OB 3

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1

What anomaly is found in the neck?

cystic hygroma

goiter

2

What is Micrognathia?

small chin

3

What is associated with micrognathia?

suckling problems

trisomy 13 & 18

treacher collins

4

What is treacher collins

An inherited condition in which some bones and tissues in the face aren't developed.

low set ears

micrognathia

5

What is macroglossia?

big tongue

6

What does macroglossia suggest?

downs (21)

beckwith-wiedemann syndrome

7

What is beckwith-wiedemann syndrome?

Large 95th percentile

8

What is beckwith-wiedemann syndrome caused by?

excessive amounts of growth hormone

9

When should the lip be evaluated?

when mouth is closed

10

what is the philtrum?

the junction between the two halves of the upper lip or of an animal's nose

11

When can the evaluation of cleft lip be done trans abdominally?

as early as 18 weeks

12

Who has the highest prevalence of cleft lip?

native americans

13

What causes cleft lip?

failure of fusion of primary and secondary palates

14

What is the most common congenital facial abnormality?

cleft lip and palate

15

What causes cleft palate?

lateral palatine processes fail to fuse in the midline

16

What is the most determinant of fetal viability?

pulmonary development

17

What week are babies not considered special care?

34 weeks

babies produce enough surfactant to breath normally

18

What is the major reason fetuses younger than 24 weeks are considered nonviable?

lung maturity

19

How do the lungs appear in the 1st and 2nd trimester?

isoechoic to liver

20

How do the lungs appear in the 3rd trimester?

hyperechoic

21

What is the formula for predicting hypoplasia?

(chest area - heart area / chest area )*100

22

What are the possible anomalies of small thoracic circumference?

pulmonary hyperplasia?

23

What happens when heart is enlarged?

concern for lungs

24

How much chest space should the heart take up?

30% to 50%

25

What are the most common lung cyst detected prenatally?

bronchogenic

26

What are bronchogenic cysts?

generally occur within the lungs

appear as echo-free mass

27

What is bronchopulmonary sequestration?

non-functioning pulmonary tissue that is separate from normal trachiobronchio tree

28

Where does bronchopulmonary sequestration occur?

intra-lobar - within pleural lung sac

extra-lobar - connected to the inferior body of lungs

29

How does bronchopulmonary sequestration appear?

hyperechoic solid mass in lower lung lobe

Doppler - feta vessels light up

30

What is cystic adenomatoid malformation?

benign cystic condition of the lungs

usually unilateral

31

What is the appearance of Type 1 adenomatoid malformation?

several large replace normal lung tissue

32

What is the most common type of adenomatoid malformation?

Type I

33

What is the appearance of Type II adenomatoid malformation?

multiple small cysts less than 2 cm

34

What is the suvival rate of type II adenomatoid malformation?

75%

35

What is the appearance of Type III adenomatoid malformation?

homogeneous hyperechoic lungs (pop out)

cysts are so small lungs appear hyperechoic

36

What percent of adenomatoid malformation resolve spontaneously?

17%

37

What is a diaphragmatic hernia?

defect in diaphragm permitting abdominal organs to enter chest

lung are compressed and may become hyperplastic

38

Where does the most common type of diaphragmatic hernia occur?

75% - 95% through foramen of Bochdalek

39

What is diaphragmatic hernia associated with?

chromosomal abnormalities

40

What is the survival of diaphragmatic hernia dependent on?

location of liver

41

When the liver is intra-thoracic what is the survival rate of diaphragmatic hernia?

40%

42

When the liver is intra-abdominal what is the survival rate of diaphragmatic hernia?

80%

43

What is chyle?

fatty lymph absorbed by lacteals

44

What is hydrothorax?

pleural effusion

accumulation of fluid within the pleural space

45

What is the most common type of pleural effusion?

Chylothorax

46

What is chylorothorax?

right unilateral collection of fluid secondary to malformed thoracic duct.

47

What is the mortality rate in chylorothorax?

50%

48

What is a lacteal?

special organs that absorb fatty lymph (chyle)

49

How much chyle does the thoracic duct transport per day?

4 liters.

50

What is pulmonary hyperplasia?

decreased lung volume resulting in small inadequately developed lungs

small chest or low fluid

51

What is the fatality of pulmonary hyperplasia?

80%

52

What is the cause of pulmonary hyperplasia?

congenital diaphragm hernia

oligohydramnios - PROM or renal agenesis

thoracic circumference less than 5th percentile

53

What is an omphalocele?

anterior abdominal wall defect

- herniation of the gut into the umbilical cord

54

What do bowel only omphaloceles have a higher risk of?

chromosomal abnormalities

55

What is the major reason fetuses younger than 24 weeks are considered nonviable?

lung maturity

56

What is gastroschisis?

abdominal wall defect usually in boys on right side

No membrane surrounding bowel

57

What is the survival rate of gastroschisis?

85%

*when no other complications

58

What are complications of gastroschisis?

ischemia

gangrene

59

WHat is the survival rate of gastroschisis when complications are involved?

50%

60

What is the appearance of gastroschisis?

free floating bowel

bowel in the amniotic fluid

61

What are the indications of gastroschisis?

increased AFP

*higher than omphalocele

62

What is amniotic band syndrome?

rupture of amnion leading to entrapment of fetal parts by sticky chorion.

63

What can early entrapment of amniotic band syndrome cause?

craniiofacial defects

64

What can late entrapment of amniotic band syndrome cause?

limb amputation

65

What causes polyhydramnios?

anything that deters swallowing

66

What is the most common cause of macroglossia?

Beckwith-Weiderman Syndrome

present 97%

67

What is Beckwith-Weiderman Syndrome?

greater than 95th percentile

Everything is big...caused by dysfunctional placentia producing too much growth hormone

omphalocele

macroglossia

organomegally

68

What is Bladder exstrophy?

defect in lower abdominal wall usually in boys

bladder is on surface of abdominal wall

69

What is Pentalogy of Cantrell?

5 defects

  • ectopic heart
  • omphalocele

these cause

  • anterior diaphragm defect
  • diaphragmatic pericardium defect
  • lower sternum defect
70

What is limb body wall defect?

extreme form of amniotic band syndrome

large cranial defect

facial cleft

body wall defect

scoliosis

71

The foramen ovale always shunts from ____________ to ____________.

right to left

72

What is the 5th chamber on a 5 chamber view of the heart?

Ascending aorta

73

A 4 chamber view allows us to exclude ____% of anomalies.

65%

74

What should we see in the normal 4 chamber view?

right atrium and ventricle

moderator band

tricuspid & mitral valves

left atrium and ventricle

interventricular septum

foramen ovale

75

Where does the apex of the heart point?

to the left ribs

76

Where does the base of the heart point?

right shoulder

77

At what angle is the normal cardiac axis lie?

45 o to 90o

78

what angle is the average cardiac axis lie?

45o

79

What is hypoplastic left ventricle?

small or absent left ventricle

the size of the left ventricle is variable

80
card image

hypoplastic left ventricle

81

What is the cause of hypoplastic left ventricle?

abnormalities that limit the flow of blood through the heart

- stenosis of mitral valve

- stenosis of aortic valve

- stenosis of foramen of ovale

82

What is hypoplastic right ventricle?

small or absent right ventricle

the size of the left ventricle is variable

83

What is the cause of hypoplastic rightventricle?

- stenosis of tricuspid valve

- stenosis of pulmonary valve

84

Which is more common left or right hypoplastic ventricle?

left

85

What can hypoplastic right ventricle cause?

hydrops and ascites due to poor venous flow

86

What is Epstein's anomaly?

malformation of malpostion of the tricuspid valve

- portion of the right ventricle is contiguous with the right atrium

-valve is dysplastic and imcompetent

-right atrium is enlarged

87

What is the mortality rate of Epstein's anomaly?

80%

88
card image

Epstein's anomaly

89

What is the most common congenital heart defect?

ventricular septal defect

90

What is a venticular septal defect?

opening in membranous or muscular portion of the interventricular septum

91

Which is more common with ventricular septal defect?

A) membranous

B) muscular

A) membranous

92

Which has a better outcome of ventricular septal defect?

A) membranous

B) muscular

membranous

membranous tend to be small (some repair spontaneously)

muscular tend to have poor outcome

93

How is ventricular septal defect diagnosed?

4 chamber view

94

What is the most common ventricular septal defect?

foramen of ovale does not close

95
card image

ventricular septal defect

96

What is endocardial cushion defect?

large defect in central portion of heart

involves both A/V valves and both atrial and ventricular septa

97

What are other names for endocardial cushion defect?

atrioventricular septal defect

A/V canal malformation

98
card image

endocardial cushion defect

99

What is the prognosis of endocardial cushion defect?

poor

100

What is tetralogy of fallot?

D - displaced aorta

R - right ventricle hypertrophy

O - opening of septum

P - pulmonary valve stenosis

101
card image

tetralogy of fallot

102

What is transposition of great vessels?

Pulmonary artery arises from left ventricle

aorta arises from right ventricle

103

How is diagnosis best made of transposition of the great vessels?

long axis of left ventricle

104
card image

transposition of the great vessels

105

What is coarctation of the aorta?

stenosis of distal aortic arch close to ductus arteries

106

What does coarctation of the aorta cause?

left ventricular overload creating left ventricular hyper trophy

107
card image

coarctation of the aorta

108

What is Truncus Arteriosus?

the aorta and pulmonary arteries are combined in one large trunk

109

What is Truncus Arteriosus associated with?

hypoplasia of rt ventricle

hypoplasia of let ventricle

ventricular septal defect

A/V canal

110
card image

Truncus Arteriosus

111

What is Ectopic cordis

heart outside the fetal thorax

112

What is Ectopic cordis associated with?

pentalogy of cantrell

amniotic band syndrome

113

What is the prognosis of Ectopic cordis?

dismal

114

What is pericardial effusion?

abnormal accumulation of fluid between the viseral and parietal layers of the pericardim

115
card image

pericardial effusion

116

What is pericardial effusion called in adults?

cardiac tamponade

Medical emergency

117

Why is pericardial effusion dangerous?

atrium and ventricles can not expand

118

What is the most common tumor of the heart?

rhabdomyoma

119

What percentage of cardiac tumors are malignant?

10%

120

Name the cardiac tumors.

rhabdomyoma

teratoma

fibroma

myxoma

hemangioma

121
card image

rhabdomyoma

122

What is the sonographic appearance of a rhabdomyoma?

hyperechoic and large