Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
49 Cards in this Set
- Front
- Back
What are the guidelines of US for looking at a fetus
|
Aium guidelines
|
|
What type of view of the heart should be obtained
|
a 4 chamber view
|
|
Should you look for the location and orientation of the heart
|
yes, the heart should be central to slightly left and rotated to the left
|
|
What is the view of the heart if you come a bit superior with the probe
|
a 3 vessel view
|
|
What is always larger the aorta or the pulmonary artery
|
the pulmonary artery
|
|
What should you be concerned about if the aorta is bigger than the pulmonary artery
|
TOF
|
|
Is it easy to detect pulmonary hypoplasia if you look at a posterior coronal image of the fetus
|
no, because the ribcage maintains the contour of the fetus and therefore it is better to look anteriorly
|
|
What are 6 abnormalities of fetal lung development
|
pulmonary hypoplasia
cystic adenomatoid malformation of the lung congenital diaphragmatic hernia pulmonary sequestration laryngeal/tracheal atresia pulmonary hydrothorax |
|
How do you measure pulmonary hypoplasia
|
measure the thorax (in the same transverse view used to look at the 4 chamber heart) and compare the measurement to a standardized table
|
|
In a coronal view of the fetus what is a rule of thumb for determining if a fetus has pulmonary hypoplasia
|
compare the size of the thorax to the abdomen in coronal view.
|
|
What is the ddx for skeletal dysplasia
3 |
jeunes ATD, Thanatophoric dysplasia, achondrogenesis
|
|
What is the DDX for oligohydraminos
3 |
PROM, renal agenesis, renal obstruction
|
|
What is the DDX for a small thorax
3 |
pulmonary hypoplasia
oligohydraminos skeletal dysplasia |
|
If a fetus has decreased amniotic fluid? , a small or abnormal extremity and a small thorax what should you suspect
|
skeletal dysplasia
|
|
Why does oligohydraminois cause a small thorax
|
fluid is secreted and absorbed by the lungs (among other things) and the fluid acts a s a internal stent for normal lung development and lack of fluid and external compression causes pulm hypoplasia
|
|
What is the ddx for a solid appearing intrathoracic fetal mass
5 |
congenital cystic adenomatoid malformation
pulmonary sequestration laryngeal/tracheal/bronchial atresia congenital diaphragmatic hernia bronchial foregut abnormality |
|
What is the DDX for cystic appearing intrathoracic fetal masses
4 |
CCAM,
mediastinal cystic teratoma congenital diaphragmatic hernia Bronchopulmonary foregut abnormality Note: diaphragmatic hernia, bronchopulmonary foregut abnormality, CCAM are also solid appearing. |
|
What is a CCAM
|
Anomalous fetal development of terminal respiratory structures resulting in an adenomatoid proliferation of bronchiolar elements and cyst formation
|
|
What are the 3 categories of CCAM
|
type 1, 2 and 3
this is based on size of cyst and not really used |
|
Can the cyst be so small in CCAM that you cant really see them
|
yes, kinda like ARPKD (TYPE 3)
|
|
Do type 3 CCAM appear solid
|
yes this is the one that has many small cyst and appears as a large solid mass.
|
|
How to you recongnize a type 3 CCAM
|
it is a mass with increased echogenicity
|
|
What is does a type 1 CCAM look like?
|
It is a large cyst
|
|
Can a CCAM be a large echogenic mass
|
yes
|
|
Can a CCAM be bilateral
|
yes
|
|
What are the 2 types of pulmonary sequestration
|
intralobar and extralobar
|
|
Where is the most common location for an extralobar pulmonary sequestration
|
the left basal hemithorax
|
|
Can a CCAM look similar to a pulmonary sequestration
|
yes almost identical look
|
|
What should you think about if there is a hyperechogenic mass in the thorax
|
pulmonary sequestration or CCAM
|
|
Can a pulmonary seqeustration go below the diaphragm
|
yes,it can be subdiaphragmatic
|
|
How do you differentiate a pulmonary sequestration from a CCAM
|
by using color doppler and you will see blood flow to a sequestration.
|
|
What are pulmonary sequestrations commonly associated with
|
hydrothorax
|
|
Can a pulmonary seqestration be bilateral
|
yes
|
|
Can both CCAMs and pulmonary sequestrations be bilateral
|
yes
|
|
Do all intrathoracic masses of fetus grow throughout pregnancy
|
no, many disappear or decrease in size
|
|
What percent of congenital diaphragmatic hernias are left sided
|
90%
|
|
What happens to the heart with diaphragmented hernia
|
moves to the opposite side
|
|
What is typical appearance of US of diaphragmatic hernia
|
the heart pushed over to one side and the stomach above the diaphragm adjacent to the heart on a transverse view
|
|
What determines the prognosis of a diaphragmatic hernia
|
size of hernia
liver herniation size of visible lung |
|
What is a hybrid lesion
|
this is a combination of sequestration or CCAM and something else. Basically two of any pathology going on at the same time.
|
|
What is the cause of upper respiratory tract agenesis
|
this is caused by an insult that occur at 4-6 weeks and it is a narrowing or agenesis of trachea or upper respiratory tree.
|
|
How to the lungs appear in laryngeal atresia
|
bilateral echogenic
|
|
How do the trachea and bronchi appear in layrngeal atreasia
|
dilated and there is bilateral echogenic lungs
|
|
What causes a fetal hydrothorax
|
rupture or failure of fusion of thoracic channels
|
|
What side does a fetal hydrothorax most commonly occur on
|
the right side.
|
|
If you dont see the stomach below the diaphragm what should be suspected
|
a diaphragmatic hernia
|
|
What should you suspect if there is an echogenic mass in the thorax and it has cyst within it
|
Cystic adenomatoid malformation
|
|
If you see an echogenic mass in the thorax and on doppler it has vessels what should you suspect
|
pulmonary sequestration
|
|
If you see bilateral echogenic masses in the thorax what should you suspect
|
upper respiratory tract atresia
|