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High Risk Finals

1 (This is associated with Decreased MSAFP) Which of the following is not associated with elevated MSAFP: 1.Down's Syndrome, 2.Incorrect dates, 3.Multiples, 4.ONTD, or 5.Gastroschisis.
Aneuploidy abnormal number of chromosomes
Genotype basic combination of genes in a person
50 Dominant disorder: A condition caused by a single, defective gene. Inherited from an affected parent or results from a new mutation. Transmitted to ______% of offspring.
4 AFP (Alpha-fetoprotein) is not found in which of the following: 1.fetal spine, 2.GI tract, 3.liver, 4.brain, 5.kidneys
3 Which of the following is the most sensitive for the longest amount of time: 1. Lips & face, 2. Genitalia, 3. Eyes & Ears, 4. Limbs
Sequential Screening Screening tests that occur in order; one after another
inhibin-A Quadruple Screening has what lab values: AFP, unconjugated estriol, B-hCG, & ________
84 CRL (Crown Rump Length) should be between 45 & ____ millimeters to do a NT
6; 15 Abnormal Nuchal Fold is >_____ after_____ weeks
T21 Most common aneuploidy
1 not true of CVS: 1.only performed transcervically, 2.US directed aspiration/biopsy of the placenta or chorionic villi; 3.Used to obtain a fetal karyotype & allows for dx of genetic disorders in 1st trimester; 4.Cells from villi are cultured & analyzed
3 Indications for amniocentesis include all of the following EXCEPT: 1.lung maturity, 2.fetal infections, 3.cardiac anomalies, 4.isoimmunization, 5.therapeutic
2 Fetoscopy: All EXCEPT: 1."viewing of the fetus"; 2.Testing 1st tri of blood, skin, & liver for prenatal diagnosis; 3.TV & TA; 4.US guided with a needle introduced into the amniotic cavity
Preeclampsia What condition has an association with HELLP?
T18 Holoprosencephaly and exomphalos are seen in a fetus with what condition?
T18 Sonographic signs of strawberry shaped skull and rocker bottom feet are associated with what condition?
F (should be 45-84 mm) T/F: CRL (Crown Rump Length) should be between 22 & 63 millimeters to do a NT
T21 Which trisomy exhibits elevated hcg, inhibin-a, and decreased afp?
Turner's Syndrome Cystic hygroma and ascites are associated with what condition?
micrognathia Term that describes a small chin?
equals sign represents nasal bone and maxilla According to the FMF website, all are true of nasal bone requirements, except?
Pentalogy of Cantrell This is rare and associated with omphalocele?
100,000 In molar pregnancies, the hcg level will be greater than?
non-immune hydrops This hemolitic disease is marked by anemia, enlargement of liver and spleen, and hydrops fetalis.
Eclampsia This causes comas and seizures in the 2nd/3rd trimesters.
4 All are prenatal treatments of hydrops except? 1. aspiration 2.FBS 3.Transfusion 4.Intubation
Rh incompatibility Immune hydrops is caused by
results are available within 48 hours (this is FISH) Which of the following is not true of CVS?
anasarca What is the term for generalized subcutaneous edema?
FISH Which karyotyping results are available in 1-2 days?
F T/F: Non-immune hydrops is associated with alloimmunization.
3 All of the following is associated with fetal hydrops except: 1.pleural effusion 2.ascites 3.placental thinning 4.polyhydramnios
3 All are alternate sites for FBS except for: 1.Free cord loop 2.Intrahepatic vein 3.Common iliac junction 4.Umbilical insertion site
F T/F: Hypertension is associated with large placentas
4 Which is true of TTTS? 1.Donor gets smaller 2.recipient gets bigger 3.aka Poly-oli sequence 4.all of the above
F T/F: Genetic counseling gives specific decisions for parents undergoing it.
Non-immune hydrops 70% of fetal death is associated with what condition?
Ballantyne What is the term for edema developing in the mother as a result of fetal hydrops?
MCDK (Multicystic Dysplastic Kidney) Most common renal cystic disease in childhood?
ADPKD (Autosomal Dominant Polycystic Kidney Disease) Cystic Kidney disease with Normal AFI
ARPKD (Autosomal Recessive Polycystic Kidney Disease) Cystic Kidney disease Associated with Oligohydramnios
Decidua basalis Thickened decidua at implantation site occurs between the blastocyst & myometrium
Decidua Capsularis Thin, overlies the GS facing the UT cavity
Smooth Chorion Opposite side of the implantation (degenerating villi)
Chorion Frondosum Definitive placenta
Chorionic villi Functioning units of the placenta
Basal Plate Divided into cotyledons(composed of several villi & their branches)
Chorionic plate Fetal surface of placenta
E Which of the following is not a cause of placental thickening: A.Intraplacental damage; B.Chorioangioma; C.Intraplacental hemorrhage; D.Fetal Hydrops; E.Placentoma
C (Amniotic Fluid Function) All are functions of the placenta except: A.Nutrition from maternal blood; B.Excretion of fetal waste products; C.Acts as a reservoir to fetal metabolites; D.Protection from microorganisms
B All of these are associated with Advanced maturation of the placenta EXCEPT: A.Htn; B.Hormone Stimulation; C.IUGR; D.Cigarette Smoking; E.Multiples
Succenturiate Placenta Accessory Lobe connected to the body of the placenta by blood vessels
Vasa previa This dangerous condition in which vessels cross the cervical os
Percreta Which is the most dangerous type of adherence?
C All are factors of placenta percreta EXCEPT: A.AMA; B.Multiparity; C.IUGR; D.Prior C-Section; E.Smoking
Marginal Which type of abruption is a low pressure bleed?
Umbilical; deoxygenated _______ are continous with the iliac arteries and carry _________ blood from the fetus to the placenta.
A true of umbilical cord EXCEPT: A.Defined as the distance between the same umbilical artery making 2 turns around the umbilical vein; B.Twists towards the left more often; C.Develops approximately 40 spiral turns; D.Coiling may result from fetal activity
C All are associated with a long cord EXCEPT: A.Excessive coiling; B.Mulitple loops of nuchal cord; C.IUGR; D.Cord Prolapse
B (25%) All are true of nuchal cord except: A.Multiple loops (greater than 2) should be reported to an OB; B.Occurs in 45% of deliveries; C.Rarely associated with complications; D.Defined as entanglement of UC around fetal neck
B If a single Umbilical artery is seen which of the following should be investigated for abnormalities: A.Upper & lower GI tract; B.Kidney & Heart; C.Brain & Spine; D.Extremities
Battledore This CI is at the margin of the placenta
Velamentous This umbilical cord is attached at the placental membranes
Pyelectasis Dilation of only the renal pelvis
C The following questions are helpful in defining and characterizing urinary tract abnormality EXCEPT: A. Is the bladder identified and normal in appearance?; B.Are kidneys present?; C. What is the fetal presentation?; D.What is the fetal gender?
B All are associated with BRA (Bilateral Renal Agenesis) EXCEPT: A.Facial anomalies; B.Severe Polyhydramnios; C.Nonvisualization of Kidneys; D. Lying-down adrenal sign
Crossed Renal Ectopia This occurs when the kidneys are located on the opposite side of their ureteral orifice
D ARPKD is best described by which of the following: A. Juvenile results in prenatal death; B. Perinatal appears at 1-5 years of age; C. Also known as Potter type 3; D. Affects the kidney & liver
ADPKD (Autosomal Dominant Polycystic Kidney Disease) The most common hereditary renal cystic disease
A Which is false regarding renal neoplasms: A.Congenital tumors are common; B.Most common renal tumor in the fetus & newborn is fetal renal hamartoma; C. Most tumors are benign; D. Polyhydramnios is frequent
Hydronephrosis Abnormal dilation of renal pelvis and calyces
UPJ (Uteropelvic Junction Obstruction) Most common cause of fetal hydronephrosis
PUV (Posterior Uretheral Valves) Sonographically this appears as a keyhole sign
D All are associated with Prune Belly Syndrome EXCEPT: A.Oligohydramnios; B.Undesceded Testes; C.Tortuous dilated ureters; D.Renal agenesis
A MCDK is best described as: A.renal tissue displaced by cysts of multiple sizes; B.Unilateral can be lethal (19-24%); C. Bilateral is associated with renal abnormalities including agenesis (13-26%)
Exstrophy of Bladder Caused by an incomplete median closure of the inferior portion of the anterior abdominal wall and the anterior wall of the urinary bladder
A Which of the following is NOT associated with abnormal genitalia: A.Urethral atresia; B.Hypospadias; C.Hydrocele; D.Enlarged clitoris; E.Undescended testes
D All are functions of the amniotic fluid EXCEPT: A.Allows embryonic and fetal movement; B.Maintains a constant temperature; C.Acts as a cushion to protect the fetus; D.Act as "fetal lungs"; E.Essential for fetal lung development
B All are associated with polyhydramnios EXCEPT: A.Accentuated fetal anatomy; B.AFI is greater than 15cm; C.Freely moving fetus; D.This one is made up
A Which is not associated with Oligohydramnios: A.GI abnormalities; B. Renal abnormalities; C.IUGR; D.Postdates
ABS (Amniotic Band Syndrome) May cause amputation of limbs and amputation of fetal parts
C Amniotic fluid is produced by all EXCEPT: A.Umbilical Cord; B.Membranes; C.Liver; D.Kidneys
C not true regarding the adrenal glands: A.In the second & third trimester they appear as a "Y" or "V" shape; B.Most common abdominal malignancy in neonates is neuroblastoma; C. Renal neoplasm is indistinguishable from adrenal hemorrhage
A All of the following are part of a normal sonographic evaluation EXCEPT: A.Open eyelids; B.Axial view of the maxilla; C. Sagittal nose/lips view; D.facial profile include nasal bone
Noonan Associated with low-set ears: A. Beckwith-Weidemann; B. Goldstein; C. Epstein; D. Noonan
C What is not associated with the eyes: A.Hypotelorism; B.Hypertelorism; C.Microstomia; D.Anopthalmia; E.Micropthalmia
Dacryocystocele All of the following are neck masses EXCEPT: A. Cervical Teratoma; B. Goiter; C. Cystic Hygroma; D.Epignathus
Anencephly 1:1000; Rare, fatal, & orbits are present. (Not actual image)
Agenesis of Corpus Callosum pointed anterior ends of LV (Teardrop) (Not actual image)
Iniencephaly Rare, fatal, dysraphism. Note the specimen's position. (Not actual image)
Proboscis What is this facial protuberance? (Not actual image)
Frontal Bossing Abnormal forehead associated with syndromes & bony dysplasia. (Not actual image)
A Which of the following is/are not prominences: A.Temporal; B.Frontonasal; C.2 Maxillary; D.2 Mandibular
Hypotelorism Hypo or hypertelorism: Holoprosencephaly & T13
Hypertelorism Hypo or hypertelorism: Craniosynostosis & Cleft lip
males Is clefting more common in males or females?
Cyclopia Single midline eye
otocephaly union of the ears on the front of the neck
C Limitations for evaluation by US of the fetal face include all of the following EXCEPT: A.bone shadowing; B.poor fetal position; C.polyhydramnios; D.maternal obesity; E.hyperactivity
OOD measured from outermost lateral border of the orbit to the opposite lateral border
Midface Hypoplasia abnormal concavity of the midface
13 & 18 Cleft lip is associated with trisomy ____ & ____
five week? CNS development
six week? Cephalic end enlarges
eighteen week? Corpus callosum; ____-20
eighteen week? Cerebellar vermis
eleven What week? Mineralization of bones
ventriculomegaly Most common cranial abnormality
MeckelGruberSyndrome Assoc: encephalocele, cystic renal dysplasia, polydactyly
Semilobar Type of Holoprosencephaly: rudimentary occipital horns
Alobar Type of Holoprosencephaly: Absent interhemispheric fissure & Corpus callosum/single vent
Schizencephaly Clefts or defects begin at outer cortex & extend toward LV
Lissencephaly Smooth brain surface lacking normal sulci & gyri
Microcephaly 1:6250-­1:8500; Caused by the following: genetic, environmental, infection, drugs, etc.
Hydranencephaly Rare, congenital, most severe form of brain destruction; Almost total absence of cerebrum
ACC SONO: early DX diff; disproportionate enlg of occipital horns; lateral displacemt of medial & lateral ventricular walls; pointed anterior ends of LV; Sunburst
Teratoma Most common lesion
B NOT true of lat vents: A.Borderline ventriculomegaly is 10-15 mm; B.The lateral vent nearest the txr should be measured; C.A measurement greater than 10mm is suggestive of ventriculomegaly; D.Measurement greater than 15mm is marked for ventriculomegaly
Encephalocele Herniation of intracranial structures through a defect in the cranium
Open What form of SB is associated with elevated MSAFP?
SpinaBifida Lemon sign is associated with what condition?
holoprosencephaly This brain condition has a prevalence of 1:5,000-1:16,000
Myelomeningocele Meninges & neural tissue protrude from the vertebral canal through spina bifida defect in the posterior midline neural arches.
A Which of the following is not associated with NTD's: A:Maternal hypertension; B:Valproic acid, C:Sibling with NTD
OneThousand Open NTDs occur in 0.5 to 2 per ______ births in North America and with higher frequencies in other geographic areas.
closure Most cases of spina bifida result from failure of ______ of the embryologic neural tube, although some may be caused by rupture of the neural tube after primary closure.
A Not associated with Spina Bifida: A.Sunburst Sign; B.IUGR; C.Renal Anomalies; C.Concave frontal bones; D.Omphalocele
lumbosacral The ______ spine is most often involved in Spina Bifida Occulta
One not particularly useful in raising suspicion of an NTD: 1.Increased BPD; 2.Nonvisualization of the cisterna magna; 3.Deformation of the cerebellar shape (banana sign); 4.Concave frontal bones (lemon sign); 5.Dilation of the lateral cerebral ventricles
4CH Where do you measure the chest circumference?
E true for kyphosis & scoliosis except: A.Kyphosis is exaggerated curvature of the spine in the sagittal plane; B.Scoliosis is lateral curvature of the spine; C.Associated with Limb-body wall complex (LBWC); D.Associated with VACTERL; E.TORCH
NinetySeven Chiari II malformation is highly associated with open spina bifida (>______% of cases).
Ventriculomegaly Usually mild in the second trimester and worsens postpartum after repair of the spinal defect. This is seen in 44% to 86% of fetuses with spina bifida.
myelocystocele Prenatal and postnatal sonography demonstrates a "Cyst Within A Cyst" appearance
D Stages of lung development all except: A.embryonic, B.pseudoglandular, C.canalicular, D.diaphragmatic, E.alveolar
B Factors associated with normal lung growth: A. fetal breathing movement; B. fetal tone; C. adequate amniotic fluid; D.adequate gestation
B Sonographic characteristics of the thoracic cavity: A.Symmetrically bell-shaped; B.Clavicles upper margins & diaphragm lower margin; C. ribs encompass 1/2 of lungs on either side
E NOT true regarding Sacrococcygeal teratoma: A.Contains all 3 germ layers; B.Most common tumor of neonates; C.At birth, 75% of sacrococcygeal teratomas are benign; D.Mass in the rump or buttocks area adjacent to the spine; E.Males more likely than females
SacrococcygealTeratomas Sonography usually demonstrates a mass in the rump or buttocks area adjacent to the spine
End of organogenesis When does CDH occur?
hydrothorax accumulation of fluid in the pleural cavity
CHAOS (Congenital High Airway Obstruction ) EXIT procedure at delivery; almost always lethal if untreated
B CCAM All EXCEPT: A.Three types; B.50% of congenital lung masses
C diff between CCAM & CDH EXCEPT: A.CCAM due to early pulmonary insult; B.Abdominal organs don't rise up to the fetal chest area during inspiration for CCAM; C.Failure of pleuroperitoneal canal to close @ end of organogenesis
7 Week? TV-Limb Buds
8 Week? Osteogenesis of clavicle/mandible
11-12 Week? Primary ossification centers of long bones, scapulae, ilea, phlanges
4 Month? Ischium, Metacarpals, metatarsals
5-6 Month? Pubis, Calcaneus, Talus
38 Week? PHE
CampomelicDysplasia Skeletal dysplasia with ventrally bowed tibia and femur and clubfoot
Mesomelia Distal segment shortening (radius/ulna/tibia/fibula)
HeterozygousAchondroplasia Most common nonlethal?
ThanatophoricDysplasia Most common lethal?
Micromelia shortening of the entire limb
TD1 Telephone receiver shaped extremities
AsphyxiatingThoracixDysplasia Handlebar clavicles & renal dysplasia
EllisVanCreveldSyndrome Inbred Population
ChondrodysplasiaPunctata Humerii shorter than femurs
ArthrogryposisMultiplexCongenita Buddha?
EdwardsSyndrome Syndactyly & Persistent Clenched hand
PatauSyndrome Polydactyly/Clinodactyly & Microcephaly
Triploidy Syndactyly of 3rd & 4th finger
HeterozygousAchondroplasia Macrocranium (97% at term)
Banana Sign (or Lemon Sign) What sign is shown that is associated with spina bifida? (Not actual image)
Rachischisis (or Myeloschisis) Most severe NTD
Caudal regression partial to complete sacral agenesis and abnormalities of the lumbar spine, pelvis, and lower limbs
TD1 typical "telephone receiver" shape of the extremities; frontal bossing; craniosynostosis; platyspondyly
Achondrogenesis 2nd most common lethal skeletal dysplasia
ACH1 20%; short, cuboid bones; metaphyseal scalloping; autosomal recessive; thick, redundant skin folds
OI2 the neonatal lethal form of skeletal dysplasia
HypophosphatasiaCongenita lethal; 1:100,000; thin appearance of bones
CampomelicDysplasia short and ventrally bowed tibia and femur; absent or hypoplastic fibula
ShortRibPolydactylySyndrome decreased thoracic circumference; polydactyly; genitourinary abnormalities
HeterozygousAchondroplasia brachydactyly, with a trident configuration of the hand
AsphyxiatingThoracicDysplasia inverted "handlebar" appearance of the clavicles, polydactyly
EllisVanCreveldSyndrome high prevalence among inbred populations
OI1 blue sclerae; most fractures occur from childhood to puberty; progressive hearing loss
OI3 nonlethal; progressively deforming variety that often spares the humeri, vertebrae, and pelvis
ProximalFocalFemoralDeficiency asymmetrical degree of absence of subtrochanteric femur; ipsilateral fibular hemimelia
RadialRayDefects absence of a visualized forearm bone, associated with talipomanus (club hand)
AaseSyndrome hypoplastic distal radius with radial clubhand, and a triphalangeal thumb; cardiac defects
ArthrogryposisMultiplexCongenita multiple joint contractures; limb pterygium; "Buddha position" of the fetus
Neurulation the process of folding of the neural plate into the neural tube
D spina bifida except: A.incidence declined in recent years due to use of folic acid; B.due to failure of closure of embryologic neural tube; C.incidence is 0.5 to 2 per 1000 births in North America; D.The spinal defects usu occur at the cervicothoracic
97 Chiari II malformation is associated with open spina bifida (>_____% of cases)
PulmonaryHypoplasia incomplete or insufficient lung development
Left The majority of CDH are on the _______ side (84%)
D (25%) Which of the following is NOT true of Congenital cystic adenomatoid malformation (CCAM): A.Accounts for 50% of congenital lung masses; B.Vascular flow to lesion from branch of pulmonary artery; C.Mass may become isoechoic on prenatal US; D.3 types
BronchopulmonarySequestration nonfunctioning lung tissue at base of lung, with blood supply from anomalous systemic vessels
Clinodactyly permanent incurvature of a finger
Camptodactyly permanent flexion of a finger
RockerBottomFoot convex plantar surface with posterior bulging of the calcaneus
B The following are lethal skeletal dysplasia except: A.Thanatophoric dysplasia; B.Heterozygous Achondroplasia; C.Short-rib polydactyly syndromes; D.Hypophosphatasia congenital; E.OI2
Created by: 1319517318