Mod 6

Question 1

Mean sac diameter

Answer 1

MSD
Used when embryo is not identified
Used from 4-8 weeks

Question 2

What do you measure in MSD

Answer 2

Length+width+height \ 3

Question 3

What do you have to ensure you see when see the MSD

Answer 3

Double decidual reaction

Question 4

Why is the MSD compared to the embryo

Answer 4

Useful in early diagnosis of oligohydraminos

Question 5

What does oligohydraminos mean

Answer 5

Low fluid

Question 6

What is the formula for calculating oligohydraminos

Answer 6

MSD(mm)-CRL(mm)

Question 7

When is the oligohydraminos calculated and what does the calculation have to be less than for oligohyraminos to be suspected

Answer 7

5.5-9 weeks

<5mm

Question 8

What is calculated/assessed in the 1st trimester scan

Answer 8

MSD
CRL
Nuchal lucency

Question 9

How much does the gestational sac grow each day

Answer 9

1.1 mm / day

Question 10

An EV scan should have what kind of MSD

Answer 10

8mm if yolk is seen

16mm if embyro is see

Question 11

A transabdominal scan should have what MSD

Answer 11

8mm-yolk seen

16mm- embryo seen

Question 12

When is a CRL used

Answer 12

Between 6 and 13 weeks

Question 13

What is the most accurate measurement to predict gestational age +/- 3 days

Answer 13

CRL

Question 14

Where do you measure on a CRL

Answer 14

Tip of the head to the end of the rump

Question 15

What do you not include on a CRL

Answer 15

Yolk sac

Question 16

What position should the fetus be in for a CRL and what position is the probe in

Answer 16

Neutral position

Probe is midline sag

Question 17

What are the US findings with an ectopic

Answer 17

No IUP
PUL (pregnancy of unknown location)
Free fluid in posterior cul de sac
Lt adnexal mass
Fetal pole identified in mass with FH seen

Question 18

What does the free fluid in the posterior cul de sac indicate

Answer 18

Pregnancy has ruptured

Question 19

What is the definition

Answer 19

A pregnancy that occurs outside the uterine cavity

Question 20

What is the classical clinical triad

Answer 20

1. Pain
2. Bleeding
3. Adnexal mass

Question 21

What percentage of people present with these symptoms

Answer 21

45

Question 22

What are other presenting symptoms of ectopic pregnancy

Answer 22

Amenorrhea
Adnexal tenderness
Cervical tenderness

Question 23

When does ectopic pregnancies usually present

Answer 23

Between 5-8 weeks

Question 24

what are the risk factors that can result in ectopic pregnancies

Answer 24

tubal surgery
pregnancy with an IUCD
PID
previous ectopic
endometriosis
chrons disease
previous appendicitis

Question 25

what is the risk of an ectopic presenting in the other tube after it presented in one

Answer 25

50%

Question 26

what does PID stand for

Answer 26

pelvic inflammatory disease

Question 27

where are the sites of ectopics

Answer 27

``` fallopian tubes cervix interstitial segment of the tube ovary peritoneal cavity ```

Question 28

what percentage of ectopics occur in the ampulla

Answer 28

95%

Question 29

what are the most dangerous areas to have an ectopic

Answer 29

cervix | cornua areas

Question 30

what is another term for the cornua area

Answer 30

interstitial

Question 31

why is having an ectopic in the cornua area the most dangerous

Answer 31

it is one of the only areas in the body that wont coagulate

Question 32

why are the cornua area and cervix the most dangerous

Answer 32

high risk of hemorrage because they are highly vascular areas with little or no thickened endometrium for the embryo to burrow into

Question 33

what are the sonographic features of an ectopic

Answer 33

adnexal mass free fluid absence of an IUG or presents with a pseudo sac may see a viable ectopic pregnancy instead of adnexal mass

Question 34

what is a viable ectopic

Answer 34

gestational sac seen with an embryo with a heart beat seen outside of the uterus 100% accurate for the diagnosis of an ectopic may also indicate that the pregnancy has not yet ruptured

Question 35

should the menstrual history of that is given by the patient be trusted

Answer 35

not in this case, however knowing when the first pregnancy test was postitive is helpful

Question 36

what is common of the ß hCG levels

Answer 36

lower than normal but can still be in the same range

Question 37

what should happen to the ß hCG levels in a normal pregnancy but not with a ectopic pregnancy

Answer 37

levels should double every 2 days

Question 38

in early gestation, 5 weeks, what should happen to the levels of ß hCG in the blood work

Answer 38

should increase

Question 39

what would happen to ·ß hCG levels in the blood in the case of a spontaeous abortion

Answer 39

should decrease

Question 40

in the case of PID what should the ß hCG levels in the blood be

Answer 40

negative, not pregnant

Question 41

what is a heterotopic pregnancy

Answer 41

an interuterine pregnancy with a twin ectopic pregnancy

Question 42

what is the rarity of a heterotopic pregnancy

Answer 42

1/7000 incidences

Question 43

what did the ratio of heterotopic pregnacies use to be

Answer 43

1/40000

Question 44

why have the incidences of heterotopic pregnanices increased

Answer 44

due to ART

Question 45

what does ART mean

Answer 45

assisted reproductive technology

Question 46

what does a negative ultrasound result mean for ectopic and why

Answer 46

does not rule out ectopic as it may be too small recognize with sonography

Question 47

what must be done in a follow up to rule out ectopic

Answer 47

ev ß hCG levels repeated every 2 days scan repeated in one week

Question 48

what is the interstitial line sign

Answer 48

echogenic line extending from the endometrial canal up to the center of the interstitial sac or hemorrhagic mass

Question 49

what is the interstitial line sign help diagnosis

Answer 49

interstitial ectopic pregnancies

Question 50

gestational sacs must have a minimum of how many mm of what surrounding it

Answer 50

5mm of myometrium