Chapter 23 - The first trimester Flashcards
1
Q
complete expulsion or partial expulsion of the conceptus
A
Abortion
2
Q
sonographic sign which describes appearance of ectopic pregnancy within FT
A
adnexal ring sign
3
Q
wall of inner sac (amniotic cavity) that contains the embryo and amniotic fluid echogenic curvilinear structure that may be seen during 1st trimester within gestational sac
A
Amnion
4
Q
cavity that contains simple appearing amniotic fluid and the developing embryo
A
amniotic cavity
5
Q
an abnormal pregnancy in which there is no evidence of a fetal pole or yolk sac within the GS
-refereed to as blighted ovum
A
Anembryonic gestation
6
Q
a condition of having abnormal number of chromosomes
A
Aneuploid
7
Q
stage of conceptus that implants within the decidulaized endometrium
A
Blastocyst
8
Q
low heart rate
A
Bradycardia
9
Q
most malignanet form of gestation trophoblastic disease with possible metastatic to liver and lungs and vagina
A
choriocarcinoma
10
Q
outer membrane of gestation that surround amnion and developing embryo
A
chorion
11
Q
part of the chorion covered by chorionic villi that is the fetal contribution of the placenta
A
chorion frondosum
12
Q
he space between the chorionic sac and amniotic sac that contains the secondary yolk sac; also referred to as the extraembryonic coelom
A
chorionic cavity
13
Q
gestational sac
A
chorionic sac
14
Q
fingerlike projections of gestational tissue that attach to the decidualized endometrium and allow transfer of nutrients from the mother to the fetus
A
chorionic villi
15
Q
specialized cells within the ventricular system responsible for cerebrospinal fluid production
A
choroid plexus
16
Q
e combination of a female ovum with a male sperm to produce a zygote also referred to as fertilization
A
Conception
17
Q
physiologic ovarian cyst that develops after ovulation has occurred
A
corpus luteum cyst
18
Q
the corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone
A
corpus luteum of pregnancy
19
Q
the corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone
A
corpus luteum of pregnancy
20
Q
the measurement of the embryo/fetus from the top of the head to the rump
A
CRL
21
Q
the endometrial at the implantation site and the maternal contribution of the placenta
A
decidua basalis
22
Q
the physiologic effect of the endometrium in the presence of a pregnancy
A
decidual reaction
23
Q
the level of human chorionic gonadotropin beyond which an intrauterine pregnancy is consistently visible
A
Discriminatory zone
24
Q
*Normal US appearance of decidua capsularis & decidua parietalis
*Separated by anechoic fluid-filled uterine cavity
A
double decidual sign
25
a sequela of preeclampsia in which uncontrollable maternal hypertension and proteinuria lead to maternal convulsions and possibly fetal and maternal death
eclampsia
26
term given to the developing fetus before 10 weeks gestation
embryo
27
-The death of an embryo before 10 weeks gestation
embryonic demise
28
-A double fold of dura mater located within midline of the brain
falx cerebri
29
the fingerlike extension of the fallopian tube located on the infundibulum
fimbria
30
-Localized, painless contractions of the myometrium in the gravid uterus that should resolve within 20-30 minutes
focal myometrial contraction
31
the way in which a pregnancy can be dated based on the first day of the last menstrual cycle also referred as menstrual age
gestational age
32
a disease associated with an abnormal proliferation of the trophoblastic cells during pregnancy; may also be referred to as molar pregnancy
gestation trophoblastic disease
33
the name for the dominant follicle prior to ovulation
Graafian follicle
34
the development of blood cells
Heamtopoiesis
35
co-existing ectopic and intrauterine pregnancies
heteropic pregnancy
36
-The most common form of gestational trophoblastic disease in which there is excessive growth of the placenta and high levels of human chorionic gonadotropin
-typically benign
hydatidiform mole
37
excessive vomitting during pregnancy
hyperemeis gravid arum
38
a bleed that occurs at the time in which the conceptus implants into the decidualized endometrium
implantation bleeding
39
distal segment of fallopian tube
infundibulum
40
Appearance of small gestational sac in uterine cavity surrounded by thickened, echogenic endometrium
intradecidual sign
41
a type of gestational trophoblastic disease in which a molar pregnancy invades into the myometrium and may also invade through the uterine wall and into the peritoneum
Invasive mole
42
early embryonic structures that will eventually give rise to the extremities
limb buds
43
the measurement of the gestational sac to obtain a gestational age; achieved by adding the measurements of the length width and height of the gestational sac and dividing by 3
mean sac diameter
44
a chemotherapy drug used to attack rapidly dividing cells like those seen in an early pregnancy; this drug is often used to manage ectopic pregnancy
methotrexate
45
the spontaneous end of a pregnancy before viability
miscarriage
46
Fetal demise with retained fetus
missed abortion
47
the developmental stage of the conceptus following the zygote
morula
48
the normal developmental stage when the midgut migrates into the base of the umbilical cord
physiologic bowel herniation
49
Pregnancy-induced maternal high blood pressure & excess protein in urine after 20 weeks gestation
preeclampsia
50
-The appearance of an abnormally shaped false gestational sac within the uterine cavity as a result of an ectopic pregnancy
-this often corresponds with the accumulation of blood and secretions within the uterine cavity
pseudogestional sac
51
the primary brain vesicle also referred to as the hindbrain become the cerebellum pons medulla oblongata and fourth ventricle
rhombencephalon
52
the structure responsible for early nutrient transfer to the embryo; the yolk sac seen during a sonographic examination of the early gestation
secondary yolk sac
53
a bleed between the endometrium and the gestational sac at the edge of the placenta
subchorionic hemorrhage
54
having three sets of each chromosome or 69 total
triploid
55
chromosomal aberration in which there is a third chromosome 18
trisomy 18 (Edwards syndrome)
56
Chromosomal aberration in which there is third chromosome 21
Trisomy 21 (Down syndrome)
57
the cells that surround the gestation that produce human chorionic gonadotropin
Trophoblastic cells
58
a chromosomal aberration where one sex chromosome is absent; may also be referred to as monosomy X
Turner syndrome
59
the structure that connects the developing embryo to the secondary yolk sac
vitelline duct
60
he cell formed by the union of two gametes the first stage of a fertilized ovum
zygote
61
What cells produce hCG
trophoblastic cells
62
primary yolk sac regressresses during week ___
4
63
the neural tube will become the fetal ____ and ___
head, spine
64
In the 1st trimester _____ maintains the corpus luteum cyst
hug
65
hCG is detected in the maternal blood as early as ___ days menstrual age
23
66
a gestational sac with TV sonography should be visualized between ____ and ____ mIU per mL
1,000, 2,000 discriminatory zone or level
67
normal hcg levels will double every ____ hours in the 1st trimester
48 hours
68
will hCG rise or decline in complete molar pregnancy?
rise
69
The _____ ____ of the endometrium is essentially the first sonographically identifiable sign of a pregnancy. However, the first sign of a definitive sign of an IUP is the ____ ____ within the endometrium.
decimal reaction, gestational sac
70
Sonographic identification of the decidua capsularis, decidua parietalis, and decidua basalis to differentiate a "pseudo sac" associated with ectopic pregnancies from a gestational sac
Double sac sign
71
l+w+h of gestational sac and /3.
you can also add 30 to MSD meas (mm) for an estimate of gestational age in days.
MSD formular
72
the first structure seen with sonography within the gestational sac is the
secondary yolk sac
73
The gestational sac consists of two cavaties:
chorionic cavity , amniotic cavity
74
what duct connects the yolk sac to the embryo?
vitelline duct
75
The embryo will grow at a rate of ___mm per day
1
76
The most accurate sonographic measurement of pregnancy is
CRL
77
midgut herniation begins at week ___ and regresses at week ____
8,12
78
The placenta is formed by the _____ ____ and the ____ _____
decidua basalis, chorion frondosum
79
what are the most common abnormalities seen with NT?
trisomy 21, 18, Turner syndrome and congestive heart failure
80
the NT optimally measured between ___ and ___ weeks ____ days when the CRL measures between ___ and ___ mm
11,13,6,45,84
81
what is the maximum meas of NT?
3mm
82
The most common location of an EUP is
ampullarf portion of the tube
83
classic clinical triad of ectopic pregnancy
pain, vaginal bleeding, and a palpable abdominal pelvic mass
84
which is more common, a complete or incomplete molar (GTD) pregnancy?
complete
85
are molar pregnancies typically benign or malignant?
benign, but do have malignant potential
86
The most common forms of malignant GTD are
invasive mole, choriocarcinoma
87
The most common sites of metastasis
lungs, liver and vagina
88
The ovarian mass associated with molar pregnancy and elevated hCG is the ___ ____ cyst
theca lutein
89
A ____ ____ or anembryonic gestation is diagnosed when there is no evidence of a fetal pole or yolk sac within the gestational sac
blighted ovum
90
clinical findings of blighted ovum
vaginal bleeding, reduction of pregnancy symptoms, low hCG
91
fibroids are stimulated by what hormone?
estrogen
92
the complete expulsion or partial expulsion of the conceptus
abortion
93
what structure connects the embryo to the yolk sac?
vitelline duct
yolk stalk
amnion
chorionic stalk
A
94
what is the name of the dominant follicle prior to ovulation?
Graafian
corpus luteum
morula
corpus albicans
A
95
fertilization typically occurs within ______ after ovulation
40 hours
12 hours
24 hours
56 hours
C
96
the most common site of fertilization is within the:
isthmus
fundus
cornu
ampulla
D
97
with a normal pregnancy, the first structure noted within the decidualized endometrium is the:
yolk sac
chorionic sac
amniotic cavity
embryo
B
98
the structure created by the union of sperm and egg is:
blastocyst
zygote
morula
ampulla
B
99
the trophoblastic cells produce
estrogen
progesterone
FSH
hCG
D
100
sonographically, a normal appearing 7-week IUP is identified. within the adnexa, an ovarian cystic structure with a thick, hyperechoic rim is also discovered. what does this ovarian mass most likely represent?
theca lutein cyst
corpus luteum cyst
corpus albicans
ectopic pregnancy
B
101
what is the stage of the conceptus that implants within the decidualized endometrium?
blastocyst
morula
zygote
ovum
A
102
another name for the chorionic sac is the:
chorionic cavity
extraembryonic coelom
amniotic sac
gestational sac
D
103
what is often used to medically treat an ectopic pregnancy?
dilatation and curettage
dilatation and evacuation
open surgery
methotrexate
D
104
what structure lies within the extraembryonic coelom?
gestational sac
embryo
yolk sac
amnion
C
105
what hormone, produced by corpus luetum, maintains the thickened endometrium?
estrogen
progesterone
hCG
LH
B
106
what is the most common form of GTD?
complete molar pregnancy
partial molar pregnancy
invasive mole
choriocarcinoma
A
107
in the first trimester, normal hCG levels will:
double every 48 hours
triple every 24 hours
double every 24 hours
double every 12 hours
A
108
compared with a normal IUP, the ectopic pregnancy will have a:
high hCG
low hCG
markedly elevated hCG
high AFP
B
109
which of the following locations for an ecoptic pregnancy would be least likely?
isthmus
ampulla
ovary
interstitial
C
110
the first sonographically identifiable sign of pregnancy is the:
amnion
yolk sac
decidual reaction
chorionic cavity
C
111
the first structure noted within the gestational sac is the:
yolk sac
embryo
decidual reaction
chorionic sac
A
112
NT measures are typically obtained between:
1 and 5 weeks
5 and 8 weeks
8 and 11 weeks
11 and 14 weeks
D
113
the normal gestational sac will grow:
2mm per day
3mm per day
1cm per day
1mm per day
D
114
during the 1st trimester US, you note a round, cystic structure within the fetal head. this most likely represents:
prosencephalon
mesencephalon
rhombencephalon
proencephalon
C
115
the migration of the embryologic bowel into the base of the umbilical cord at 9 weeks is referred to as:
physiologic bowel herniation
pseudo-omphalocele
omphalocele
gastroschisis
A
116
during a 12 week US, bilateral echogenic structures are noted within the lateral ventricles of the fetal cranium. these structures most likely represent:
cerebral tumors
cerebral hemorrhage
anencephalic remnants
choroid plexus
D
117
he most common pelvic mass associated with pregnancy is the:
uterine leiomyoma
dermoid cyst
theca luteum cyst
corpus luteum cyst
D
118
all of the following are associated with an abnormal NT except:
trisomy 21
trisomy 16
trisomy 18
Turner syndrome
B
119
what hormone maintains the corpus luteum during pregnancy?
estrogen
progesterone
FSH
hCG
D
120
the most common cause of pelvic pain with pregnancy is:
ectopic pregnancy
heterotopic pregnancy
missed abortion
molar pregnanc
A
121
the most common location of an ectopic pregnancy is the:
ovary
interstitial
cornual
ampullary
D
122
all of the following are contributing factors for an ectopic pregnancy except:
PID
assisted reproductive therapy
IUCD
advance paternal age
D
123
all of the following are clincial features of an ectopic pregnancy except:
pain
vaginal bleeding
shoulder pain
adnexal ring
D
124
in the early gestation, where is the secondary yolk sac located?
chorionic cavity
base of umbilical cord
embryonic cranium
amniotic cavity
A
125
all of the following are sonographic findings consistent with ectopic pregnancy except:
decidual thickening
complex free fluid within the pelvis
bilateral, multiloculated ovarian cysts
complex adnexal mass separate from the ipsilateral ovary
C
126
all of the following are consistent with a complete hydatidiform mole except:
heterogenous mass within endometrium
bilateral theca lutein cysts
hyperemesis gravidarum
low hCG
D
127
malignant form of GTD is:
choriocarcinoma
hydatidiform mole
anembryonic
hydropic villi
A
128
an US exam was performed on a pregnancy patient who complained of vaginal bleeding. sonographically, a crescent-shaped anechoic area is noted adjacent to the gestational sac. the gestational sac contained a 6week single live IUP. what is the most likely definition?
ectopic pregnancy
molar pregnancy
subchorionic hemorrhage
anembryonic gestation
C
129
all of the folliwng would be associated with lower-than-normal hCG levels except:
ectopic pregnancy
molar pregnancy
blighted ovum
spontaneous abortion
B
130
all of the following are clinical findings consistent with a complete molar pregnancy except:
vaginal bleeding
HTN
uterine enlargement
small for dates
D
131
which of the following is most likely metastatic location for GTD?
rectum
pancreas
spleen
lungs
D
132
all of the following may be sonographic findings in the presence of an ectopic pregnancy except:
pseudogestational sac
corpus luteum cyst
adnexal ring
low beta-hCG
D
