OB/GYN Registry Review part 2 Flashcards
damage that is done from PID
chronic PID
history of STDs
fever
chills
pelvic pain/tenderness
purulent vaginal discharge
vaginal bleeding
dyspareunia
leukocytosis
acute PID
endometritis
pyosalpinx or hydrosalpinx
free fluid CDS
complex adnexal masses
acute PID
chronic pelvic or abdominal pain
infertility
palpable adnexal mass
irregular menses
vaginal discharge
chronic PID
hydrosalpinx
adhesions seen as echogenic bands within tube
complex adnexal masses
chronic PID
confined to uterus. Evidence of endometritis. Thickened endo, heterogeous with maybe blood or pus; comet tail/reverb artifacts classic
stage 1 PID
spread into tubes and adnexa, evidence of salpingitis, hydrosalpinx, or pyosalpinx. Hyperemia of tube may also be documented
stage 2 PID
severe progression of infection in adnexa. Bilateral complex adnexal masses known as TOA. Once it’s reached this stage, it will always remain chronic.
stage 3 PID
PID progression into adnexa. Adhesions develop between tubes and ovaries leading to fusion
tubo-ovarian complex
The first trimester is weeks __-__
1-13
Fertilization usually occurs in the ____
ampulla
Fertilzation usually occurs with ___ hours of ovulation
24
Once conception occurs, the fertilized egg is termed a:
zygote
At 3-4 days after fertilization, the cluster of cells of the zygote is called the:
morula
By day 5, 1st time cell differentiation takes place and it is now a _____
blastocyst
outer ring of trophoblastic cells begin to produce HCG.
trophoblaster
Endometrium prepares for implantation and becomes decidualized called the:
decidual reaction
The outer layer of the trophoblast will eventually become the ____ and ______
chorion
placenta
inner cell mass that will develop into embryo, amnion, cord, and yolk sacs
embryoblast
Implantation occurs __-__ days after fertilization
7
9`
Finger-like projections of the trophoblast called ______ form links into decidualized endometrium
chorionic villi
Implantation is complete by day ___ from LMP
28
HcG levels double every ___ hours until __ weeks
48
9
earliest visible sign of pregnancy is a ______
decidualized endo
By ____-____ mIU/mL HCG the gestational sac should be seen by TV
1000
2000
By _____ mIU/mL the gestation sac should be seen by TA
3500
Mean sac diamater length equation
lenth + width + height divided by 3
The gestation sac grows by __ mm per day
1
The first definitive sign of IUP is:
gesational sac with yolk sac
The gestational sac with yolk sac should be visualized by a MSD of __ mm
10
The gestational sac should be located in the space of the chorionic cavity between the amnion and chorion
extraembryonic coelem
The _______ is responsible for producing AFP, angiogenesis, and hematopoeisis.
Secondary yolk sac
The secondary yolk sac connects to the embryo by the _____
vitelline duct
The _______ visualized as a round, anechoic with thin echogenic rim and measuring <6mm
secondary yolk sac
“double bleb sign”
enlarged yolk sac next to amnion
Enlarged yolk sac indicates:
impending demise
By __ weeks the fetal pole is visualized
6
The fetal pole must be seen by MSD of ___ mm
25
Most reliable estimation of gestational age
CRL
Starting at 6 weeks, the fetal pole grows __ mm per day
1
Calculation of gestational age from CRL
CRL (cm) + 6.5 = GA (in weeks)
Cardiac activity must be noted by __ mm CRL
5
formation of limb buds and fetal head appears larger than body
7 weeks
cystic structure noted within the head at 8 weeks
rhombencephalon
The rhombencephalon evetually develops into the _____
fourth ventricle
_______ is a normal migration of midge bowel into the base of the umbilical cord.
physioloigical bowel herniation
Physiological bowel herniation should be completed by ___ weeks
12
embryonic phase has ended and is now referred to as a FETUS
10 weeks
Fetal limbs and facial profile/cranium should be clearly evaluated and normalized. May also be documented: heart, stomach, cord insert, and possibly bladder
11 weeks
Within the fetal head, lateral ventricles filled with echogenic ______ on either side of the ______
choroid plexus
falx cerebri
By the end of the 1st trimester, see as well-defined, cresent shaped and slightly echogenic mass of tissue.
placenta and umbilical cord
The placenta and umbilical cord are formed by _____ (maternal) and _____ (fetus)
decidual basalis
chorion frondosum
First trimester screening happens between:
11 weeks and 13 weeks 6 days
the fluid filled layer between the fetus and skin layer and should never measure more than 3mm
nuchal transclucency
NT may also be enlarged with trisomy __
13
The CRL should measure between ___-___ mm
45
84`
a pregnancy located anywhere other than the central uterine cavity
ectopic pregnancy
Most common cause of pelvic pain with positive pregnancy test
ectopic pregnancy
The most common location of an ectopic pregnacny
ampulla of the fallopian tube
Most dangerous ectopic pregnancy
interstitial
IUP and coexisting ectopic
heterotopic pregnancy
pain
bleeding
palpbale mass
lower than expected hCG
low hematocrit
should pain
ectopic pregnancy
extrauterine GS “live” ectopic
complex adnexal mass or adnexal ring sign
free or complex fluid in pelvis
pseudogestational sac
poor decidual reaction in endometrium
ectopic pregnancy
gestational trophoblastic disease also known as
molar pregnancy
abnormal combination of male and female gametes resulting in rapid proliferation of trophoblastic cells (what will form the placenta)
gestational trophoblastic disease
Trophoblasts produce:
HCG
placenta grows out of control, takes over, and undergoes degeneration become complex with cystic changes
gestational trophoblastic disease
most common GTD
complete hydatidform mole
absence of fetus or gestational sac. Benign with malignant potential. Contained within myometrium, clear defined borders.
complete hydatidform mole
coexisting IUP/GS and possibly fetus. minimal malignant potential
partial hydatidform mole
molar pregnancy that becomes malignant and invades into myometrium, through uterine wall into peritoneum
invasive molar (chorioadenoma destruens)
most malignant progressive form with possible mets to lung (most common), liver, and brain
choriocarcinoma
hyperemesis
markedly elevated HCG
bleeding
enlarged uterus
hypertension
GTD
large complex mass with uterus “vesicular snowstorm”
multiple cystic areas throughout “swiss cheese”
loss of myometrium or borders if invasive
bilateral theca lutein cysts
GTD
An anembryonic pregnancy is also known as:
blighted ovum
large gestational sac without yolk sac or embryo based on sac size
anembryonic pregnancy
GS >10mm + no YS
anembryonic pregnancy
GS >25mm + no FP
anembryonic pregnancy
death of embryo or fetus
fetal demis
Demise is confirmed by a fetal pole > __ mm with no ____
5
cardiac activiity
termination of pregnancy before viability whether elective or not
abortionm
miscarriages are also known as:
spontaneous abortions
spotting
low fetal heart rate
threatened miscarriagesp
spotting
low HCG
intact demise
missed abortion
heaving bleeding
+ HCG
retained products of conception
incomplete abortion
bleeding
- HCG
normal endometrium
complete abortion
cramping/spotting
low lying GS
inevitable abortion
implies the miscarriage is still in process and there are retained products of conception with internal flow within the cavity
incomplete miscarriage
miscarriage is done, cavity is empty, endo is thin
complete miscarriage
bleed between endometrium and gestational sac
subchorionic hemorrhage
crescent-shaped hypoechoic or medium level echoes area adjacent to the sac
subchorionic hemorrage
may appear as round masslike area within the myometrium but will disappear within 30 minutes
contractions
most common pelvic mass in 1 trimester
corpus luteum of pregnancy
physiologic, functional cyst that maintains endo by secreting progesterone, maintained by HCG, usually 2-3 cm but may grow large up to 10 cm
corpus luteum of pregnancy
The second trimester is weeks __-__
13
26
The quadruple screen
HCG
AFP
estriol
inhibin A
HCG, estriol, and inhibin A are produced by the ______
placenta
AFP is produced by the _____
fetujs
“open” or protruding fetal abnormalities will show elevated ___
AFP
Most common cause of abnormal serum screening
incorrect dates
baby is parallel to mother
longitudinal lie
head presenting or closest to cervix
cephalic or vertex
feet first
complete breech
buttocks closest to the cervix
frank breech
one leg closest to the cervix
footling breech
fetus lie is perpendicular to mother
transverse lie
Long baby and clockwise
cephalic
long baby and counter
breech
trans baby and clockwise
head right
trans baby and counter
head left
spine to stomach is
clockwise
The heart is initially __ tubes that fuse and fold to form ___ chambers
2
4
The heart begins to contract at ___ days gestation (5 weeks)
36
The heart is detected on US by CRL of __mm
5
NL heart rate first trimester
120-180
The heart is fully formed by ___ weeks
10
The apex of the heart is angled to the ____ of midline at a 45 degree angle from the ______.
left
spine
The heart occupies ___ of the chest
1/3
________ is confirmed with imageing of fetal lie, stomach and apex pointing to the left of fetus
situs solitus
normal cardiac position
levocardia