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DSM OB/GYN > OB II Test 4 Review Ch 62, 63, 64 > Flashcards

OB II Test 4 Review Ch 62, 63, 64 Flashcards

1
Q

What is the difference between partial situs inversus and complete situs inversus?

A

Complete: total reversal of thoracic and abdominal organs

Partial: more severe, thoracic viscera are usually reversed and abdominal viscera may/may not be reversed; two combinations of organ reversals, asplenia or polysplenia
pg. 1342

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2
Q

What is double bubble?

A

Blockage of the duodenal lumen by a membrane that prohibits the passage of swallowed amniotic fluid

Also called Duodenal Atresia

Pg. 1345

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3
Q

What should you look for when you encounter loops of dilated echogenic bowel?

A 
?Bowel obstruction
?Meconium ileus
?Cystic Fibrosis
Pg. 1346?
possible chromosomal abnormalities so check everything thoroughly
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4
Q

What is the normal position of the spleen in reference to other parts of the body?

A

Posterior and to the left of the fetal stomach.

Imaged in transverse plane

Pg. 1342

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5
Q

What are the possibilities if you find echogenic areas in the fetal abdomen?

A

Calcified
Peritoneal calcifications: Meconium peritonitis, hydrometrocolpos
Intraluminal meconium calcifations: anorectal atresia, small bowel atresia,
Parenchymal: Liver, splenic, adrenal, ovarian cyst
Cholelithiasis: gallbladder
Noncalcified
Echogenic Meconium, intraabdominal extrathoracic pulmonary sequestration, tumors, adrenal hemorrhage

Green Box: pg. 1348

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6
Q

What would a cystic growth on the common bile duct be termed?

A

Choledochal Cyst

pg. 1343

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7
Q

Haustral folds are seen on the ___.

A

Colon

Pg. 1340

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8
Q

What is Meckel diverticulum?

A

Remnant of proximal part of yolk stalk that fails to degenerate and disappear during early fetal period.
Most common malformation of the midgut.

Pg. 1338

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9
Q

A normal esophagus will appear with a ___ pattern.

A

multi-layered

per Beth

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10
Q

Which malformation of the midgut is most common?

A

Meckel’s Diverticulum

Pg. 1338

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11
Q

At how many weeks should you be able to tell the difference between large and small bowel?

A

After 20 menstrual weeks.

Pg. 1340

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12
Q

Information about the stomach.

A

Fetuses 14-16 wks should have fluid in stomach
There may be a significant change in size of stomach
Echogenic debris can sometimes be seen along dependent wall
Esophageal anomalies are the LEAST common problem for nonvisualization of the stomach
Pg. 1338

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13
Q

What is polysplenia?

A
  • -More than one spleen
  • – represented by transposition of liver, spleen, and stomach and absent GB

Pg. 1342

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14
Q

What is psuedoascites?

A

Sonolucent band near the fetal anterior abdominal wall found in fetuses over 18 weeks gestation

Pg. 1343

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15
Q

What is the most reliable criteria for diagnosing dilated bowel loops?

A

Bowel diameter

Pg. 1344

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16
Q

What are the causes for a double bubble?

A
    • duodenal atresia
  • -duodenal stenosis
  • -annular pancreas
  • -Ladd’s bands
  • -proximal jejunal atresia
  • -malrotation
  • -diaphragmatic hernia

Pg. 1345

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17
Q

What are some other defects that may coexist with esophageal defects?

A

Tracheoesophageal fistula
Pg. 1336

Anorectal Atresia
VACTERL
Growth Restriction
Trisomies 18 and 21
Pg. 1344
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18
Q

What is a derivative of the hindgut?

A
    • Left part of transverse colon
    • descending colon
    • Sigmoid colon
    • Rectum
    • Superior portion of anal canal
    • Epithelium of Bladder
    • most of Urethra

Pg. 1338

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19
Q

At 30 weeks, what are the peritoneal calcifications of the fetus?

A

Meconium peritonitis and Hydrometrocolpos?

Pg. 1348 (green box)

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20
Q

What is the VACTERL group of anomalies?

A 
V= Vertebral
A= Anal
C= Cardiac
T= Trachea
E= Esophageal
R= Renals
L= Limbs
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21
Q

What is correct about the normal liver?

A
  • Relatively large in comparison to other intraabdominal organs and occupies most of upper abdomen
  • Accounts for 10% of total weight at 11 weeks and 5% at term
  • Hepatic veins and fissures formed by the end of the first trimester
  • Left lobe is larger than right in utero secondary to greater supply of oxgenated blood
    pg. 1341
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22
Q

What is anorectal atresia?

A

Presents as a complex disorder of the bowel and genitourinary tract and may be present as part of the VACTERL association or in caudal regression. One of the findings in this is an imperforate anus, which is when a membrane covers the anus prohibiting the expulsion of meconium. Prognosis is poor because of associated anomalies. Incontinence of both bowel and bladder is common.
pg. 1347

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23
Q

At how many weeks should you see fetal kidneys on ultrasound?

A

By 13 weeks?
Pg. 1354

18 weeks? kidneys should be documented in all fetuses sonographically
Pg. 1354

Please check this, the book has 3 different weeks….

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24
Q

What is the protrusion of the posterior wall of the bladder?

A

Extrophy of the Bladder

Pg. 1361

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25
Q

What is it called when a fetus has both ovarian and testicular tissue?

A

True Hermaphroditism

Pg. 1377

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26
Q

What will you find with complete renal agenesis?

A
    • Severe Oligo after 13-15 weeks
    • Absence of urine in fetal bladder
    • No visualization of kidneys or renal arteries
    • Small thorax

Pg. 1360
You will not find a dilated fetal bladder
quizlet

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27
Q

What are some specifics to Potter’s syndrome?

A

Potter’s facies: flat nose, recessed chin, abnormal ears, and wide-set eyes, as well as abnormal or malpositioned limbs (these deformities caused by a lack of amniotic fluid)

Cardiac defect

Musculoskeletal disorders: sirenomelia, absent radius and fibula, anomalies of digits, sacral agenesis, diphragmatic hernia, and cleft palate

CNS anomalies: hydrocephalus, meningocele, cephalocele, holoprosencephaly, anencephaly, and microcephaly

GI anomalies: duodenal atresia, imperforate anus, tracheoesophageal fistula, malrotation, and omphalocele

Uterine anomalies

Testicular hypoplasia, agenesis, and hypospadias

pg. 1359

Renal agensis, oligphydramnios, pulmonary hypoplasia, abnormal fancies, malformed hands/feet
Quizlet

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28
Q

What is multicystic dysplastic kidney disease?

A

Characterized by multiple, smooth- walled, nonfunctioning, noncommunicating cysts of varying sizes and numbers. Renal tissue is replaced by cysts that are found throughout the kidney. The entire kidney or only a portion may be affected. The affected kidney is nonfunctional.
pg. 1364

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29
Q

What is the most common kidney obstruction?

A

UPJ

30
Q

What is the criteria for hydronephosis?

A

Abnormal intrapelvic AP diameter measurement. Measurement greater than 4-4.5 mm before the third trimester or greater than 7 mm after the third trimester.
Another useful guide is that if the measurement exceeds 1/3 of the renal diameter.
Pg. 1368

31
Q

What is a keyhole bladder?

A

Posterior Urethral Valves (PUV)

– abnormal congenital membrane within posterior urethra

Pg. 1371

32
Q

What is prune belly syndrome?

A

Characterized by 3 features: cryptorchidism, agenesis, or hypoplasia of anterior abdominal wall muscle
Dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia
Pg. 1373
Sono findings include all except: renal agenesis
quizlet

33
Q

What is the normal thickness of a fetal bladder wall?

A

Less than 2mm

Pg. 1356

34
Q

What is renal agenesis?

A

Complete absence of kidneys

Pg. 1359

35
Q

Where do the permanent kidneys derive from?

A

Metanephros

Pg. 1351

36
Q

What to the ureteric buds give rise to?

A
  • -Ureter
    • Renal pelvis
    • Calyces
    • Collecting Tubules

Pg. 1351
Doesn’t give rise to Bowman Capsule
quizlet

37
Q

In what position to the fetal kidneys initially lie?

A

Very close together in the pelvis

Pg. 1351

38
Q

What may encounter if the allantois persists while the urachous forms

A

Urachal Fistula develops,

– causes urine to drain from bladder to umbilicus

Pg. 1361

39
Q

At 20 weeks, how much pyelectasis can occur?

A

.4cm

Per Beth

40
Q

What might a cystic structure in the fetal bladder be?

A

Ureterocele

pg. 1374

41
Q

What is the most likely cause of bilateral hydronephrosis?

A

Posterior Urethral Valves (PUV)
Pg. 1357

***Bladder Outlet Obstruction
Pg. 1368

42
Q

Normal amniotic fluid volume cannot exclude renal agenesis before how many weeks?

A

15-18 weeks

Pg. 1359
14-16 weeks (quizlet)

43
Q

What are the sonographic finding of posterior urethral valves?

A
  • -Severe bladder dilatation
    • Massive Hydronephrosis
    • Dilated Ureters
  • -Oligohydramnios

Pg. 1372
Doesn’t include thinning of bladder wall
Quizlet

44
Q

What are the sonographic findings of a fetal ovarian cyst?

A

Anechoic or Hypoechoic

If Torsed, complex or solid appearance

Pg. 1379
This statement is incorrect: A fetal ovarian cyst has no diagnostic significance
Quizlet

45
Q

What are we looking at if the fetal kidneys are enlarged and echogenic?

A 
Infantile Polycystic Kidney Disease:
Syndromes assoc:
--Meckel-Gruber syndrome
--Patau's syndrome (trisomy 13)
-- Beckwith-Wiedemann syndrome
-- Short Rib Polydactyly syndrome

Pg. 1363 (green box)

46
Q

What are the 2 ways to divide renal malformations?

A
  1. Congenital Malformation
  2. Those resulting from obstructive process

Pg. 1358

47
Q

What is the term when there is only 1 teste visible within scrotal sac?

A

Cryptorchidism or undescended testis

pg 1377

48
Q

What is Pena Shokier syndrome?

A

Abnormal joint contractures, facial abnormalities, polyhydramnios, IUGR, and pulmonary hypoplasia.

Pg. 1390

49
Q

Micromelia and a hitchhiker thumb can indicate ___.

A

Diastrophic Dysplasia

Pg. 1387

50
Q

What is the term for the shortening of a proximal portion of an extremity?

A

Rhizomelia – humerus and femur

Pg. 1382

51
Q

What is thanataphoric dysplasia?

A

Lethal short-limb dwarfism characterized by a marked reduction in the length of the long bones, pear-shaped chest, soft tissue redundancy, and frequently clover-leaf skull deformity and ventriculomegaly
Pg. 1382

52
Q

What is the anomaly associated with the Amish community?

A

Ellis-van Creveld Syndrome
AKA: Chrondroectodermal Dysplasia

Pg. 1389

53
Q

What might we be looking at if we see multiple fractures and a compressed calvarium?

A

Osteogenesis Imperfecta

Pg. 1385

54
Q

Who has the cloverleaf skull?

A

Thanataphoric Dysplasia

Type 2 has cloverleaf skull, Type 1 does NOT!

Pg. 1382

55
Q

What is the most common nonlethal skeletal dysplasia?

A

Achondroplasia

Pg. 1383

56
Q

Who has an alkaline phosphatase deficiency?

A

Congenital Hypophosphatasia

Pg. 1386

57
Q

What is the congenital collagen production disorder?

A

Osteogenesis Imperfecta

Pg. 1385

58
Q

Severe micromelia, decreased or absent ossification of the spine, macrocephaly, and micrognathia are characteristics of ___.

A

Achondrogenesis

Pg. 1384

59
Q

Who has bent long bones?

A

Camptomelic Dysplasia

Pg. 1387

60
Q

A small thorax, rhizomelia, renal dysplasia, and polydactyly describe ___.

A

Jeune’s Syndrome

Pg. 1389

61
Q

When diagnosing talipes, what is the positioning of the foot and lower leg?

A

Abnormal inversion of the foot perpendicular to the lower leg

Pg. 1393

62
Q

What is fusion of the lower extremities?

A

Sirenomelia- mermaid.

Pg. 1390

63
Q

Sonographic features of achondroplasia may not be evident until after how many weeks?

A

22 weeks

Pg. 1384

64
Q

What is the most common lethal skeletal dysplasia?

A

Thanataphoric Dysplasia

Pg. 1382

65
Q

There are 2 types of achondroplasia, which does not have a good survival rate?

A

Homozygous Achondroplasia

Pg. 1383

66
Q

Which classification of osteogenesis imperfecta is most severe?

A

Type 2

Pg. 1385

67
Q

Which rare condition with phocalmelia with facial anomalies?

A

Roberts Syndrome

Pg. 1387

68
Q

The majority of club feet occur because __.

A

Oligo and Mulitple gestations

Pg. 1393
hand and feet abnormalities may occur with skeletal dysplasias, or part of chromosomal syndrome, or isolated
pg 1391

69
Q

Define skeletal dysplasia.

A

Abnormal growth and density of cartilage and bone

Pg. 1380

70
Q

What is achondrogenesis?

A

Caused by cartilage abnormalities that result in abnormal bone formation and hypomineralization.

Two types:

    • Type 1 (Parenti-Fraccaro): most severe (autosomal recessive)
  • -Type 2 ( Langer- Saldino): less severe, more common (spontaneous mutation)

Pg. 1384

71
Q

Which lethal skeletal dysplasia has short ribs, short limbs, and polydactyly?

A

Short Rib Polydactyly Syndrome

Pg. 1389

72
Q

A fetus with webbing across the joints and multiple contractures may have ___.

A

Lethal Multiple Pterygium Syndrome

Pg. 1390

DSM OB/GYN (10 decks)

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