Exam #4

Question 1

What are the landmarks for the 2nd trimester fetal biometry?

Answer 1

• BOD
• HC
• AC
• FL

Question 2

BPD

Answer 2

*biparietal diameter
-most reliable for predicting fetal age

Question 3

HC

Question 4

AC

Question 5

FL

Question 6

What are the landmarks for the posterior fossa?

Answer 6

• arnold chiarri (banana sign)
• spina bifida
• cisterna magna

Question 7

Why is it important to image the posterior fossa?

Answer 7

to monitor if fluid increases, nuchal fold thickens

Question 8

IUGR
- what is it?
- list some causes?

Answer 8

*Intrauterine Growth Restriction
- fetal birth weight AT or BELOW 10% for gestational age
- causes:
- HTN
- smoking
- previous IUGR
- UT anomaly (bicorn or fibroid)
- placenta hemorrhage/insufficiency

Question 9

Symmetric IUGR occurs in the __ trimester and is generally caused by _____.

Answer 9

• 1st
• severe insult:
  
  • intrauterine infection
  • maternal malnutrition
  • fetal alcohol syndrome
  • chromosomal anomaly
  • severe congenital anomaly

Question 10

Asymmetric IUGR occurs in the __ trimester and is often caused by _____.

Answer 10

• 2nd
• placental insufficiency

Question 11

What tests are included in the biophysical profile?

Answer 11

• cardiac non stress test (NST)
  
  • Doppler: heart rate & UT contractions
• fetal breathing movements
• fetal movements
• fetal tone
• AFV

Question 12

Biophysical profile is used to determine __.

Answer 12

fetal well-being

Question 13

AFI
- what is it?
- what is the normal range?

Answer 13

• Amniotic Fluid Index
• normal range:
  
  • four quadrant (total): 5-22 cm
  • single pocket: 2-8 cm

Question 14

AFI: Polyhydroamnios

Answer 14

• four quadrant (total): >22 cm
• single pocket: >8 cm

Question 15

AFI: Oligohydroamnios

Answer 15

• four quadrant (total): <5 cm
• single pocket: <2 cm

Question 16

List the dangers of Maternal Diabetes:

Answer 16

• polyhydramnios
• macrosomic baby
• very severe vascular disease can cause IUGR

Question 17

Macrosomic baby

Answer 17

a birth weight AT or ABOVE the 90th percentile

Question 18

It is important not to confuse IUGR with a baby who is just ___.

Answer 18

SGA

Question 19

SGA
- what factors result in this type of baby?

Answer 19

*
- AT or BELOW 10th percentile
- factors
- genetics
- poor maternal weight gain & nutrition
- intrauterine infections
- chromosomal anomaly
- placental insufficiency

Question 20

What are the functions of the placenta?
(HINT: P.H.E.R.N.)

Answer 20

• protection
• hormone production
• excretion
• respiration
• nutrition

Question 21

TORCH
- what is it?
- what can it lead to?

Answer 21

• Toxoplasmosis
• Ruebella
• Cytomegalovirus
• Herpes

Question 22

What are the abnormal umbilical cord insertion types?

Answer 22

• Battledore (Marginal)
• Succenturiate
• Velamatous

Question 23

Describe the normal central insertion type of the umbilical cord.

Question 24

Vasa Previa
*what is it?
- what does it result from?

Answer 24

*
- Velamatous

Question 25

What are the types of abnormal placental attachment?

Answer 25

- placenta accreta - placenta increta - placenta percreta

Question 26

Placenta Accreta

Answer 26

invades 50% through the myometrium

Question 27

Placenta Increta

Answer 27

invades <50% through the myometrium

Question 28

Placenta Percreta

Answer 28

extends through UT into the bladder and adjacent pelvic structures

Question 29

Name the four grades of placenta previa from least to most severe?

Answer 29

- Low Lying - Marginal - Partial - Complete

Question 30

What are the dangers of nuchal cord?

Question 31

The dangers of nuchal cord to the fetus may result in...

Question 32

Mid Gut Herniation *what is it? - why it happens - when it happens - when it should resolve

Answer 32

* - - happens around 8 wks; resolve by 12 wks

Question 33

Omphalocele

Answer 33

when the midgut herniation fails to resolve

Question 34

Gastroschisis

Answer 34

an abdominal defect (more likely RT-sided) where intestines spill out into the amniotic fluid

Question 35

Why is there an increase in AFP in association with ____?

Question 36

How many vessels are in the umbilical cord? How long is the umbilical cord (in cm)?

Answer 36

3-- 1 vein, 2 arteries - 40-60 cm

Question 37

What are two ways to image the umbilical cord vessels?

Question 38

The umbilical cord is covered in ___. What is the purpose?

Answer 38

- Wharton's jelly -

Question 39

What is placental abruption?

Question 40

What type of placental abruption presents with NO vaginal bleeding?

Question 41

Dizygotic

Answer 41

two zygotes (fertilized eggs)

Question 42

Monozygotic

Answer 42

one fertilized egg (which divides)

Question 43

Chorion refers to the...

Answer 43

placenta

Question 44

What are the types of twins?

Answer 44

- MA/MC (monoamniotic/monochorionic) - DA/DC (diamniotic/dichorionic) - DA/MC (diamniotic/monochorionic) - conjoined

Question 45

What is the most dangerous twinning?

Answer 45

mono/mono

Question 46

The 'Twin Peak" or 'Lambda Sign' indicates what type of twinning?

Answer 46

Di/Di

Question 47

The 'T-sign' indicates what type of twinning?

Answer 47

Diamniotic/Monochorionic

Question 48

TRAP

Answer 48

*Twin Reversed Arterial Perfusion - 1 twin is acardiac (receives ALL bl. supply from pump twin)

Question 49

TTTS

Answer 49

*Twin Twin Transfusion Syndrome - 1 twin recieves majority of blood over the other due to an AV shunt w/in placenta

Question 50

What is a vanishing twin?

Answer 50

a twin that dies early in 1st trimester and the mother's body absorbs the remains

Question 51

What is a "stuck twin"?

Answer 51

*diamniotic pregnancy - polyhydramnios in one sac - severe oligohydramnios in other sac - manifests 16-26 wks

Question 52

What are the tests in the Quadruple screen?

Answer 52

- AFP - Elevated neural tube defects/anencephaly & spina bifida

Question 53

Trisomy 21

Answer 53

*aka Down Syndrome - very common chromosomal defects - adv. maternal age - nuchal translucency (>3mm) & nuchal fold (>6mm) - mental retardation - hygroma - duodenal atresia (double bubble) - echogenic bowel - mild ventriculomegaly

Question 54

Trisomy 18

Answer 54

*aka Edwards Syndrome - 2nd most common chromosomal defect - abnormal quad screen - heart defects - clenched hands - rocker bottom foot - cleft lip & palate - omphalocele - congenital diaphragmatic hernia - cerebellar hypoplasia - profoundly retarded w/ 90% dying in 1st year of life

Question 55

Trisomy 13

Answer 55

*aka Patau's Syndrome - extremely severe w/ multiple brain anomalies - holoprosencephaly - cyclopia & proboscis - polydactyly, omphalocele - micrognathia - meningomyecele - 80% die in 1st month

Question 56

Micrognathia

Answer 56

small chin

Question 57

Talipes Equinovarus

Answer 57

clubfoot (abnormal medial rotation of foot)

Question 58

Syndactyly

Answer 58

same, or all of the fingers/toes, partly or wholly united

Question 59

Polydactyly

Answer 59

extra fingers/toes

Question 60

Proboscis

Answer 60

a rare fetal anomaly - appendage-like structure projecting from the ML fetal face/forehead.

Question 61

Cyclopia

Answer 61

prosencephalon fails to properly divide the orbits into two cavities (often with a proboscis)

Question 62

Turner's Syndrome

Answer 62

*45X - genetic abnormality - absence of an X or Y chromosome

Question 63

Cystic Hygroma

Answer 63

* - infants CAN survive - physical ft: - short stature - webbed neck

Question 64

Triploidy

Answer 64

- extra set of chromosomes - physical/mental ft: - head defects - cranial & renal anomalies - omphalocele - mental retardation

Question 65

Dominant disorder

Answer 65

*autosomal dominant - caused by a single defective gene

Question 66

Recessive disorder

Answer 66

*autosomal recessive - caused by a PAIR of defective genes - one from each parent