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96 Cards in this Set
- Front
- Back
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Explain how pregnancy is maintained before the placenta is developed?
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-In the event of fertilization, the corpus luteum cyst produces progesterone ncessary to maintain the pregnancy until the placenta develops and begins hormone production.
-these cysts usually resolve by 10-12 weeks |
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Name 3 ways of telling when physiologic midgut herniation should no longer be present?
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1. when the CRL =>45mm
2. the base of the umbilical cord should not exceed 7mm 3. physiologic herniation should resolbe y the 12 week gestation |
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T/F the presence of any organ other than small bowel outside of the abdominal cavity represents-at any gestational age - a defect of the abdominal wall
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true
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What is the value required to identify a normal intrauterine pregnancy transabdominally according to the IRP value, and 2nd international standard? What about for endovagianl?
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Transabdominally:
-First international reference period=>3600miu/ml -2nd international standard=>1800miu/ml Endovag: FIRP=2000miu/ml 2IS=>1000miu/ml |
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How can you tell the difference btw a normal early intrauterine gestational sac, or just endometrial fluid surrounded by a deciduized endometrium?
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With an intrauterine pregancy, you can identify a double decidual ring.
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What is the definition of missed abortion?
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-retention of a dead conceptus for a prolonged period of time(ie. 2 mo. )
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Your patient is 10 weeks by good dates, but presents w/ pregnancy induced hypertension. What should you suspect?
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-Hydatidiform mole
-in most cases, pregnancy induced hypetension dosn't present until second trimester. Preeclampsia in the first trimester is almost always due to molar pregnancy |
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What should the size and appearance of an 8 week gestation be? 10 weeks?
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8 weeks: sac should occupy 1/2 of the uterine cavity and show a YS, embyo and HR.
10 weeks: sac should fill the uterine cavity, and well-defined fetus should be appearent. |
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Name and describe the statistics for the types of ectopic pregancies?(fallopian tubes, ampullary, ishtmic, corneal, ovarian, cervical)
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-97%-occur in fallopian tubes(93% ampullary, 4% isthmic)
-2.5% intersticial within uterine corua -0.5% ovarian -0.12% in the cervix -0.03% in the abdomen |
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what is the location of the choroid plexus?
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-within the atria of the lateral ventricals bilaterally
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under U/S, fetal gender cannot be determined until what GA?
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16 weeks
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physicians usually do not start to consider a c-section due to placental previa until what week of gestation?
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37th gestational week
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The thickness of the full term placenta should not measure more than how many centimeters? what is a good way to remember this?
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Shouldn't exceed 4cm
Placental thickenss(in mm) can be approximated by taking the gestational age of the fetus in weeks plus or minus 10mm. |
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cellabellar measurements can be used to estimate GA but lose accuracy after how many weeks?
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30 weeks
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Epiphyseal enters will not be identified sonographically until after how many weeks?
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30 weeks
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Why is head circumferece considered more accurate than BPD? explain
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Unlike HC, BPD can be affected by head shape. BPD measurements are therefor less reliable than HC measurements.
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What things can affect the shape of the fetal head?
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-breech position
-rupturued membranes -multiple gestations |
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What is the function of the non-stress test? What is considered a pass for the NST?
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-calculates fetal heart rate according to fetal activity.
-heart acceleration is observed during fetal meovment -3 or more fetal movements over 30 minues with fetal heart acceleration of at least 15 beats amplitude of 1 seconds duration is considered a pass for the NST. |
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What is the most sensitive parameter for detecting assymetric IUGR?
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FL/AC
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What is the puerperium period?
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time from termination of labour to completer involution of th euterus. This process usually takes from 6-8 weeks
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T/F THere is an increased incidence of dizigotic twins if the father was a twin?
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False-Fetal number is determined by the female, while fetal sex is determined by the male
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With intrauterine fetal blood transfusion, how is it done?
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Packed red blood cells are introduced into the umbilical vein.
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With pregnancy, which maternal kidney is more often affected by pelvectasis and hydoureter?
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The right side is affecteed 90% of the time, and the left is affected in approx. 67% of patients.
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what is the most common cause of acute post partum hemorrhage?
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uterine atony. Uterine contractions are mostly responsible for squeesing of small blood vessels, and stopping bleeding. If the uterus is unable to adequtely contract, bleeding will persist.
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Which of the following would not be considered a function of amniotic fluid?
-allows for normal development of muscular skeletal system -regulates body heat -provides a means of protection -allows for normal lung development -provides nourishment |
provides nourishment
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Which of the following is not associated with elevated MSAFP?
-abdominal wall defects -feetal demise -hydatidiform mole -maternal renal abnormalities -multible gestations |
hydatidifom mole; because there is no fetus in a complete molar pregnacy, little or no AFP is produced, thereby decreasing the MSAFP.
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What is ACHE(acetyl cholinesterase) most specific for?
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spina bifida
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A disorder that is caused by the presence of only one defective gene is called what?
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autosomal dominent
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what does lithopedion mean?
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calcified fetus
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What is the most common cause of fetal death in the 3rd trimester?
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unknown. Although causes can vary, the most common cause of death in 3rd tri. is unknown.
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what is deuel's sign?
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aka halo sign that the subcutaneous scalp edema produces on radiography of the fetal head.
-has been associated w/ intrauterine death of the fetus. |
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what is the most common cause of fetal demise in the 1st trimester?
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chromosmal anomolies. Are rarely seen due to early fetal death, and therefore preganncy loss.
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What is the most common NTD, and most common abdnormalitiy associated with the CNS?
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anencephaly
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Differentiate btw anencephaly, microcephaly, and acrania
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Microcephaly-abnormally small head measureing 2 or more standard deviations from the mean. Cranial bones are present, but there is often a small brain due to small head.
Anencephaly-absence of the brain; sometimes confused w/ acrania Acrania-without cranial bones(total or partial absence). Because the fetal brain is exposed to amniotic fluid, and deteriorates, acrania usually but not always develops into anencephaly. |
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Holoprosencephaly is most often associated with which chomosomal abnormality?
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Especially T-13
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transabdomnal u/s reveals a soft tissue mass protruding from the anterior wall of the fetus just inferior to the cord insertion. The diagnostic possibilities include what?
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bladder or cloacal exstrophy
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If one identifies a dialted bladder, megaureters, and hydronephrosis, one should suspect what?
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posterior urethral vavs.
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What is the most common cause of bladder outlet obstruction in the male fetus? explain its?
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PUV(posterior urethral valves):
-persistant, and often profoundly dialated bladder or thickened bladder walls. Moderate to severe oligo may be present due to inability to void. |
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What is the most common cause of bladder outlet obstruction in the female fetus?
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-cloacal malformation or urethral atresia
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the congenital absence of the kidneys bilaterally and severe oligo suggests what?
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classic potter's syndrome.
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Bowing of the femur can be the reult of what ? explain
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artifact or dysplasia: Side lobe, or grating lobe are off axis artifacts. Artifacts an cause the fetal femur to appear bowed or even fratured. Changeing the angle of insonation and makeing other probe adjustments can corret the artifactual bowing.
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Fracture of the femur can be due to what?
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osteogenesis imperfectica and artifact
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What chromosomal anomoly often accompanies a strawberry shaped head?
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trisomy 18(edward's syndrome)
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How can you tell the difference btw a strawberry and lemon shaped head.
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the cerebellum in a strawberry shaped head should appear normal, while with a lemon, shaped head, it is usually accompanied by a banana cerebelum.
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By only using the BPD with a dolichocephaly baby, would you over, or underestimated the gestational age? What parameter is better to use?
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underestimate GA. The cephalic index is used to determine normality of fetal head shape.
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What is the formula for cephalic index? what are thenormal ranges? what would suggeest dolichephaly, and brachycephaly?
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CI=BPD/OFD
Normal=75-85% <75%=dolicephaly >85%=brachycephaly. |
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Which skeletal dysplasia are you most likely to see fronal bossing?
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anchondroplasia
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clinodactyly
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overlapping digits
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Doubl right outlet is almost always associated with what?
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hypoplastic left ventrcle
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What are the 3 main kinds of premature contractions?
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1. premature atrial contractions
2. premature ventricular contractions 3. premature juncional contractions |
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What is the normal heart rate of a fetus? What is considered tachy and bradycardia?
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Normal=110-180bpm
tachycardia=>200bpm bradycardia=<100bpm |
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when is the best time to operate during pregnancy?
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16-20 weeks
-Laparotomy for ovarian masses is usually not conducted until the mid second trimester(after 18 wks), provided, of course, that the operation can ve postpoed until then. |
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what is the name of the uterine contractions commonly seen in OB u/s's? Explain them .
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-focal myometrail contractions;
-painless localized contractions -not to be confused with baxton-hicks contractions where the enytire utrus contracts similar to that in delivery. |
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The muscles most often mistaken for enlarged ovaries are what?
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pirifomis
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What part of the fallopian tube does fertilization usually occur?
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in the ampula
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premenstral syndrome
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caused by corpus luteum cyst. Progesterone is responsible for the symptoms of pregnancy such as nausea, fatigue, and breast tenderness. It is also responsible for irritability, breast tenderness, and water retension associated w/ PMS
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Which vessels provides the best landmark for locailizing the ovary?
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Internal illiac artery-it is immediately posterior to the ovary followed by the vein and ureter.
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What is the typical doppler waveform of the uterine arterial flow?
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high velocity high resistance pattern.
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Doppler waveforms of the ovarian arterial flow typically show?
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low velocity, low resistance waveform.
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What is the anatomic relationship btw tthe ureter, ovary and illiac vessels?
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the ureter and illiac vessels are posterior to the ovary.
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What is the depth of penetration of endovaginal transducers?
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they are high resolution, so they can only penetrate a couple of inches.
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All of these statements abouthe broad ligament are true except?
-it is not a true ligament -it divides the true pelvis into anterior and posterior compartments -the ovaries attach to the posterior surface -it is a major suspensory ligament for the uterus -it can ve seen when there is pelvic ascites. |
It is not a major suspensory ligament for the uterus . it is actually a double fold of peritoneum and doesn't provide a solid means of suspension for the uterus.
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For doppler evaluation of the uterine artery, which level provides best acess to the vessel?
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at the level of the cervix.
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What is the potential spae around the cevix called?
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fornix
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Ovulation usually occurs when the dominant follicle gets how big? How fast does the dominent follicle grow.
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around 2.5cm. It grows about 2-3mm/day
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A 24 year old patient at day 14 of her menstral cycle should show what type of endometrium?
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periovulatory.
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fertilization usually occurs how many hours after ovulation?
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24-36 hours
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all of the following are considered physiologic conditions of the ovary except?
-follicular cyst -corpus luteum cyst -dermoid cyst -theca lutein cyst -polycystic ovaries |
dermoid cyst
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endometrial proliferation is stimulated by which hormone?
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estrogen
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when monitoring the hormone levels during early pregnancy, normal hCG levels should double every how many hours?
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48
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Explain how the hCG of an ectopic pregnancy goes(on a line diagram)
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-increases to a point and then plateu's
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If a 30 year old female is on day 8 of her menstral cycle, what AP measurement should her endomentrium be?
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8mm
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What is the hormone responsible for inducing ovulation during the normal menstral cycle?
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LH
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what is the hormone mostly responsible for premenstral sympoms and those of early pregnancy?
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progesterone
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In the female, where is circulating testosterone mostly derived from?
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ovary and adrenal gland
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In the absence of fertilization, the corpus luteum cyst should regress after how many days?
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14. it will befin to regresss into the corpus albicans.
-upon fertilization, the ovum begins producing hCG which inhibits the corpus luteum from regressing and it continues to produce estrogen and progesterone until the trophoblastic cells of the placenta are able to produce enough hormones to sustain the pregnancy. |
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Female pseudohermaphroditism is most often caused by which of the following?
-failure of the miullerian ducts to fuse -testicular feminization -ovarian masculinization -adrenal hyperplasia -pituitary imbalence. |
adrenal hyperplasia
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What are the most common causes of infertility among couples?
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-tubal damage
-endometriosis -sperm failure -ovulatory failure |
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what does postcoital mean?
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after sexual intercourse
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what hormone in the female body stimulates cervical mucus production?
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estrogen
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The drug of choic most commonly used to induce ovulation is what? Explain how it works?
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clomid. helpful in stimulating ovulatin in patients sho fail to ovulate beause of hypothalmic or pituitary problems. It suppresses circulating estrogen tricking the pituitary gland int oreleasing extra FSH and LH.
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What hormone is used to trigger ovulation?
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hCG-acts to mature the developing follicle and trigger the release of the egg.
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What is postmenopausal endometrial fluid usually due to
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Postmenopausal endometrial fluid collections are common and usually due to atrophy and degeneration of the endometrium resulting in a serous type fluid contained in the cavity.
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what is the most common cause for postmenopausal bleeding?
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benign hyperplasia
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Why is endometriosis not seen in postmenopausal women?
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Endometriosis and it's symptoms rely on hormone stimulation . In the absence of hormone production, as seen in postmenopausal women, the process and symptoms subside.
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What is the most common gynecologic malignancy in the us?
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endometrial. Over the past 50 yrs, the incidence of endometrial carcinoma has been rising, while the incidence of cervical carcinoma have been declining.
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what does a dermoid cyst contain tissues from?
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the ectoderm
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Your patient has a supcous adnexal neoplasm. To assst in ruling out tes, you should scan what?
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the lymph nodes .
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T/F endometriosis is associated with multiparity?
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false-patients w/ endometriosis often have infertility.
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What is the most common location for a benign cystic teratoma?
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anterior and superior
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All of the following could be cause of pelvic inflammatory idsease except which?
-STD's -ruptured ectopic -TORCH infections -exposure to DES -tuberculosis |
exposure to DES
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Explain what the purpose of DES was?
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used in teh 1940's and 50's to inhibit the incidence of spontaneous abortions.
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what are the symptoms of fitz-hugh curtis syndrome?
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RUQ pain, and PID
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whenever you suspect pelvic ascites, what other space should you check?
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morrison's pouch
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In the sagital view transvaginally, the bladder will be seen to fill in what part of the image?
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in the left upper corner of the image .
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what position is the patient in for a transvaginal exam?
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lithotomy
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