours
Bilaterality Concentric calcifications (psamomma bodies)
28
Name 2 features of Brenner tumours
Most are benign Most likely epithelial ovarian tumour to be solid
29
Name 2 complications of ovarian teratomas
Torsion Malignant transformation to SCC (1%)
30
Name 2 monodermal (specialised teratomas)
Struma ovari (mature thyroid tissue- hyperthyroidism) Ovarian carcinoid (GI tract tissue- carcinoid syndrome)
31
Name 2 features of ovarian dysgerminoma
Unilateral and solid (all malignant) Can produce beta-HCG
32
Name 2 features of yolk-sac tumour
Predominantly solid and secretes AFP Schiller-Duval body
33
Name 2 features of ovarian choriocarcinoma
Secretes beta-HCG and highly aggressive Identical to GTD but NOT responsive to Rx
34
Name the main 3 sex-cord stromal tumours
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
What is the most common ovarian met?
Müllerian origin: uterus, fallopian tube, contralateral ovary
36
Name the 2 types of cervical cancer
SCC (80%): arises at squamo-columnar junction Adenocarcinoma (15%): arises from endocervical glandular epithelium. Not detected by pap-smear and poorer prognosis
37
Top 3 locations of endometriosis
Ovaries Uterine ligaments Pouch of Douglas
38
FIGO classification of endometrial carcinoma
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
Name 4 features of type I endometrial carcinoma
Age 50 Risk factors: unopposed oestrogen, obesity, DM (endometrial hyperplasia) Morphology: Endometrioid Prognosis: Indolent- myometrial invasion and lymphatic spread
40
Name 4 features of type II endometrial cancer
Age 70 Risk factors: endometrial atrophy (endometrial intraepithelial carcinoma) Morphology: serous, clear cell and mixed müllerian tumour Prognosis: Aggressive- intraperitoneal and lymphatic spread
41
What is the incidence of molar pregnancy? Name 3 RF.
1:1000 Advanced maternal age PHx of molar pregnancy or missed miscarriage Asian ethnicity
42
In utero exposure to DES and vaginal malignancy
Increased risk of clear cell adenocarcinoma (NOT SCC)
43
Sequence of PID
Ascending infection from vagina Acute suppurative salpingitis Salpingo-oophoritis Pyosalpinx followed by hydrosalpinx (long term)
44
Name 2 features of CIN I on microscopy
Koilocytes (perinuclear vacuolation) Indistinguishable from condyloma accumina
45
What is Bowen disease?
SCC in situ (penis or vulva) Strongly associated with HPV infection
46
Fragile X
Mental retardation, long mandible, lax joints Macro-orchidism and height BELOW average Excessive repetition of CGG trinucleotide
47
Endometrial polyps
Most commonly sessile
48
4 main causes of choriocarcinoma
Following molar pregnancy (50%) Post miscarriage (25%) Post normal pregnancy (20%) EP, genital teratomas (5%)
49
Endometrial mass showing osteoid, cartilage and muscle on biopsy. Dx?
Endometrial carcinosarcoma (malignant mixed müllerian tumour)
50
2 most common ovarian neoplasms arising from endometriosis
Endometrioid carcinoma Clear cell carcinoma
51
4 most common ovarian tumours to be bilateral
Serous tumours (60-70%) Endometrioid tumours (40%) Dermoid (10-15%) Metastases (Krukenberg)
52
Most common cause of jaundice or liver disease in pregnancy?
Cholestasis of pregnancy
53
TTTS vs TRAPS (twin reversed arterial perfusion sequence)
TTTS: AV anastomosis TRAPS: artery-to-artery anastomosis
54
Most common ovarian tumours according to age?
Pre-menopause: S, M, E, C Post-menopause: S, E, C, M
55
Bilateral ovarian tumour- 2 most common
Serous cystic neoplasms Endometrioid ovarian cancer
56
Uterine leiomyoma
Monoclonal and no mitotic activity Some can have chromosomal abnormalities
57
Incidence of choriocarcinoma
0.5% partial mole 5% complete mole
58
Granulosa cell tumour of ovary- histology and serum marker?
Call-Exner bodies Inhibin is the serum marker
59
Not associated with Meig syndrome?
Dysgerminoma
60
Pleural effusion in Meig syndrome?
Right sided
61
Name 3 ovarian tumours associated with Meig?
Fibroma-thecoma Granulosa cell Brenner
62
Most common cause of vasa praevia?
Velamentous cord insertion (type 1)
63
1st trimester screen (triple test)
NT Beta-HCG PAPP-A Note: NBL used as an adjunct
64
2nd trimester screen (quadruple test)
Beta hCG AFP Oestriol US findings (NF, NBL, structural anomalies)

Radiology (16 decks)

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