treatment for endometriosis does not include what type of therapy?
radiation
Fitzhugh-Curtis Syndrome is a syndrome related to what?
Pelvic Inflammatory Disease
what is the most common way that you can acquire PID?
untreated sexually transmitted disease
what is a focal implant of endometrial tissue in the pelvis called?
endometrioma or chocolate cyst
a caucasion in her mid 30's best describes a typical patient of?
endometriosis
what can the use of an IUD for contraception increases your chances of?
PID
a patient presents with leukocytosis, a temp of 103 and pain in the right adnexa, what is the most likely diagnosis?
PID (pelvic inflammatory disease)
when endometrial tissue is outside of the endometrial cavity is called what?
endometriosis
retrograde menstruation can be caused by what?
endometriosis
what can block the fallopian tubes and inhibit infertility?
endometriosis
painful menstruation, painful sex and pelvic pain can all be symptoms of what?
endometriosis
where can endometriosis implant?
anywhere in the peritoneal/pelvic cavity
what is a chocolate cyst?
repeated episodes of bleeding and sloughing within the cyst, the old clotted blood is brown and refers to the "chocolate
what are the 2 most common STD's associated with PID?
-chlamydia
-gonorrhea
what are possible treatment options for endometriosis?
-natural menopause
-oral contraceptives
-surgery, including complete hysterectomy
-drug or laser treatment
-pregnancy
how many cases of PID associated with salpingitis are found in the USA each year?
about 1 million
what type of therapy is used to treat PID?
antibiotic therapy
what is hydrosalpingitis associated with?
stage 2 PID where the fallopian tubes are filled with bacterial serous fluid
what happens in stage 3 PID?
the infection progresses through the fallopian tubes and into the peritoneal cavity causing TOA (tubo ovarian abscess), where pus leaks from the end of the tubes into the peritoneal cavity
what type of cyst is thick walled, spherical, and may be complex filled with blood?
endometrioma (aka chocolate cyst)
how is the MSD (mean sac diameter) calculated?
length + width + height divided by 3
when the ovum and sperm merge, their genetic content creates a single cell called?
zygote
what is the portion of the decidua that lies deep to the blastocyst and that is involved in the formation of the maternal portion of the placenta?
decidua basalis
what does the yolk sac look like on ultrasound?
small, sonolucent structure with an echogenic ring located between the chorion and the amnion
what is the most accurate parameter in dating of the fetus throughout the pregnancy?
CRL (crown rump length)
how do we document the fetal heart rate?
M-mode
how would we describe the condition of a patient with vaginal bleeding and closed cervix prior to 20 weeks gestation?
threatened abortion
what would necessitate an ultrasound in the first trimester?
-too large or too small for gestational age
-vaginal bleeding
when should we see a gestational sac by on transabdominal ultrasound?
6 weeks
what should be done if you are unable to visualize fetal heart motion?
call the radiologist and watch for fetal heart motion for 3 minutes
what is a missed abortion?
retention of a dead embryo
what is the most important parameter is the decision as to whether the pregnancy is intrauterine of extrauterine?
visualization of the gestational sac within the uterus with a double sac sign
what positive serum is produced and rises in pregnancy?
beta HCG (human chorionic gonadotropin)
if a patient presents with a positive HCG, vaginal bleeding, pelvic cramping and a dilated cervix, what would this likey be associated with?
inevitable abortion
what decidual portion is superficial to the blastocyst and projects into the uterine lumen?
decidua capsilaris
what is the most common fetal presentation?
cephalic
what is the first definite ultrasound appearance confirming an intrauterine pregnancy?
the gestational sac
at what week of gestation should the kidney, fetal heart and bladder all be seen?
20 weeks
how do you measure the crown rump length?
top of the baby's head to the bottom of the baby's bottom
an empty gestational sac that is too small for gestational age indicates what?
an anembryonic pregnancy also called a blighted ovum
with gamete intrafallopian transfer (GIFT) procedure, the sperm and ova are placed where?
into the fallopian tube (ampullary region)
what can definitively exclude the presence of an ectopic pregnancy?
negative HCG
chorioadenoma destruens is a condition associated with what?
engorged and swollen chorionic villa
what is the most common site of implantation of an ectopic pregnancy?
fallopian tubes, region of ampulla
what is the correct placement of an IUD?
fundus of the uterus above the internal os
what can using an IUD increase your risk of?
-PID (pelvic inflammatory disease)
-ectopic pregnancy
-uterine perforation
what 2 drugs are most commonly used to induce ovulation?
-clomid
-perganol
where does AFP come from in the fetus?
fetal liver
what is the accepted method for measuring the BPD (biparietal diameter)?
measuring from leading edge to leading edge (outer to inner edge)
what does the umbilical cord contain?
2 arteries and 1 vein
measuring the BPD(biparietal diameter), AC (abdominal circumference), FL (femur length) and HL (humerus length) can all be used to determine what?
fetal age
if a patient is experiencing compression of the IVC by the uterus during an exam, what should you do?
stop the exam immediately and have them turn on their left side
when is the BPD most accurately measured?
14-20 weeks
what structure initially secretes HCG?
trophoblast
what is the most common fetal presentation?
cephalic
what is the length of time for human gestation in days, week and months?
-280 days
-40 weeks
-9 calendar months
what is the name of the procedure in which a suture is used to keep the cervix closed?
cerclage
what is most associated with choroid plexus cysts?
trisomy 18 (edward's syndrome)
the fetal heart, bladder and kidneys should all be visualized by how many weeks of gestation?
20 weeks
formation of the fetal organs occurs within the first how many weeks of gestation?
within the first 10 weeks
how do we assess the fetal head shape?
measuring the BPD and dividing it by the OFD (occipital frontal diameter)
which landmark must be visualized in order to ascertain the proper AC measurements?
-stomach
-3 ossification centers
-"hockey stick" sign
what fetal measurement is the most important when calculating the weight of the fetus?
AC (abdominal circumference)
to obtain the most accurate femur length measurement the sonographer should measure what?
the ossified femoral diaphysis of the femur closest to the transducer
what bones could be mistakenly measured as the femur?
-humerus
-fibula
-tibia
what is the EDC?
estimated date of confinement
how do we describe a hydatiform mole on ultrasound?
snowflake" or "lacey" appearance
monozygotic twins are not associated with what?
intrauterine growth restriction
what is wharton's jelly?
mucoid substance surrounding the unbilical vein and artery
what is the most common type of conjoined twins?
thoracopagus
what type of twinning has the highest risk of complications?
monochorionic monoamniotic (risk increases when the twins are sharing the placenta or amniotic sac)
what is the spalding sign?
non-specific indicator of fetal demise. the ultrasound appearance shows overlapping sutures of the fetal head with smaller that expected BPD and HC
painless vaginal bleeding in the 2nd or 3rd trimester is commonl associated with what?
complete previa
how would we grade a placenta with a smooth chorionic plate and no calcifications
grade 0
what is the name of the most common benign tumor of the placenta?
chorioangioma
what is fetal papyraceus?
a condition where one fetus dies in a twin gestation and is preserved in a distorted for due to the effects of polyhydramnios in the other amniotic sac
what portion of the fetal brain can be visualized by the 7th week of pregnancy?
rhombencephalon
dizygotic twins are called?
fraternal twins
monozygotic twins are called?
identical twins
when scanning twins, you should always document fetus A based on what?
fetus closest to the cervix
what are the clinical signs for fetal death in the 1st trimester?
-maternal bleeding
-uterus is too small for dating
-patient doesn't feel pregnant
-no fetal hear rate detected
what is the placenta?
a vascular organ shaped like a disc that provides the fetus with oxygen rich blood and nutrients
describe a velamentous cord insertion?
the umbilical cord attaches to the uterine membrane instead of the placenta and it is not protected by wharton's jelly and therefore thrombus and rupture may occur
what is a complete previa?
when the placenta is completely covering the internal os
what is a vasa previa?
when the placenta vessels are present between the internal os and the fetus
what can a 2 vessel cord abnormality cause?
-atrophy of the artery
-renal and cardiac anomalies
-intrauterine growth restriction
what is the PUBS procedure?
Percutaneous Umbilical Blood Sampling- ultrasound guided removal of fetal blood from the umbilical cord
what is the presentation called when the baby is bent at the waist and the butt is coming into the cervix first?
frank breach