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162 Cards in this Set

  • Front
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what are the causes of facial anomolies
-developmental/inherited
-affected by drugs/alcohol
-chromosomal aberation
hyloid artery
-seen from 16-32 wks
->32 wks=cannot see it
-echogenic line in orbits
frontal bossing
-prominant frontal bone
-associated w/ dwarfism
what is the schisencephaly due to?
-clefts due to an obstruction of the MCA
-triangular defect
is there microcephaly with a cephalocele?
no
what is the brain like with acrania
abnormal, but present
is there fusion of the thalmus with ACC?
no
when might microcephale be diagnosed sonographically
24 wks
DWM
-occurs 1é30,00
-4th ventricle connects with the cisterna magna
-due to obstruction of the foramina of luschka and magendie
-cyst in post. fossa and defect involving cerebellar vermis(may be partial or complete)
craniosynostosis
-premature fusion of cranial sutures causing abnormal cephalic index and mmishapen skull
what is hydrocephalus associated w/
DWM
NTD-spina bifida
-cloverleaf skull
-aquaductal stenosis
What is ventriculomegaly associated w/?
-polyhydramnios
-hepatomegaly and ascites caused by infections
-other cranial abnormalities:
-meningomyelocele, encephalocle, dandy walker, intracranial tumors
Intracranial hemorrhage
-chorioid plexus cysts are most sensitive to hypoxia
-when there is hypoxia, the choroid plexus cysts bleed and cause an intracranial hemorrhage
-poor outcome
-usually in preterm infants
what are the differential diagnosis for prencephalic cysts, and the sonogrphic appearance of a normal one?
Diff Dx:
-arachnoid cyst
-vein of galen aneurysm
SONOGRAPHICALLY:
-round head
-cystic area in the brain
what are remants of brain tissue called
angiomatous stroma or cerebrovasculosa
what are the sonographic features of microcephaly?
-small BPD, but normal other measurements
-Increased or decreased HC/AC ratio
-sloping forehead
-poor cranial growth on sonographic follow-up
-abnormal cerebral architecture
-intracerebral calcifications suggestive of infection(parvovirus/cytomegaloviris)
-diagnosis made w/ serial exams
-may not be evident until 3rd trimester.
what are the causes of anencephalyÉ
-part of a syndrome
-chromosomal abnormality
-teratonogenic insult
-folic acid deficiency
-hyperthermia
In most cases, there is a multifactoral cause:
-genetic
-environmental
-metabolic
-nutritional
holoprosencephaly
-results from incomplete cleavge of prosencephalon
-results in abnormal single large midline ventricle
-assoc. with midline facial abnormalities(single nostril, or one orbit)
-assoc. with chromosomal abnormalities(esp. trisomoy13 & 18)
what may acrania be associated with?
-spinal NTD-meningocele and myelomeningocele
-equinovarous
-cleft palate
-umbilical hernia
-increased fetal activity
what does hydarnenecephay result from?
-ICA occlusion(most common)(vascular accident)
-infection(toxoplasmosis, herpes virus)
intracranial calcifications
-diffuse or focal
-non-infectious and infectious causes
-cross placenta to infect fetus
TORCH
-toxoplasmosis
-rubella
-cytomegalic inclusion cyst
-herpes
what are the etiologies and songoraphic appearance of schizencephaly?
ETIOLOGY:
-infarction of the MCA
-uncertain
-vascular occlusion
-primary maldevelopment
-infectious process
SONOGRAPHICALLY:
-bilateral symmetric areas of cystic necrosis
what are some associated anomolies with ACCÉ
-clef lip
-GI
-GU
-CV
-musculosketal pulmonary anomolies
-trisomies
-dandy-walker syndrome
-holoprosencephaly
-median facial clefts
-complete or partial
-acquired or developmental
what are some associated anomolies with holoprosencephalyÉ
-CNS anomolies:
-hydrocephalus
-ACC
-microcephaly
-ecophocele
-myoelomeningocele
-GI
-facial
porencephalic cyst
-cystic area of the brain that sometimes communicates with the ventricle
-single or multiple
-no mass effect
-due to intracranial hemorrhage or tissue nectosis resorption
-milder form of hydroanencephale
-cystic cavities within normal brain tissue
-infarction or hemorrage into brain tissue
what is the sonographic appearance of agenesis of the corpus callosumÉ
1)lateral displacement of lateral ventricles
2)enlarged apical and occipital horns
3)absent CSP
4)sunburst sign-increase suci from Intrahemispheric fissure(observed in last trimaster)
5)absence of CSP by 17-20 wks because it should be seen at 12wks
6)mild hydrocephalus
7)3 line appearance where the falx should be
anencephale
-6:1 white black ratio
-occurs 1or 2 :1000 births
-failure of closure of the rostral portion of the neural tube at 5 wks
-absent brain and skull superior to orbits
-most common and severe NTD
-portions of midbrain, and stem may be present
-proboscus may replace nose
FEATURES:
bulging eyes
-macroglossia
-short neck
what are the sonographic features of an anencephaly
-cranial contents identified 12-15 wks
-acrania with absent intracranial structes
-face and orbits present
-normal or polyhydraminios
-vasc. malformation
-increaased fetal activity
-sulci present
what are the sonographic features of Dandy-walker malformations
-4th vventricle enlargement
-cystic mass continuous with the 4th ventricle
-large posterior fossa
-hypoplastic cerebellar vermis
-obstructive hydrocephalus(80%)
-absent corpus callosum(70%)
-often polyhydramnios
-cerebellar hemispheres may be flattened and separated
-may be differentiated from subarachnoid cyst by continuity with thr 4th ventricle
-
what are the neural migration anamolies?
-Lissencephaly
-pachygyri
-agyfia
-encephaly
ACC
(ACC)
-occurs 1é19,00
-failure of the development of the corpus callosum
-usually associated with other anomolies(80%)
-partial agenesis involving the posterior portion
-CSP absent
-high 3rd ventricle
-unclear etiology(occurs in alcolol and substance abuse)
what are the causes of microcephaly?
-maternal phenylketonia
-inherritance
-chromosomal aberration
-prenatal radiation exposure
-maternal infection
-heroin addict
-mercury poisening
-asphyxia
what is ventriculomegaly a result of?
-increased CSF production
-decreased CSF absorption
-cerebral atrophy
-primary failure of brain growth
schizencephaly
congintal
-bilat clefts in the cerbrum
-fetal stage of development will determine resultant brain destruction
amniotic down syndrome
fetus attached to membrane
first trimester screening
Maternal serum biochemical markers:
-fbhCG(free beta subunit oc HCG)
-PAPP-A(pregnancy associated plasma protien)
TRISOMY 21:(60% detection rate w/ serum screening):
-incresed fbhCG
-decreased PAPP-A
give the causes of antepartum fetal deaths
30%-asphyxia-IUGR, prologed gestation
30%-maternal complications-placental abruption, hypertension, preeclamsia, diabetes mellitis
15%-Congenital malformation, chromosomal anomolies
5%-infection
Triple Marker screen(TMS)
what is it?
-optional blood test for pregnant women
-performed at 15-20 wks
-measures markers produced by the fetus and/or the placenta
PAPP-A
pregnancy associated plasma protien-A
-1st trimester screen
-derived from trophoblastic tissue
-diffuses into maternal blood stream
-decreased levels in aneuloidy
what is the other sceen for the quadruple scree vs. the triple screen?
Dimetric inhibin A(a placental protien)
-Elevated in down syndrome
w/ edwards syndrome, what is sonographically different?
-orbits are too far apart
-small orbits
-extended/overlaping digits
-omphalocele(associated w/ chromosomal abnormalities)
Fetal papyraceous
-rarly seen
-may occur in a missed abortion of a co-twin
-nonviable fetus is compressed by the growing sac of the cotwin and becomes artially absorbed throughout the pregancy
how is spina bifida determined?
-increased AFP
-amnio done
-childen w/ spina bifida do not necessarily have a chromosmal problem
-25% of spina bifida fetuses have hydrocephale(lg. ant horns)
preeclampsia
-hypertension
-edema
-proteinemia
-must be cause early because it may cause the mother to have seizures, and thus fetal demise
what is decreased MS-AFP associated w/
-<0.5 MOM
-not pregnant or normal
-incorrect dates
-chromosome abnormality(down syndrome)
-fetal demse
-GTD
-unexplained
MS Unconjugated Estriol(Ms-uE3)
Production is under the control of the:
1. placenta
2. fetal adreals
3. fetal liver
25% ;pwer om [regmamcoes affected bu trisomy 21
aneuploidy
abnormal number of chromosomes
what markers are increased/decreased with trisomy 21?
-hCG and Dimetric inhibin A are increased
-AFP and uE3 are decreased
what are some examples of ovarian causes of infertility?
-PCOD
-hypothalamic amenorrhea
-LUF-luteinized unruptured follicles
what are the classifications of infertility?
primary-inability to produce ova or sperm
secondary-inability to transport fertilized egg to uterus(damage, adhesions, absence or obstruction of fallopian tubes)
what are the complications of OHS?
-multiple pregancies of high order(may require fetal reduction)
-increased incidence of ectopic pregnancy
-increased risk of heterophic pregnancy(1/100)
what are some examples of tubal obstruction?
-ectopic pregnancy
-endometriosis
-PID
when does follicular monitoring begin with IVF/
day 7 post CC or hmg
medical abortions
drugs: mexotrexate and misporostol:
-up to 49 days LMP
-pregnancy end in a day or two
-may take up to 4 weeks to terminate
when does OHS occur, how often does it occur
-occurs 5-8 days post hMG
-<1% of the time
what are the types of abortion?
1. medical abortion-<7 wks
2. suction and curritage(vaccuum)(6-14 wks)
3. D&E-dialation and evacuation(15-19wks)
depo-provera
-shot of progesterone that lasts 3 months
-prevents ovulation, mucous changes
ICSI
intracytoplastic sperm injection
laminaria
derived from seafood; causes natural cervical dialation
what is the clinical and songoraphic appearence of ascherman's syndrome?
CLINICALLY:
-amenorrhea
-dysmenorrhea
SONOGRAPHICALLY:
-thin endometrium
-endometrium may be restored aftery lysis of adhesions and hormonal stimulation
what drugs are used to induce ovulation
-lupron-suppresses ovulation; nasal spray
-HCG-lg dose=ovulation
dysgerminoma
-rare
-malignant
-young people(10-30)
-unilateral
-rapid growth
-spred by:
-rupture of capsul;e
-peritoneal spread
-lyphatic routes
pseudomyxoma peritoni
-associated w/ mucin producing tumors of the bowel and mucinous cystadenoma and cystadenocarcinoma
-produce thick gelatin material
-metastatic implants may present as thick, solid mass adjacent to the adominal wall and bowel.
-other implants may appear on the peritnela surface as focal echogenic implants.
name some other facts about endometriosis?
-most common among young reproductive women
-symptoms decrease w/ pregnancy and in postmenopausal years
-can cause fixed retroversion of the uterus
-usually a bilateral disease
-diffuse or focal
what does an abscess present as clinically(usually)
-lower abdominal absceess
-adnexal tenderness
-tenderness w/ cervical motiion
what may a mimic a PID, and visa versa?
-ectopic gestation
-cyst w/ hemorrhage
-malignancy
-dermoid
MUST USE CLINICAL FACTORS AND HORMONE IMBALANCE TO DETERMINE ORIGIN OF MASS.
papillae
echogenic formations protruding into the liquid phase
cystic teratomas(dermoids)
-unilateral
-reproductibve age
-benign
-contain hair, fat, teeth, bone
-superior to fundus
-usually benign, but have malignant potential, and can mimic other malignant patholigy, aso are surgically removed.
serous cystadenocarcinoma
-malignant
-multilocular
-90% of ovarian cancers
-may contain debris
-up to 20 cm
-
cystadenocarcinoma
type of ovarian cancer to do with surface epithelial stroma tumor
what are symptoms of PID?
vaginal discharge
fever
leukocytosis
rapid pulse
pelvic pain
tenderness
what are some examples of functional cysts?
-corpus luteal cyst
-follicular cyst
-theca lutein cyst
name and describe the stages of PID?
EDOMETRITIS:
-thich heterogenous endometrium
-fluid in endometrial canal
STAGE 2-SALPINGITIS:
-tubular shaped distension
-cogwheel sign
-acute or chronic
-hydro, hemato, pyosalpinx

STage3:tubo-ovarian abscess:
-usually bilateral
-pyosalpinx and adhesions and fixed pelvic peritonitis
-fitz hugh curtis syndrome
when ovarian masses occur in the monopausal age group?
-theocma
-fibroma
-ovarian CA
parovarian cyst(paratubualar cyst)
-usually simple
-assymptomatic
-wolffian duct remenatns
-located in broad ligaments
-sonographicallys appear as simple cyst adjacent to the ovary
serous cystadenoma
-most common benign tumor
-reproductive and post meno
-rapid growing
-large and thin walled septa
-unilateral
-
what dp androblastomas look like songraphically? what is a differential diagnosis for them?
SONOGRAPHICALLY:
-solid w/ cystic components
-lobulated
-encapsulated
-2-30 cm in size
-unilateral
DIFF DX:
fibroid(need to distinguish origin)
non-gynecologic pelvic mass
found in post-operative and transplant patients:
-rectus sheath hematoma
-abscess
-hematomas
-lymphoceles
what is the clinical presentation, and sonographic appearence of ovarian torsion?
Clinical:
-acute unilateral pain-RLQ pain may mimic appendicitis
-nausea
-vomiting
-palpable adnexal mass
SONOGRAPHICALLY:
-absent or decreased blood flow
-dialated vessels along rim
-free fluid in cul de sace
-surgical emergency
what is teh sonographic appearance of a dysgerminoma?
-solid homogenous and irregular definition
-foci of necrosis and cystic degeneration
-radiosensitive
-remove ovary
-female seminto male
-
what is endometriosis cuases by? what are the clinical symptoms of it?
CAUSES:
-menstral reflux thru tubes
-embryonc error of mullerian sys.
CLINICAL:
-infertility
-dysmenorrhea, metromenorrhagia
-dyspareunia
what are the risk factors, and survival rate for ovarial carcinoma?
RISK FACTORS:
-family hx
-breast cancer
-nulliparity
-infertility
-late menopause
5 yr. survival rate=50%
meig's syndrome
triad of ascites, pleural effusion, and benign ovarian tumor
-classically on the rt side
hemorrhagic ovarian cyst:
what is it? what is the clinical presentation?
What does it look like sonographically?
-benign
-rupture of blood vessels
CLINICALLY:
-pelvic pain-abrupt onset
-nausea
-vomiting
-elevated temperature
-enlarged ovary(may be palpated)

SONOGRAPHICALLY:
-Can appear as any cystic appearence, or a hyperechoic mass simuating a solid lesion.
-to differentiat, serial scans can be performed
-a hemorrhagic cyst will have an altered internal sonographic appearance and/or decreased in size within 7-10 days.
arrenoblastoma: what is it, when does it occur, what is the clinical appearence?
-sertoli-leydig tumor/androblastoma
-"sir" or"andro"=masculinizing
-25-45 yrs.
-ammenorrhea dn infertility
what is the clinical presentation, and sonographic appearence of polycystic ovarian disease?
clinically:
-hirsuitism
-obesity
-infertility
-oligomenorrhea
SONOGRAPHIC:
-normal or enlarged ovaries>12.5
-bilateral
-multiple tiny cysts(string of pearl sign)
-absence of dominant follicle
fitz hugh curtis syndrome
extrapelvic manifestation of RUQ pain from perihepatitis
what is a theca lutein cyst, and what are the symptoms of it?
-cuased by increase b-hCG
-multiple cysts which means enlarged ovaries(up to 20cm)
Symptoms: Nausea and vommitting
hydrosalpinx
-usually post PID due to adhesive processes(endometriosis)
-pus in pyosalpinx resorbes and is transformed into fluid
-fluid is trapped in fallopian tube
-represents chronic infection
what are the cliical symptoms of acute and chronic TOA? what is the sonographic appearence of it?
ACUTE:
-nausea
-vomitting
-abdominal pain
-leukocytosis
-fever, chills
-abdominal distension
-high erythrocyte sedimentation rate(ES)
CHRONIC:
-asymptomatic
-vaguly symptomatic
SONOGRAPHICALLY:
-loculations w/ irregular borders
what is the clinical presentation and sonographic appearence of pseudomyxoma peritoni?
clinical: very sick pateint if benigh, and metastatic implants if malignant.
-SONOGRAPHIC:
-thick, solid mass adjacent to abdominal wall or
-focal, small echogenic masses adjacent to peritoneal surface outlined by ascites
brenner tumor and sonographic appearance
-uncommon
-solid
-epithelial
-2% of neoplasms
-over 40 age group
-estogenic-present w/ irregular bleeding
-rare assoc w/ meig's syndrome
-echogenic mass w/ small cystic spaces
theca cell tumors(thecoma)
-benign, solid unilateral mass
--menopausal and post menopausal
-estrogen producing
-unilateral
PID
-infection and inflammation of reproductive organs and peritoneal surfaces
-usually retrograde source
-risk factors:
-increases sexual activity IUCD users, smoking
what are the types of sex cord stromal tumors? what sets them apart from other ovarian neoplasms?
-fibroma
-thecoma
-granulosa cell tumor
-sertoli leydig tumor(arrenoblastoma)
-meigs syndrome
(all solid)
chronic salpingitis
-sereial incidents of falllopian tube inflammation
-tubal ostium may bo obliterated
-peritoneal adheasion that devolop may cause tubal occlusion
-associated w/ infertility and ectopic pregnancy
-diagnosed w/ hysterosalpingofraphy or sonogysterography
chronic PID
-normal looking uterus and complex adnexal and cul-de-sac masses
what is teh clinical and sonographic appearance of thecomas?
clinical: pelvic pain, and presssure symptoms
sonographic: same and fibroma
what does pseudomyxoma peritonei cause?
loculated ascites and a mas effect
acute PID
-fuzzy outline of the uterus
-bilateral adnexal masses
-clinical symptoms of uterus and ovaries feel fixed due to adhesions and fivrosis formation in pelvis
rectus sheath hematoma
-bleeding into the recus sheath of the arterior abdominal wall
CAUSES:
-trauma
-surgery
-blood dyscrasias
-anticoagulant therapy
meig's syndrome
1. pelvic mass
2. ascites
3. peural effusion(rt side, which causes SOB)
-may compicate fibroma
-once fibroma is removed, all symptoms are resolved.
what is stein-leventhal?
an endocrine disorder associated with obesity, infertility, hirsuitism, oligomenorrhea, and polycystic ovaries
what is poycystic ovarian disease?
-follicles located on the periphery of a 20-30yr old
-benign
-Dysfunctional hormone cycles
-increased blood levels of LH/FSH
-25% will have normal appearing ovaries
fibroma
-unilateral
-up to 25 cm
-multiple well, encapsulated solid tumors
-associated with meig's syndrome
TOA
tubo-ovarioan abscess:
-pus from fallopin tube communicates w/ ovary
-gonorrheal or nonvenereal
-sucessful treatment w/ antibiotic therapy
corpus luteum cyst of menstration and pregnancy
-reproductive age
-post ovulatory
-filled w/blood and serous fluid
-produce progesterone and estrogen to a lesser extent.
-less than 2.5 cm w/menstration, angd <10 w/ pregnancy
-hyperechoic rim(ring of fire)
-regress by 16 weeks pregnancy
what is the clinical and songoraphic appearance of hydrosalpnx?
CLINICAL:
-colicky pain
-asymptomatic-incidental finding
-B-hCG useful to differentiate from ectopic
SONOGRAPHICALLY:
-anechoic fluid filled tube that is enlarged and fusiform(sausage shaped)
-uni/biateral
-tube normally tapers where it enters uterus and enlarges distally.
what drugs may affect facial developing?
-alcohol
-codine
-diazepam(valium)
-retin A
-antiepileptric drugs
scanning criteria for nasal bone measurment
-midline sagital profile
-magnify image to display only head and uppper thorax
-profle/transducer angle=45 degrees
-obtain 3 lines in nasal region
-=sign represents sline line, and nasal bone(inner)
-3rd line is tip of nose`
nuchal thickening
-thickening of skin on back of neck seen on the cerebellar veiw
->6mm@16-20wks=abnormal
-outer edge of bone to outer skin edge
-downs syndrome in 20-40%
epignathus
-rare pharyngeal tuor that arises from the palate
-extends through the mouth ad creats an anterior mass
-caries greatly in size and texture
when should tooth buds be seen by?
-15/16 wks
macrognathia(retrognathia)
-shortening of the mandible
-small receeding chin
-overbite
-assoc. w/ trisomy 13 and 18
macroglossia
-enlarged tounge prenatally
-often protruding
-beckwith-wiedemann syndrome
-hypothyroidism
MEDIAN cleft face syndrome
-aka frontal nasal dysplasia malformation complex
-hypertelorism
-median clefting of the nose
-varying degrees of palate cleftin
-V shaped arterior hairline
hypertelorism
-increased intraorbital distance
-may be isolated or part of a syndrome
-assoc. anomolies:
-craniosynostosis
-anterior cephalocele
-median cleft syndrome
hypotelorism
-decreased intraorbital distance
-assoc. w/ holoprosencephaly(most common)
-associated w/ microcephaly, trisomy 21, and 13
-best scan plane=coronal oblique
fetal thyroid
`-functions by 12 wks
-thyroid enlargement or goiter may be seen with hypo/hyperthyroidism
cebocephaly
-flat and rudimentry nose
-hypotelorism
-single flat nostril
-absent philtrum of upper lip
-assoc. w/ holoprosencephaly
give examples of other neck masses
--hemangioma
-lyphangioma
-teratoma:
these are all differentials for eachother
goiter
-thyroid enlargement
-impared swallowing=polyhdramions
-may be seen w/ fetal hyper/ hypothyroidism
-small percentage of mothers w/ grave's disease have hyperthyoid fetus
what are the fetal manifestations w/ a goiter?
-IUGR
-oligo
-tachycardia
-polyhadramnios
-hyperextension of the neck
give examples of giant neck masses
-cervical teratomas
-orthopharyngeal
what are some associated anomolies w/ cleft lip?
-skeletal anomolies(most common)
-CVS-2nd common
-trisomy13
-triploidy(69 chromosomes)
-multiple syndromes
-anencephaly
-holoprosencephaly
ethmocephaly
-extreme hypotelorism w/ supraorbital proboscis or absent nose
-assoc. w/ holoprosencephaly
cyclopia
-single median orbit w/ various degrees of ocular fusion
-absent nose
-proboscus from lower forehead
-abscent facial bones
-absent philtrum of upper lip
-low set ears
-assoc. w/ holoprosencephaly
prognathism
large forward jutting jaw
diprosopus
-duplication of craniofacial structures
-from isolated duplication to completer facial duplication
-single neck and body
-rare form of conjoined twins
name and explain some rare eye anomolies?
-anopthalmia-absence of one or both eyes
-micropthalmia-abnormally small eyes
-cataracts-abnormally echogenic lens
-dacrocystocele-lacrimal duct cyst located inferomedial to orbit.
cleft lip and palate
-most common facial deformity at birth-lack of fusion of facial grooves
-fissure results in communication btw mouth and nasal cavity
-best visualized in coronal oblique
-incomplete cleft involves upper lip
-2/3 patiens w/ cleft lip have cleft palate
-congenital anomolies occur in more than 50% of fetuses w/ facial clefts
-
look at ian suchet dvd
normal face
frontal bossing
cleft lip and palate
nasal bone
nasal proboscis
which chromosomal abnormalities do choroid plexus cysts occur w/
trisomy 18 and 13
not 21
exencephale
aka acrania; see nothing above the orbits
what is nuchal edema
aka nuchal fold; done at the cerebellum level
->6mm=abnormal
Is ACC associated w/ any cyts?
yes-there is often a cyst by the frontal horns w/ ACC
where is the best place to measure the lateral ventricle?
-@ the occipital horn(atria/trigone)
which anatomical structure is anterior to the thalmus of the following?
-occipital horns
-cerebellum
-cisternal magna
-csp
csp
where is the 3rd ventricle in relation to teh thalmi?
-medial
what is abnormal for interventricular distance btw the mid atrial wall and the choroids?
->3mm
what 3 things describe arnold chiari?
-hydrocephalus
-lubosacral meningocele
-cerebellar herniation
when are cysts seen in the endometrium?
-cystic atrophy
-cystic hyperplasia
-endometrail polyps
-endometrial CA
-GTD
-Tomaxifen therapy
cervicala polyps
-irregular bleeding
-begnign
-multigravidas
-attached with a pedicle
-canal may appear thicker than usual
-usually asymptomatic.
what are the 3 pelvic findings that may be influids by tomoxifen therapy?
-thickened endometrium
-endometrial polyps
-endometrial CA
-endometrial cystic hyperplasia
pedunculated fibroids
appear as extrauterine masses
-fibrous stalk may be seen arising from the uterine fibroids
ectocervix
a portion of the canal of the uterine cervix that is lined with squamous epithelium
what is the sonographic appearence of cervical cancer?
-retrovesical mass
-obstruction of the ureters
-invasion of the bladder
-bulkey and irregular cervix w
-enlarged cervix with a solid echogenic mass.
intrauterine synechiae
found in women with posttraumatic history(curretage, and/or infertility)
distinguish btw fibroids and adenomyossi?
-fibroids are nuliparis, but A is multiparous
-F has discrete mass, But A is ill defined
-F has a hypoechoic periphery, but A has myometrial thickening
-F-hypo, iso, or hyperechoic; A-mixed echogenicity
-F-cysts are uncommon; A-commonly has cysts
F-Peripheral vessels; A-central vessels
F-diffuse shadows; A-streaky shadows
F-non tender; A-tender
F-calcify after pregnancy; A-do not calcify
what are the congenital and acquired causes of hydrometrocolpos and hydrometra?
CONGENITAL:
-imperforate hymen
-vaginal septum
-vaginal atresia
-rudimentery uterine horn

ACQUIRED:
-endo/cervical tumors post radiation fibrosis
Endometrial hyperplasia
-may be related to chronic estrogen stimulation
-most common cause of uterine bleeding
-premonopauseal uterus>14mm
-postmenopausal uterus>8mm
-may be precurser to endometrial cancer
what are the 4 causes of secondary cervical stenosis?
-cervical carcinoma
-radiation therapy
-cone biopsy
-post menopausal cervical atrophy
what are some diff dx for dysmenorrhea?
-endometriosis
-salpingoophoritis
-acute uterine retroersion
most common presenting symptoms of adenomyosis?
-uterine enlargement
-pelvic pain
-dysmenorrhea
-menorrhea
name the 6 sonographic features of leiomyomas
-globular
-localized-hypo, heterogenous
-distortion of uterine wall
-attenuation of sound
-old fibroids have calcified walls
-degeneration/necrosis
endometrial polyps
-occur in 10% of women
-perimenopausal women
-adenomatous endometrial tissue
-usually asymptomatic but may present with bleeding
cervical cancer
-affects menstral age women
-associated with:
-early sex encounters
-multiple sex partners
-exposure to herpes2
-usually affects squamus cells
what are the qualities of a subseptate uterus?
1 vagina
1 uterus
suptum btw horns
-able to get pregnant, but cannot continue pregnancy
-septum can be removed in order for successful pregnancy, and it is often successful
what is the clinical presentation of endometriosis?
-dysmenorrhea
-dysmarunia
-infertility
-pain 24-48 hrs before menstration
-normal uterus
what is seen in hysterectemy patients after surgery?
vaginal cuff
why, with congenital uterine anomolies, is there an increased rate of miscarriage and preterm dellivery?
-increased weakness of cervcal muscles
-decreased intrauterine space
-decreased vascularity of placental implantation site
-septate uterus associated with 1, 2nd trimester loss.
-congenital anomolies associated with uterine rupture
when does endometrial carcinoma most frequently occur?
-obesity
-hypertension
-diabetes
-short stature
-more common in jewish women