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44 Cards in this Set
- Front
- Back
when should you see the stomach at OB US
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by 16 weeks during 1 hour of scanning
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when should you see the bladder at OB US
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by 16 weeks
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what measurement do you use to estimate age in the:
1st trimester 2nd 3rd |
1st trimester: CRL
2nd trimester: BPD 3rd trimester: FL or combination |
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what is a normal amniotic fluid index
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7-25
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what is normal nuchal skin thickness
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6mm or less measured at post fossa between 16-22 weeks
*pearl* >3mm anytime during 1st trimester is abnormal |
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what are the soft signs of down's syndrome
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double bubble
endocardial cushion defect nuchal skin thickness > 6mm echogenic papilla pyelectasis echogenic bowel |
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where do you measure the uterine artery for resistive measurements, the umbilical artery
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uterine artery: uterine wall
umbilical artery: the cord |
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what is a normal uterine artery resistance
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low resistance system: changes from 2.0-1.7 over time
>3 at any time is abnormal |
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what is normal umbilical artery resistance
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changes from 4.3 (at 16w) to 2.5 (term) on average
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what is normal placental thickness
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2-4 cm
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what percentage of cords with a single artery have fetal anomalies
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50%
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ddx: thick umbilical cord
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DM
polyhydraminios urachal remnant tumor (cyst, carcinoma) (focal) hemangioma (focal) |
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ddx: thin placenta
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DM
vasculitis HTN |
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ddx: thick placenta
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hydrops fetalis
gestational diabetes choriocangioma oligohydramnios TORCH |
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what percentage of fetuses with open spina bifida have elevated AFP, closed spina bifida
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open: 90%
closed: 10% |
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what enzyme may be elevated in amniotic fluid of fetuses with spina bifida
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acetylcholinesterase
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ddx: elevated maternal AFP
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A MINOR
atresia (espophageal) multiple gestation incorrect dates neural tube defect omphalocele/gastroschisis renal anomaly |
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describe features of sacrococcygeal teratoma
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graded as 1 thru 4 based on degree of intrapelvic extension
arise from hensen's node at the coccyx are associated with hydrops and CHF after 4 months malignant degeneration increasingly occurs (operate early!) |
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with what are cystic hygromas associated
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turner's syndrome
trisomy hydrops (virtually all) |
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what is the significance of ventriculomegaly in the fetus
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virtually all have anomalies
*pearl* 10% have down's; 80% of down's have ventriculomegaly |
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how often do trisomy 13 fetuses have holoprosencephaly
vice versa |
80%
50% |
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ddx: microcephaly
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destruction (TORCH, anoxia)
subnormal growth (IUGR) syndromic (meckel-gruber, trisomies) CNS abnormalities |
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when is a choroid plexus cyst worrisome
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associated with other abnormalities
large (>1cm) bilateral |
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what is the triad of meckel-gruber
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polydactyly, large kidneys, encephalocele
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ddx: fetal cystic chest mass
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CDH - bochdalek type
CPAM - type 1,2 bronchogenic cyst |
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ddx: fetal solid chest mass
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CDH - morgagni type
sequestration CPAM - type 3 |
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ddx: fetal small chest size
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pulmonary hypoplasia
jeune syndrome ellis van creveld dwarf |
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how often is a double-bubble associated with duodenal atresia
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40%
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how often do fetuses with down's syndrome have double bubble
vice versa |
33%
20% |
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ddx: fetal/neonatal ascites
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MUSHH
meconium peritonitis urine ascites storage disease (glycogen) hydrops hepatitis |
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what are causes of bilateral ovarian cysts
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hormonal therapy
molar pregnancy stein-levinthal syndrome bilateral cystic neoplasm |
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what is normal thickness of the endometrial stripe
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postmenopausal = 5mm
premenopausal - depends on phase of menstrual cycle |
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ddx: postmenopausal thick endometrium
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carcinoma
polyp hyperplasia |
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how can a thick endometrium in a postmenopausal woman be managed
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5-8mm - hysterosalpingography, close f/u or Bx
>8mm - Bx |
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ddx: complex adnexal mass
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CHEETA
cystadenoma/adendoca hemorrhagic cyst endometrioma ectopic pregnancy teratoma abcess hematoma |
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what features of an adnexal cyst are suspicious for malignancy
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solid components
doppler flow in solid elements |
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ddx: enlarged ovary in young woman
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functional cyst
ovarian torsion polycystic ovary syndrome ovarian mass |
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what are the features of stein-levinthal syndrome
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oligomenorrhea
hirsutism obesity aka polycystic ovary syndrome |
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what findings suggest ovarian torsion
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large ovarian size
peripheral follicles cul-de-sac fluid *pearl* there are no specific signs for ovarian torsion |
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what are the classic signs of ovarian teratoma
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dermoid plug (focal echogenic shadowing nodule)
tip of the iceberg (can't see through it) *pearl* you can mistake these for bowel! |
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what are the features you should evaluate in first trimester US
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gestational sac
yolk sac embryo cardiac activity CRL uterine anatomy placental location |
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what are the parts of the double decidual sac sign
what does it indicate |
decidua parietalis
decidual capsularis decidual basalis it is highly associated (98%) with IUP |
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ddx: positive beta HCG without IUP
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early IUP
ectopic spontaneous abortion molar pregnancy |
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what are features suggestive of ectopic pregnancy
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no IUP
complex adnexal mass complex cul-de-sac fluid tubal ring single decidual layer |