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238 Cards in this Set
- Front
- Back
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What is the banana and lemon sign associated with
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chiari 2
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Describe the banana and lemon sign
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. The cerebellum is banana shaped as it wraps around the midbrain. Frontal bone concavity gives the calvarium a lemon shape
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What finding is common on sagital of the spine in a pt with chiari malformation
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sacral myelomeningocele
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What are the findings of a chiari 2 malformation
3 |
lemon sign, banana sign (posterior fossa), ventriculomegaly
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What is placenta previa
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placental edge near or covering the internal os
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What is the earliest you may determine if a fetus has a placenta previa
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20 weeks
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Are there varying degrees of how much the cervical Os is covered by a placenta previa
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yes, complete or partial
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What is a low lying placenta
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a placenta within 2 cm of the OS
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What is placenta previa
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maternal veins cross the OS
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What is marginal sinus placenta previa
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placental veins near or cross the IO
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What is a common cause of a false previa
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full bladder
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What percent of pt with placenta previa have associated accreta or percreta
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5%
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What is placenta percreta
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The worst form of accreta is when the placenta penetrates the entire myometrium
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What is velamentaous cord insertion
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The cord normaly leaves the placenta from a central location. In this condition the vessels traverses the membrane of the placenta peripheraly and seperately
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What are the radiographic findings of velamentous cord insertion
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Best diagnostic clue: Color Doppler shows velamentous CI adjacent to placenta
Vessels separated at CI site Some or all vessels on membranes |
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What is a major risk factor for velamentous cord insertion
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multiple gestations
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What is Succenturiate Lobe
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A succenturiate (accessory) lobe is a second or third placental lobe that is much smaller than the largest lobe. Unlike bipartite lobes, the smaller succenturiate lobe often has areas of infarction or atrophy. At risk for post partum bleeding and RPOC
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What is gastroschisis
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Paraumbilical (not midline) so cord does NOT insert onto, can see cord next to it
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Does gastroschsis contain a peritoneal membrane
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No covering membrane, bowel floats freely
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What lab will be elevated in a baby with gastroschisis
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Elevated MS-AFP in abdominal wall defects
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Do you need chromosomal analysis in a patient with gastroschisis
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NOT associated w/chromosomal abnormalities
DO NOT need amniocentesis just for this |
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Where is the cord insertion for a omphalocele
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midline
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Are the liver and bowel commonly in the omphalocele defect
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yes
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does an omaphacele contain a membrane
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yes
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What are 5 common associated anomalies with an omaphacele
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chromosome
cardiac CNS GI GU |
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What is a time requirement for diagnosing an omaphalocele
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cant diagnose before 12 weeks because it may be physiologic
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Name 3 findings of PUV in a fetus
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hydronephrosis
dilated bladder 'keyhole' bladder and urethra |
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Does PUV ever occur in female
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no
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What is an associated pulmonary finding of PUV
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pulmonary hypoplasia from oligohydramnios
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Why does oligohydramnios cause pulmonary hypoplasia
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results in a small thorax
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What are the 2 broad categories that may cause a small thorax
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Oligohydramnios
Skeletal Dysplasia |
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What are the causes of a oligohydramnios
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PROM
renal agenesis renal obstruction |
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What are the causes of small thorax related to skeletal dysplasia
3 |
leune
thanatophoric achondrogenesis |
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What is the to and fro wave form caused by
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a pseudoaneurysm with the neck/communicating tract allows blood to flow from the artery into the pseudonaneurysm during systole and out the same channel throughout diastole, creating the to-and-fro waveform.
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What is the swirling flow 'yin-yang' pattern caused from
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pseudoaneurysm from the flow in and out of the communication with vessel
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What is a common ultrasound guided procedure for pseudoaneurysm
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US guided thrombin injection
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Describe how a thrombin injection is done
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22-25 gauge needle, with aliquots of 50-300 units of thrombin; endpoint is no visible blood flow. Thrombin is injected into the PSA but not directly into the tract because of the increased likelihood of native vessel thrombosis.
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What are the contraindications of a thrombin injection
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AV fistula
thrombin allergy |
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What is the MCC of a peripheral AV fistula
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Arteriovenous fistulas (AVFs) can result when there is puncture of an artery and vein with a direct communication between the two injured vessels
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What is the arterial spectral doppler findings above (proximal to) an AV fistula site
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Spectral Doppler analysis of the effected artery above the AVF will demonstrate a mono-phasic continuous waveform with elevated systolic and diastolic velocities.
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What will be the doppler findings in the venous portion of an AVF
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Spectral Doppler analysis of the effected vein central to the AVF will demonstrate “arterialized flow” with pulsations during systole and a lack of respiratory phasicity.
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What are the doppler findings of the involved artery distal to the AVF site
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Flow in the injured artery distal to the AVF will generally have normal pulsatility.
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What do you commonly see if you look at the AVF connection its self on doppler
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Color Doppler imaging of AVFs will often demonstrate a bruit artifact
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What is an indication that a vessels is thrombosed (DVT)
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No flow
Non-compressible |
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What are the classic findings in a pt with an acute DVT
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Acute tends to enlarge vein with central clot and peripheral flow
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What are the classic findings in a pt with a chronic DVT
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Chronic tends to have nl or small vein, wall thickening, central flow
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Describe the normal phasic flow of a vein
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there normal variation in the phasic flow corresponding to the heart.
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What happens to the normal phasic flow of a vein if there is an obstruction located proximal
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there will be loss of phasic variation and it will become continous if an obstructing lesion is present
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What is Doppler augmentation
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Squeezing the calf will produce the augmentation of venous flow to complete color doppler filling of the lumen.
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What is a normal doppler augmentation
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probe behind the knee
squeeze more distally (the calf) increased flow indicates there are no obstructing lesions between the site of examination and calf. |
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What does loss of respiratory variation of a vein indicate
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DVT
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What is the normal size of the endometrium in premenopausal women
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Up to 4 mm in menstrual phase (days 1-4)
8 mm in proliferative phase (days 5-14) 16 mm in secretory phase (days 15-28) |
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What is the normal endometrial size in a post menopausal women that is bleeding
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Bleeding: < 4 mm no bx, > 4 mm bx
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What is the normal endomentrial size in a post menopausal woman not bleeding
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Not bleeding: < 8 mm no bx, > 8 mm bx (possible f/u if on hormone therapy)
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What is the DDX of endometrial stripe thickening
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hyperplasia
polyp cancer submucosal leiomyoma retained products |
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Can endometrial hyperplasia occur both focally and diffusely
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yes
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What additional finding of the endometrial thickening favors hyperplasia
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uniform thickening
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What additional finding of the endometrium favors carcinoma
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disruption of the junctional zone
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What can be used to characterize a polyp/mass vs uniform hyperplasia
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sonohysterography
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What are tamoxifen associated changes
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ovarian cyst
polyps hyperplasia cystic atrophy adenomyosis endometrial carcinoma |
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What type of leiomyoma can be mistaken for cancer or hyperplasia of the endomentrium
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submucosal
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What is the echotexture of a US of a RCC
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Hypoechoic (48%)
isoechoic (42%) hyperechoic (10%) renal mass |
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How do you differentiate an RCC from a hyperechoic AML
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look for other features (cyst, calcification, necrosis)
(order a CT look for fat) |
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What percent of RCC have calcification
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20-30%
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What is the CRL that without HR implies fetal demise
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greater than 5mm
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If there is no yolk sac what is the MS diameter that you may call a failed pregnancy
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greater than 8mm (TVUS)
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If there is no embryo what is the MSD that you may call a failed pregnancy
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greater than 16mm (TVUS)
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How do you determine if there is first trimester oligohydramnios
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MSD-CRL should be 5 or greater. If less than oligohydramnios
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MSD is 20mm and there is a yolk sac but no fetus
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fetal demise
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What is spalding sign
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overlapping of fetal skull bones and is indicative of fetal demise
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What does spalding sign indicate
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fetal demise
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What is the ddx of ureteral obstruction
6 |
stone
tumor clot fungus ball ureteritis cystica ureterocele |
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What are 2 causes of non-obstructive dilation of the ureter
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reflux
primary megaureter |
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What RI value indicates obstruction
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greater than 0.7
or RI difference b/w sides >0.1 |
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size of a parathryoid gland
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Approximately 6 mm length, 3-4 mm transverse & 1-2 mm in anteroposterior diameter
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What is the double bubble sign typically seen with
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doudenal atresia
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Thyroid nodule with microcalcifications
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-if it has microcalcifications and is greater than 1 cm consider biops
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What does the double bubble sign look like on fetal US
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two connected 'cyst' in abdomen (stomach and dilated duodenum)
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Solid thyroid nodule
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if it is solid and greater than 1.5cm consider biopsy
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What additioal fetal findings is assoicated with doudenal atresia
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polyhydramnios
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Mixed solid cystic thyroid nodule
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-if it is mixed solid and cystic and greater than 2cm consider biopsy
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What is the DDX of a double bubble
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duodenal atresia
duodenal stenosis malrotation annular pancreas ladd band |
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thyroid cyst with mural nodule
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-mural nodule and clos e to 1cm then consider biopsy
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What is duodenal atresia associated with
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downs
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What are the ultrasound findings indicating fatty change of the liver
3 |
increased echogenicity
loss of periportal echoes decreased sound transmission with depth |
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What is a clue that a hyperechoic area is focal fat and not a mass
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no mass effect
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What is the DDX of a fatty liver
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obesity
alcohol diabetes steriods TPN hyperlipidemia pregnancy glycogen storage |
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Describe the findings of a complete mole
4 |
Enlarged uterus with hyperechoic tissue (snowstorm) and good through transmission
May see small cystic areas May have associated ovarian theca lutein cysts (50%) ascites |
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What percent of complete hydatidiform moles are invasive
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13% invade the myometrium
2% metastasize (as chorio) |
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What is the ddx for solid ovarian tumor
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fibroma, adenofibroma, thecoma, brenner tumor, dysgerminoma, metastatic tumor
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What is the ddx for metastic ovarian tumor
4 |
krukenberg tumor, other gastric colon, pancreas
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What is the ddx for physiological ovarian cyst
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follicular, corpus luteum, theca lutein
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What is the MC benign cystic/fatty adnexal neoplasm ( may be solid as well)
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dermoid
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What percent of dermoid tumors are bilateral
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15 - 20 %
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What age group most commonly have endometriomas?
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30-45 yrs
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What is a follicular cyst
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a surge of luteinizing hormone (LH), which signals the follicle holding your egg to release it.
LH surge doesn't occur. The result is a follicle that doesn't rupture or release its egg. Instead it grows and turns into a cyst. Disappear on their own within two or three menstrual cycles. |
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What is a corpus luteum cyst
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LH does surge and your egg is released, the ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. Sometimes, however, the escape opening of the egg seals off and fluid accumulates inside the follicle, causing the corpus luteum to expand into a cyst.
Although this cyst usually disappears on its own in a few weeks, it can grow to almost 4 inches in diameter and has the potential to bleed into itself or cause the ovary to twist, cutting off its blood supply and causing pelvic or abdominal pain. |
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What is gestational trophoblastic disease
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tumors that involve abnormal growth of cells inside a woman's uterus. these tumors start in the cells that would normally develop into the placenta during pregnancy
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What are the four subcategories of GTD?
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hydatidiform mole (partial or complete)
invasive mole choriocarcinoma placental site trophoblastic tumor |
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What is another name for hydidiform mole?
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molar pregnancy
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How do molar pregnancy occur?
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villi that have become swollen with fluid. The swollen villi grow in clusters that look like bunches of grapes.
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Can a normal baby develop from a hydadiform mole?
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no
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Is a molar pregnancy precancerous
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yes
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What is a complete hyditaform mole?
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most often develops when either 1 or 2 sperm cells fertilize an "empty" egg cell (a cell that contains no nucleus or DNA). All the genetic material comes from the father's sperm cell. Therefore, there is no fetal tissue.
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What is a partial mole?
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A partial hydatidiform mole develops when 2 sperm fertilize a normal egg. These tumors contain some fetal tissue, but this is often mixed in with the trophoblastic tissue. It is important to know that a viable (able to live) fetus is not being formed
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What happens to 1 in 5 woman after removal of the complete molar pregnancy
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There will be persisent remaining tissue following surgery and this could be an invase mole
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Why is it important to remove all the tissue of a molar pregnancy
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because if it persist the patient is at risk of choriocarcinoma
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Which is more difficult to remove partial or complete mole
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complete...1 in 5 have retained product and this is more likely to develop into malignant. Partial moles rarely develop into malignancy
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What is persitent GTD
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this is a term used to describe a molar pregnancy that was not initially cured by surgery
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What type of surgery is used to remove a hyditaform mole
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D and C
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What are the types of persistent GTD
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invasive mole (by far the MC)
choriocarcinoma placental site trophoblastic tumor |
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What is an invasive mole
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an invasive mole (formerly known as chorioadenoma destruens) is a hydatidiform mole that has grown into the muscle layer of the uterus (the myometrium).
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What can invasive moles develop from
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complete (mc) and partial moles
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How often does an invasive mole develop in a woman with a complete mole
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Invasive moles develop in a little less than 1 out of 5 women who have had a complete mole removed.
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What is a placental site trophoblastic tumor
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Placental site trophoblastic tumor (PSTT) is a very rare form of GTD that develops where the placenta attaches to the uterus. This tumor most often develops after a normal pregnancy or abortion, but it may also develop after a complete or partial mole is removed.
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What do choriocarcinomas develop from?
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Choriocarcinoma most often develops from a complete hydatidiform mole, but it can also occur after a partial mole, a normal pregnancy, or a pregnancy that ends early (such as a miscarriage or an elective abortion).
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Can choriocarcinomas devolp without pregnancy
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yes, These can be found in areas other than the uterus, and can occur in both men and women. They may develop in the ovaries, testicles, chest, or abdomen.
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Describe a partial mole
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Intrauterine gestation with focal placental thickening and cystic changes
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What type of molar pregnancy has a triploid karyotype
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partial mole
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What type of molar pregnancy is associated with preeclampsia/eclampsia
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both
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What type of ovarian cyst are associated with high beta HCG
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theca lutein cyst
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What are some conditions that may result in theca lutein cyst
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multiple pregnancies
gonadotropin therapy (clomiphene) trophoblastic disease |
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What is the ddx for retroperitoneal adenopathy
4 |
germ cell mets
lymphoma primary retroperitoneal sarcoma malignant schwannoma |
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What is the ddx for primary retroperitoneal sarcoma
3 |
liposarcoma
MFH leiomyosarcoma |
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A young male with retroperitoneal LNs... you susptect what
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germ cell mets
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What is the MC open neural tube defect
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anencephaly
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What are the fetal US findings of anencephaly
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abscense of the cerebral hemisphere and lack of bony calvarium above the orbits
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What type condition resembles a fron with big eyes and not much above it
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anencephaly
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Does a fetus with anecephaly have a normal posterior fossa
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yes
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Does a fetus with anenephaly have various amounts of hyperechoic ill defined soft tissue above the orbits covering the defect
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yes (angiomatous stroma)
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What percent of pts with testicular microlithiasis have a germ cell tumor at the time of initial diagnosis
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10%
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What are the germcell tumors associated with testicular microlithiasis
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seminoma
seminoteritoma intratubular germ cell neoplasm |
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What are the findings of testicular microlithiasis
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diffuse punctate non-shadowing hyerechoic foci thoughout the testicle
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Is testicular microlithiasis usually bilateral
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yes
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What is the pathophysiology of a testicular microlithiaisis
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concretions in the semniferous tubules
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What is testicular microlithiasis associated with
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cryptorchidism and infertility
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What is the MC uterine anomaly
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septate (55%)
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list the 4 main uterine anomalies and order of occurence
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septate 55%
unicornate 20% bicornuate 10% agenesis/hypoplasia 10% didelphys 5% |
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Describe the findings in didelphys
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2 uteri
2 cervices 2 vaginas |
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Describe the findings in bicornuate uterus
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2 uteri (possiiby to cervices)
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How do you diagnose uterine a bicornuate uterus
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Fundal cleft > 1 cm separating divergent, symmetric uterine horns
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What are the two types of bicornuate uteri
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Bicornuate unicollis: Solitary cervix
Bicornuate bicollis: Duplicated cervix |
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Describe a unicornuate uterus
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one horn (1/2 of a uterus) and one fallopian tube
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How do you diagnose an arcuate uterus
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Graphic of an arcuate uterus shows mild thickening of the fundal myometrium causing a broad, smooth indentation on the endometrial cavity.
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How do you differentiate a arcuate uterus from a septate uterus
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broad smooth indentation in the endometrial cavity.
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How is a arcuate uterus differentiated from a bicornuate uterus
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no fundal cleft
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How do you differentiate a septate uterus from a bicornuate uterus
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Uterine fundal contour is flat, convex or mildly concave ≤ 1 cm
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What is the risk of having a uterine abnormality
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increased incidence of spontaneous abortion and infertility
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What percent of patients will have a urinary tract abnormality with uterine anomalies
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20-50%
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What percent of patients will have a renal agenesis with a uterine abnormality
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5-20%
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What are the findings of fetal hydrops
7 |
ascites
pleural effusions pericardial effusions skin thickening placental enlargement polyhydramnios +/- hepatosplenomegaly |
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What are 2 causes of fetal hydrops
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Immune hydrops (10%)
Nonimmune hydrops (90%) |
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What is the immune cause of fetal hydrops
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Maternal Rh sensitization
Maternal lack of D antigen Fetal D antigen causes antibody response Maternal antibodies attack fetal red blood cells Sensitization 2° to fetal-maternal hemorrhage < 1 cc fetal cells can lead to anti-D antibody |
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What are the non-immune causes of fetal hydrops
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idiopathic
cardiac (Congenital anomaly) fetal masses placental chorioangiomas chromosomal anomalies twin-twin transfusion infection |
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What is the MC infectious causes of fetal hydrops
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parvovirus
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What are 2 common masses which may result in hydrops
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teratoma
hemangioendothelioma |
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Can a placental chorioangioma result in fetal hydrops
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yes (AV shunting or fetal anemia from hemolysis)
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Why does turners result in fetal hydrops
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lymphatic obstruction
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Why does a hemangioendothelioma cause fetal hydrops
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increased cardiac output
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What is the tx for fetal hydrops
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fetal blood transfusion
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What are the findings in multicystic dysplastic kidneys
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paraspinous mass with macroscopic cyst
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What happens to the overall size of the kidneys in multicystic dysplastic kidnesy
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enlarged
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What % of pts with MCDK are bilateral and what percent have anomalies in the contralateral kidney
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20%
40% |
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If a MCDK are discoverd in a fetus what should be followed carefully
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amniotic fluid volume
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What can be very similar appearing to MCDK
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UPJ obstruction and resultant hydronephrosis
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What is the appearance of a UPJ obstruction
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hydronephrosis without hydroureter or bladder dilation
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What percent of pts with UPJ obstruction are bilateral
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10%
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What percent of pts with a UPJ obstruction have a contralateral renal anomaly
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25%
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What is the appearance of appendicitis on US
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Tubular bowel in RLQ with diameter > 6 mm, noncompressible and nonperistaltic
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What is the appearance of periappendiceal inflammation
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Periappendiceal inflammation seen as increased echogenicity in fat
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Is there sometimes hyperemia on doppler in appendicitis
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yes
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What does a periappendiceal fluid collection suggest
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perforation
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Describe the findings of a parathyroid adenoma on US
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homogenous
hypoechoic |
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Do parathyroid adenomas tend to be hypervascular
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yes
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Where is the MC location of an ectopic parathyroid adenoma
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superior mediastinum
retrotracheal tracheoesophageal groove carotid sheeth |
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Name 4 false positive finding on uS for a parathyroid adenoma
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LN
thyroid nodules esophagus longus coli muscle |
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What are 2 clues that a parathyroid adenoma may be carcinoma
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areas of necrosis
calcifications |
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What are 3 names of a colloid nodule
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colloid nodule
hyperplastic nodule adenomatous nodule |
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What is a colloid cyst
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a degenerated colloid nodule
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What percent of thyroid nodules are colloid nodules
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85%
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Describe the findings of a comet tail of a colloid cyst
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cystic thyroid nodule with echogenic debris
comet tail artifact in the cystic portion |
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What are the findings on an US suggestive that a nodule is benign
6 |
Uniform, well-defined thin hypoechoic rim, peripheral eggshell Ca+, hyperechoic to gland, primarily cystic, comet-tail artifact
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When examining the thyroid lobes look at
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nodules...texture (diffuse or focal), location, borders and size
also look for lymphnodes and meaures size if enlarged, determine if hyperemic |
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When examing the thyroid isthmus
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look at size and for nodules- texture, location and size
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how do you describe borders of a nodule
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ill defined vs well defined
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If there are many nodules of the thyroid which one do you comment on and measure
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What is the normal max volume of a lobe of the thyroid
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8cc
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What are the characteristics of a colloid cyst
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hyperechoic center with hypoechoic periperhy
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what are characteristics of suspicous node in neck
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peripheral vascularity, calcivication, cystic change, lack of hilum fat, very large and hyperechoic
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What should you always check when examining the thyroid?
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lymph nodes.
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What does a colloid cyst of the thyroid look like
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cytic with echogenic foci.
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Describe a parathyroid adenoma
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hypoechoic
circumscribed in the vertical axis |
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How does a parathyroid adenoma look differenet than carcinoma on a US
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malignant: ill defined, invasive, fixed on exam, calcificaiton, cystic
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What is the normal size of a parathyrid gland
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Approximately 6 mm length, 3-4 mm transverse & 1-2 mm in anteroposterior diameter
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What is the ddx for a parathyroid adenoma
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exophytic thyroid nodule
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How do you differentiate a parathyroid adenoma from a thryoid nodule
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nuc med sestamibi scan
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What are the findings of a nodule suggestive that it is malignant
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solid
ill-defined hypoechoic nodule punctate microcalcs chaotic intranodular vessels |
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What is considered more worrisome for malignancy on nucs
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cold (15-20% chance)
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What are the 4 different types of thyroid cancer
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papillary, follicular, medullary, anaplastic
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What are the percentage of occurence for the 4 different thyroid cancers
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papillary 75-85
follicular 10-20 medullary 5-8 anaplastic <5 |
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What are the top 3 benign thyroid nodules
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macrofollicular adenoma (simple colloid)
microfollicalar adenoma Embryonal adenoma (trabecular) |
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Is a hyperfunctioning thyroid nodule (hot nodule) an indication of benignity?
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yes
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What is the MC substance to fill a benign cystic lesion
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colloid
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What is the characteristic appearance of a colloid cyst on ultrasound?
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in addition to the well-defined cyst, several echogenic foci with comet tails are visualized in the cyst
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What is the appearance of thyroid lymphoma on US?
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the appearance of a hypoechoic mass, often a large one with lobulated margins and large, anechoic necrotic areas.
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What are 3 characteristics of a benign thyroid nodule?
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Typical benign nodules are well defined, mostly cystic, and hyperechoic relative to adjacent parenchyma
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What type of calcification would you see in a benign lesion?
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egg shell
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Do benign lesions ever have internal debri
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yes, most of the time they will.
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What would be expected to surround a benign nodule?
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a thin echolucent halo.
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What is a thyroglossal duct
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midline lesion, due to persistent sinus tract connected to foramen cecum or suprasternal notch, or blind tubular structure
70% of congenital neck cysts, often presents as infection in children age 5+ years |
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What are the SS of graves disease?
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cardiac (palpitations, congestive heart failure, cardiomegaly, atrial fibrillation, fatty change), fatty change of skeletal muscle or liver, osteoporosis from bone resorption, generalized lymphadenopathy
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What is a specific finding of papillary ca
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Internal punctate shadowing calcifications (psammoma bodies) are a specific finding
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What percent of pts with papillary thyroid cancer have multipe lesions
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20-80%
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What are malignant features of a thyroid nodule
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solid nature, hypoechoic texture, punctate or coarse calcifications and hypervascularit
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What is the MCC of a renal artery AVF
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post trauma
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What are the findings of a renal AVF
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burst of color in adjacent kidney from vibration of briskly flowing blood in fistula
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What is my criteria for a malignant thyroid nodule
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Malignant indicators
-taller than wide -mural nodular with flow -chunky or speckled calcification within a nodule - ill defined -growing out of the thyroid or invading guidelines: -if it has microcalcifications and is greater than 1 cm consider biopsy -if it is solid and greater than 1.5cm consider biopsy -if it is mixed solid and cystic and greater than 2 cm consider biopsy -mural nodule and close to 1cm then consider biopsy -multinodular thyroid then do biopsy on the 1-2 more suspicious nodules -if rapidly growing biopsy |
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What does turbulent flow look like on spectral doppler
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In turbulent flow, the velocity spectrum is broadened with
many different velocities being presented at any one time (the spectral line is very wide) |
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What do you expect to see in the feeding vessel in a pt with an AVF
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Elevated velocity in feeding artery; turbulent/pulsatile flow draining vein
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What do you see on the color doppler
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Focal soft tissue vibrations in transplant parenchyma on color Doppler US
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What do you see in the AVF and the draining vein
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turbulent flow
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What do you expect to see in the surrounding renal parenchyma in a pt with an AVF
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Bursts of color (turbulence) in adjacent kidney from vibration of briskly flowing blood in fistula
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What are 3 major defects that can be seen in a downs fetus
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AV septal defect
duodenal atresia increased nuchal translucency |
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name 9 downs syndrome markers that can be seen during the 2nd trimeseter
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nuchal thickening
short femur and humerus echogenic bowel intracardiac echogenic focus renal pelviectasis absent or hypoplastic nasal bone finger abnormality sandal gap foot |
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What is the sandal gap foot
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wide gap b/w 1st and 2nd toes
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What is the measurement for nuchal thickening
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> 5 mm abnl
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What is the criteria to determine if bowel is echogenic
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It is as bright as bone
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What does the intracardiac echogenic foci look like in downs
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left or right ventricle, as bright as bone
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How do you determine if there is pelviectasis in trisomy 21
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> 3 mm abnl, anterior-posterior measurement
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What are the finger defects of downs syndrome
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hypoplastic middle phalanx, distal finger curves inward
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When is first trimester screening for downs syndrome done
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11-14 weeks
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What is the screening for downs syndrome during the first trimester
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maternal serum free beta hcg
plasma protein A nuchal measurements (80-90% sensitive) |
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When is the 2nd trimester screening done
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15-20 weeks
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What is the screening procedure during the 2nd trimester for downs syndrome
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maternal beta HCG
estriol alpha fetoprotien |
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What is the sensitivity of 2nd trimester screeen
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it is less only 60%
(higher false positive also) |
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If a thyroid nodule is solid and ill defined with microcalcification is it bad
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yes
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Why are follicular adenomas resected
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difficult to differentiate from follicular cancer pathologically and therefore these will be resected.
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What percent of papillary cancer will have a cystic component
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20%
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