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Med/Clinical Flashcards

1
Q

Describe Lobes of the Liver

A
  • I - Caudate lobe
  • II - Lt Lateral superior
  • III - Lt LAteral inferior
  • IVa - Lt Medial superior
  • IVb - Lt Medial inferior
  • V - Rt Anterior inferior
  • VI - Rt Posterior inferior
  • VII - Rt Posterior superior
  • VIII - Rt Anterior superior
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2
Q

Normal Size of Liver/Definition of Hepatomegaly

A
  • 13-15 cm sagittal (> 15 cm = hepatomegaly)
  • 20-23 cm transverse (> 23 cm = hepatomegaly >23)
  • If Parenchyma of liver extends beyond inferior pole of kidney, likely hepatomegaly
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3
Q

What is Riedel’s Lobe

A

Riedel’s Lobe
Tongue-like projection of liver, anatomic variant

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4
Q

What are Normal/Abnormal measurements of the Common Bile Duct

A
  • CBD < 6 mm normal
  • > 8 mm is definitely dilated
  • +1mm/10 years of life
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5
Q

Ultrasonographic Features of Hepatic Cysts

A
  • Sharp margins
  • Anechoic
  • Posterior wall acoustic enhancement
  • 5% prevalence in general population
  • usually at > 50 yo
  • if seen earlier, may need w/u for PCKD
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6
Q

Ultrasonographic Features of Hepatic Abscess

A
  • Poorly defined walls
  • Mixed echogenic material can have gas
  • Reverberation artifact
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7
Q

Ultrasonographic Features of Fatty Liver/Focal Fatty [infiltration/sparing]

A
  • Fatty liver is ++hyperechoic to Renal Cortex
  • Diffuse Fatty liver - very hyperechoic
  • Focal fatty sparing is area of liver that is hypoechoic to rest of liver
  • Focal fatty infiltration is area of liver that is hyperechoic to rest of liver
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8
Q

Ultrasonographic Features of Cirrhosis

A
  • Ascites
  • Surface nodularity
  • Coarse hetergenous appearance
  • Segmental atrophy
  • Concern for malignancy
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9
Q

Ultrasonographic Features of Lipoma

A
  • Variable echogenicity (hyperechoic 20-52%, isoechoic 28-60%, hypoechoic 20%)
  • No acoustic shadowing
  • No or minimal colour doppler flow
    (Radiopaedia)
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10
Q

Ultrasonographic Features of Focal Nodular Hyperplasia

A
  • Solid mass with varying echogenicity
  • Usually has central fibrous scar solitary not a true malignancy
  • Developmental hyperplastic lesion.
  • More common in Females, and OCP use
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11
Q

Ultrasonographic Features of Hepatocarcinoma (HCC)

A
  • Variable appearance, often heterogenous/hypoechoic
  • Ring of focal fatty sparing (FFS)
  • Hepatic Metastasis Variable, can be localized or can be widespread, usually encapsulated.
  • Can be hypo or hyperechoic.
  • Irregular borders sometimes
  • Send (Tumor Markers Alpha fetoprotein(AFP), CA 19-9, CA 125, Beta HCG, Carcinoemryonic antigen (CEA))
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12
Q

Ultrasonographic Features of Cholecystitis

A
  • Wall Thickness > 3 mm (Ascites, CHF, Pancreatitis/ Hepatitis can also cause GBW thickening)
  • Cholelithiasis in GB neck / impacted
  • Pericholecystic fluid
  • Sonographic Murphy’s
  • GB Sludge
  • > 10 cm in length, > 4 cm transverse

Complications
* Empyema
* Gangrenous cholecystitis
* Perforation
* Pericholecystic absces
* Bilioenteric fistula

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13
Q

What is Wall Echo Shadow (WES)

A

Wall echo shadow (WES)
* Wall of gall stones that obscure entire GB
* Porcelain GB with calcification of GB wall due to chronic cholecystitis can also cause this effect

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14
Q

Causes and components of Gallbladder Sludge

A

Causes
* Fasting / rapid weight loss
* Alcohol abuse
* Pregnancy
* TPN
* Gastric surgery

Components
* Cholesterol crystals
* Calcium bilirubinate pigment
* Other calcium salts

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15
Q

List 3 Anatomical Variants of GB

A

Phrygian Cap
* Fundus folded back upon itself
* Asymptomatic with no pathological significance

Septation
* Congenital or acquired
* Single or multiple (can look like honeycomb)

Polyps
* Nonmobile
* Non shadowing
* < 10 mm usually benign, but get outpatient US f/u if > 5 mm

Hartmann Pouch
* GB diverticulum at the neck of the GB
* Junctional fold fold between neck and body of GB

Spiral Valves of heister in cystic duct can cause false positive for stone in neck of GB

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16
Q

Structures in/contacting pancreatic head List

A
  • IVC
  • Common Bile Duct
  • Ampulla of Vater
  • Gastroduodenal Artery
  • Duodenal C loop
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17
Q

Ultrasonographic Features of Pancreatitis

A
  • Cholelithiasis

Acute
* Enlarged hypoechoic pancreas

Chronic
* Small echogenic gland
* Pancreatic duct dilataion
* Pseudocyst
* CBD dilation
* Portal vein thrombosis

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18
Q

Ultrasonographic Features of splenomegaly

A
  • < 4 cm wide, < 11cm long is normal
  • Below inferior pole of LT Kidney
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19
Q

Abnormal US Features of Spleen

A

Splenic Calficications
* Hyperechoic structures seen within spleen and splenic vasculature
* TB, Histoplasmosis, Granulomas, Pneumocystis Carinii, Splenic Infarcts

Splenic Cysts
* Pancreatic Pseudocysts eroding into spleen, or epidermoid cysts can vary, but up to 10cm in size

Splenic Tumors
* Usually hypoechoic, but can vary

Splenic Infarct
* Wedge shaped hypoechoic area

Splenic Abscess
* Hypoechoic, anechoic, complex contents

Sickle Cell Disease
* Splenomegaly, with calficiations, fibrosis
* Will then shrink and become fibrotic (autosplenectomy)

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20
Q

Causes of Splenomegaly

A
  • CHF
  • Portal Hypertension
  • Endocarditis
  • Hemolysis (Thalassemia, Hereditary sphreocytosis, CML, CLL, Lymphoma)
  • Sarcoidosis
  • Polycythemia Vera
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21
Q

Ultrasonographic Features of Appendicitis

A
  • Blind-Loop
  • Non compressible
  • No peristalsis > 6 mm in diameter
  • Wall thickness > 3 mm
  • Echogenic/periappendiceal fat
  • Ring of fire/Hyperemia of appendix
  • Appendicolith targetoid appearance on TV view
  • Sonographic tenderness over RLQ
  • RLQ Free Fluid/Periappendiceal fluid collection
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22
Q

List 5 Types of Hernias

A

**Umbilical **
* Near umbilicus due to natural weakness of abdominal wall from umbilical cord

Epigastric
* Weakness on midline of upper abdominal wall between breast bone and umbilicus

Incisional
* Weakness from previous surgical incision

Spigelian
* Edge of rectus adbominus sheath through spigelian fascia, lateral to abdomen

Femoral
* Through femoral canal adjacent to femoral vein
* Associated with pregnancy

Inguinal Hernia (Direct/Indirect)
* Direct- Adjacent to Inguinal canal. lower risk.
* Indirect - Follows inguinal canal, higher risk for strangulation

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23
Q

Ultrasonographic Features of Abdominal Hernia

A
  • Search for defect in this area
  • Reducible
  • ?Valvasa augmentation
  • Direct vs indirect
  • Fat vs bowel
  • Intraluminal air, fluid, peristalsis
  • > 3 mm SB wall thickeness is abnormal
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24
Q

Retroperitoneal structures

A

SAD PUCKER
* Suprarenal (adrenal) glands
* Aorta (and IVC)
* Duodenum (2nd, 3rd, 4th parts)
* Pancreas (head and body)
* Ureters colon (ascending and descending)
* Kidneys
* Esophagus (lower 2/3)
* Rectum (upper 2/3)

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25
Q

Layers of Bowel Wall

A

5 Layers of Bowel Wall with alternating hyper/hypoechoic lines. From Inside out:
* Mucosa
* Muscularis mucosa
* Submucosa
* Muscularis propria
* Serosa
(there may only be 4 layers, as per pic)

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26
Q

Ultrasonographic Features of Pyloric Stenosis

A
  • Muscle thickness > 3 mm
  • Channel length > 17 mm
  • Cross section diameter > 15mm

Clinical presentation
* 3-8 wk old with non-bloody, non-bilious projectile vomiting
* olive shaped pylorus on palptation
* visible peristalsis

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27
Q

Ultrasonographic Features of Intussussception

A
  • Pseudo-kidney mass
  • Target Sign +/- color (if no color could be sign of ischemia)

Clinical presentation
* 6months - 6 years of age
* Ileocolic (90%) of cases
* ‘Red currant jelly’ bloody diarrnea
* Intermittent AP

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28
Q

Ultrasonographic Features of Small Bowel Obstruction

A

Thin gut wall with hyperperistalsis To and Fro Movement of intraluminal contents Piano key sign - prominent Plicae Circularis Distal bowel may be small than proximal bowel

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29
Q

Ultrasonographic Features of Diverticulitis

A

Thick walled outpouching with hypoechoic thickening of adjacent bowel Bowel Wall >5mm Pericolonic Fat enhancement (Hypoechoic thicekning of adjacent bowel) Focal Sonographic Tenderness Increased vascularity Features of SBO, Perforation,

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30
Q

Ultrasonographic features of normal Kidey (How components looks on US)

A

Echogenic features Cortex is isoechoic or hypoechoic to liver Medullary pyramids are usualyl anechoic Renal Sinus is hyperechoic Renal Hilum Artery (middle), vein (anterior), ureter (posterior) Length 9-13cm Width 5cm Depth 3cm

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31
Q

Renal Pathology Seen on US

A

Parapelvic Cysts Sonolucent pyramids (no hydronephrosis) Hypertrophied columns of Bertin (normal variant with prominent renal cortex between pyramids.) Dromedary Hump duplicated collecting systemic/Duplex Kidneys Ectopic/Congenital Kidneys (Horseshoe, Pelvic, unilateral kidney, Ectopic Kidney) PCKD Transplant kidneys Obstructive Uropathy

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32
Q

Hydronephrosis Grading

A

Hydronephrosis grading I - Renal pelvic dilation alone II - Pelvis and caliceal dilation. medulla and cortex and normal (Major Calices) III - Meduall is short and thin, cortex normal (Minor Calices) IV - Cortex is thin, <2mm, no corticomedulary dilation (Cortical Thinning) I is mild, II-III is moderate, III-IV is severe

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33
Q

Common Locations for obstructive nephrolithiasis

A

Renal COllecting System Ureteropelvic junction (UPJ) Crossing of Illiac Vessels, about 2/3 way down Ureterovesicular Junction (UVJ) Bladder

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34
Q

Classification system for renal cysts?

A

Bosniak Classification of renal cysts (% risk of CA) I - (<1%) Uncomplicated, simple benign cyst [no F/u] II - (<3%) <3cm in size, <1mm septations, fine calcifications in septum [no f/u] IIF - (5-10%) multiple thin septa, >3cm, intrarenal [Repeat US in 4 wks] III - (40-60%) Uniform wall thickness and nodularity, thick calcifications, thick septa, contrast enhancement [Urology f/u, ?surgery) IV - (>80%) LArge cystic components, irregular margins, nodules, solid enhancing elements [Urology f/u, ?surgery)

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35
Q

Causes of Elevated Renal Artery Resistive Index

A

Transplant Rejection, RA Stenosis, RA thrombosis, Pyelonephritis Color Doppler/Flow Arterial Resistive Index is elevated - measure using PW doppler RI = (Peak Systolic Velocity - End diastolic velocity ) / Peak Systolic Velocity (0.5-0.7 is normal), >0.8 is abnormal (Increased RI is usualyl bad)

36
Q

Bladder Volume Calculation

A

Bladder Size LxWxH x 0.7 (constant will change depending on shape) Can also be 0.5 - 0.7

37
Q

DDX Renal Pathology on US

A

Obstructive Uropathy Renal Colic RCC RAS Pyelonephritis Renal Abscess Bladder Diverticuli Bladder Carcinoma Ureteroceles

38
Q

Complications of Acute Cholecystits

A

Emphysematous Cholecystitis Cholangitis/CBD dilation Gangrenous Cholecystitis Perforation Cholecystoenteric Fistula Gallstone Illeus Chronic Cholecystitis

39
Q

5 Causes of Biliary Obstruction

A

Choledocolithiasis, Mirizzi syndrome, Cholangitis, Cholangicarcinoma, Biliary Atresia, GB CA, Pancreatic CA, PSC Biliary Ascariasis (roundworm)

40
Q

5 Causes/RF of acalculous cholecystitis

A

DM, Abdominal Vasculitis, AIDS, Children, ICD, TPN, Severe systemic Illness, Recent Trauma, Hemolysis, Prolonged Fasting

41
Q

US Features of Portal Vein Thrombosis

A

Portal vein Hypertension/Thrombosis Dilated portal vein > 13mm +/- thrombus Increased collaterals (Caput Medusa) Features of Cirrhosis (Ascites, Fqtty Liver) or malignancy (for PV thrombosis)

42
Q

7 CXR findings of Thoracic Aortic Dissection

A

CXR Findings -TAD Wide Mediastinum Lt Pleural Effusion Calcium Sx Obscured Aortic Knob Lt Apical Cap Loss of PA Window Tortuous Aorta Tracheal Deviation NG/ETT Displacement Normal CXR

43
Q

Describe Acute Management of Thoracic Aortic Dissection

A

Type A - Cardiac Surgery Type B - Vascular Surgery Supportive Care Labetalol 20mg IV q5min x 3 then 2mg/min infusion Target HR <60, SBP <110mmHg Nitroprusside 0.5-10 mcg/kg/min IV Infusion Nitroglycerin 20-200mcg/min IV Infusion

44
Q

Describe the Anatomy of the Abdominal Aorta and it’s branches from ascending to descending

A

Anatomy (Starting cephalad moving caudad) Celiac Axis/Celiac Artery&raquo_space;> Common Hepatic Artery, Lt Gastric Artery, Splenic Artery Superior Mesenteric Arteric (1cm inferior to celiac axis) Renal Arteries Lt Gonadal Artery Rt Gonadal artery (Rt passes posterior to IVC) Inferior Mesenteric Artery Common Lt/Rt Illiac Artery

45
Q

Compare/Contrast Aneurysm vs. Pseudoaneurysm

A

Adventitia, Media, Intima (outside to inside of artery) True aneurysms involve all 3 layers Pseudoaneurysm/False Aneurysm result from injury to vessel wall and extravasated blood is walled off by surrounding tissue Dissecting Aneurysm is separation of intima from media of aortic wall RF

46
Q

List 3 types of Aneurysms (not location)

A

Berry Aneurysm (small saccular aneruysm (in brain) Mycotic Aneruysm (infected aneurysm) Atherosclerotic aneurysm (weakening of media from severe athersclerosis) Fusiform Aneurysm - spindle shaped dilationg affect entire circumference of artery Saccular Aneurysm - localized outpouching of vessel wall (easy to miss)

47
Q

List common locations for Abdominal Aneurysm, and indicate which is most common

A

Infrarenal - most common Suprarenal - <10% Juxtarenal Aorto-illiac ‘Seagull’ sign, Where Celiac Artery branches into Heaptic and Splenic Arteries

48
Q

What is the association b/w AAA size and risk of rupture

A

Risk of Rupture 3-4cm - 0.5% 4-5cm - 1% 5-6cm - 3% 6-7% - 9-10% >7cm - 25%

49
Q

Mortality rate associated with AAA Rupture

A

Ruptured AAA 60-80% mortality rate 50% survival to hospital 5% effective repair 1% decrease survival rate per MINUTE

50
Q

Types of Endoleaks

A

Types of Endoleaks I-Stent Vessel Anastomosis II-Retrograde Artery III-Stent/stent Anastomosis IV-Through Stent V-Aneurysm Grows Over

51
Q

Describe Anatomy of the LE Veins, starting from the External Illiac Vein to the trifurcation

A

External Illiac Vein > CFV and GSV CFV First Lateral Perforator branches off (small) then CFV bifurcates into FV + DFV Follow FV until it dives under femur Popliteal Vein until trifurcation Trifurcates into Anterior Tibial, Posterior Tibial, Peroneal Veins

52
Q

US Features of DVT

A

Non-compressible under pressure Hyperechoic vasculature Color Augmentation - increase flow with calf muscle contraction Spectral Doppler/PWD - increase flow with calf contraction Phasic Flow/Valsalva Should have changes in velocity with breathing Vessels Distal to clot won’t have this change while vessels proximal to clot should

53
Q

List 5 Risk factors for DVT

A

Coagulopathy, OCP, CA, Chemotherapy, Trauma, Surgery MAy Thurner (Illiac Vein compression) Syndrome, where Lt Common illiac vein is compressed against Lumbar vertebrae by overlying Rt. Common illiac artery

54
Q

Wells DVT score

A

C3PO+R2D2 Cancer Calf Swelling >3cm Collateral Veins Pitting Edema Obvious Swollen Leg Tender DVT Recent Sx (12w) Recent Immob./Cast DVT HX DVT not main Dx

55
Q

Well’s PE

A

Wells PE /7 MEMBOLI 3-PE#1 3-Sx of DVT 1.5-HR>100 1.5-Hx DVT/PE 1.5-Hx Surgery(4w) 1-Hemoptysis 1-Hx of CA <4-Low Risk, 1-3% <7-Mod Risk, 15% >7-Hi Risk, 40%

56
Q

YEARS criteria

A

YEARS /3 Pregnant Lady coughing Blood on swollen Leg 1-Hemoptysis 1-Leg Swelling 1-PE #1 r/o if 0 - Dimer<1000 1 - Dimer<500

57
Q

PERC Rule

A

PERC /8 HASCLOTS Age<50 HR<100 SpO2<95% Sx of DVT Hx DVT/PE Hx Trauma/Sx (4w) Hemoptysis OCP Use

58
Q

Diagnostic Criteria for Pericarditis

A

2 of 4 needed

59
Q

Causes of Pericarditis

A

Infectious Viral, TB, Lyme Disease, EBV, Parvo19 post- Injury Trauma, Dressler’s(Post MI), Radiation Systemic SLE, RA, Uremia, MEtastatic CA, Amyloidosis, Sarcoidosis, Aortic Dissection Idiopathic/?Viral

60
Q

Stages of Pericarditis

A

Acute - 2/4 Diagnostic Criteria Incesscent - 4-6 wks long, <6months Recurrent - Reoccurance after 6 wks of resoltuion/asymptomatic Chronic - <3 months

61
Q

ECG Features of Pericarditis

A

Diffuse STE, PR Depression. Reciprocal STD in AvR (1-2wks) Spodick sign J point transition, Flattening T waves (1-3 wks) Inverted T waves(3+ weeks) Then normalize ECG (3+ weeks)

62
Q

PESI Score. Pulmonary Embolism Severity Index

A

Age Male Hx of CA Hx of CHF Hx of Lung Dx HR >110 SBP <100 RR > 30 T <36 ALOC SpO2 <90%

63
Q

Risk Factors for poor PE Prognosis

A

Hypotension RV Dysfunction Massive PE >70% Proximal DVT SpO2 <90% HR > 120 Poor Reserve RV Thrombus High PESI

64
Q

Treatment of PE/DVT

A

Rivaroxaban 15mg PO BID x 21d, then 20md PO OD x 6wks Apixaban 10mg PO BID x 7d, then 5mg PO BID x 6 wks Dalteparin 200U/kg OD

65
Q

Inidications to treat Superficial Thrombophlebitis or superficial vein thrombosis (of GSV)

A

Large territory > 5cm near saphenofemoral junction Very symptomatic

66
Q

Indications for Thrombolysis in PE

A

Massive PE Unstable SubMassive PE Severe RV Dysfunction SBP<90 Shock Index >1 SpO2<92% >2hr Delay Cath tPa Alteplase 100mg/2hr IV Tenecteplase 40mg IV bolus (70kg patient)

67
Q

Contraindications to Thrombolysis

A

ST3MI-BLD

68
Q

Prevalence of Hetertrophic PRegnancy

A

Heterotrophic Pregnancy 1/7000 to 1/30,000 of Spontaneous Pregnancy 1/100 with Fertility Treatment

69
Q

Features of IUP

A

Criteria for IUP transabdominally Uterine-Bladder Juxtaposition Gestational sac > 25mm Fetal Pole/Yolk Sac (double sac) 5mm of uterine tissue in all planes (Myometrial Mantle) Decidual Reaction - Heterogenous tissue around GS, thicker endometrium around HS +/-FHR

70
Q

Prevalence of Ectopic Pregnancy, and 5 Risk Factors

A

Ectopic pregnancy is 2% of all pregnancy (more prevalent over past 20 years Mortality has dropped to 0.05%, less deadly Risk Factors Previous Ectopic, Hx of Tubal Ligation/surgery, Current IUD use (and pregnant) Hx of PID, Hx of Infertility, Smoking, Hx of G+C/STD

71
Q

5 Locations for an Ectopic Pregnancy, which is most common?

A

Tubal 95% Interstitial/Cornual Pregnancy (2%) higher mortality due to delayed rupture and more bleeding Ovarian 3% Adbominal 1% Cervical <1% Other Rare C-Section scar, Intramural, Heterotopic, Twin Ectopic

72
Q

Diagnostic Criteria for Ectopic Pregnancy on US

A

Diagnostic

73
Q

Quantification of Pelvic Free Fluid

A

Quantification Small - <1/3 way up posterior uterine wall Moderate - 1/3-2/3 up posterior uterine wall, not free flowing into pelvis/abdo Large > 2/3 up posterior wayy OR flowing into pelvis/abdomen

74
Q

Timeline for the formation of Early Pregnancy features (to 10 weeks)

A

Week 0 - LMP Week 2 - Conception occurs Week 4 - GS appears Wk 5 - Yolk sac appears Wk 6 - Embryyo appears, cardiac pulsations with lower limit of 100bpm Wk 7 - Amniotic membrane appears, lower limit of 120 bpm Wk 8 - Spine developmens Wk 9 - Head curvature, motion of embryo occurs Wk 10 - Rhombencephalon develops

75
Q

Discriminatory zone for TA/TV, and expected rise of BHCG

A

BHCG should double every 48h for first 4 wks then double ever 96 hrs after 6 wks Then decline after 12 wks Classic teaching is >3000 for TA, 1500 for TV But not very discriminatory. signficant overlap between normal IUP and Ectopics Case Report of Rupture ectopic at serum BHCG of 13 IU/L urine BHCG detects 25-50 IU/L

76
Q

Describe the location of the salivary glands and their anatomy

A

Parotid Glands (higher up, adjacent/anterior to Ears) Drained by Stensen’s duct into oral cavity Submandibular Glands Beneath jaw and within level I of neck drained by Wharton’s Duct Sublingual Glands Beneath tongue, anterior and superior to submandibular gland

77
Q

Name 3 Salivary gland tumors and 3 benign

A

BEnign Pleomorphic Adenoma Warthin’s Tumor Oncocytoma Malignant Mucoepidermoid carcinoma Adenoid Cystic carcinoma Malignant Mixed Tumor Acinic Cell Carcinoma

78
Q

3 congenital extrinsic neck masses

A

Thyroglossal Duct Cyst Most Common midline neck mass, seen in adolescents with URTIs Branchial Cleft Cyst Solitary cystic mass on Lateral aspct of neck at angle of mandible under SCM Remnant of embryonic development May be connected to mouth and lead to infections Cystic Hygroma Congenital lymphatic malformation, often seen at birth Associated with Turner’s Syndrome, Down’s syndrome, Klinefelter(XXY), Trisomy 18, Trisome 13 US - Cystic multiloculated cervical mass

79
Q

Features of Malignancy in Breast Cysts

A

Malignant Features Marked Hypoechogenicity Taller > Wide (sagittal Scan) Angular Margins Spiculated Contour Posterior Acoustic Shadowing, Punctate Calcifications, Duct Extension BRanch Pattern Multilobulations

80
Q

US Features of Mastitis

A

Mastitis mastitis appears as an ill-defined area of altered echotexture with increased echogenicity in the infiltrated and inflamed fat lobules, hypoechoic areas in the glandular parenchyma, and associated mild skin thickening with occasional distended lymphatic vessels Anechoic/Complex Collection Microcalcifications are concerning for malignancy

81
Q

TWIST Score for testicular torsion

A

TWIST score (/7 points) Testicular Swelling Hard Testicle Absent Cremasteric Reflex Nausea/Vomiting High riding testicle

82
Q

US findings of testicular torsion

A

Enlarged, hypoechoic compared to contralateral Decreased vascular flow on power doppler decreasing PRF (Color scale) can optimize image to assess slower flows

83
Q

Management of Ectopic PRegnancy, and contraindications to medical therapy

A

Methotrexate, Misoprostol Contraindications

84
Q

Clincal Features of Gestation trophoblastic disease

A

Clinical Features Vaginal Bleeding, Hyperemesis, Large Uterus for dates, Anemia, HTN/Preeclampsia, Thyrotoxicosis, Very high serum BHCG, >100,000 Treatment OBGYN Surgical Evacuation D+C vs. Hysterectomy +/- chemotherapy Serial BHCH Imaging PRN, usually CXR

85
Q

US Features of Gestational trophoblastic diseaes (Molar Preg)

A

Snowstorm Heterogenous hyperechoic mass with hypoechoic foci Cluster of Grapes small anechoic cystic spaces within the mass Swiss Cheese Placenta Enlarged with Internal cystic changes Large, Empty, Amorphous GS Large Fluid collections/Oligohydramnios Theca Lutein Cysts

...POCUS (7 decks)

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