Test2:Review

Question 1

What are the three types of holoprosencephaly and which is the most serious?

Answer 1

alobar-most serious

semilobar

lobar

Question 2

What is the cavity in which the fetus exists?

Answer 2

amniotic cavity

Question 3

What are the lab tests that indicate pregnancy?

Answer 3

hCG test

Question 4

Where is the 1st site of red blood cell formation that will nourish the embryo?

Answer 4

primary yolk sac

Question 5

What is the difference between menstrual and embryonic age?

Answer 5

menstrual age(gestational age)-calculated from the 1st day of the last normal menstrual period

embryonic age(conceptual age)-calculated from when conception occurs

Question 6

What are monochorionic, monoamniotic, dichorionic, and diamniotic?

Answer 6

monochorionic-one chorionic sac, one yolk sac

monoamniotic-one amniotic sac, one yolk sac

dichorionic-two chorionic sacs

diamniotic-two amniotic sacs

Question 7

What is decidua capsularis? (understand ring around pregnancy)

Answer 7

villi covering developing embryo

Interface between decidua capsularis and echogenic, highly vascularized decidua on opposite wall of endometrial cavity forms double decidual sac sign

Question 8

When will hCG levels plateau?

Answer 8

8 wks

Question 9

When do the chorion and amnion fuse?

Answer 9

16 wks

Question 10

When should you see the first heartbeat?

Answer 10

5 1/2-6wks

Question 11

MSD-what size indicates a problem when you can’t see the yolk sac?

Answer 11

> 8mm

Question 12

How do we measure MSD?

Answer 12

length(mm)+width(mm)+height(mm)/3=MSD

Question 13

What is the first structure visualized in the gestation sac?

Answer 13

secondary yolk sac

Question 14

What is the normal size of the yolk sac?

Answer 14

normal diameter should not exceed 6mm

Question 15

When should we see the abdominal contents back in the fetus?

Answer 15

descends into fetal abdomen at about 11th wk

Question 16

What is the normal cystic are in the head?

Answer 16

choroid plexus cyst-should be gone by 25wks

Question 17

What should a normal gestational sac look like?

Answer 17

shape-round or oval

position-fundal or middle portion of uterus; a center position relative to endometrium (double decidual sac or intradecidua finding)

contour-smooth

wall(trophoblastic reaction)-echogenic

internal landmarks-yolk sac present when gestational sac is >12mm; embryo present when gestational sac in >18mm

Question 18

What does the corpus luteum secrete?

Answer 18

estrogen and progesterone

Question 19

What are all the different stages follicle to implantation?

Answer 19

mature ovum-released at day 14

fertilization-occurs 1-2 days after conception

morula-16 cell (zygote forms 16 cell morula)

blastocyst-further cell proliferation brings the morula to this stage, enters uterus 4-5 days after ovulation

implantation-completed within 12 days post fertilization

time of implantaion until end of 10th wk-embryo

after 10wks-fetus

Question 20

1800 m/u hCG

Answer 20

should see a heartbeat (normal gestational sac can be seen)

Question 21

What are the differnt cavities?

Answer 21

amniotic cavity-cavity in which the fetus exists

amnion(amniotic membrane)-separates the amniotic and chorionic cavities

chorionic cavity-surrounds the amniotic cavity and contains the yolk sac

chorion-outermost extraembryonic membrane

Question 22

what side is the conceptus on?

Answer 22

fetal/embryonic side

decidua basalis-portion on the myometrial or burrowing side of the conceptus

Question 23

how quickly will the gestational sac grow?

Answer 23

gestational sac grows at a rate of 1mm/day

Question 24

​measure CRL up to 12wks, then how is the baby measured?

Answer 24

individual parts

Question 25

what do hCG levels do everyday?

Answer 25

they double

Question 26

what is an ectopic pregnancy, where are the potential sites, and what is the most common location?

Answer 26

ectopic-pregnancy located outside the uterus potential sites: isthmic-top of uterus(interstitial portion-most serious-massive hemorrhage or death) tubal-within fallopian tubes(most common-approx 95% of cases) ovarian-within ovary peritoneal-abdominal cervical-results in full hysterectomy

Question 27

what is an ovum without an embryo?

Answer 27

anembryonic pregnancy or blighted ovum

Question 28

what are gastrochisis and omphalocele?

Answer 28

abdominal contents are outside of baby (herniation of bowel-normally goes back approx 11th wk) gastrochisis-no membrane, surgery is performed right after birth and abdominal contents are placed back inside body omphalocele-membrane, associated with genetic abnormalities (Tri 13 and 18)

Question 29

what is acrania?

Answer 29

partial or complete absence of the cranium (mickey mouse head) predecessor of anencephaly AFP unusually high

Question 30

what is ancephaly?

Answer 30

absence of brain and cranial vault AFP unusually high

Question 31

what is cephalocele?

Answer 31

midline herniation, protrusion of the brain from the cranial cavity (herniation of brain and meninges) Western Hemisphere defect primarily occipital

Question 32

what is iniencephaly?

Answer 32

rare neural tube defect in which brain tissue protrudes through a fissure in the occiput so that the brain and spinal cord occupy a single cavity (open spinal defect)

Question 33

what is Dandy-Walker malformation?

Answer 33

6th-7th wk gestation, cystic dilation of 4th ventricle dysgenesis or agenesis of cerebellar vermis and hydrocephally

Question 34

what is spina bifida?

Answer 34

occurs when failure of neural tube to close after 6wks gestation spinal irregularities or bulging within posterior contour of fetal spine and extrusion of the mass from vertebral column cranial signs-lemon sign(scalloping frontal bones), banana sign(curved appearance of cerebellum)

Question 35

what is Turner's syndrome?

Answer 35

nonlethal genetic abnormality in which chromosomal makeup is 45XO instead of normal 46XX or XY only happens in females born with no ovaries fetus detected with cystic hygroma in 2nd and 3rd trimester

Question 36

fibroids in pregnancy

Answer 36

early-must be identified in reference to the location of the placenta 3rd trimester-identified in reference to the cervix

Question 37

what is the hemorrhage between the gestational sac and placenta?

Answer 37

subchorionic hemorrhage-most common occurrence of bleeding in 1st trimester

Question 38

when do corpus luteum cysts regress?

Answer 38

typically regress between 16-18wks

Question 39

ectopic pregnancy-associated risk factors

Answer 39

rise in incidence of pelvic infections use of intrauterine contraceptive devices fallopian tube surgeries approx 10% of maternal deaths related to ectopic pregnancy infertility treatments history of ectopic pregnancy

Question 40

what is a pseudogestational sac?

Answer 40

decidual reaction with fluid present within the uterus in a patient with an ectopic pregnancy (intrauterine saclike structure found in approx 20% of patients with ectopic)

Question 41

clinical findings associated with ectopic pregnancy

Answer 41

vaginal bleeding empty uterus presence of adnexal mass positive pregnancy test does not produce normal hCG levels

Question 42

typical heart rates

Answer 42

typical heart rate: 120-160bpm ## Footnote embryonic activity should always be seen by 46 menstrual days or when CRL \> 4mm 6wks: rates of 90-115bpm 9wks: rates of 140-160bpm late 1rst-2nd trimester: approx 140bpm bradycardia: \<90bpm (poor prognosis) tachycardia: \>170bpm, moves to hydrops-plueral fluids, pericardial fluids, and acites develop, then blood transfusion

Question 43

when can you see the bladder?

Answer 43

10-12wks

Question 44

what happens to hCG levels in trophoblastic disease?

Answer 44

hCG levels are dramatically elevated, often \>100,000 IU/ml

Question 45

what is a heterotopic pregnancy?

Answer 45

pregnancies outside and inside the uterus