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275 Cards in this Set
- Front
- Back
- 3rd side (hint)
Question
|
Answer
|
Hint
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what is hydrosalpinx?
|
fluid with in the fallo[ian tube
|
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pyosalpinx
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retained pus in the inflammed fallopian tube
|
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salpingitis
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inflammation of the fallopian tube
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what is myometritis?
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infection within the myometrium of the uterus
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|
|
oophoritis
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inflammation of the ovary
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pelvic inflammatory disease is
|
all-inclusive tern that refers to all pelvic infections (ie. endometritis, salpingitis, hydrosalpinx, pyosalpinx, and TOA)
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adenomyosis
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benign invasion growth of the enodetrium into the muscular layer of the uterus
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endometrioma
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localized tumor of endometriosis
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endometriosis
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occurs when funtioning endometrial tissue invades sites out side the uterus
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parametritis
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infection with in the uterin serosa and broad ligaments
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what are the risk factors associated with PID?
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early sexual contact, multiple sex partners, hx of stds, douching
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what are the causes of PID
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sexually transmitted disease, abcess collections that have ruptured into pelvis, IUD, post abortion complications
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|
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what are the symptoms associated with PID?
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intense pelvic pain, hx of infertility, large palpable mass, vag. discharge, abn bleeding
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a pt diagnosed with PID has a higher risk of
|
ectopic pregnany
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what are 4 differential dx associated with PID?
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hematoma, dermoid cyst, ov neoplasm, endometriosis
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what is the most common for of infection that causes PID?
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sexual transmission
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what are 3 things hydrosalpinx can occur as a result of?
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pid, endometriosis, post operative adhesions
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what are the diff. dx that are associated with hydrosalpinx?
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fluid filled bowel, dilated distal ureter, omental cyst, ov cyst, TOA
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what is the sonographic appearence for salpingitis, hydrosalpinx, and pyosalpinx associated with PID?
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fluid in cul de sac, mild ut enlargement, endometrial fluid and thickening
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what are the sonographic findings of a TOA?
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complex hypoechoic adnexal mass with septaions, irregular margins, fluid debris levels, complex mass in cul de sac, distorts pelvic anatomy
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|
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what are the sonographic appearences associated with peritonitis?
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gas forming bubbles with abscess collection, loculated areas of fluid in pelvis
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|
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endometriosis is found :
|
could be present in almost any areas of the body
|
|
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what are some symptoms associated with endometriosis
|
painful periods, painful intercourse, infertility secondary to adhesions and fibroids
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what are the diff dx for endometriosis
|
hemorrhagic ov cyst, toa, cystic ov neoplasm, solid tumor, ectopic preg
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|
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what is the symptom for a pt with endometrioma
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asymptomatic
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|
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what is the other name for an endometrioma
|
chocolate cyst
|
|
|
sonographic appearences of endometrioma:
|
internal echoes, acoustic enhancement, predominat cysticc mass, well defined
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what most often occurs in association of PID:
|
endometritis
|
|
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symptom of endometritis
|
intense pelvic pain
|
|
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sonographic findings of endometritis:
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predominant, irregular- or both endo, endo fluid, pus in cul de sac, enlarged ov with multiple cysts, dilation of tubes
|
|
|
symptoms of a pt with adenomyosis:
|
middle age, heavy painful periods, uterine enlargement
|
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|
treatment for adenomyosis
|
local excision of affected area, hysterectomy if severe
|
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sonographic findings of adenomyosis
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difficult to dx, most common finding of extensive adenomyosis is ut enlargemnt
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what are the differential dx of complex mass
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ectopic preg, endometriosis, pid, dermoids, benign tumors
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TOA is
|
infection that involves fallopian tube and ovary
|
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most common location pid is found :
|
oviducts (salpingitis)
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which type of pid responds well to antibiotic treatment
|
TOA
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endometriosis affects women in which years
|
reproductive
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what is the interventional ultrasound method used for deep pelvis abscess
|
transrectal drainage
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most common benign abd found in cervix
|
nabothian cyst
|
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aquired cond. of the cx is? why does this occur?
|
cervial stenosis. occurs of an obstruction of cx canal at internal or external os, results from proir instrumentation, childbirth, surgery, cancer, irradiation
|
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symptoms of cervical stenosis
|
cramping menopausal= asmyptomatic
|
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sonographic findings of cervical stenosis
|
distended fluid filled uterus
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benign abnormality found in the vagina is
|
gartners duct cyst
|
|
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what are the diff dx of an enlarged uterus?
|
pregnancy, postpartum, lieomyoma
|
|
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what are the diff dx of a uterine tumor
|
lieomyoma, carcinoma
|
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most common gynecologic tumor found in the uterus is?
|
lieomyoma
|
|
|
symptoms of lieomyoma are:
|
pelvic pressure, pain, bleeding, heavy mentrual bleeding
|
|
|
list the locations lieomyomas are found in the uterus
|
submucosal intramural subserosal
|
|
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which hormone is responsible for the growth of a lieomyoma
|
estrogen
|
|
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which endometrial abnormality most often occurs in association with PID and post partum?
|
endometritis
|
|
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which uterine abnormality is found in women with prior hx of uterine curettage or spontaneous abortion? sonographic appearence?
|
intrauterine synechiae; bright echoes within the endometrial cavity
|
|
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the most endometrial malignany that occurs in peri and postmenopausal women:
|
endometrial carcinoma
|
|
|
how does doppler evaluation help distinguish benign from malignant endo thickening?
|
doppler of the ut artery RI of less than 0.4 is suspicious of endometrial carcinoma
|
|
|
sonographic appearence of IUD's: tatum T
|
t shaped
|
|
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approx what % of pregnancies abort on extraction of IUD?
|
50%
|
|
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which IUD is known for causing numerous complications?
|
dalkon shield
|
|
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what type of carcinoma kills more women every year more than uterine and cervix alone?
|
ovarian cancer
|
|
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what cervical abn arises from hyperplastic protrusion of epithelium of the endocervix or ectocervix?
|
cervial polyps
|
|
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what causes cx polyps?
|
chronic inflammation
|
|
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what are the diff dx of a thickened endo?
|
endometrial hyperplasia RPOC inflammatory disease endometrial carcinoma
|
|
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list the diff dx of endometrial fluid:
|
endometritis RPOC PID cx obstrution
|
|
|
list the diff dx of cx shaddowing:
|
gas IUD calcified fibroid/vessels RPOC
|
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|
what is a rare uterine abnormality?
|
uterine leiomyosarcoma
|
|
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what is the cause of endometrial hyperplasia?
|
prolonged endogenous or genous estrogenic stimulation
|
|
|
sonographic findings of endometrial hyperplasia:
|
abnormal thick endo
|
|
|
sonographic findings of endometrial polyps: symptons are:
|
appear as cysts or dense masses in endo canal; asymptomatic;may cause ut bleeding
|
|
|
symptoms of endometrial carcinoma include:
|
irregular bleeding thickened endo postmenopausal bleeding -associated with estrogen stimulation
|
|
|
sonographic findings of endometrial carcinoma include:
|
prominant endo complex enlarged uterus irregular areas of low-level echoes
|
|
|
sonographic appearence of lippes loop IUD:
|
appears as 5 dotted lines
|
|
|
sonographic appearence of copper 7 IUD:
|
shaped like 7 copper wire spiraled around verticle shaft
|
|
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sonographic appearence of straight shafted IUD:
|
form solid lines
|
|
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sonographic appearence of dalkon shield IUD:
|
small flat disk hooks around the periphery rarely found anymore
|
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|
polycystic ovarian disease can be caused by:
|
stein-leventhal syndrome
|
|
|
symptoms associated with stein-leventhal syndrome:
|
infertility oligomenorrhea hirsutism
|
|
|
what causes endometriosis?
|
reflux of tissue though the fallopian tubes; embrionic
|
|
|
what is the name for a malignant teratoma?
|
dysgerminoa
|
|
|
a fibroma that is associated with ascities and pleural effusion is called:
|
Meigs' syndrome
|
|
|
define dermoid:
|
benign tumor comprised of hair, muscle, teeth, and fat
|
|
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define cystadenoma:
|
benign adenoma containing cysts
|
|
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define cystadenocarcinoma:
|
malignant tumor that forms cysts
|
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define paraovarian cyst:
|
cystic structure that lies adjacent to the ovary
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ovarian masses are described sonographically in what 3 ways?
|
primarily cystic, complex, and predominatley solid
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what are 3 types of functional ovarian cysts?
|
follicular, corpus luteum, and hemorrhagic cysts
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which ovarian abnormality is caused by an endocrine disorder associated with chronic anovulation?
|
plycystic ovarian disease
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sonographic appearence of polycystic ovarian disease:
|
enlarged ovaries contains increased number of follicles
|
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which benign adnexal abnormality arises from the broad ligament? also the mesothelial or paramesonephric orgin?
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paraovarian cysts
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which benign adnexal cyst is associated with high levels of hCG?
|
theca-lutein cysts
|
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which benign adnexal cyst is seen most frequently in association with gestational trophoblastic disease?
|
theca-lutein cysts
|
|
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what are the 2 most common types of epithelial tumors?
|
serous mucinous
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which epilthelial tumor is found in women between the ages 13 and 45?
|
mucinous cystademona
|
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which epithelial tumor occurs bilaterally, has thick walls, irregular walls, and septations, and occurs in 10% of menopausal women?
|
mucinous cystadenocarcinoma
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what is the second most common benign tumor of the ovary?
|
serous cystadenoma usually unilateral
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which epithelial tumor accounts for 60-80% of all ovarian cancers?
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serous cystadenocarcinoma
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which group of adnexal tumors is associated with elevated alpha-fetoprotien and hCG levels? usually unilateral
|
germ cell tumors
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what is the name for the most common ovarian neoplasm?
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teratoma, dermoid
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teratomas are made up of/contain:
|
fatty, subcaceous material hair, cartilage, bone, teeth
|
|
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what are the sonographic findings of a dermoid tumor?
|
cystic/complex/solid mass, with echogenic components, acoustic shadowming
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what is a rare malignant germ cell tumor that is unilateral and occurs in women less than 30 years old?
|
dysgerminoma
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|
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ovarian cancer arises from what kind of tumors?
|
epithelial tumors
|
|
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describe the risk factors of ovarian cancer:
|
the strongest risk fators is family hx of ov or breast cancer. -breast cx pts have a increased risk of developing ov. cx -women w/ ov. cx are 3-4x more likely to develop breast cx. -other risk factors include: nullipartity, infertility, uninterrupted ovulation and late menopause
|
|
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what type of tumor constitutes for 60-70% of ovarian cancer?
|
serous cystadenocarcinoma
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over 70% of women first seen by a doctor with ov cx is iin which stage?
|
advanced stage
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|
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about 80% of ov carcinoma involve women of what age?
|
over 50, with more risk with increasing age
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what is the primary clinical problmem with ovarian carcinoma?
|
its asymptomatic and undetectable nature of the cancer in its earliest stages. -pts often seek medical attention after ascities has iniciated; abdominal distention
|
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what is the cause of 20-40% of female infertility?
|
tubal obstruction
|
|
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what is a krukenbergs tumor?
|
cancer that originates in the bowel and travels to the ovary
|
|
|
define ovarian torsion:
|
partial or complete rotation of the ovarian pedicle on its axis
|
|
|
define ovarian carcinoma:
|
malignant tumor of the ovary that may spread beyond the ovary and matastisize to other organs via the peritoneal channels
|
|
|
define mucinous cystadenoma:
|
benign tumor of the ovary that contains thin-walled multilocular cysts
|
|
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define mucinous cystadenocarcinoma:
|
malignant tumor of the ovary with multilocular cysts
|
|
|
define androgen:
|
substance that stimulates the development of male charactoristics such as the hormones testosterone and androsterone
|
|
|
define serous cystadenocarcinoma:
|
most common type of ovarian carcinoma; may be bilateral with multilocular cysts
|
|
|
define serous cystadenoma
|
second most common benign tumor of the ovary; unilocular or multilocular
|
|
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define theca-lutein cysts:
|
multilocular cysts that occur in pts with hyperstimulation (hydatiform mole, and infertility patients)
|
|
|
define polycystic ovarian deisease:
|
ENDOCRINE disorder associated with chronic anovulation
|
|
|
list the common cystic ovarian masses:
|
follicular cysts corpus luteum cyst cystic teratoma paraovarian cyst hydrosalpinx endometrioma
|
|
|
list the common complex masses of the ovary:
|
cystadenoma dermoid cyst TOA Ectopic pregnancy granulosa cell tumor
|
|
|
list the common solid ovarian masses:
|
solid teratoma adenocarcinoma arrhenoblastoma fibroma dysgerminoma torsion
|
|
|
what are the benign adnexal cysts:
|
functional cysts polycystic ovarian disease paraovarian cysts theca-lutein cysts
|
|
|
what is the most common cause of ovarian enlargement is young women?
|
functional ovarian cysts
|
|
|
what is the sonographic appearence of theca-lutein cysts?
|
large, bilateral, multilocular cystic masses
|
|
|
what are the symptoms a patient might present with theca-lutein cysts?
|
nausea and vomiting
|
|
|
describe the sonographic appearence of a mucinous cystademona:
|
simple or septate, thin-walled multilocular cysts that often contain internal echoes with components differing in echogenicity
|
|
|
describe the sonographic appearence for a serous cystademona: what are the symptoms:
|
unilateral unilocular or multilocular, smaller than mucinous symptoms include pelvic pressure and bloating
|
|
|
sonographic appearences for serous cystadeocarcinoma:
|
smaller than mucinous cysts, bilateral, irreguar boarders, loss of capsular definition, bilateral ov enlargement, may contain septations, calcifications may be present, ascities forms due to secondary to peritoneal surface implantation, may spread to lymphnodes (periaotric, medialstinal, supraclavicular)
|
|
|
list the different types of germ cell tumors:
|
teratoma, dysgerminoma, embryonal cell carcinoma, choriocarcinoma, transdermal sinus tumor.
|
|
|
teratomas occur in what percentage of women in childbearing age?
|
80%
|
|
|
what is a stroma ovarii, and what age of women does this occur?
|
a rare dermoid that is composed of thyroid tissue and may produce unsuppresible thyrotoxicosis. -malignant degeneration into squamous cell carcinoma frequently occur usually in older women.
|
|
|
what are the sonographic findings of a dysgerminoma?
|
hyperechoic, solid mass areas of hemorrhage and necrosis speckled pattern of calcifications
|
|
|
what are the 4 types of stromal tumors?
|
granulosa cell tumor thecoma fibroma steri-leydig cell tumor `
|
|
|
what are the 2 most common stromal tumors?
|
thecoma fibroma
|
|
|
which stromal tumor is the most common hormone-active estrogenic tumor of the ovary but rarely found? (1-3%)
|
granulosa cell tumor
|
|
|
what are some clinical symptoms of a pt with ovarian cancer?
|
vague abdomninal pain swelling indigestion frequent urination constipation weight change (ascities)
|
|
|
what type of tumor constitutes for 50% ov ovarian cancers?
|
endometroid tumor (similar to endometrial cercinoma)
|
|
|
what is the survival rate for stage 1 tumors diagnosed early and confined to the capsule?
|
90% at 5 years
|
|
|
what is the 5 year survival rate for stage IV ovarian cancer?
|
5%
|
|
|
explain stage 1 ovarian cancer:
|
stage 1= limited to ovary a limited to one ov b limited to 2 ov positive peritoneal lavage/ascities)
|
|
|
explain stage 2 ovarian cancer:
|
stage II= limited to pelvis a involvement of uterus/fallopian tubes b extension to other pelvic tissue positive peritoneal lavage
|
|
|
explain stage 3 ovarian cancer:
|
stage III= limited to abdomen intraabdominal extention outside pelvis/retroperitoneal nodes/ extension to small bowel/ omentum
|
|
|
explain stage 4 ovarain cancer:
|
stage IV= hematogenous disease liver parenchyma/ spread beyond abdomen
|
|
|
what is the treatment path for ovarian cancer:
|
-surgery -chemo initially, followed by second laprotomy in 6 months -followed up CA125 blood test -CT scans
|
|
|
what are some other causes of female infertility?
|
-adhesions from previous surgery -endometriosis -infection -ruptured apendix
|
|
|
when is InVitro fertilization and embryo transfer used?
|
-used in women w/ out tubal function -used in patients who fail to ovulate spontaneously
|
|
|
what are some complications of invitro fertilization (ovulation induction)?
|
-multiple pregnancies -ovarian hyperstimulation syndrome
|
|
|
what is Meigs' Syndrome?
|
associated with stromal tumors (granulosa/fibroma) that rupture and cause massive ascities and pleural effusion.
|
|
|
what percentage of a granulosa tumor is seen and adolescence and reproductive age?
|
reproductive-45% menopause- 50% adolescence-5%
|
|
|
what are the clinical symptoms of a granulosa?
|
preconcicous puberty -vaginal bleeding -full breasts -pain, pressure, and fullness
|
|
|
what is a masculinizing ovarian tumor that occurs in females 15-65 years of age with a peak incidence at 25-45 years of age?
|
arrhenoblastoma
|
|
|
what are some clinical symptoms of arrhenoblastoma?
|
features are the same for other pelvic masses with the addition of amenorrhea, and infertility. many experience malignant transformation in 22% of pts
|
|
|
what are the sonographic findings of arrhenoblastoma?
|
-solid mass with cystic components -lobulated and well encapsulated -95% of patients unilateral -size ranges from 2-30cm
|
|
|
the ovary is a common site of metastasis from carcinoma though which other parts of the body?
|
-lymphoma -bowel (krukenburg's tumor) -breast -endometrium -melanoma
|
|
|
the use of a high frequency tranvaginal transducer results in:
|
less penetration, more magnification, and better resolution
|
|
|
what are the estrogen and progesterone hormones responsible for?
|
-produce and mantain secondary gender charactoristics -prepare the uterus for implantation of the fertalized ovum -develop of mammary glands
|
|
|
what is the leutenizing hormone responsible for?
|
causes ovulation
|
|
|
a fully distended bladder in a pt undergoing transvaginal sonography will:
|
occupy most of the image and displace organs of interest out of the focal range.
|
|
|
what is the name for the normal position of the uterus?
|
anteverted
|
|
|
a uterus with a forward bend is called:
|
aniflexed
|
|
|
a uterus with a backward bend in termed:
|
retroverted
|
|
|
a uterus that is bent severely is termed:
|
retroflexed
|
|
|
what do ovaries produce?
|
the ovum-reporoductive cell hormones- estrogen and progesterone
|
|
|
what part of the ovary is estrogen produced?
|
the follicles
|
|
|
what is the region of the ov where follicles are found?
|
cortex-outer region covered by the tunica albuginea
|
|
|
what region of the ovary is lymphatic vessels, nerves, and blood vessels found?
|
medulla-inner region
|
|
|
what is the normal measurement of a follicle?
|
2.5cm/25mm/1 inch
|
|
|
the endometium is at its thickest point in which phase of the ovarian cycle?
|
secretory phase
|
|
|
which phase of the ovarian cycle does the uterus shed the endometrium?
|
menstrual phase
|
|
|
what is responsible for the release of an egg? why? which phase is this?
|
-graafian follicle releases the follicle because it enlarges -proliferative phase
|
|
|
the vagina is anterior and posterior to:
|
anterior to the rectum and posterior to the pubis symphysis, urinary bladder, and urethra
|
|
|
which group of vessels are used as a landmark for the lateral pelvic way and the ovary?
|
internal iliac vessles -commonly seen lateral and deep to the ovary
|
|
|
what 3 terms decribe mentrual status?
|
premenarche menarche menopause
|
|
|
salpingeal folds are located between:
|
the fimbriae
|
|
|
which muscle begins at the hilum of the kidneys and extends inferiorly along both sides of the spine into the pelvis?
|
psoas muscle
|
|
|
describe the bony land marks of the pelvis:
|
the pelvis is divided by an oblique line that seperates the greater (false) pelvis from the lesser (true) pelvis.
|
|
|
describe the lesser pelvis:
|
the lesser pelvis represents teh area caudal to the pelvic brim inferior-most portion of the body cavity
|
|
|
describe the greater pelvis:
|
the greater pelvis communicates with the abdomen cephalically
|
|
|
describe the exact location of the coccygeus muscle:
|
its the muscular part of the sacrospinus ligament and forms the pelvic diaphram
|
|
|
describe the exact location of the levator ani muscle:
|
the anterior part of the diaphram is formed by the levator ani muscles
|
|
|
the uterus consists of three amniotic subdivisions:
|
-fundus -corpus(body) -cervix
|
|
|
the isthmus uteri is the slightly constricted area between:
|
body and cervix
|
|
|
the walls of the uterus are made up of 3 layers:
|
endometrium myometrium serosa (peritoneum)
|
|
|
in the pelvic cavity, what muscles forms the lower margin of the pelvic floor?
|
levator ani and coccygeous muscles
|
|
|
what are the 4 anatomic subdivisions of the fallopian tubes?
|
interstitial, isthmus, ampulla, infundibulum
|
|
|
what are the functions of the fallopian tubes?
|
fertilization and transport of the ova from the ovaries
|
|
|
normal measurement of the ovaries:
|
3x2x1CM
|
|
|
normal size of the adult uterus in women who have never been preganant?
|
7.5x3x5CM
|
|
|
what are the 2 most common causes of uterine enlargement?
|
pregancy and fibroids
|
|
|
the floor of the bladder consists of a triangular area called the:
|
trigone
|
|
|
hCG is first detectable about how many days after conception?
|
10 days
|
|
|
a normal rise of hCG doubles every _____ hours?
|
72 hours
|
|
|
a falling hCG level is indicative of:
|
non viable IUP or an ectopic pregnancy
|
|
|
the duration of pregnancy can be calculated from:
|
the first day of the last menstral period and is referred to as the menstrual age
|
|
|
the average duration of a pregnancy is about:
|
280 days 40 weeks 9 calendar months 10 lunar months
|
|
|
the yolk sac appears at the mentrual age of:
|
5.5 weeks
|
|
|
the yolk sac is no longer visable at:
|
10-12 weeks
|
|
|
the function of amniotic fluid is:
|
to protect the fetus against possible injury, and to regulate the fetal body temperature
|
|
|
amniotic fluid is produced by:
|
-kidneys -skin -umbilical cord
|
|
|
what kind of cyst is associated with pregnancy?
|
corpus luteum cyst
|
|
|
what are three sonopgraphic findings of a corpus luteum cyst:
|
-unilocular -may contain low-level echoes -normally regress before 16 weeks of pregnancy
|
|
|
what position should the patient be placed in for transvaginal exams?
|
the lithotomy position with a slight fowlers tilt.
|
|
|
the major limitation of TV's is that?
|
its field of view is limited.
|
|
|
what is a retention cyst formed in the cervx due to occlusion of the cervical gland?
|
nabothian cyst
|
|
|
what are the normal measurements of the uterus for the menarche, adult, and postmenopausla patient?
|
-menarche- 7.5x3x5 cm -adult- 8-10cm long, 5-6cm AP and TRV -post- 3-5cm lenth, 2-3 TRV
|
|
|
expain atherman's syndrome:
|
when the endometrum is gone causing the uterus wall to sticking together.
|
|
|
what is the name for normal vessels often seen in the uterus?
|
arcuate vessels
|
|
|
name the 2 layers of the endomentriom and describe each of its fuctions:
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1.zonafunctionalis-sloughs off with period, not in communication w/ myometrium 2.zonabasalis-regenerates new zonafunctionalis after menses communicates with myometrium
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where are the ovaries located in the female pelvis?
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in the fossa of waldauer
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where is progesterone produced?
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in corpus luteum after agg is expelled
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what is the normal size of the ovary?
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3cm long
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a females reproductive years begin around what age?
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11-13
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what are the phases of the ovarian cycle?
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menstrual, proliferative, secretory phase
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which ov cycle phase does fertilization occur?
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proliferative phase aka follicular phase
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the ovaries are under the influence of FSH during this phase of the ovarian cycle:
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proliferative
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what is the normal measurement of the vagina?
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10cm/4inch length
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which muscle is responsible for rectal and urinary continence, and also helps hold the position of the uterus and vagina?
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levator ani muscle
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which lab test is used for the marker of ovarian cancer when increased?
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CA125
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the pituitary gland sends a signal to secrete leutenizing hormone in which phase of the ovarian cycle?
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proliferative
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what frequency is used for transabdominal ultrasound examination?
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3.5 MHz
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what frequency transducer is used for transvaginal ultrasound examination?
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7.5 MHz
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which type of scan is more accurate for the measurement of the endometrium?
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transvaginal
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what is the normal measurement of the iliac arteries (when in ovarian area)?
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5-7mm
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since fibroids attenuate sound, what frequency should you use to penetrate the fibroid?
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5 MHz
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what is the purpose of a hysterosonogram?
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-done to evaluate the contents of the endometrium -polyps are seen surrounded by water bc the water is pushed into the endometrium via the "goldstein" catheter
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during which phase of the ovarian cycle produces a graafian follicle which is producing estrogen?
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proliferative phase
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explain partial hysterectomy:
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removal of the uterus
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explain vaginal hysterectomy:
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removal of the uterus via the vagina
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list the female reproductive organs:
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-uterus -ovary -fallopian tubes
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explain bilateral salpingoophorectomy (BSO):
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removal of the fallopian tubes and the ovaries
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what phase of the ovarian cycle does it start over?
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proliferative phase days 5-14
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what ligament attahces the cornua (where the fallopian tube exits the uterus) to the ovary?
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ovarian ligament
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which ligament lies between layers of the broad ligament?
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round ligament
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what is the name for a cyst formed at the lower ends of the primitive mesonephric tubules, generally located on the walls of the vagina?
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gartners duct cyst
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the posterior walls of the pelvic cavity is formed by what bone structures?
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the sacrum and coccyx
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what is the functional cyst that regresses spontaneously, which includes the development and growth due to hormones?
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follicular cyst
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the examination table is tilted for transvaginal sonography to:
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pool intraperitoneal fluid into the cul de sac to outline pelvic organs better
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which muscle lies posterior from the coccyx?
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periformis muscle -obturator internus lies medial
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what is the follicle-stimulating hormone?
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(FSH) hormone produced in the pituitary gland that influences the ovaries
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what is the free margin of the upper portion of the broad ligament where the oviduct is found?
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mesosalpinx
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describe the exact location of the iliacus muscle:
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the iliacus muscle forms the pelvic side wall
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describe the exact location of the piriformis and obturator internus muscles:
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the piriformis and obturator internus muscles pass out from the pelvis through the sciatic foramina to attach to the greator tuberosity of the femor
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what is the function of the broad ligament?
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broad ligaments are a double fold of peritoneum and provide bilateral support for the uterus
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discuss the function of the round ligament:
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the round ligaments occupy space between the layers of broad ligament and occur infront of and below th fallopian tubes
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what are the 3 major muscle groups in the female pelvis that are visualized by ultrasound?
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-obturator internus -levator ani -iliopsoas
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ovaries are located in the:
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waldeyers fossa
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explain total abdominal hysterectomy:
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removal of the uterus and cervix -ovaries and fallopian tubes are left
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before a pelvic ultrasound, what pertinent information should be requested from the patient?
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LMP, menstrual status, symptoms, gravidity, parity, hormone regimone, hx of cx, surg, labs, prev exam findings
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what location of an ectopic pregnancy is the most life threatening?
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interstitial pregancy 2% of all ectopics
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define embryologic age:
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date from which conception occured
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define mentrual/gestational age:
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embryologic age + 2 weeks
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when does fertilization occur
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1-2 days after ovulation
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fertilized ovum is called:
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zygote
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define blastocyst:
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contains inner cell mass which forms the embryo -enters uterus 4-5 days after fertilization
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at 8 weeks MSD is approx:
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1800mIU/ml or greater
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sonographic visualization of gestational sac is seen approx:
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at 5th week IUP is seen 1-2mm sac with echogenic ring and sonolucent center
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the echogenic ring is made up of:
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-decidua basalis- thickest side; myometrial or burrowing side -decidua capsularis-rest of ring -double decidua sac sign- interface between the deciduas capsularis and endometrium
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double deciduas sac sign confirms:
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viable gestation
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the gestational sac grows how much per day?
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1mm per day
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yolk sac is visualized between what dates?
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5-5 1/2 weeks
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FHR is seen when:
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5.5-5.6 weeks
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what are the fuctions of the yolk sac?
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-hematopoiesis-forms RBC's -supplies nutrients -forms the primitive gut
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when does chorioamniotic fushion take place?
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approx 16-17 weeks
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fetal period begins:
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after 10 weeks
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explain the physiological herniation of bowel:
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primitive gut is formed as a result of incorporation of yolk sac into embryo
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at what week does the midgut descend into fetal abdomen?
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11th week
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around what week does brain vesicles develop?
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around 6th week
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what are the 3 primary brain vesicles?
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prosencephalon mesencephalon rhombencephalon
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explain how the hind brain is formed?
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the rhombencephalon divides into 2 segments called the -cephalic portion (metencephalon) -caudal component (myelencephalon)
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what is formed once the rhombencephalon divides?
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cystic rhomboid fossa -seen on u/s from 8-11th week
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choroid plexus can be visualized at what week?
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9th week
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what is the most accurate determination of gestational age?
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CRL YS GS-(MSD)
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what kind of pregnancy compromises for 70% of all twins?
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diamniotic-dichorionic (dizygotic- 2 ova)
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what is the sonographic appearence of a Di-Di pregnancy?
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each sac has an INDIVIDUAL yolk sac, amniotic membrane, and embryo
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what is the sonographic appearence of a monochorionic-diamniotic pregnancy?
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contained within once chorionic sac, 2 amnions, 2 yolk sacs, 2 embyros
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what is the sonographic appearence of a monoamniotic-monochorinoic pregnancy?
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1 gestational sac, 1 amniotic membrane, may contain 1 or 2 yolk sacs, and 2 embryos within the single amniotic membrane.
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