OB/GYN Registry Review Part 4

Question 1

_____ twinning will always be:

Answer 1

dichorionic/diamniotic

Question 2

early division <4 days results in:

Answer 2

dichorionic/diamniotic

Question 3

The most common division is between __-__ days

Answer 3

4
8

Question 4

Division between 4 and 8 days results in:

Answer 4

monochorionic/diamniotic

Question 5

Late division >8 days results in:

Answer 5

monochorionic/monoamniotic

Question 6

two completely separate gestational sacs within the uterine cavity in the first trimester

Answer 6

dichorionic

Question 7

Twin peak (labda or delta sign)

Answer 7

dichorionic/diamniotic

Question 8

thin membrane inserting like a T into placenta which means one shared placenta T sign

Answer 8

monochorionic/diamniotic

Question 9

Monochorional twins share one placenta so there’s increased risk of ____ and ____

Answer 9

fetal shunting
growth issues

Question 10

fetal shunting through vessels in the placenta

Answer 10

Twin to Twin Transfusion syndrome

Question 11

Donor twin gives blood to other, eventually suffering from ____ and ____ in TTTS

Answer 11

anemia
IUGR

Question 12

The recipient twin receives too much blood and can suffer from _____ and ____ due to the overload of blood going to the heart in TTTS

Answer 12

hydrops
CHF

Question 13

1st initial sonographic indication of TTTS

Answer 13

discordant fetal growth

Question 14

The donor twin in TTTS signs:

Answer 14

smaller/IUGR
oligohydramnios
anemia

Question 15

The recipient twin in TTTS signs:

Answer 15

larger
polyhydramnios
hydrops/CHF

Question 16

most severe type of TTTS

Answer 16

stuck twin

Question 17

Oligohydramnios is so severe that the donor twin appears to be stuck to the side of the uterine wall

Answer 17

Stuck twin (TTTS)

Question 18

Acardiac twinning is also known as ____

Answer 18

TRAP sequence

Question 19

TRAP sequence is:

Answer 19

twin reversed arterial perfusion syndrome

Question 20

abnormal anastamosis of placental vessels that support the growth of parasitic or acardiac twin

Answer 20

TRAP sequence

Question 21

One normal fetus and one abnormally developed fetus with no heart

Answer 21

TRAP sequence

Question 22

The pump twin in TRAP sequence maintains:

Answer 22

the growth of the parasitic twin

Question 23

The pump twin in TRAP sequence has a mortality rate of __% secondary to polyhydramnios and prematurity.

Answer 23

50

Question 24

The acardiac twin in TRAP sequence demonstrates:

Answer 24

absent upper body, absent heart, and hydrops

Question 25

Conjoined twins only happen in;

Answer 25

monochorionic/monoamniotic twins

Question 26

Occurs when zygote splits >13 days

Answer 26

conjoined twins

Question 27

Most common types of conjoined twins

Answer 27

thoracopagus omphalopagus

Question 28

thoracopagus

Answer 28

conjoined at the chest

Question 29

omphalopagus

Answer 29

conjoined at the abdomen

Question 30

_____ twins have a greater chance of survival in cause of one twin demise, especially earlier on in the first trimester

Answer 30

dichorionic

Question 31

fetal death in 1st trimester and is maintained, not reabsorbed. May eventually become vanishing

Answer 31

fetus papyraceus

Question 32

death of a twin in the early 1st trimester and is reabsorbed

Answer 32

vanishing twin

Question 33

______ fetal demise will often lead to death of other twin

Answer 33

monochorionic

Question 34

Fetal demise in the second trimester of monochorionic can lead to:

Answer 34

twin embolization syndrome

Question 35

demised twin begins to breakdown and vascular products can travel through common vascular channels with shared placenta.

Answer 35

twin embolization syndrome

Question 36

The _____ and ____ are usually affected in twin embolization syndrome

Answer 36

central nervous system kidneys

Question 37

The normal placenta is __-__ cm thick

Answer 37

2 4

Question 38

The major function of the placenta is an ____ organ

Answer 38

excretory

Question 39

The _____ exchanges gases and wastes products with nutrients and oxygen and is the means of nutrition and respiration.

Answer 39

placenta

Question 40

The maternal side of the placenta

Answer 40

decidua basalis

Question 41

The fetal side of the placenta

Answer 41

chorion frondosum

Question 42

functional unit of placenta

Answer 42

lobes of chorionic villi termed cotyledons

Question 43

2 discs of equal size joined together by an isthmus of placental tissue

Answer 43

bilobed

Question 44

additional small lobe separate from the main placental mass but connect by vascular connections. No placental tissue connection

Answer 44

accessory lobe/succenturiate lobe

Question 45

curled up placental contour appearing appearing as a shelf. Curled edges, do not lay flat or smooth along wall. Increased risk of abnormal placental development and future abruption

Answer 45

circumvallate placenta

Question 46

pools of maternal venous blood. Sonolucent areas within placental mass. Will not fill in with color, but can be "swirling" in B-mode

Answer 46

venous lakes/maternal lakes/placental lakes/lacunae

Question 47

Advanced maturation of the placenta can be indications of maternal complications leading to:

Answer 47

placental insufficiency asymmetrical IUGR

Question 48

Grade 0 placenta

Answer 48

homogenous, smooth texture. No indentations in the chorionic plate. Smooth borders (1st tri to early 2nd tri)

Question 49

Grade 1 placenta

Answer 49

subtle indentations in chorionic plate, small random hyperechoic foci (2nd tri to early 3rd tri)

Question 50

Grade 2 placenta

Answer 50

larger, comma-like indentations alter chorionic plate, larger calcifications in basal plate (late 3rd tri)

Question 51

Grade 3 placenta

Answer 51

post dates/advanced. Complete indentations chorionic to basal plate. Irregular calcifications with shadowing. Related to drug abuse and preeclampsia. may cause IUGR if early gestation

Question 52

-previa

Answer 52

presenting/before

Question 53

placenta is implants within the LUS and covers/near to internal os

Answer 53

placenta previa

Question 54

most likely cause of painless vaginal bleeding in 2nd/3rd trimester

Answer 54

placenta previa

Question 55

Placenta previa can only by diagnosed __ weeks onward due to possible placental migration

Answer 55

20

Question 56

internal os is completely covered by placental tissue

Answer 56

complete placenta previa

Question 57

edge of placenta touches internal os

Answer 57

marginal placenta previa

Question 58

edge of placenta is within 2cm of internal os

Answer 58

low-lying placenta

Question 59

general term for abnormal adherence of placenta to myometrium

Answer 59

placenta accreta

Question 60

loss of basal plate or myometrial/serosal layer, multiple placental lacunae, and increased peripheral vascularity

Answer 60

placenta accreta

Question 61

Most common (accreta, increta, or percreta)

Answer 61

accreta

Question 62

Placenta _____ invades the myometrium

Answer 62

increta

Question 63

Placenta ____ penetrates through the uterus and breach serosal layer

Answer 63

percreta

Question 64

premature separation of placenta from uterine wall

Answer 64

placental abruption

Question 65

hypoechoic or anechoic region between placenta and uterine wall at level of basal plate

Answer 65

placental abruption

Question 66

most severe abruption, entire retroplacental hematoma

Answer 66

complete placental abruption

Question 67

A few centimeters of separation (abruption)

Answer 67

partial

Question 68

placental edge, lifting the chorionic membrane from the wall (abruption)

Answer 68

marginal

Question 69

most common placental tumor

Answer 69

chorioangioma

Question 70

Most common location of chorioangioma

Answer 70

adjacent to umbilical cord insertion at placenta