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DSM OB/GYN > OB II Final Review from PP slides > Flashcards

OB II Final Review from PP slides Flashcards

1
Q

What is Menarche

A

Onset of menstruation

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2
Q

What is Menopause

A

Stop of menstruation

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3
Q

What is Metrorrhea

A

irregular bleeding

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4
Q

What days does menstruation occur in the cycle

A

1-4 days

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5
Q

What is the sonographic appearance of the endometrial canal during mestruation

A

hypoechoic line

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6
Q

What is a corpus luteum

A

small endocrine structure that develops in a ruptured ovarian follicle.

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7
Q

What hormones does a corpus luteum secrete

A

progesterone and estrogen

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8
Q

What is the broad ligament

A

double fold of peritoneum that covers the uterus, ovaries and fallopian tubes

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9
Q

what are the round ligaments

A

Between layers of broad ligament

In front and below fallopian tubes

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10
Q

What are the cardinal ligaments

A

supports the cervix

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11
Q

Where is the Posterior Cul-de-sac

A

between the uterus and rectum

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12
Q

What are other names for the posterior cul-de-sac

A

pouch of douglas

rectouterine pouch

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13
Q

Where is the anterior cul-de-sac

A

between the bladder and uterus

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14
Q

what is another name for the anterior cul-de-sac

A

vesicouterine pouch

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15
Q

what is the blood supply to the vagina

A

anterior uterine artery

posterior branch of internal iliac

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16
Q

where is the space of retzius

A

Between the anterior bladder wall and pubic symphysis

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17
Q

what is another name for the space of retzius

A

retropubic space

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18
Q

what is the blood supply to the ovaries

A

aorta
ovarian arteries
uterine arteries

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19
Q

what do the ovarian veins drain into

A

left vein: drains into left renal vein

right vein: drains into IVC

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20
Q

what is the blood supply to the fallopian tubes

A

ovarian arteries and veins

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21
Q

where are arcuate vessels found

A

along the peripheral edge of the uterus

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22
Q

what is the embryology of the uterus and vagina

A

they both develop from the mullerian ducts between 7-12weeks

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23
Q

what are the 3 layers of the uterus

A

perimetrium
myometrium
endometrium

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24
Q

what are the 2 layers of the endometrium

A 
zona functionalis (superficial functional layer)
zona basalis (deep basil layer)
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25
Q

what is the songraphic appererance of the endometrium

A

echogenic to hypoechoic, depending on cycle

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26
Q

What layer sheds during menses

A

zona functionalis

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27
Q

What is the size of ovaries

A

3x2x2

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28
Q

What supports the ovary posteriorly

A

broad ligament via mesovarium

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29
Q

what is the sonographic appearance of the ovary

A

homogeneous, with an echogenic medulla

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30
Q

what supports the ovary medially

A

ovarian ligament

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31
Q

what supports the ovary laterally

A

suspensory ligament (infundibulopelvic)

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32
Q

what is ovarian torsion

A

complete or partial rotation of the ovary, cutting off the blood supply

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33
Q

what day does ovulation occur

A

day 14

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34
Q

what is the menstrual cycle

A

menstraution = 1-4days
proliferative phase = 5-14 days
secretory phase = 15-28 days

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35
Q

what is the ovarian cycle

A

follicular phase = 1-14 days

luteal phase = 15-28 days

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36
Q

what is the size of a graafian follicle

A

2cm

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37
Q

what is the rate of growth of a graafian follicle

A

2-3mm per day

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38
Q

what is the length of the fallopian tubes

A

10-12cm

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39
Q

what are the sections of the fallopain tube

A

infundibulum, ampulla, isthums and inerstitial portion

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40
Q

what section of the fallopian tube is the widest

A

ampulla

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41
Q

what are cysts in the cervix called

A

nabothian cysts

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42
Q

what are cysts in the vagina called

A

gartners duct cyss

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43
Q

what are the most common tumors of the uterus

A

fibroids (leiomyomas)

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44
Q

where can fibroids form

A

submucosal
intramural - most common site
subserosal
pedunculated

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45
Q

what is adenomyosis

A

nests of endometrial tissue within the myometrium

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46
Q

what can cause calcifications within the uterus

A

fibroids and arcuate arteries

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47
Q

what is the size of a vaginal cuff

A

2cm

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48
Q

who can acquire endometritis

A

postpartum patients,

occurs with PID too

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49
Q

what is the most common ovarian mass

A

simple ovarian cysts

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50
Q

simple ovarian cysts in postmenopausal women can be what size

A

less than 5cm before consider malignant

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51
Q

what are thecomas

A

benign, unilateral mass seen in postmenopausal women

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52
Q

what pelvic organ in the most involved with metastatic disease

A

ovaries

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53
Q

what % of postmenopausal bleeding is endometrial carcinoma

A

10%

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54
Q

what is the most common mass during pregnancy

A

corpus leutal cyst

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55
Q

what is another term for endometriomas

A

chocolate cysts

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56
Q

where are endometriomas commonly located

A

ovaries, cul-de-sac, retrovegainal septum, peritoneal surface of posterior wall of uterus

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57
Q

what is the most common benign tumor of the ovary

A

dermoid

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58
Q

what is a mucinous cystadenoma

A

Epithelial tumor lined with mucinous elements of endodermis and bowel
Typically larger than serous cystadenoma
Simple, septated cyst with differing echogenicity

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59
Q

what is a serous cystadenomas

A

2nd most common benign tumor of ovary
Smaller than mucinous cystadenomas
Unilateral, septated, irregular borders

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60
Q

what is another name for PCOS

A

Stein-Leventhal syndrome

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61
Q

what is PCOS

A

disorder with chronic anovulation
bilateral enlarged round ovaries
teens-twenties
amenorrhea, obesity, infertile, hirsutism

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62
Q

what is salpingitis

A

infected fallopian tubes

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63
Q

septate uterus can cause what

A

infertility

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64
Q

what is hydrops

A

excessive fluid within fetal body cavities

ascites, pericardial effusion, pleural effusion, polyhydramnios

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65
Q

What is nonimmume hydrops

A

hydrops that is not related to Rh factor

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66
Q

what is the sonographic appearance of hydrops

A 
scalp edema
pleural effusion
pericardial effusion
ascites
polyhydramnios 
thick placenta
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67
Q

what are sonographic markers for downs

A 
thick NT/nuchal fold
choroid plexus cysts
echogengic bowel
pylectasis
short long bones
EIF
absent nasal bone 
omphalocele
talipes
micrognathia
diaphragmatic hernia
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68
Q

how often does trisomy 21 occur

A

1/600 births

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69
Q

how often does trisomy 18 occur

A

3/10,000 births

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70
Q

what are sonographic markers for Edwards

A 
heart defects
clench hands
omphalocele
micrognathia
talipes
choroid plexus cysts
strawberry head
cleft lip & palate 
diaphragmatic hernia
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71
Q

how often does trisomy 13 occur

A

1/5,000 births

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72
Q

what are sonographic markers for Pataus

A 
holoprosenchephaly
polydactyly
talipes
cleft lip & palate
renal anomalies
menignomylocele
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73
Q

what are sonographic makers for Turners Syndrome

A 
cystic hygroma
heart defects
coarctaion of the aorta 
hydrops 
renal anomalies
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74
Q

what commonly causes triploidy

A

1 ova fertilized by 2 sperm

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75
Q

what are sonographic markers for Triploidy

A 
heart defects
omphalocele
renal anomalies
cranial defects
facial defects
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76
Q

what is VACTERL

A 
vertebral defects
anal atresia
cardiac anomalies
transesophageal fistula
renal anomalies
limb dysplasia
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77
Q

what diseases can happen to pregnant women

A

diabetes

hypertension (chronic or pregnancy induced)

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78
Q

hypertensive mothers can have what size placenta

A

small

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79
Q

what are some sonographic markers in diabetic pregnancies

A 
polyhydramnios
macrosomia
caudal regression syndrome
NT defects
heart defects
renal anomalies
GI defects 
single umbilical artery
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80
Q

what is preeclampsia

A

high blood pressure
proteinuria
edema

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81
Q

what is eclampsia

A

preeclamptic signs with seizures

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82
Q

maternal obesity can cause what type of defects

A

neural tube defects

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83
Q

at what week is it still considered preterm labor

A

37 weeks

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84
Q

what are dizygotic twins

A

2 separate ova fertilized by 2 separate sperm

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85
Q

what are monozygotic twins

A

1 fertilized egg that divides into 2 fetuses

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86
Q

when does Di-Di twinning occur

A

division of zygote at 1-3 days

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87
Q

when does Di-Mono twinning occur

A

division of zygote at 4-8 days

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88
Q

when does Mono-Mono twinning occurs

A

division of zygote at 8 days

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89
Q

when does conjoined twinning occurs

A

division of zygote after 13 days

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90
Q

what is a vanishing twin

A

early fetal demise that is absorbed

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91
Q

what is fetus papyraceous

A

fetal demise still in utero

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92
Q

what is poly-oli sequence

A

“stuck twin” occurs around 16-26weeks
one twin has polyhydramnios
the other has oligohydramnios

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93
Q

what is twin to twin transfusion

A

an arteriovenous shunt within the placenta

the arterial blood of 1 is pumped into the venous system of 2

94
Q

what happens to the fetuses in twin to twin

A

the donor twin becomes anemic and growth restricted
(oligo, pulmonary hypoplasia, renal hypoplasia) poor outcome

the recipient grows too quickly, too much blood,has polyhydramnios, can have heart failure, and hydropic

95
Q

what type of twinning is twin to twin transfustion

A

monochorionic

diamniotic

96
Q

what is acradiac twin

A

twin abnormality where 1 twin develops without an upper half, occurs in monochorionic twins

97
Q

what are the 5 different locations for conjoined twins

A 
thoracopagues
omphalopagus
craniopagues
pygopagus
ischiopagus
98
Q

What is Fitz-Hugh-Curtis syndrome

A

Perihepatic inflammation that can result from PID or endometritis

99
Q

What are the 2 types of 3D acquisitions

A

Manual “free hand”

Automatic

100
Q

What are the 2 types of 3D imaging modes

A

Multiplanar reconstruction mode

Volume rendering mode

101
Q

What is multiplanar reconstruction

A

Demonstrates anatomy in 3 different planes and angles (long, trans, coronal)

102
Q

What is volume rendering

A

An extension of multiplanar, where the techniques are applied to a ROI 3D volume data set

103
Q

What are the 2 types of 3D rendering modes

A

Surface rendering

Transparent rendering

104
Q

What is surface rendering

A

Displays surface detail of anatomy

Ex. Fetal face

105
Q

What is transparent rendering

A

Looks beyond the surface anatomy to reveal structures located within

106
Q

What are other modes to transparent rendering

A

Maximum
Minimum
X-ray

107
Q

When does the umbilical cord form

A

Develops in the first 5 weeks

108
Q

Where does the umbilical cord rise from

A

Omphalomesenteric (yolk stalk) and allantios ducts

109
Q

How long are the intestines herniated outside the fetal abdomen

A

From 7-10 weeks

110
Q

What covers the umbilical cord

A

Whartons jelly

111
Q

What is the diameter of the umbilical cord

A

1-2cm

112
Q

What is the normal length of the umbilical cord

A

40-60 cm

113
Q

What is the ductus venosus

A

Conduit between the portal system and systemic veins

114
Q

What is a short cord

A

Less than 35cm

115
Q

What is a long cord

A

Greater than 80cm

116
Q

What are true knots

A

Knot is formed when a loop of cord is slipped over the fetal head or shoulders

117
Q

What are true knots associated with

A

Long cords
Polyhydramnios
IUGR
Mono mono twins

118
Q

What is a velamentous cord insertion

A

Cord inserts into the membranes before the placenta

119
Q

What is the occurrence of cleft lip and palate with different races

A

Blacks 1/3,000
Whites 1/600
Asians 1/350
Native Americans 1/150-250

120
Q

What is exophtalmia

A

Abnormal protrusion of the eyeballs

121
Q

What is the most common neck mass

A

Cystic hygroma

122
Q

What is anencephaly

A

Absence of skull and brain

123
Q

What is the occurrence of anencephaly

A

1/1,200

124
Q

What are cephaloceles

A

A neural tube defect in which the meninges or meninges and brain herniate thru a defect in the calvarium

125
Q

What abnormalities associate with cephaloceles

A

Trisomy 13

Meckel Gruber syndrome

126
Q

What can cause a celphalocele

A

Amniotic band syndrome

127
Q

What is a encephalocele

A

A herniation of the meninges and brain thru a defect

128
Q

What abnormalities associate with encephaloceles

A

Meckel Gruber

129
Q

What malformation is associated with a banana shaped cerebellum and lemon shaped head

A

Arnold Chiari

130
Q

What are the sonographic findings of spina bifida

A 
Splaying of posterior ossification center
Meningocele
Meningomylocele
Cleft in skin
Intracranial malformations
131
Q

What kind of intracranial malformations could be present with spina bifida

A

Lemon head
Banana cerebellum
Absent cisterna magna
Ventriculomegaly

132
Q

When is a ventricle considered dilated

A

Greater than 10mm

133
Q

What can cause ventriculomegaly

A

Spina bifida

Encephalocele

134
Q

Fetuses younger than ____ are considered non viable, due to pulmonary development

A

24 weeks

135
Q

how do you evaluate the fetal chest

A

size
shape
symmetry

136
Q

ultrasound cannot asses what in the fetal chest

A

lung maturity

137
Q

what is congetntial cystic adenomatoid malformation (CCAM)

A

abnormal cystic growths within the bronchial trees that can cause a mediastinal shift, hydrops and polyhydramnios

138
Q

how many types of CCAM are there

A

3

139
Q

what is type 1 CCAM

A

one or more large cysts that replace normal lung tissue
2-10cm

favorable outcome

140
Q

what is type 2 CCAM

A

lesions that have multiple small cysts

poor outcome

141
Q

what is type 3 CCAM

A

large bulky noncystic mass

142
Q

what are bronchogenic cysts

A

most common lung mass that is a small circumscribed masses without a mediastinal shift

143
Q

what is pulmonary hypoplasia

A

poor or reduced lung growth causing inadequate lungs

144
Q

what is are common causes for pulmonary hypoplasia

A

prolonged oligohydramnios

or a small thoracic cavity

145
Q

what % of neonates die from pulmonary hypoplasia

A

80%

146
Q

what is pleural effusion

A

accumulation of fluid within the pleural cavity

147
Q

if pleural effusion is seen, what structures should be carefully search

A

lungs, heart and diaphragm to rule out associated abnormalities

148
Q

what is the occurrence of a congenital diaphragmatic hernia

A

1/2,000 to 1/5,000

149
Q

at how many weeks is the diaphragm intact

A

by the end of the 8th week

150
Q

what is the most common type of diaphragmatic hernia

A

hernias 90% of the time are thru the foramen of Bochdalek

151
Q

where is the foramen of Bochdalek located

A

posterior and laterally

152
Q

what are the 2 most common anterior abdominal wall defects

A

gastroschisis

omphalocele

153
Q

what process helps the embryo transform itself into a cylindrical shape

A

“folding”

154
Q

when do the intestines return to the abdominal cavity

A

12 weeks

155
Q

what is an ompalocele

A

central abdominal wall defect with eviscerated bowel and or liver into the base of the umbilical cord

156
Q

what forms the membrane that surrounds the omphalocele

A

peritoneum and amnion

157
Q

what can occur with omphaloceles

A 
ascites
polyhydramnios
complex cardia diseases
GI defects
NT defects
genitourinary tract anomalies 
diaphragmatic hernia
158
Q

what is gastroschisis

A

an opening in the abdominal wall with a herniation of bowel, no membranous covering

the herniation of the stomach and genitrourinary organs happen infrequently

159
Q

what causes gastroschisis

A

atrophy of the right umbilical vein
or
disruption of the omphalomesenteric artery

160
Q

how big are gastroschisis defects

A

2-4cm located to the right of a normal cord insertion

161
Q

gastroschisis causes an elevation in what lab

A

MSAFP

162
Q

markedly dilated bowel in gastroschisis may suggest what

A

infarction or bowel atresia

163
Q

early entrapment in amniotic bands can lead to what

A

severe craniofacial defects

internal malformations

164
Q

limb body wall complex involves what other defects

A

cranial defects
facial clefts
body-wall defect of thorax / abdomen (or both)
limb defects

165
Q

scoliosis is associated with what type of defect

A

limb body wall defect

166
Q

what side is more common to be affected by limb body wall

A

left side 3x more likely than right

167
Q

what side is more common to be affected by limb body wall

A

left side 3x more likely than right

168
Q

what is the sonographic appearance of haustral folds

A

thin linear echoes with the lumen of the colon

169
Q

what is the normal diameter of the colon at full term

A

14-18mm

170
Q

what is the appearance of meconium as it grows near term

A

increasing echogenicty

171
Q

what is situs inversus

A

total or partial reversal of thoracic and abdominal organs

172
Q

what organs are involved with partial situs inversus

A

only the heart or abdominal organs are reversed, the stomach may or may not be involved

173
Q

what is pseudoascites

A

a sonolucent band near the fetal anterior abdominal wall

174
Q

when can pseudoascites be seen

A

18 weeker or greater

175
Q

what happens in duodenal atresia

A

the duodenal lumen is blocked by a membrane that prohibits the passage of amniotic fluid, causing a double bubble

176
Q

where are most cases of duodenal atresia founds

A

below the ampulla

177
Q

what abnormality can often coexist with double bubble

A

an annular pancreas

178
Q

what % of double bubble cases have trisomy 21

A

30%

179
Q

what % of duodenal atresia have other anomiles

A

50%

180
Q

what is the occurrence of esophageal atresia

A

1/2,500 live births

181
Q

what % of esophageal atresia cases have coexisting anomalies

A

50%-70%

182
Q

what is the most common anomaly found with esophageal atresia

A

anorectal atresia

others could be VACTERL

183
Q

what is the occurrence of extrophy of the bladder

A

1/50,000 male births

184
Q

what causes bladder extrophy

A

a defective closure of the inferior part of the abdominal wall at 4 weeks

185
Q

what 2 renal findings are incompatible with life

A

renal agenesis

infantile polycystic kidney disease

186
Q

when do the fetal kidney start contributing to amniotic fluid

A

14-16 weeks

187
Q

in renal agenesis what structures can be mistaken for as kidneys

A

adrenal glands

188
Q

what is the sonographic appearance of renal agenesis

A

severe oligohydramnios
persistent absence of the bladder
failure to see kidneys
small thorax

189
Q

what is Potters syndrome associated with

A 
renal agenesis 
oligohydramnios
pulmonary hypoplasia
abnormal facies
malformed hands and feet
190
Q

how many types of Potters syndrome are there

A

4

191
Q

what is type 1 Potters syndrome

A

(AR) infantile polycystic kidney disease

192
Q

what is type 2 Potters syndrome

A

renal agenesis, multicystic kidneys, renal dysplasia

193
Q

what is type 3 Potters syndrome

A

(AD) polycystic kidney disease

194
Q

what is type 4 Potters sydndrome

A

renal dysplasia

obstructive kidney disease

195
Q

what is the most common form of renal cystic disease in infants and neonates

A

multicystic dysplastic kidney disease

196
Q

what happens in multicystic dysplastic kidney disease

A

renal tissue is replace by multiple noncommunicating cysts, causing the kidney to be nonfunctional

197
Q

what is the sonographic appearance of infantile polycystic kidney dieases

A

kidneys appear enlarged

198
Q

what is the most common reason for hydronephorsis in utero

A

UPJ

199
Q

where does the UPJ obstruction occur

A

at the junction between the renal pelvis and ureter

200
Q

True/False

UPJ’s are usually a unilateral defect

A

True

201
Q

what can cause UPJ

A

abnormal bend/kinks in ureter
abnormal valves in ureter
abnormal outlet shape

202
Q

what findings occur with posterior urethral valves

A

hydronephrosis
hydroureters
enlarged bladder and posterior urethra “keyhole” appearance

203
Q

what is the most common fetal anomaly

A

hydronephrosis

204
Q

the renal pelvis should not measure more than ____

A

4mm

205
Q

what is skeletal dysplasia

A

abnormal growth and density of cartilage and bone

206
Q

how many types of skeletal dysplasia are there

A

over 100, but not all are detected by ultrasound

207
Q

dwarfism occurs ______ to a skeletal dysplaisa

A

secondary

208
Q

what is rhizomelia

A

short long bones (Hum/Fem)

209
Q

what is mesomelia

A

short distal bone (ulna/radius, tib/fib)

210
Q

what is micromelia

A

shortening of all the extremity bones

211
Q

what are sonographic findings of thanatophoric dysplaisa

A 
rhizomelia & bowed long bones
narrow thorax
large head or cloverleaf head
flat vertebral bodies
frontal bossing
hypertelorism
212
Q

what is type 1 thanatophoric dysplaisa

A

short, curved femurs and flat vertebral bodies

213
Q

what is type 2 thanatophoric dysplaisa

A

straight, short femurs, flat vertebral bodies and cloverleaf skull

214
Q

what is the most common nonlethal skeletal dysplaisa

A

achondroplasia

215
Q

what is the occurence of achondroplasia

A

5-15/10,000 births

1/66,000 births in USA

216
Q

what type of bones does achondroplasia produce

A

short, squat bones

217
Q

what % of achondroplasia cases are from spontaneous mutation

A

80%

but some can be transmitted in an autosomal form

218
Q

what is osteogenesis imperfecta

A

disorder of production, secretion or function of collagen causing brittle bones and hypomineralization

219
Q

what is the occurrence of osteogenesis imperfecta

A

1/20,000 - 30,000 births

220
Q

what are findings of osteogenesis imperfecta type 2

A

numerous fractures
short femurs
decreased mineralization of bones and calvarium

221
Q

what is the occurrence of osteogenesis imperfecta type 2

A

1/60,000 births

222
Q

jeunes syndrome has what

A

a very narrow thorax, causing pulmonary hypoplasia

223
Q

how is jeunes syndrome acquired

A

inherited by an auto-recessive manner

224
Q

what are sonographic findings of jeunes syndrome

A

small thorax
rhizomelia
renal dysplasia
polydactyly

225
Q

how often does club foot occur

A

1/400 births

unilateral & higher in males

226
Q

what chromosomal anomaly has rocker-bottom feet

A

trisomy 18

227
Q

how often does Ellis-Van Creveld syndrome occur

A

1/200,000 births

228
Q

what community has a high incidence of Ellis-Van Creveld

A

Amish

229
Q

what is another name for Ellis-Van Creveld

A

chondoectodermal dysplasia

230
Q

what are sonographic features of Ellis-Van Creveld

A

short limbs
polydactyly
heart defects 50%
narrow thorax

DSM OB/GYN (10 decks)

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