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

Final Spring 2021 Flashcards

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
Q

Pituitary Gland

A

Secretes FSH

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26
Q

Vesicouterine pouch

A

The peritoneal space anterior to the uterus

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27
Q

Sonography pelvic muscles appear

A

Hypoechoic

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28
Q

4 D’s of endometriosis

A

Dysmenorrhea- pain before & during menses
Dyschezia - pain with bowel movements
Dyspareunia - pain with intercourse
Dysuria- difficult/painful urination

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29
Q

Adenomyosis

A

Diffuse, benign invasion of endometrial tissue into the myometrium.

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30
Q

Appearance of an incompetent cervix;

A

Shortened

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31
Q

Cervical polyp

A

The most common benign neoplasm of the cervix

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32
Q

Endometriosis may be defined as;

A

Ectopic endometrial tissue

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33
Q

Sonographic appearance of an endometrioma is;

A
  1. ) A discrete, thick-walled oval mass
  2. ) Heterogeneous structure
  3. ) A mass that contains low-level echos; &/or exhibits ETT
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34
Q

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
A

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
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35
Q

Some effects of Tamoxifen therapy

A
  1. Endometrial hyperplasia
  2. Increased endometrial thickness
  3. Increased risk of endometrial cancer
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36
Q

Sonographic findings of endometrial carcinoma

A
  1. Increased uterine size
  2. Thickening of the endometrial tissue
  3. Fluid in the endometrial cavity
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37
Q

Sonographic feature of leiomyomas

A
  1. Complex, well circumscribed attenuating uterine mass
  2. Distortion of the normal uterus contour
  3. Displacement of the normal linear endometrial “strip”
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38
Q

Women with a HX of PID are at risk for;

A
  1. Tubal scaring
  2. Ectopic pregnancy
  3. Perionitis
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39
Q

Gartner’s duct cyst

A

Found in the Vaginal canal

40
Q

Nabothian cyst

A

Cervix

41
Q

Oophoritis

A

Inflammation of the ovary

42
Q

Abnormal Vaginal bleeding may be associated with;

A
  1. Endometritis
  2. Multiple myomas
  3. Endometrial polyps
43
Q

Endometrioma (Chocolate cyst)

A

Cyst associated with endometriosis

44
Q

Endometrial polyp sonographic findings?

Procedure to help enhance visualization of the polyp separate from the endometrium?

A

Stalk/base with blood flow

Sonohysterography

45
Q

PID is most frequently caused by what?

A

STD/STI sexually transmitted organisms

46
Q

Sonographic/clinical findings of Tubo-Ovarian abscess

A

A complex adnexal mass
High WBC
Extreme pelvic pain
Fever

47
Q

Sonographic/ clinic signs for a most likely dx of Pyosalpinx

A

Right sided pelvic pain
Purulent vaginal discharge
Tubular structure in the right adnexa with low level echos

48
Q

Causes of uterine calcifications

A

Fibroids, calcified arcuate arteries

49
Q

The sonographic findings of a properly placed IUD

A
  1. Hyperechoic with reverberation & Shadows

2. Centrally located within the body/fundus of the uterus.

50
Q

Adenomyosis clinical findings

A
  1. Dysmenorrhea & pelvic pain
  2. Diffusely enlarged uterus
  3. Myometrium has a heterogenous echo texture & streaky shadowing.
51
Q

Endometrial polyps sonographic findings

A

Typically hyperechoic to surrounding endometrial tissue, & blood flow can be seen at eh stalk/base

52
Q

Endometrial leiomyomas sonographic findings

A

Hypo or isoechoic with calcifications and shadowing

53
Q

Leiomyosarcoma of the uterus

A

Malignant tumor of the uterus

54
Q

Androgen

A

The substance that stimulates the development of male characteristics

55
Q

Cystadenoma

A

The most common cystic ovarian tumor

56
Q

Teratoma

A

Benign tumor of the ovary comprised of hair, muscle, teeth and fat

57
Q

Theca Lutein
Serous cystadenoma
Fibroma

A

Forms of typically benign ovarian tumors

58
Q

Theca lutein cysts sonographic/clinical findings

A

Markedly elevated bata HCG levels

Ovaries are covered in multiseptated cysts bilaterally

59
Q

Laparoscopy is indicated if an ovarian cyst measures;

A

Over 10cm

60
Q

The malignant ovarian mass associated with pseudomyxoma peritonel

A

Mucinous cystadenocarcinoma

61
Q

Dysgerminoma

A

Malignant ovarian tumor that contains elements of germ cells

62
Q

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.

A

Tip of the iceberg sign

63
Q

Serous Cystadenoma

A

The most common benign ovarian tumor of epithelial origin

64
Q

Stein-Leventhal

A

String of pearls appearance

65
Q

Thecoma tumor

A

Estrogen producing

66
Q

Ovarian Fibroma

A

Associated with Meigs syndrome

67
Q

What ovarian tumor is associated with virilization due to excess androgen production?

A

Sertoli-Leydog tumor

68
Q

Polycystic ovarian syndrome - clinical/sonographic findings

A
  1. Amenorrhea, obesity, anovulation

2. Small cyst located peripherally on the ovaries, bilateral, enlarged ovaries, string of pearls.

69
Q

Corpus luteum

A

Produces progesterone

70
Q

Sonographic findings of;
Benign ovarian mass
&
Malignancy ovarian mass

A

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
Q

Acute vs. Chronic Torsion

A

Acute - Hypoechoic, acute/sharp pain, little to no blood flow, enlarged, complex
Chronic- Increased echogenicity, shrunken, dull aches, no blood flow, necrotic

72
Q

Meigs’ syndrome

A

Pleural effusion, solid benign pelvic mass, asities

73
Q

Functional cysts

A

Follicular cyst
Theca luteal cyst
Corpus luteum cyst

These cysts are response to the female natural cycle

74
Q

3 ways that ovarian malignancy can spread

A
  1. Arterial & venous system spread
  2. Direct invasion
  3. Lymphatic spread
75
Q

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 ________.

A

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
Q

Ampulla

A

The portion of the fallopian tube where fertilization happens & the most common area for an ectopic pregnancy to occur

77
Q

Zygote

A

Newly fertilized egg

78
Q

The normal gestational sac grows approximately how fast?

A

1mm/day

79
Q

Decidua Capsularis

A

The portion of the endometrium that closes over & surrounds the blastocyst

80
Q

Decidua Basalis

A

The portion of the endometrium that lies between the blastocyst & the uterine muscle which will become the maternal side of the placenta

81
Q

Decidua Parietalis

A

The portion of the decidualized endometrium that lines the uterine cavity

82
Q

In a normal first trimester pregnancy, how often should the levels of hCG double?

A

Every 36-48 hours

83
Q

Sonographic findings associated with a normal first 1st trimester pregnancy

A
  • 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
Q

Embryonic cardiac activity during the first trimester

A
  • 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
Q

Crown Rump Length

A

The most accurate method used to date first trimester pregnancies

86
Q

Complete abortion

A

When the uterus empties itself of all products of conception

87
Q

The chorion & the Amnion fuse at approximately…….

A

12-16 wks

88
Q

Hydatidiform (molar) pregnancy

A
  • Beta hCG levels are very high
  • The patient;s uterus measures large for dates
  • The patient may have hyperemesis
89
Q

When performing a transabdominal ultrasound, a yolk sac should be visualized when the MSD is;

A

20 mm

90
Q

Conditions can be associated with abnormally high hCG

A
  • Incorrect dates
  • Gestational trophoblastic disease
  • Multiple gestations
91
Q

Missed abortion

A
  • 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
Q

What is the mass most commonly seen during a normal first trimester pregnancy?

A

Corpus luteal cyst

93
Q

To differentiate an early intrauterine pregnancy from a pseudo-gestational sac, it helps to visualize;

A

The yolk sac

94
Q

Heterotopic pregnancy

A

An intrauterine & extrauterine simultaneous pregnancy

95
Q

Nuchal translucency measurements can only be obtained between what weeks of gestation?

A

11 & 13 weeks gestation

96
Q 
Ectopic pregnancy
Clinical signs
Sonographic appearance 
& 
Risk factors
A
  • 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
Q

Sonographic/clinical signs & etiology of Gestational trophoblastic disease (AKA - Molar pregnancy)

A
  • 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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