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Cellular pathology > Ultrasound > Flashcards

Ultrasound Flashcards

1
Q

What are ultrasounds?

A

Sound waves with frequencies higher than the human audible range

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2
Q

What is the upper limit for ultrasounds considered?

A

Upper limit is considered to be approximately 20kHz

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3
Q

How many functions does the ultrasound probe have and what are they?

A

• The ultrasound probe has 2 main functions:

a. Emit a sound wave
    b. Receive the echoes from the original wave
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4
Q

What happens whenever an ultrasound wave passes through a tissue boundary?

A

• Whenever the ultrasound wave passes through a tissue boundary it can be reflected or will pass through and continue propagating

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5
Q

What will reflect more of the sound wave?

A

Adjacent tissues with varying densities will reflect more of the sound wave

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6
Q

What is some of the ultrasound beam lost to?

A

Some of the beam is lost to heat energy

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7
Q

Basics of an ultrasound

A

• Greyscale image
○ Colour can be added later
○ Bright white: bone
§ Bone reflects beam back
• Black: fluid
○ Nothing in the area is reflecting back
○ i.e. blood/amniotic fluid
• Everything in between is grey
○ Brightness of grey depends on density
• Top of an ultrasound image relates to where the hand is
○ Bottom of the image is deeper in
○ Sides of the image are dependent on which way the transducer has been held
-The image can be flipped if the wrist is rotated 180 degrees

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8
Q

Why do we use ultrasounds?

A

• No radiation
○ Needs to be used carefully in pregnant women as heat is produced
○ If used too often in pregnancy, heat can damage cells
○ Kept as low as reasonabaly achievable
• Widely accessible
• No documented side effects in humans
• Usually non invasive
• Well tolerated
• Results can often be available immediately
○ Bedside
• Real time imaging
-Can move patient around and see effects

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9
Q

Why not ultrasound?

A

• Training is more resource intensive for departments compared to other modalities
• Ultrasound image quality is dependent on patient habitus
○ Higher frequency = better resolution image but can only travel peripheral into the body
○ Lower frequency = deeper penetration
§ Lose details the deeper you go
• Effectiveness and accuracy are highly operator dependent

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10
Q

What are the variables involved in the choice of transducers?

A

○ Choice over sector width, scan depth (resolution), patient habitus, field of view

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11
Q

What screening is high frequency for?

A

• High frequency for more peripheral screening

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12
Q

How can we take images of blood vessels?

A

• Intravascular probe can be passed through catheter and take image of blood vessels

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13
Q

What are all women in the UK offered during pregnancy(12/20 weeks in)?

A

• All women in the UK are offered ultrasound sreening during pregnancy (12/20 weeks)

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14
Q

How long is the fetus between 11+2wks-14wks of pregnancy?

A

• Fetus is approximately 45-84mm in length (11+2wks – 14wks)

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15
Q

What does obstetric ultrasound detect?

A

○ Viability
○ Number of fetus’
○ Gross anatomy
§ Start to see larger pathology
§ Anencephaly – cranium hasn’t formed, brain is exposed
§ Omphalocele – mid-gut herniation
□ Mid abdominal wall hasn’t formed properly so contents of abdomen is outside of body
○ Detectable major abnormalities
§ Blighted ovum – miscarriage/ phantom pregnancy
○ Morphology of ovaries
Accurate gestational age of the fetus

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16
Q

What is down syndrome caused by?

A

Caused by change in one of the genes in egg before fertilization

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17
Q

What is the frequency of down syndrome in births?

A

• Frequency: 3/2000 births

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18
Q

What does fetal nuchal translucency screening use and to measure what?

A

Fetal nuchal translucency (NT) screening uses ultrasound to measure the size of the nuchal pad at the nape of the fetal neck

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19
Q

What increases the risk of down syndrome?

A

○ Increased thickness of sac of fluid at back of neck = increased risk

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20
Q

When should screening for downsydnrome be performed?

A

○ Should be performed between 11 weeks and 13 weeks + 6 days

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21
Q

What is image detail like in the 20 week scan and why is this the best time?

A

Finer details/pathologies as fetus is bigger

-Best time to do this because bigger than this and the baby is squashed so details are hidden 

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22
Q

What can you see in 20 week scan?

A

Can see placenta and where it sits so it doesn’t cover baby’s exit

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23
Q

What abnormalities does a 20 week scan identify?

A

Identify abnormalities which:

  • May indicate the baby has a life-limiting condition
  • May benefit from antenatal treatment
  • May require early intervention following delivery
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24
Q

What are the other standard aims of a 20 week scan?

A

Other standard aims:

  • Placenta localisation
  • Fetal Biometry
  • Fibroid Monitoring
  • Liquor Assessment
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25
Q

What does a Doppler ultrasound give information about and why is it able to do so?

A

Gives information about blood flow because it is in color

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26
Q

What is the shape of the cerebellum in spina bifida?

A

Cerebellum is in a banana shape because spina bifida is pulling down on the brain

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27
Q

What happens in achondroplasia?

A
  • Bowing of long bones

- Shortening of limbs

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28
Q

What is achondroplasia a common form of?

A

Most common form of dwarfism

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29
Q

What surrounds long bones in achondroplasia?

A

Thickened soft tissue surrounding the long bones

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30
Q

What scans can we use to diagnose this?

A

3D ultrasound

31
Q

How do we measure the distance of the placenta from the cervix and what is it done to ensure?

A

Measure the distance from lowest edge of placenta to the internal OS of cervix
-Need to ensure placenta is not covering exit 

32
Q

What is required if placenta is within 2.5 of the cervix?

A

If placenta is within 2.5cm of the cervix then future scans are required 

33
Q

What happens if placenta does not raise higher closer to due date?

A

If placenta does not raise higher closer to due date a c-section may be required 

34
Q

What is club foot/Talipes?

A

Internal rotation of the foot

35
Q

What is the chances of a baby having club foot/talipes if one parent had a condition?

A

If one parent had the condition as a baby their own baby would have a 1 in 30 chance of also having talipes

36
Q

What placental issues can arise?

A
  • Oligohydramnios

- Polyhydramnious

37
Q

When is heartbeat detected in fetus?

A

Can detect heartbeat at 5 weeks

38
Q

What is the fetal pole detected as an area of?

A

The fetal pole is detected as an area of thickening along the periphery of a yolk sac

39
Q

What is ectopic pregnancy?

A

When an egg implants outside of the uterine cavity it is know as an ectopic pregnancy

40
Q

What are the symptoms of ectopic pregnancy?

A

-Associated with severe pain and also bleeding

41
Q

What can ectopic pregnancy be caused by?

A

Can be caused by tubal damage

42
Q

What is multiple pregnancy usually caused by?

A

Multiple pregnancy usually caused by delays in the fertilized egg reaching the womb before implanting

43
Q

What can mothers with multiple pregnancy do?

A

Selective reductions

-People choose to terminate 1 or 2 fetus’ to give others a better chance of survival

44
Q

Why is 3D/4D scanning useful ?

A

Useful for showing parents as they’re able to visualise

45
Q

3D vs 4D scanning

A

3D: still image
4D: 3D moving image 

46
Q

What happens in amniocentisis?

A

Needle inserted into amniotic fluid to take sample from baby

47
Q

What is the risk of miscarriage in amniocentesis?

A

1:3

48
Q

What is follicle tracking used in conjunction with and to determine what?

A

Often used in conjunction with IVF treatments to determine the optimal time to extract eggs for fertilisation

49
Q

What do fibroids consist of?

A

Consist of fibrous muscular tissue that has overgrown

50
Q

What do fibroid eventually grow until?

A

Many eventually grow until the blood supply they receive can no longer support further growth

51
Q

What are uterine polyps?

A

Growths from the inner wall of the womb which extend throughout the cavity and into the cervix and vagina

52
Q

What can other malignant masses around polyps do?

A

Often malignant masses can exacerbate growth of vascular networks 

53
Q

What can tell us whether the poly is benign or mallignant?

A

Doppler can tell us where this extra vasculature Is so can tell us whetehr malignant or benign 

54
Q

What are the 3 features of PCOS?

A
  1. Irregular Periods – you don’t regularly release eggs
  2. Excess Androgens – (‘male hormones’ which may cause symptoms such as excessive hair)
  3. Polycystic Ovaries – ovaries become enlarged and contain additional fluid filled sacs (follicles which surround the eggs)
    - A patient must exhibit 2 of these symptoms to be diagnosed with PCOS
55
Q

What can aortic screening allow?

A

Can check abdominal aorta for aneurysm 

56
Q

Sizes of abdominal aorta and response

A
  • If diameter is >3cm = risk 

- If diameter >5cm = surgery needed

57
Q

Where are aortic abdominal aneurysms monitored in?

A

AAAs are monitored in specialised clinics surgery

58
Q

When is the section of abdominal aorta defined as aneurysmal?

A

Section of abdominal aorta is defined as aneurysmal when reaching 3cm in AP diameter

59
Q

What method is used to treat an abdominal aortic anuerysm?

A

EVAR-Endo vascular aortic repair

60
Q

What can fibrosis cause to the liver?

A

Fibrosis can decrease liver function

61
Q

What are gallstones usually caused by?

A

Usually caused by an imbalance in the chemical make up within the bile

62
Q

What is sonographic murphys sign?

A

If press probe down on gallbladder and results in pain = gallstone indication 

63
Q

How will gallstones look on an ultrasound?

A

Stones are denser so will reflect more ultrasound beam = bright white on ultrasound

64
Q

What can bright white on ultrasounds be instead of gallstones and how do we differentiate between the 2?

A

Could a be polyp but polyps are attached are stones are free-moving
-In this case, ask patient to move and as stones move, if it moves = stone, if unmoved = polyp

65
Q

What is testicular mass usually?

A

Testicular mass usually malignant

66
Q

What happens to testicle if masses present?

A

Testicle is removed without any additional scanning 

67
Q

What is testicle surrounded by?

A

Testicle surrounded by fluid

68
Q

What is hydrocele and what happens to testicular size?

A

Hydrocele is swelling that occurs around the testes due to build up of fluid and causes testicular size to increase

69
Q

What can we demonstrate using colour flow doppler?

A

Using colour flow doppler we can demonstrate that the femoral vein is completely occluded by the lack of colour in this region

70
Q

What does ultrasound of MSK allow us to see?

A

Allows us to see function whilst patient is moving

71
Q

What is POCUS?

A

Point of care ultrasound

72
Q

What is FAST?

A

FAST is an ultrasound scan protocol undertaken at the time of presentation of a trauma patient 

73
Q

What can ultrasounds detect in trauma cases?And compare values to x-ray

A

Ultrasound can detect as little as 20ml of free fluid, compared to 200ml required with plain x-ray 

Cellular pathology (12 decks)

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