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CNIH > OB- abdo/GI > Flashcards

OB- abdo/GI Flashcards

1
Q

Small or absent fetal stomach is associated with?

A
  • can be normal (allow 30 mins to fill)

associated with:

  • aneuplody
  • tracheoesophageal fistula
  • oilohydranios
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2
Q

what is esophageal atresia?

A
  • congenital absence of a segment of the espogus

associated with:
- tracheoesophageal fistula (TEF)

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3
Q

What is the most common esophageal fistula?

A

fistula connecting the distal portion of the esophagus with the trachea (90%)

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4
Q

what should an esophageal atresia be suspected?

A

when an empty or small fetal stomach is seen in the presence of polyhydramnios

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5
Q

what is the upper neck pouch sign?

A
  • visualization of the proximally dialated esophagus
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6
Q

grouping of anomalies with esophageal atresia is known as?

A

VACTERL

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7
Q

Abnormal gastric dilation is most commonly seen in association with?

A

duodenal atresia

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8
Q

what is the most common site of intestinal atresia?

- what sign is seen?

A

duodenal atresia

  • double bubble sign
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9
Q

what is double bubble sign?

A
  • 2 fluid filled bubbles seen with duodenal atresia

- dialated stomach and dialated proximal duodenum

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10
Q

what is duodenal atresia associated with?

A
  • coexisting anomalies (50%)

- 1/3rd have tri-21

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11
Q

what is the most common etiology associated with jejunoileal atresia?

A

isolated vascular compromise

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12
Q

jejunal-ileal obstruction is diagnosed based on?

A

dialated loops of bowel

  • without dialated stomach
  • somtimes with hyper-peristalsis
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13
Q

The top normal lumen diameter used to diagnose bowel dilation is?

A

7mm

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14
Q

what is the apple peel sign?

A
  • seen with jejunal atresia
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15
Q

cystic fribrosis is a common underlying etiology for what?

A
  • ileal obstruction with or without meconium
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16
Q

polyhydramnios is less common in what kind of atresia?

A
  • lower bowel obstructions than in duodenal atresia
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17
Q

what is the most common large bowl atresia?

A

anorectal atresia

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18
Q

what has the highest incidence of associated anomalies of any of the GI atresias?

A

anorectal malformations (48-98%)

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19
Q

sonographic diagnosis of anorectal atresia?

A

0 dialated loops of small bowel or colon in the absence of polyhydramnios

20
Q

management of anorectal atresia?

A
  • fetal echocardigram

- genetic counseling

21
Q

what is echogenic bowel characterized by?

A

echos of bowel are as echogenic as the iliac crest

22
Q

echogenic bowel: common associated risks? (8)

A 
Aneuploidy
 Cystic fibrosis
 Swallowed fetal blood
 Infection
 Gastrointestinal atresias
Meconium peritonitis
 Intrauterine growth restriction
 Fetal Demise
23
Q

what is the most common anomaly of the abdominal wall?

A

omphalocele

24
Q

what is omphalocele?

A
  • defect in the anterior abdominal wall and the site of the imbilical cord insertion
25
Q

how is omphalocele identified?

A
  • herniation of abdominal organs (liver and bowel) into the base of the umbilical cord
26
Q

what is associated with omphalocele?

A
  • pentaolgy of cantrell
  • beckwidth-wiedemann syndrome
  • may be isolated
  • heart defects
  • chromosome anomalies (tri-18 m/c)
27
Q

how are fetal anterior wall abnormalities diagnosed on u/s?

A
  • Ventral mass seen at the cord insertion site
  • Omphalocele may be small (only bowel) or large (bowel and liver) and appear solid
  • covered by a membrane, which represents the amnion covering of umbilical cord
  • Ascites may be seen in peritoneal membrane
28
Q

what is pentalogy of cantrell associated with? (5)

A
  • ectopia cordia
  • heart defect
  • diaphragmatic hernia
  • pericardial defect
  • omphalocele
29
Q

what is bechwidth- wiedemann syndrome characterized by? (4)

A
  • macrosomia
  • macroglossia
  • omphalocele
  • renal neoplasm
30
Q

what is gastroschisis?

- where is it located?

A
  • cleft defect of the anterior abdominal wall with extrusion of abdominal organs into the amniotic cavity
  • usually only contains small bowel and is isolated
  • most commonly to the right of midline at umbilical level
31
Q

what is the main difference between gastrochisis and omphalocele?

A

in gastroschisis the herniated content is not covered by a membrane and the herniated content is free in the amniotic fluid

32
Q

risk of gastrochisis?

A
  • teenage mothers
  • tobacco use
  • drug use
  • pseudoephedrine
33
Q

what is gastroschisis associated with? (3)

A
  • atresias
  • stenosis
  • perforations
34
Q

what 6 things does the fetal abdomen contain?

A
  1. umbilical vein
  2. liver
  3. IVC
  4. descending aorta
  5. spleen
  6. fetal stomach
34
Q

what 6 things does the fetal abdomen contain?

A
  1. umbilical vein
  2. liver
  3. IVC
  4. descending aorta
  5. spleen
  6. fetal stomach
35
Q

when can hepatomegly been seen?

A
  • in severe hemolytic diseases
  • splenomegaly
  • hydrops
36
Q

splenomegly is associated with?

A

severe hemolytic disease due to isoimmunization and infection

37
Q

asplenia is associated with?

A
  • situs incersus
38
Q

what is associated with heterotaxy syndromes?

A
  • asplenia

- polysplenia

39
Q

GB may be seen sonographically after what week?

A

20 weeks GA

40
Q

what is a neuroblastoma?

A
  • a malignant tumor of the adrenal gland
  • most common neonatal tumor
  • complex mass and areas of calcifications
41
Q

what is a hemorrhage?

A
  • associated with fetal destress in older fetuses

- simular to adrenal or renal tumor

42
Q

causes of ascites? (7)

A 
Genitourinary
Gastrointestinal
Liver
Cardiac
Infections
Metabolic storage disorders
Idiopathic
43
Q

causes of pseudoascites?

A
  • gastrointestinal obstruction with bowel perforation
  • may present as meconium peritonitis and ascites
Nongastrointestinal causes include:
Immune and nonimmune hydrops
Urinary tract obstruction 
Congenital infection 
Some abdominal tumors
44
Q

psedoasciates on u/s?

A

Sonolucent band near fetal anterior abdominal wall commonly identified during routine obstetric examinations in fetus over 18 weeks of gestation

  • band results from normal musculature surrounding abdominal wall
  • always confined to anterior fetal abdomen and centrally located
  • never outlines falciform ligament

CNIH (69 decks)

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