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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
What is it called when a fetus has both ovarian and testicular tissue?
True Hermaphroditism Pg. 1377
26
What will you find with complete renal agenesis?
- - 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
27
What are some specifics to Potter's syndrome?
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
28
What is multicystic dysplastic kidney disease?
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
29
What is the most common kidney obstruction?
UPJ
30
What is the criteria for hydronephosis?
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
What is a keyhole bladder?
Posterior Urethral Valves (PUV) -- abnormal congenital membrane within posterior urethra Pg. 1371
32
What is prune belly syndrome?
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
What is the normal thickness of a fetal bladder wall?
Less than 2mm Pg. 1356
34
What is renal agenesis?
Complete absence of kidneys Pg. 1359
35
Where do the permanent kidneys derive from?
Metanephros Pg. 1351
36
What to the ureteric buds give rise to?
- -Ureter - - Renal pelvis - - Calyces - - Collecting Tubules Pg. 1351 Doesn't give rise to Bowman Capsule quizlet
37
In what position to the fetal kidneys initially lie?
Very close together in the pelvis Pg. 1351
38
What may encounter if the allantois persists while the urachous forms
Urachal Fistula develops, -- causes urine to drain from bladder to umbilicus Pg. 1361
39
At 20 weeks, how much pyelectasis can occur?
.4cm Per Beth
40
What might a cystic structure in the fetal bladder be?
Ureterocele | pg. 1374
41
What is the most likely cause of bilateral hydronephrosis?
Posterior Urethral Valves (PUV) Pg. 1357 ***Bladder Outlet Obstruction Pg. 1368
42
Normal amniotic fluid volume cannot exclude renal agenesis before how many weeks?
15-18 weeks Pg. 1359 14-16 weeks (quizlet)
43
What are the sonographic finding of posterior urethral valves?
- -Severe bladder dilatation - - Massive Hydronephrosis - - Dilated Ureters - -Oligohydramnios Pg. 1372 Doesn't include thinning of bladder wall Quizlet
44
What are the sonographic findings of a fetal ovarian cyst?
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
What are we looking at if the fetal kidneys are enlarged and echogenic?
``` 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
What are the 2 ways to divide renal malformations?
1. Congenital Malformation 2. Those resulting from obstructive process Pg. 1358
47
What is the term when there is only 1 teste visible within scrotal sac?
Cryptorchidism or undescended testis | pg 1377
48
What is Pena Shokier syndrome?
Abnormal joint contractures, facial abnormalities, polyhydramnios, IUGR, and pulmonary hypoplasia. Pg. 1390
49
Micromelia and a hitchhiker thumb can indicate ___.
Diastrophic Dysplasia Pg. 1387
50
What is the term for the shortening of a proximal portion of an extremity?
Rhizomelia -- humerus and femur | Pg. 1382
51
What is thanataphoric dysplasia?
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
What is the anomaly associated with the Amish community?
Ellis-van Creveld Syndrome AKA: Chrondroectodermal Dysplasia Pg. 1389
53
What might we be looking at if we see multiple fractures and a compressed calvarium?
Osteogenesis Imperfecta Pg. 1385
54
Who has the cloverleaf skull?
Thanataphoric Dysplasia Type 2 has cloverleaf skull, Type 1 does NOT! Pg. 1382
55
What is the most common nonlethal skeletal dysplasia?
Achondroplasia Pg. 1383
56
Who has an alkaline phosphatase deficiency?
Congenital Hypophosphatasia Pg. 1386
57
What is the congenital collagen production disorder?
Osteogenesis Imperfecta Pg. 1385
58
Severe micromelia, decreased or absent ossification of the spine, macrocephaly, and micrognathia are characteristics of ___.
Achondrogenesis Pg. 1384
59
Who has bent long bones?
Camptomelic Dysplasia Pg. 1387
60
A small thorax, rhizomelia, renal dysplasia, and polydactyly describe ___.
Jeune's Syndrome Pg. 1389
61
When diagnosing talipes, what is the positioning of the foot and lower leg?
Abnormal inversion of the foot perpendicular to the lower leg Pg. 1393
62
What is fusion of the lower extremities?
Sirenomelia- mermaid. Pg. 1390
63
Sonographic features of achondroplasia may not be evident until after how many weeks?
22 weeks Pg. 1384
64
What is the most common lethal skeletal dysplasia?
Thanataphoric Dysplasia Pg. 1382
65
There are 2 types of achondroplasia, which does not have a good survival rate?
Homozygous Achondroplasia Pg. 1383
66
Which classification of osteogenesis imperfecta is most severe?
Type 2 Pg. 1385
67
Which rare condition with phocalmelia with facial anomalies?
Roberts Syndrome Pg. 1387
68
The majority of club feet occur because __.
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
Define skeletal dysplasia.
Abnormal growth and density of cartilage and bone Pg. 1380
70
What is achondrogenesis?
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
Which lethal skeletal dysplasia has short ribs, short limbs, and polydactyly?
Short Rib Polydactyly Syndrome Pg. 1389
72
A fetus with webbing across the joints and multiple contractures may have ___.
Lethal Multiple Pterygium Syndrome Pg. 1390

DSM OB/GYN (10 decks)

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