Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's > Practise viva > Flashcards

Practise viva Flashcards

1
Q

Hydrops

A

At least 2 fetal oedema components
Immune (blood group incompatibility) or non-immune
Non-immune: Turners or trisomy, cardiac disease, infection, twin related, neoplastic (AV shunts), inborn errors of metabolism, anaemia,

Immune now uncommon due to practice of giving mother anti-immunoglobulin when she is Rhesus negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Endometrial thickening

A

Best measured immediately post-menstrual / early proliferative
Hyperplasia, neoplasia / carcinoma, polyp, tamoxifen (causes polyps, hyperplasia, carcinoma), infection

15mm top normal for secretory. <6mm to exclude thickening. Should not be above 5 post menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cornual ectopic / other ectopics

A

Cornual sometimes used interchangeably with interstitial ectopic, but should be reserved for when there is a rudimentary horn (bicornuate or septate)

Interstitial ectopics have a higher risk of rupture and haemorrhage compared with tubal ectopics. Present later with larger size.

Risk factors for ectopic:
Prior
IVF
Tubal surgery or inflammation
PID
Salpingitis isthmica nodosa (nodular scarring of tubes, controversial aetiology, not post infective)
IUDs
Congenital abnormalities

HCG tends to rise at a slower rate
At <2000 may not see an intrauterine pregnancy anyway

Heterotopic essentially only occurs in IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Symmetric v asymmetric growth restriction

A

Symmetric - all measurements <10%
A - classically AC <10%

S: Trisomy, infection, maternal drugs
A: Placental insufficiency. Low or minimal karyotype abnormalities. HC reduced in maternal cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Uterine artery assessment

A

High resistance non-pregnant waveform, drops in resistance during pregnancy. Abnormally high resistance increases risk of pre-eclampsia and IUGR
Notching (trough like between systole and diastole) should not persist throughout pregnancy (22 weeks). Bilateral more concerning, or unilateral on same side as unilateral placenta
Normal RI <0.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Umbilical artery assessment

A

Surveillance of fetal wellbeing in 3rd trimester
Should be low resistance, PI approximately 1

Normal???

CPR should be greater than one (MCA should be high resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Filling defects on HSG

A

Fibroids, polyps, cancer, adhesions

Ashermans / uterine synechiae is multiple adhesions, associated with infertility, often develops after pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Breast density

A

Fatty
Scattered fibroglandular
Heterogeneously dense
Dense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Technically adequate mammogram

A

Nipple in profile, and midline on CC
Pectoral shadow down to nipple level or lower
Inframammary fold seen
Symmetric
Posterior nipple line similar, within 1cm, on CC and MLO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gynaecomastia

A

Usually unilateral / asymmetric

Flame shaped (mammography)
Disc shaped (palpation, ultrasound - hypoechoic, triangular)
CODES
Cirrhosis
Obesity
Digitalis
Estrogen (or androgen deficiency - the imbalance)
Spirinolactone

Testicular tumours - examine testes.
Estrogenic tumours may also cause (adrenal, liver, lung, pituitary)

Senescent change - pseudogynaecomastia - increased fat and decreased muscle. No actual mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ovarian torsion

A

Mostly dermoids or paraovarian cysts
Hyperstimulated cystic ovaries at high risk

Enlarged ovary, midline, peripheral follicles, with altered vascularity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ASUM fetal demise

A 
MSD > 25mm no HB
FP >7mm no HB
Both > or =
14 days after GS seen no HB
11 days after GS with yolk sac no HB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Uterine congenital abnormalities

A

Septate most common
Septum can be removed.
Normal external contour, unlike bicornuate
Arcuate is mild indentation at fundus
Didelphys there are two cervixes, vaginas
Can have two cervixes in bicornuate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cleopatra view

A

Axillary view

An exaggerated CC for if can only see on MLO in axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Placental abruption

A

Associated with smoking, cocaine, PROM, thrombophilia, chorioamnionitis, previous abruption
Retroplacental haematoma not commonly seen. Hyperechoic actutely then becomes hypo
Small treated conservatively. Risk of IUGR or demise.

Subchorionic haemorrhage - increased risk of preterm labour and of placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Molar pregnancy

A

Complete mole Diploid XX, or less commonly XY - All chromosomes from sperm - snowstorm, bunch of grapes, bilateral theca lutein cysts
Partial mole triploid usually XXY (can be XXX or XYY)

Complete may progress to invasive mole, or choriocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Major cardiac views on fetal ultrasound

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bilateral ovarian tumours

A 
Serous tumours are more commonly bilateral than mucinous.
Serous are more common.
Mucinous oftern larger, multiseptated.
Serous tumours more commonly calcify
Most likely mets

Krukenberg tumour is adenocarcinoma met to ovary.
Stomach, colon most common
Breast and lung next most common mets, and oppositve ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Inflammatory breast cancer

A

Clinical appearance of breast swelling and skin thickening. Mimics mastitis
Can be any type of invasive carcinoma, but most commonly ductal
Tendency to early metastasis
Poor prognosis
Dilated dermal lymphatics in 80%. Invasion of these pathognomonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

BIRADS 5

A

Highly likely to be malignant
Any 2 of - spiculated or irregular mass
High density
Fine linear or linear branching segmental calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

BIRADS 2

A

Lymph nodes
Cysts
Calcified fibroadenomas
Fat containing lesions - hamartomas, oil cysts, lipomas, galactoceles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ductus venosus

A

Most sensitive to cardiac function

S, D, and A waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cervical funnelling

A

Percentage (funnel length / functional cervix + funnel)
Shape (U shaped higher risk of preterm delivery than V shaped)

Cervical length should be at least 30mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal mammary ducts

A

Up to 3mm on ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lobular carcinoma

A

Often difficult to see as don’t invoke desmoplasia
Still stellate mass is the most common presentation
Often bilateral
Leptomeningeal spread more common
Calc rare
52% sensitivity of mammography
Less than 30% well defined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

DCIS

A

10% present as mass
10% present as mass with calcs
80% just calcs - pleomorphic, amorphous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Breast implants

A

Saline or silicone
Fibrous capsule forms around implant, which may calcify
May have herniation through capsule without rupture of implant
May have intra or extra capsular implant rupture
Linguine sign is of intracapsular implant rupture (silicone)

Silicone implants should have uniform density and no valve
Silicon will be denser peripherally, and have a valve

Snowstorm appearance of extracapsular silicone rupture on ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Single deepest pocket

A

2-8cm normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

True lateral

A

Calcs - tea cupping
Masses - localisation
And for biopsy planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Placenta praevia

A

.

31
Q

Uterus didelphus

A

With haemotcolpos?

32
Q

Breast conserving surgery

A

Must be <40mm

33
Q

Molar pregnancy

A

.

34
Q

Placental abruption

A

.

35
Q

Fetal echo views

A

.

36
Q

Endometrial cancer

A

.

37
Q

SROM

A

.

38
Q

Krukenberg tumour

A

Metastatic tumour to ovary
Mucinous signet ring cells, most commonly from GI tract
Stomach > colon
May also be breast, lung, contralateral ovary, pancreatic, cholangio, gallbladder

39
Q

Keyhole bladder

A

.

40
Q

Fetal demise

A

.

41
Q

Mucinous v serous ovarian tumour

A

Serous more common
Serous more commonly unilocular
Mucinous multiple thin septa
Serous more commonly bilateral - 15%

42
Q

Ovarian teratoma

A

CT:
Fat fluid level
Rokitansky nodule or dermoid plug (calicum, hair, teeth, sebaceus, fat)
Suspect malignant transformation if large (>10cm) or irregular soft tissue borders

USS:
Dot dash and tip of the iceberg

Monitor if large. May surgically remove
Risk of torsion

Anti NMDA limbic encephalitis

43
Q

Posterior urethral valves

A

.

44
Q

Renal dilatation

A

.

45
Q

Renal cystic disease

A

.

46
Q

Polyhydramnios

A

.

47
Q

Oligohydramnios

A

.

48
Q

Omphalocele

A

.

49
Q

Trisomy 18

A

.
Written case with enlarged cisterna magna, omphalocele, AV canal defect, curved fingers / hands
Look these images up and review them - was in the writtens

Choroid plexus cysts
Mega cisterna magna
Associated with spina bifida, talipes,
Rocker bottom feet
Clenched hands
Radial ray
Single umbilical artery
Horseshoe kidney
50
Q

Trisomy 13

A

.

51
Q

Trisomy 21

A

.

52
Q

Turners

A

.

53
Q

Meigs syndrome

A

.
Fibroma / thecoma?
This was in the writtens - review the images

54
Q

Endometriosis

A

.

55
Q

Lemon sign

A

Concavity of frontal bones, as part of Chiari 2

56
Q

Fetal ventriculomegaly

A

> 10mm. Mild to 12, Moderate to 15, severe above 15
Separation of choroid plexus >3mm (dangling choroid)

Mild is a soft marker for chromosomal abnormality

Aqueduct stenosis
Chiari
Neural tube defect
Dandy Walker
Holoprosencephay
Obstructing mass
Other

Obstructive, dysgenesis, or destructive

57
Q

Choroid plexus cysts

A

In up to 50% of Tri 18

Also 21, Klinefelter

58
Q

Mega cisterna magna

A

Infarction
Infection esp CMV
Trisomy 18

> 10mm

59
Q

Single umbilical artery

A

Increased incidence in twins and diabetes
Increased incidence of IUGR

Chromosomal abnormality (21, 18, 13 in that order) - soft sign
Persistent left umbilical vein
Renal anomalies - agenesis on same side
Sirenomelia (mermaid)
Velamentous cord insertion
60
Q

Clubfoot

A

Large number of associations:
Choromosomal: trisomy 18, 18q deletion
Renal: prune belly and agenesis
Connective tissue: marfans, ehlers danlos
Spinal anomalies: caudal regression, diastrmatomyelia, spina bifida

61
Q

Rockerbottom foot

A

13, 18, 18q deletion

Spina bifida, arthrogryposis (which itself may be syndromic or non-syndromic)

62
Q

Echogenic bowel

A

Soft marker for trisomy 21

Also seen in CF, CMV, demise, IUGR, amniotic haemorrhage

63
Q

Echogenic cardiac focus

A

Soft marker
Trisomy 21, and 13
Dual chamber higher risk

64
Q

Soft signs

A 
Echogenic intracardiac focus (21>13)
Ventriculomegaly
Nuchal fold >6mm (turners,21)
Echogenic bowel (21,CMV,CF,demise)
Hypoplastic or absent nasal bone (21, rarely fetal warfarin syndrome)
Shortened long bones
Renal pyelectasis (21)
Choroid plexus cysts (18>21,Klinefelter)
Aberrant right subclavian artery (21,18)
Single umbilical artery (21>18>13)
Mega cisterna magna (18,CMV, infarction)
Rocker bottom feet (13,18,18qdeletion)
Clenched fists (18>13)
Sandal gap (21)
Strawberry skull (18)
65
Q

Sandal gap deformity

A

Downs

66
Q

Strawberry skull

A

Aneuploidy, particularly 18

67
Q

Cloverleaf skull, strawberry skull, lemon skull

A

Lemon - Chiari 2 - concave frontals
Strawberry - Tri 18. Flattened occiput, pointed frontal bones with hypoplastic frontal lobes, brachycephaly
Cloverleaf - severe multiple craniosynostosis - thanatophoric dysplasia, Aperts, Crouzon

68
Q

Breast calc biopsy

A

Need >5 in one specimen, or calc in 3 samples

69
Q

Lymph node thickness, axilla

A

Normal cortex <3mm

70
Q

Fibroadenoma

A

Popcorn calc
Hypoechoic, well circumscribed, macrolobulated mass

Associated with cyclosporin use, and Cowden syndrome(AD, GI hamartomas, mucocutaneous lesions, breast disease, increased risk of breast Ca, follicular thyroid ca, Lhermette Duclos)

?Consider excision if >30mm

71
Q

Fetal pericardial effusion

A

> 2mm

Associated with hydrops, aneuploidy, cardiac anomalies

72
Q

Breast lesion benign ultrasound features

A

Well circumscribed hyperechoic (fat containing lesion - lipoma, hamartoma)
Wider than deep
Gentle macrolobulation
Thin echogenic pseudocapsule (in a wider than deep lesion) (represents normal compressed tissue so therefore not an infiltrative disease)

73
Q

Malignant breast ultraound features

A 
Taller than wide
Spiculated
Microlobulated
Thick hyperechoic halo
Annular margins
Markedly hypoechoic
Acoustic shadowing
Branching pattern
Punctate calcs
Duct extension

Women's (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions