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OB/GYN REVIEW > First Trimester > Flashcards

First Trimester Flashcards

1
Q

What is a gamete?

A

male and female reproductive cells (ovum and sperm)

pg. E 82

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2
Q

What is a zygote?

A

sperm and ovum joined in infundibulum of fallopian tube

pg. E 82 O 353

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3
Q

What is a blastomere?

A

fertilized ovum that begins to divide loated in ampulla of fallopian tube
pg. E 83

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4
Q

What is a morula?

A

clusters of cells, 4 days after fertilization located in fallopian tube
pg. E 83 O 353

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5
Q

What is a blastocyst?

A

implants into endometrium 7 days after fertilization

pg. E 83 O 353

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6
Q

When does fertilization occur?

A

24-36 hours after ovulation

pg. E 83

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7
Q

What lines a blastocyst?

A

trophoblasts - which produce hCG

pg. E 83

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8
Q

What possibilities are there when hCG levels are higher than expected?

A

Further along than expected
Gestational trophoblastic disease
Multiple gestations
pg. E 83

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9
Q

What possibilities are there when hCG levels are lower than expected?

A 
Not as far along as suspected
Ectopic pregnancy
Embryonic demise
Abnormal IUP
pg. E 83
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10
Q

At what level is hCG when you can see a gestational sac TV?

A

1000 mIU/mL

pg. O 356

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11
Q

How often does hCG double and for how many weeks?

A

Doubles about every 2-3 days for the first 6-9 weeks

pg. E 83 O 356

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12
Q

When does the embryonic period end and the fetal period begin?

A

End of the 10th week

pg. E 84

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13
Q

What is the decidua basalis?

A

Maternal side of endometrium

pg. E 84

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14
Q

What does decidua mean?

A

Name for endometrium during pregnancy

pg. O 353

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15
Q

What is the decidua capsularis?

A

Fetal side of endometrium

pg. E 84 O 353

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16
Q

What is an amnion?

A

Extraembryonic membrane that lines the chorion
Contains fetus and amniotic fluid
pg. E 85 O 353

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17
Q

What is the chorion?

A

Outermost of fetal membranes
Fuses with amnion and not seen after 12-16 weeks
pg. E 85 O 353

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18
Q

When should a gestational sac be seen?

A

LMP > 5 weeks
hCG levels 1000-2000 mIu/mL
pg. E 86

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19
Q

What shape and location should a gestational sac be?

A

Round/oval/teardrop
W/in the endometrium towards the fundus
pg. E 86 O 357

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20
Q

What is a double decidua sign?

A

Thick hyperechoic rim surrounding a sonolucency, an IUP

pg. E 86 O 353

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21
Q

At what pace does a gestational sac grow?

A

1 mm/day

pg. E 86

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22
Q

A yolk sac should be present when the gestational sac is how many mm?

A

8 mm

pg. E 86 O 357

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23
Q

How is mean sac diameter calculated?

A

MSD =

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24
Q

How is the mean sac diameter calculated?

A

length + height + width / 3

pg. E 86 O 356

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25
What is the chorion?
outermost of fetal membranes; shrinks by wks 12-16 | pg. E 85 O 353
26
What is the amnion?
extraembryonic membrane that lines chorion and contains fetus pg. E 85 O 353
27
When should a gestational sac be visualized?
hCG values 1000-2000 LMP > 5 wks pg. E 86 O 359
28
What is the double decidua sign?
thick hyperechoic rim surrounding an IUP | pg. E 86 O353
29
When should a yolk sac be visualized?
5th gestational week (TV) GS = 8 mm pg. E 87 O 359
30
How should a yolk sac be measured?
inner to inner; < 6 mm | pg. E 87 O 358
31
When should an embryo be seen?
6th gestational week GS = 16 mm pg. E 87 O 359
32
What is a rhombencephalon?
Normal anechoic structure in the posterior brain seen between 8-11 weeks pg. E 88
33
What is a complete abortion?
all products of conception expelled | pg. E 90 O 359
34
What are the clinical findings associated with a complete abortion?
bleeding, cramping, low hCG levels | pg. O 359
35
What is an incomplete abortion?
some products of conception are expelled while some remain in uterus pg. E 90 O 360
36
What are the clinical findings associated with an incomplete abortion?
asymptomatic, bleeding, cramping, hypotension | pg. O 360
37
What are the sonographic findings of an incomplete abortion?
thickened endo with fluid, and possible gestational sac | pg. E 90 O 360
38
What is a missed abortion?
Embryo without cardiac activity | pg. E 91
39
What are the clinical symptoms of a missed abortion?
Asymptomatic, low hCG levels, brown vaginal discharge | pg. E 91
40
What is an inevitable abortion?
gestational sac in cx dilated cx bleeding and cramping pg. E 91
41
What is a threatened abortion?
pregnancy may abort in future patient usually has bleeding and cramping pg. E 92
42
What is another name for an anembryonic pregnancy?
blighted ovum | pg. E 92 O 359
43
What is an anembryonic pregnancy?
the embryo fails to develop | pg. E 92 O 359
44
What are the clinical signs of a blighted ovum?
``` asymptomatic hCG levels decline small for dates no fetal heart tones pg. 359 ```
45
What are the sonographic findings of an anembryonic pregnancy?
large gestational sac absent yolk sac, amnion, and embryo pg. E 92 O 359
46
What is a septic abortion?
abortion with non-sterile instruments resulting in infection of RPOC (retained products of conception) pg. E 92
47
What is an ectopic pregnancy?
pregnancy in an abnormal location | pg. E 93 O 360
48
Where can an ectopic pregnancy be located?
``` fallopian tube (most common: ampulla) cervix abdominal abnormal UT position pg. E 93 O 360 ```
49
What are the clinical findings of an ectopic pregnancy?
``` pelvic pain vaginal bleeding palpable adnexal mass low hCG levels hypotension cervical tenderness pg. O 360 ```
50
What are the sonographic findings of an ectopic?
``` no IUP fluid in endo "sliding sac sign" - can move GS with TV unusual fetal presentation free fluid oligohydramnios pg. E 94 O 360 ```
51
What is a heterotopic pregnancy?
extrauterine and intrauterine occuring at the same time | pg. E 94 O 360
52
How can you distinguish an ectopic pregnancy from a corpus luteum?
"ring of fire" - Color Doppler surrounding gestational sac will show flow, corpus luteum will not pg. E 95
53
What is the most dangerous location for a ectopic pregnancy?
interstitial/cornua | pg. E 95
54
What are the most common treatments for an ectopic pregnancy?
Methotrexate administration (MTX) Laparoscopy pg. E 95
55
What is gestational trophoblastic disease (GTD)?
abnormal proliferation of the trophoblastic tissue | pg. E 96 O 360
56
When does GTD typically occur?
during/after implantation of a fertilized ovum | pg. E 96
57
Why might gestational trophoblastic disease occur?
Lack of chromosomes in ovum Ovum fertilized by 2 sperm pg. E 96
58
What are the clinical findings of gestational trophoblastic disease?
``` Enlarged UT High hCG levels Vaginal bleeding Hyperemesis No fetal heart tones preeclampsia pg. E 96 O 360 ```
59
What is a complete hydatidaform mole?
Most common form of trophoblastic disease Chorionic villi are hydropic no fetal tissue identified pg. E 96
60
What are the sonographic findings of a complete hydatidaform mole?
``` enlarged UT echogenic mass in endo can be cystic in 2nd tri hypervascular, low resistive flow theca lutein cysts pg. E 97 ```
61
What is a partial molar pregnancy?
one set of maternal chromosomes and 2 sets of paternal triploidy chorionic villi hydropic and normal abnormal fetal tissue, but mild trophoblastic tissue pg. E 97
62
What are the sonographic findings of a partial mole?
deformed gestational sac growth restricted fetus w/ triploidy enlarged placenta with cystic areas pg. E 97
63
What is a molar pregnancy with a coexisting fetus?
2 conceptions. one in normal other is GTD very rare pg. E 97
64
What are the sonographic findings of a molar pregnancy with a coexisting fetus?
Similar to partial, but placenta is identified fetus is normal pg. E 97
65
What is persistent trophoblastic neoplasia (PTN)?
commonly follows GTD can also occur after normal term delivery, spont. abortion or ectopic hCG levels to not decline pg. E 98
66
What are the clinical findings of PTN?
hCG levels do not decline vaginal bleeding pg. E 98
67
What are the types of PTN?
Invasive mole Choriocarcinoma pg. E 98
68
What is another name for an invasive mole?
chorioadenoma destruens | pg. E 98
69
What is an invasive mole?
``` most common form of persistent trophoblastic disease malignant, nonmetastatic penetrates myometrium can cause UT to rupture pg. E 98 ```
70
What are the sonographic findings of an invasive mole?
echogenic material in endo and myometrium | irregular sonolucent areas surrounding trophoblastic tissue
71
What is choriocarcinoma?
Rare vascular invasion, hemorrhage, and necrosis of myometrium malignant, metastatic pg. E 98
72
What are the sonographic findings of choriocarcinoma?
enlarged UT | irregular mass with vascularity
73
What is psuedocyesis?
false pregnancy psychological condition pg. O 360
74
What are the clinical signs of psuedocyesis?
``` nausea/vomiting abdominal distention amenorrhea negative pregnancy test pg. O 360 ```
75
What is a subchorionic hemorrhage?
low pressure bleed from implantation of blastocyst | pg. O 361
76
What are the clinical findings of a subchorionic hemorrhage?
asymptomatic vaginal spotting pg. 361
77
What is Fitz Hugh Curtis syndrome?
Inflammation of the peritoneum due to PID | Google
78
What is the most common form of gestational trophoblastic disease?
Complete hydatidaform mole
79
What is methotrexate used for?
Cause inovulation of early ectopic pregnancies and preserve fertility URR Exam
80
What causes nausea and vomiting in the first trimester?
Progesterone | URR Exam
81
What hormone is responsible for stimulating the contraction of the Fallopian tubes to propel the egg toward the UT?
Estrogen | URR Exam
82
At how many weeks is a gestational sac visualized?
4 weeks gestation
83
At how many weeks is a yolk sac visualized?
5.5 weeks gestation
84
What are chorionic villi formed from?
Trophoblastic cells
85
Where is the yolk sac located?
Between amnion and chorion

OB/GYN REVIEW (16 decks)

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