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SON 2121 DMS OB/GYN 1 > Final Spring 2021 > Flashcards

Final Spring 2021 Flashcards

(97 cards)

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1
Q

Bicornuate Uterus

A

Failure of the mullerian ducts to fuse

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2
Q

The Muscles that make up the pelvic diaphragm

A

Levator Ani and Coccyogeus

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3
Q

Follicles of the ovary are found in the;

A

Cortex

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4
Q

Arcuate Arteries are found it which layer of the uterus?

A

Myometrium

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5
Q

True of False
The pelvic cavity is divided into two regions based on an imaginary plane running from the sacral prominence to the upper margin of the symphysis pubis

A

True

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6
Q

During the luteal phase the corpus luteum produces which hormone in order to maintain the thickened endometrium?

A

Progesterone

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7
Q

Ovaries can typically be found;

A

Lateral to uterus and medial to the iliac artery and vein

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8
Q

Menarche

A

Onset of menses

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9
Q

The female cycle;

Day 1-5

A 
*Menstrual* 
Uterine - period, Estrogen & progesterone Drop
Hypothalamus - GnRH
Pituitary- FSH
*Follicular*
Ovarian- Follicle development = estrogen
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10
Q

The female cycle;

Day 6-14

A

Proliferative
Uterine- “3 line sign” estrogen causes proliferative endometrium
Pituitary- LH
Ovulation (day 14)
Ovarian- corpus luteum makes progesterone to maintain thick endometrium for fertilized egg - (if NO hcg- corpus luteum resolves in 14days = back to day one)

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11
Q

Arteries of the uterus

A

Internal iliac artery > Uterine artery (menopause=^ resistance) > Myometrium arcuate artery > Deep endometrium Radial artery > Basal layer straight artery > spiral artery

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12
Q

Ligaments that support the uterus in the pelvis

A

Broad ligaments
Round ligaments
Ovarian suspensory ligamnets

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13
Q 
Uterine position;
Ante-
Retro-
Flexion-
Version-
A

Ante- Forward
Retro- Backward
Flexion- Position of uterus
Version- Position of cervix

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14
Q

The widest portion of the fallopian tube where fertilization occurs;

A

Ampulla

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15
Q

The right ovarian vein drains into the;

The left ovarian vein drains into the;

A

IVC

Left renal vein

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16
Q

Mullerian duct

A

Form the upper vagina, cervix, uterus & fallopian tubes.

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17
Q

The most common abnormality when the mullerian duct fail to form

A

Unicornuate uterus

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18
Q

Vaginal atresia & imperforate hymen can be diagnosed by the development of;

A

Hematometra
Hematocolpos
Hematometrocolpos

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19
Q

In a post-menopausal women the uterine artery has a typical doppler waveform with what characteristics?

A

High resistance

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20
Q

Precocious puberty

A

Development of early secondary sexual characteristics due to hypothalamic disease

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21
Q

The average length & height (AP) dimensions of the nulliparous adult uterus are;

A

6x4cm

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22
Q

Fornicies

A

Circumferential recesses around the external cervix, formed by the attachment of the vaginal wall.

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23
Q

Normal endometrial thickness for a postmenopausal patient who is NOT on hormone replacement therapy is;

A

> 4mm

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24
Q

The endometrial measurement is obtained by measuring;

A

A double thickness AP measurement in the longitudinal plane

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25
Pituitary Gland
Secretes FSH
26
Vesicouterine pouch
The peritoneal space anterior to the uterus
27
Sonography pelvic muscles appear
Hypoechoic
28
4 D’s of endometriosis
Dysmenorrhea- pain before & during menses Dyschezia - pain with bowel movements Dyspareunia - pain with intercourse Dysuria- difficult/painful urination
29
Adenomyosis
Diffuse, benign invasion of endometrial tissue into the myometrium.
30
Appearance of an incompetent cervix;
Shortened
31
Cervical polyp
The most common benign neoplasm of the cervix
32
Endometriosis may be defined as;
Ectopic endometrial tissue
33
Sonographic appearance of an endometrioma is;
1. ) A discrete, thick-walled oval mass 2. ) Heterogeneous structure 3. ) A mass that contains low-level echos; &/or exhibits ETT
34
Leiomyoma located; 1. ) Within the myometrium 2. ) Directly beneath the endometrium 3. ) On the outer surface of the uterus 4. ) Growing out of the uterus attaches by a stalk
Leiomyoma located; 1. ) Within the myometrium - Intramural 2. ) Directly beneath the endometrium - Submucosal 3. ) On the outer surface of the uterus - Subserosal 4. ) Growing out of the uterus attaches by a stalk - Pedunculated
35
Some effects of Tamoxifen therapy
1. Endometrial hyperplasia 2. Increased endometrial thickness 3. Increased risk of endometrial cancer
36
Sonographic findings of endometrial carcinoma
1. Increased uterine size 2. Thickening of the endometrial tissue 3. Fluid in the endometrial cavity
37
Sonographic feature of leiomyomas
1. Complex, well circumscribed attenuating uterine mass 2. Distortion of the normal uterus contour 3. Displacement of the normal linear endometrial “strip”
38
Women with a HX of PID are at risk for;
1. Tubal scaring 2. Ectopic pregnancy 3. Perionitis
39
Gartner’s duct cyst
Found in the Vaginal canal
40
Nabothian cyst
Cervix
41
Oophoritis
Inflammation of the ovary
42
Abnormal Vaginal bleeding may be associated with;
1. Endometritis 2. Multiple myomas 3. Endometrial polyps
43
Endometrioma (Chocolate cyst)
Cyst associated with endometriosis
44
Endometrial polyp sonographic findings? | Procedure to help enhance visualization of the polyp separate from the endometrium?
Stalk/base with blood flow | Sonohysterography
45
PID is most frequently caused by what?
STD/STI sexually transmitted organisms
46
Sonographic/clinical findings of Tubo-Ovarian abscess
A complex adnexal mass High WBC Extreme pelvic pain Fever
47
Sonographic/ clinic signs for a most likely dx of Pyosalpinx
Right sided pelvic pain Purulent vaginal discharge Tubular structure in the right adnexa with low level echos
48
Causes of uterine calcifications
Fibroids, calcified arcuate arteries
49
The sonographic findings of a properly placed IUD
1. Hyperechoic with reverberation & Shadows | 2. Centrally located within the body/fundus of the uterus.
50
Adenomyosis clinical findings
1. Dysmenorrhea & pelvic pain 2. Diffusely enlarged uterus 3. Myometrium has a heterogenous echo texture & streaky shadowing.
51
Endometrial polyps sonographic findings
Typically hyperechoic to surrounding endometrial tissue, & blood flow can be seen at eh stalk/base
52
Endometrial leiomyomas sonographic findings
Hypo or isoechoic with calcifications and shadowing
53
Leiomyosarcoma of the uterus
Malignant tumor of the uterus
54
Androgen
The substance that stimulates the development of male characteristics
55
Cystadenoma
The most common cystic ovarian tumor
56
Teratoma
Benign tumor of the ovary comprised of hair, muscle, teeth and fat
57
Theca Lutein Serous cystadenoma Fibroma
Forms of typically benign ovarian tumors
58
Theca lutein cysts sonographic/clinical findings
Markedly elevated bata HCG levels | Ovaries are covered in multiseptated cysts bilaterally
59
Laparoscopy is indicated if an ovarian cyst measures;
Over 10cm
60
The malignant ovarian mass associated with pseudomyxoma peritonel
Mucinous cystadenocarcinoma
61
Dysgerminoma
Malignant ovarian tumor that contains elements of germ cells
62
Sonographic sign associated with an ovarian dermoid tumor, when only the anterior aspects of the mass are seen as a bright reflection and the rest of the mass is obscured by shadowing.
Tip of the iceberg sign
63
Serous Cystadenoma
The most common benign ovarian tumor of epithelial origin
64
Stein-Leventhal
String of pearls appearance
65
Thecoma tumor
Estrogen producing
66
Ovarian Fibroma
Associated with Meigs syndrome
67
What ovarian tumor is associated with virilization due to excess androgen production?
Sertoli-Leydog tumor
68
Polycystic ovarian syndrome - clinical/sonographic findings
1. Amenorrhea, obesity, anovulation | 2. Small cyst located peripherally on the ovaries, bilateral, enlarged ovaries, string of pearls.
69
Corpus luteum
Produces progesterone
70
Sonographic findings of; Benign ovarian mass & Malignancy ovarian mass
Benign - Anechoic with good ETT, thin walled, smooth/well defined borders, round in both plans Malignant- Complex texture, irregular shape, ill defined/irregular borders, thick wall, shadowing
71
Acute vs. Chronic Torsion
Acute - Hypoechoic, acute/sharp pain, little to no blood flow, enlarged, complex Chronic- Increased echogenicity, shrunken, dull aches, no blood flow, necrotic
72
Meigs’ syndrome
Pleural effusion, solid benign pelvic mass, asities
73
Functional cysts
Follicular cyst Theca luteal cyst Corpus luteum cyst These cysts are response to the female natural cycle
74
3 ways that ovarian malignancy can spread
1. Arterial & venous system spread 2. Direct invasion 3. Lymphatic spread
75
After the morula enters the uterine cavity fluid passes over it & it divides into two layers & becomes the _________. The inner cell layer is called the ______ & the outer cell layer is called the ________.
After the morula enters the uterine cavity fluid passes over it & it divides into two layers & becomes the *-BLASTOCYST-* The inner cell layer is called the *-EMBRYOBLAST-* & the outer cell layer is called the *-TROPHOBLAST-*.
76
Ampulla
The portion of the fallopian tube where fertilization happens & the most common area for an ectopic pregnancy to occur
77
Zygote
Newly fertilized egg
78
The normal gestational sac grows approximately how fast?
1mm/day
79
Decidua Capsularis
The portion of the endometrium that closes over & surrounds the blastocyst
80
Decidua Basalis
The portion of the endometrium that lies between the blastocyst & the uterine muscle which will become the maternal side of the placenta
81
Decidua Parietalis
The portion of the decidualized endometrium that lines the uterine cavity
82
In a normal first trimester pregnancy, how often should the levels of hCG double?
Every 36-48 hours
83
Sonographic findings associated with a normal first 1st trimester pregnancy
- Ultrasound finding of a double decidual sign - A cystic structure seen in the fetal head called the rhombencephalon - The midgut herniates into the umbilical cord at eight weeks gastation
84
Embryonic cardiac activity during the first trimester
- Cardiac activity should be seen on an endovaginal sonogram when the crown rump length is 5mm - Cardiac activity may not be seen when the embryo is first identified using endovaginal sonography - A fetal heart rate <100 bpm may indicate fetal demise
85
Crown Rump Length
The most accurate method used to date first trimester pregnancies
86
Complete abortion
When the uterus empties itself of all products of conception
87
The chorion & the Amnion fuse at approximately.......
12-16 wks
88
Hydatidiform (molar) pregnancy
- Beta hCG levels are very high - The patient;s uterus measures large for dates - The patient may have hyperemesis
89
When performing a transabdominal ultrasound, a yolk sac should be visualized when the MSD is;
20 mm
90
Conditions can be associated with abnormally high hCG
- Incorrect dates - Gestational trophoblastic disease - Multiple gestations
91
Missed abortion
- Mild pelvic pain - No vaginal bleeding - No cardiac activity of movement - Gestational sac is located in the lower uterine segment rather than the fundal region
92
What is the mass most commonly seen during a normal first trimester pregnancy?
Corpus luteal cyst
93
To differentiate an early intrauterine pregnancy from a pseudo-gestational sac, it helps to visualize;
The yolk sac
94
Heterotopic pregnancy
An intrauterine & extrauterine simultaneous pregnancy
95
Nuchal translucency measurements can only be obtained between what weeks of gestation?
11 & 13 weeks gestation
96
``` Ectopic pregnancy Clinical signs Sonographic appearance & Risk factors ```
* Clinical signs- Vaginal bleeding, positive pregnancy test, hCG levels will not be as high as expected & enlarged uterus * Sonographic appearance - No intrauterine pregnancy visualized, adnexal mass, possible free fluid * Risk factors- Previous ectopic pregnancy, Hx of PID & Infertility treatments
97
Sonographic/clinical signs & etiology of Gestational trophoblastic disease (AKA - Molar pregnancy)
* Sonographically- Bilateral theca lutein cysts, enlarged uterus * Clinical - Vaginal bleeding, hyperemesis * Etiology- Abnormal fertilization

SON 2121 DMS OB/GYN 1 (4 decks)

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