Ardms Obgyn First Trimester (Normal) Review

Front 1

Progesterone is produced by

Back 1

The CORPUS LUTEUM

Front 2

Human chorionic gonadotropin (HCG) is found in
A. Urine
B. blood
C. Amniotic Fluid
D. A and B
E. B and C

Back 2

D. Urine and Blood

Front 3

Lucanae are structures within the ________

Back 3

Placenta

Front 4

The most accurate method of dating a gestation is the
_________

Back 4

Crown-rump length (CRL)

Front 5

Where is the yolk sac in relation to the amnion and chorion?

Back 5

Outside the amnion
Inside the chorion

Front 6

Fetal heart activity should usually be detected as early as the last menstrual period dating of _______ weeks.

Back 6

7 weeks

Front 7

Is it normal for the separation of chorion and amnion membranes to occur at 14 weeks?

Back 7

Yes

Front 8

The secondary yolk sac info

Back 8

Can be:
* bigger than the embryo
* cystic in appearance
* visualized before the embryo
* disappear before the end of the first trimester

Front 9

"Gestational sac" describes the ?

Back 9

Chorionic cavity

Front 10

How is amniotic fluid volume (AFV) normally reduced?

Back 10

fetal swallowing

Front 11

The first structure identified within the gestational sac

Back 11

Yolk sac

Front 12

At what gestational age (weeks) is the embryo sonographic ally visible with transvaginal scanning?

Back 12

5 - 6 weeks' GA

Front 13

The embryo's sonographic appearance

Back 13

Echogenic and hyperechoic to adjacent structures

Front 14

When viewed in trans, the umbilical cord presents as

Back 14

1 large, round anechoic vessel flanked by
2 small, round, anechoic vessels encircled by thick, bright walls

Front 15

Embryonic gut herniation is into ______ and occurs at ___ to ___ weeks' gestational age (GA).

Back 15

the base of the umbilical cord

10 to 10.5 weeks GA

Front 16

An anechoic area identified sonographically within the embryonic skull at 8 weeks

Back 16

The HINDBRAIN

Front 17

A sonographic marker of the chorionic cavity

Back 17

ECHOGENIC fluid

Front 18

Gestational sac size is determined by ___

Back 18

The mean sac diameter MSD

Front 19

How is Gestational Age in days calculated?

Back 19

by adding 30 to the mean sac diameter (MSD)

Front 20

What is considered to be the most accurate assessment of gestational age?

Back 20

CRL

Front 21

When (by an occurrence as well as GA) is the amniotic membrane no longer visible sonographically?

Back 21

When the amnion and chorion completely fuse
Between 12 and 16 weeks' GA

Front 22

In general, the First 2 weeks of gestation (normal events)
Day 1
Day 7
Day 13
Day 14

Back 22

DAY 1> Pituitary releases FSH - Formation of follicle in ovary begins- Estrogen release by ovary
DAY 7> Follicle is forming - Estrogen level increases
DAY 13> Follicle matured - LH released by pituitary
DAY 14> Ovulation ---- fertilization or corpus luteum releases Progesterone

Front 23

After ovulation, when does fertilization occur?

Back 23

12 - 24 hours

Front 24

1. Fusion of ovum and sperm results in ____
2. Cell division occurs resulting in a cluster of cells known as ____.
3. As morula becomes organized, it is known as ____.

Back 24

1. Zygote
2. Morula
3. Blastocyst

Front 25

Implantation begins within ____ days after fertilization as the blastocyst burrows beneath endometriumA

Back 25

7 days

Front 26

What are the layers of the decidualized endometrium?

Back 26

1. Decidua Capsularis
2. Decidua Parietalis
3. Decidua Basalis

Front 27

Normal sac appearance

Back 27

- Identified at approx 4.5 weeks gestation by EV
- Rounded anechoic structure with echogenic rim
- Decidual reaction appears as prominent, moderate
amplitude, echogenic ring surrounding the sac
- Double decidual sac sign- indicative of an IUP

Front 28

Double decidable sac sign is comprised of what layers?

Back 28

Decidua Capsularis
Decidua Parietalis
(of the decidualized endometrium)

Front 29

When (until what happens) does the amniotic sac stop expanding (due to the accumulation of amniotic fluid and growth of the embryo within the chorionic sac)?

Back 29

Until the amnion adheres to the chorion

Front 30

Where is the yolk sac located?

Back 30

Chorizo amniotic cavity

Front 31

1. When (gestational weeks) is the secondary yolk sac seen endovaginally?
2. With a normal mean sac diameter size of what?
3. Transabdominally seen?
4. Normal MSD (transabdominally)?

Back 31

1) 5 gestational weeks
2) MSD of 8.0 mm or greater
3) 6 - 7 gestational weeks
4) 20 mm or greater

Front 32

What is the earliest structure visualized in the gestational sac?

Back 32

The Yolk Sac

Front 33

What should be the maximum diameter of the yolk sac?

Back 33

5.0 - 6.0 mm

Front 34

What (in weeks) is considered the Embryonic period?

Back 34

6 - 12 weeks

Front 35

What does it mean to be trilaminar?

Back 35

Comprised of Ectoderm
Endoderm
Mesoderm

Front 36

Organogenesis is completed at approximately ___ weeks gestational age.

Back 36

10 weeks

Front 37

A large yolk and/or echogenic yolk sac may be associated with what?

Back 37

Fetal Aneuploidy (abnormal chromosomes)
- poor pregnancy outcome

Front 38

Endovaginally, fetal heart motion should be identified between ___ and ___ weeks.

Back 38

5.5 weeks and 6.5 weeks

Front 39

What is the first organ to function?
Development completed by the end of the ___ week?

Back 39

Fetal heart
8th week

Front 40

Differentiation of the head from the trunk is possible during what week?

Back 40

7th week

Front 41

What week noted sonographically?
1) limb buds
2). Cerebral hemispheres
3) Spine
4) Physiological umbilical herniation
5) Rhombencephalon

Back 41

1) 7th week
2) 9 weeks
3) 7-8 weeks (as parallel echogenic lines), but develops
during weeks 5-7
4) 8-12 weeks
5) 8-11 weeks, as cystic space in posterior brain

Front 42

What is the most common ovarian mass identified in the first trimester?

Back 42

Corpus Luteum
It secretes progesterone
Supports pregnancy in 1st trimester
Resolves by 16-18 weeks gestation
Doppler May reveal low resistant flow pattern

Front 43

the official beginning of pregnancy

Back 43

Implantation of the zygote

Front 44

The ZYGOTE goes through mitotic divisions and forms the ____, _____, and eventually the ______.

Back 44

the placenta
umbilical cord
embryo

Front 45

EMBRYONIC PHASE starts at about 3 weeks and continues through week 8. Early in this phase, the growth centers around what will be the ___ and ___.
By week ___, the embryo produces chemical to cease what??

Back 45

spine
spinal cord

the menstrual cycle

Front 46

When is the embryo capable of movement?

Back 46

by week 8 of embryogenesis

Front 47

At the end of what week is the embryo sate complete and the fetal stage begins.

Back 47

at the end of week 8

Front 48

Four broad categories of possible causes of INFERTILITY.
(inability to conceive after 12 months)

Back 48

1) Anovultion conditions- most common reasons
2) Gynecological defects (anatomical)
3) Defective spermatogenesis
4) External/ Lifestyle factors

Front 49

*infertilit- some causes

ANOVULATION - lack of cyclic egg release
30% of infertility

Back 49

Diabetes PCOS
Thyroid disorders Anorexia
Infection (PID) Ovarian cysts
Adrenal disorders Medications
Uterine fibroids
Previous cancer treatments

Front 50

*infertility- some causes

ANATOMICAL DEFECTS (some possible causes)
Aquired & Congenital

Back 50

AQUIRED: Asherman's syndrome
Endometriosis
Adhesions
CONGENITAL: Sickle cell disease
Turner's syndrome
Klinefelter's syndrome
Cushing's syndrome

Front 51

*infertility- some causes

SPERMATOGENESIS defect causes

Back 51

Decreased or absent sperm production
Sperm dysfunction
Varicocele
Hypogonadism
Infection
Hypospadias
Retrograde ejaculation

Front 52

*infertility- some causes

EXTERNAL FATORS

Back 52

Pesticide exposure
Other chemical exposure (lubricants)
Malnutrition
Emotional stress
Obesity
Yo-Yo dieting
Drugs & Alcohol, Smoking
Age
Other medical disorders (HIV/AIDS)