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RRC Cards > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

most common chromosomal anomaly associated with omphalocele

A

trisomy 18

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2
Q

omphalocele associated congenital anomalies

A
  • cardiac 50%
  • GU (bladder exstrophy, cloacal)
  • CNS anomalies
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3
Q

pentalogy of Cantell

A
  1. omphalocele
  2. ectopia cordis
  3. congenital diaphragmatic hernia
  4. pericardial defect
  5. cardiac malformation
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4
Q

OEIS complex

A
  1. omphalocele
  2. bladder/cloacal exstrophy
  3. imperforate anus
  4. spinal anomalies
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5
Q

situs - stomach and cardiac apex on left

A

situs solitus

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6
Q

situs - stomach and cardiac apex on right

A

situs inversus

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7
Q

situs - stomach and cardiac apex opposing

A

left isomerism - polysplenia

right isomerism - asplenia

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8
Q

meckel gruber syndrome

A
  • rare, lethal
  • autosomal recessive
    1. encephalocele
    2. polycystic kidneys
    3. polydactyly
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9
Q

placental infarct vs lake

A 
infarct = thick echogenic rim
lake = no rim
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10
Q

4 types of gestational trophoblastic neoplasia

A 
invasive mole
choriocarcinoma
placental site trophoblastic tumour
epithelioid trophoblastic tumour
(dx made by FIGO criteria, no specific imaging findings to distinguish types of GTN)
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11
Q

theca lutein cyst definition

A

ovarian cysts related to hyperstimulation from elevated HCG in gestational trophoblastic disease

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12
Q

2 types of benign gestational trophoblastic disease

A

complete hydatidiform mole

partial hydatidiform mole

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13
Q

staging of gestational trophoblastic neoplasia

A

stage 1: confined to uterus
stage 2: extends outside uterus but limited to genital structures (adnexa, vagina, broad ligament)
stage 3: extends to lungs +/- genital tract involvement
stage 4: involves metastatic sites

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14
Q

choriocarcinoma definition & spread

A

malignant tumor arising from trophoblasts only (NO chorionic villi) +/- hemorrhage, necrosis
very aggressive (freq nuclear atypia, high mitotic activ)
50% follow molar preg, 25% follow abortion or tubal preg, 25% follow term, preterm preg
*hematogenous spread (cf. PSTT & ETT which spread to lymph nodes)

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15
Q

what are trophoblasts

A
  • 1st cells to differentiate from fertilized ovum
  • form outer layer of blastocyst
  • eventually form FETAL PORTION of PLACENTA
  • types: cyto-, syncytio-, intermediate trophoblasts
  • “gestational trophoblastic disease”: group of disease characterized by abN prolif of trophoblasts
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16
Q

complete hydatidiform mole - pathophys

A

results from fertilization of an empty ovum by a sperm that then duplicates (90%) or by 2 sperm (10%)
- 46 XX or 46 XY
benign, MC form of GTD
beta HCG usually >100,000

17
Q

partial hydatidiform mole - pathophys

A

usu results from fertilization of haploid ovum by 2 sperm
- 69 XXX or 69 XXY or 69 XYY
benign, less common than CHM
beta HCG elevated but usually <100,000

18
Q

placental site and epithelioid trophoblastic tumors

A

rare forms of GTN
most often after term gestations
may present months to years after delivery
treated differently than invasive mole or choriocarcinoma
- hysterectomy + LN dissection +/- adj chemo (but relatively chemoresistant cf. choriocarcinoma)

19
Q

marker up in omphalocele

A

AFP

20
Q

normal AP renal pelvic diameter at:

  • 16-27 weeks
  • > 28 weeks
A

16-27 weeks: <4mm

> 28 weeks: <7mm

(postnatal: <10mm, measure after 48h of birth d/t dehydration)

21
Q

readings suggestive of IUGR

A
  1. estimated fetal weight <10th percentile
  2. femur length/abdo circumference ratio >23.5
  3. umbilical artery systolic/diastolic ratio >4
22
Q

causes asymmetric & symmetric IUGR

A

asymmetric: high BP, severe malnutr’n, ehler danlos
symmetric: TORCH, FAS, drug abus, chromosomal, anemia

23
Q

normal separation of choroid plexus from medial wall lateral ventricle

A

<3 mm

larger = ventriculomegaly

24
Q

normal cisterna magna size

A

2-11 mm

25
Q

normal amniotic fluid index

A

5-20
<5 oligo
>20, or single pocket >8 poly

26
Q

ddx echogenic bowel

A 
cystic fibrosis
downs
trisomy 18
viral infections
bowel atresia
27
Q

timing of splitting for diamniotic vs monoamniotic

A 
diamniotic = before 8 days
monoamniotic = after 8 days

> 13 days can be conjoined twin

28
Q

monochorionic complications

A
  • twin twin transfusion
  • twin anemia polycythemia sequence
  • twin reversed arterial perfusion syndrome
  • selective fetal growth restriction
  • cord entanglement
  • anomalies
  • conjoined twins
  • intrauterine fetal demise
29
Q

gestational & yolk sacs tell us what for twins?

A

gestational sac = chorionicity

yolk sac = amnionicity

30
Q

staging of twin twin transfusion syndrome

A 
I - oligo-poly
II - absent bladder in oligo baby
III - doppler abN umbilical art +/- vien
IV - fetal hydrops in 1+
V - fetal demise
31
Q

diagnosis anemia and polycythemia in twins

A

Doppler USS MCA PSV
>1.5 multiples of median = anemia
<1.0 MoM = polycythemia

32
Q

choroid plexus cyst ?normal ?aneuploidy

A

yes normal

yes associated with T18 & 21

33
Q

turners associated with advanced maternal age?

A

no

34
Q

complete/class mole vs partial mole

A 
complete = 46 xx/xy, empty ovum 2 sperm
partial = 69 xxy/xxx, ovum + 2 sperm

RRC Cards (17 decks)

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