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44 Cards in this Set

  • Front
  • Back
when should you see the stomach at OB US
by 16 weeks during 1 hour of scanning
when should you see the bladder at OB US
by 16 weeks
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
what is a normal amniotic fluid index
7-25
what is normal nuchal skin thickness
6mm or less measured at post fossa between 16-22 weeks

*pearl* >3mm anytime during 1st trimester is abnormal
what are the soft signs of down's syndrome
double bubble
endocardial cushion defect
nuchal skin thickness > 6mm
echogenic papilla
pyelectasis
echogenic bowel
where do you measure the uterine artery for resistive measurements, the umbilical artery
uterine artery: uterine wall
umbilical artery: the cord
what is a normal uterine artery resistance
low resistance system: changes from 2.0-1.7 over time
>3 at any time is abnormal
what is normal umbilical artery resistance
changes from 4.3 (at 16w) to 2.5 (term) on average
what is normal placental thickness
2-4 cm
what percentage of cords with a single artery have fetal anomalies
50%
ddx: thick umbilical cord
DM
polyhydraminios
urachal remnant tumor (cyst, carcinoma) (focal)
hemangioma (focal)
ddx: thin placenta
DM
vasculitis
HTN
ddx: thick placenta
hydrops fetalis
gestational diabetes
choriocangioma
oligohydramnios
TORCH
what percentage of fetuses with open spina bifida have elevated AFP, closed spina bifida
open: 90%
closed: 10%
what enzyme may be elevated in amniotic fluid of fetuses with spina bifida
acetylcholinesterase
ddx: elevated maternal AFP
A MINOR

atresia (espophageal)
multiple gestation
incorrect dates
neural tube defect
omphalocele/gastroschisis
renal anomaly
describe features of sacrococcygeal teratoma
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!)
with what are cystic hygromas associated
turner's syndrome
trisomy
hydrops (virtually all)
what is the significance of ventriculomegaly in the fetus
virtually all have anomalies

*pearl* 10% have down's; 80% of down's have ventriculomegaly
how often do trisomy 13 fetuses have holoprosencephaly

vice versa
80%

50%
ddx: microcephaly
destruction (TORCH, anoxia)
subnormal growth (IUGR)
syndromic (meckel-gruber, trisomies)
CNS abnormalities
when is a choroid plexus cyst worrisome
associated with other abnormalities
large (>1cm)
bilateral
what is the triad of meckel-gruber
polydactyly, large kidneys, encephalocele
ddx: fetal cystic chest mass
CDH - bochdalek type
CPAM - type 1,2
bronchogenic cyst
ddx: fetal solid chest mass
CDH - morgagni type
sequestration
CPAM - type 3
ddx: fetal small chest size
pulmonary hypoplasia
jeune syndrome
ellis van creveld
dwarf
how often is a double-bubble associated with duodenal atresia
40%
how often do fetuses with down's syndrome have double bubble

vice versa
33%
20%
ddx: fetal/neonatal ascites
MUSHH

meconium peritonitis
urine ascites
storage disease (glycogen)
hydrops
hepatitis
what are causes of bilateral ovarian cysts
hormonal therapy
molar pregnancy
stein-levinthal syndrome
bilateral cystic neoplasm
what is normal thickness of the endometrial stripe
postmenopausal = 5mm
premenopausal - depends on phase of menstrual cycle
ddx: postmenopausal thick endometrium
carcinoma
polyp
hyperplasia
how can a thick endometrium in a postmenopausal woman be managed
5-8mm - hysterosalpingography, close f/u or Bx
>8mm - Bx
ddx: complex adnexal mass
CHEETA

cystadenoma/adendoca
hemorrhagic cyst
endometrioma
ectopic pregnancy
teratoma
abcess
hematoma
what features of an adnexal cyst are suspicious for malignancy
solid components
doppler flow in solid elements
ddx: enlarged ovary in young woman
functional cyst
ovarian torsion
polycystic ovary syndrome
ovarian mass
what are the features of stein-levinthal syndrome
oligomenorrhea
hirsutism
obesity

aka polycystic ovary syndrome
what findings suggest ovarian torsion
large ovarian size
peripheral follicles
cul-de-sac fluid

*pearl* there are no specific signs for ovarian torsion
what are the classic signs of ovarian teratoma
dermoid plug (focal echogenic shadowing nodule)
tip of the iceberg (can't see through it)

*pearl* you can mistake these for bowel!
what are the features you should evaluate in first trimester US
gestational sac
yolk sac
embryo
cardiac activity
CRL
uterine anatomy
placental location
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
ddx: positive beta HCG without IUP
early IUP
ectopic
spontaneous abortion
molar pregnancy
what are features suggestive of ectopic pregnancy
no IUP
complex adnexal mass
complex cul-de-sac fluid
tubal ring
single decidual layer