OB/GYN Board Exam - Ultrasound (Associated w/)

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Intestinal Atresia - Sono - PAC PIM

P - polyhydramnios
A - ascites
C - calcifications

P - perforation,
I - increased peristalsis,
M - multiple fluid filled bowel.

Meconium Peritonitis - sono - CAMP

C - calcifications in fetal abdomen
A - ascites
M - meconium pseudocyst
P - polyhydramnios.

Etiologies of Hyperechoic Bowel: STINC

S - swallowed intra-abdominal blood (rare)
T - trisomy 21
I - infection - CMV (cytomegalovirus)
N - normal variant
C - cystic fibrosis

Cleft lip/palate - sono - PB SAM

P - polyhydramnios
B - Best seen in coronal section

S - shouldn't be mistaken for philtrum
A - Anechoic cleft extending from nostril to lip
M - may see tongue moving in cleft

Cystic Hygroma associated with: FAT TAP

F - fetal Hydrops (Large ones)
A - ascites
T - trisomy 21

T - turner's syndrome
A - anasarca
P - pleural effusion

Potter's Syndrome consists of: FLOBP

F - facies
L - limb deformities secondary to
O - oligohydramnios
B - bilateral renal agenesis (BRA)
P - pulmonary hypoplasia

ARPKD - sono: OIES

0 - oligohyramnios
I - increased kidney:AC ratio
E - Enlarged & Echogenic (due to small cysts)
S - small bladder

MCDK characteristics: HUMBS

H - has minimal Urine formation
U - unilateral
M - may not be seen early in gestations
B - bilateral
S - segmental

MCDK Bilateral- sono: RIM POV

R - randomly located
I - inability to visualize BL when renal insufficiency is
present.
M - multiple

P - peripheral
O - oligohyramnios
V - variable sized cysts

MCDK Unilateral - Sono: BMN

B - bladder seen in presence of functioning renal tissu
M - multiple cysts in 1 kidney (same as bilateral)
N - normal appearing contralateral kidney

UPJ Obstruction causes: UK FAB

U - ureteral valves
K - kinks

F - fibrous adhesions
A - anomalous vessels
B - bands

UPJ Obstruction - sono: No Di CaT

No - no hydroureter
Di - dilated renal pelvis
Ca - caliectasis
T - thinning of renal cortex in chronic states

PUV's - Sono - K BOB

K - "keyhole" sign

B - bilateral hyronephrosis & hydroureter
O - oligohyramnios
B - bladder wall thickening

Urethral Atresia Characteristics: No PuR

No - not compatible with life
Pu - pulmonary hypoplasia is certain
R - results in complete obstruction

Prune Belly Syndrome - sono - MAD BO

M - movement of fetal abdomen wall when maternal
ABD is percussed. (to tap/strike firmly)
A - abnormal compression of ABD wall by fetal small
parts.
D - distended Bladder

B - bilateral hydronephrosis
O - oligohydramnios

What should the sonographer do when long bones measure >2 SD below the mean for gestational age? MEALLLLL

M - measure all long bones
E - estimate degree of ossifictation (cran,sp,ribs,lngb)
A - assess bone contour
L - look for bowing, fractures, curvature
L - look at face and facial proflie (clefts/frontal boss)
L - look at thoracic circumference and shape
L - look for hand/foot abnormalities (club foot/polyd)
L - look for other fetal anomalies

What are the characteristics of Thanatophoric Dysplasia? RRBEN

R - rhizomelia
R - relatively large head
B - bowed long bones
E - extreme micromelia
N - narrow thorax with normal trunk

Thanatophoric Dysplasia - sono - CHHMPP

C - cloverleaf skull (kleeblattschadel)
H - hypoplastic thorax
H - hypomineralization
M - micromelia
P - platyspondyly (flattened vertebral bodies
throughout the axial skeleton)
P - polyhyramnios

Achondrogenesis Type I characteristics: MSSPP

M - Micromelia
S - short trunk
S - small pelvic bones
P - protruding abdomen
P - poor skull & vertebral ossification

Achondrogenesis Type II characteristics: TNSL

T - thicker ribs without fractures
N - normal skull ossification but lack of vertebral oss.
S - small chest
L - large head compared to body

Achondrogenesis - sono - PASS LL

P - polyhyramnios
A - associated cleft lip/palate (micrognathia)
S - small chest
S - severely shortened limbs (micromelia)

L - lack of vertebral ossification
L - large head (possibly with decreased cranial oss.)

Osteogenesis Imperfecta Type II - sono - MSSS P

M - multiple rib fractures
S - severe micromelia
S - severe hypomineralization of the skull
S - small, bell-shaped thorax

P - presence of fractures or "thick" bones due to callus
formation.

Congenital Hypophosphatasia - sono - PISD

P - possible bowing of the long bones
I - increased echogenicity of the falx cerebri
S - sever micromelia
D - decreased mineralization of the bones

Campomelic Dysplasia - sono - BAHN

B - "bent" long bones (especially lower bones)
A - associated CNS & Renal anomalies
H - hypoplastic or absent scapule
N - narrow thorax

Homozygous Dominant Achondroplasia is characterized by: BuLL Rhiz

Bu - bulky head
L - limb bowing
L - lordotic Spine
Rhiz - rhizomelia dwarfism

Homozygous Dominant Achondroplasia - sono - Large Rhiz PuCS

Large - large cranium
Rhiz - rhizomelia
Pu - pulmonary hypoplasia
C - cloverleaf skull
S - small thorax

Short-Rib Polydactyly Syndrome - sono - SSCCRP

S - severely narrow thorax with short ribs
S - severe micromelia
C - cardiac anomalies
C - cleft lip/palate
R - renal anomalies
P - polydactyly

Heterozygous Achondroplasia - sono - Micro Bra Dec Rhiz Fro

Microcrania
Brachydactyly
Decompressed nasal bridge
Rhizomelia
Frontal bossing

Osteogenesis Imerfecta Types I, III, IV characteristics: BOEM

B - blue sclera
O - occasional fractures
E - easy bruising
M - mild limb bowing

Arthrogryposis - sono - NuMB PoND

Nu - nuchal Edema
M - micrognathia
B - bilateral clubfoot (talipes)

Po - polyhydramnios
N - narrow chest
D - deformities of hips, knees, elbows, and wrists

Radial Ray Abnormalities are seen in which conditions? HoT TAR

Ho - holt-Oram
T - trisomy 18

TAR - Thrombocytopenia Absent Radius (TAR)

Sirenomelia - Sono - A BOSS

A - abnormal or absent foot structures

B - bilateral renal agenesis
O - oligohydramnios
S - single femur or 2 femur's seen side-by-side
S - skeletal abnormalities

What are some causes of decreased placenta thickness? PPIDI

P - polyhyramnios
P - pre-eclamsia
I - IUGR
D - DM predating pregnancy
I - Intrauterine infection

What are some predisposing conditions for Placental Abruption? MAMM CCUT

M - maternal hypertension
A - advanced maternal age
M - multiparity
M - maternal vascular disease

C - cigarette smoking
C - cocaine use
U - uterine fibroids
T - trauma

Placenta Abruption - sono - DeF PLacenta

De - detachment of PL from UT wall
F - fluid collection in Retroplacental space
PL - PL may be thickened
PL - pL may appear normal

Single Umbilical Artery is associated with what? GOT CC

G - GU anomalies
O - omphalocele
T - trisomy 13 &18

C - cardiovascular anomalies
C - CNS anomalies

Velamentous Insertion of Cord is associated with what? PIC

P - preterm birth
I - IUGR
C - congenital Anomalies

What is Oligohydramnios associated with? DRIPPP

D - demise
R - renal abnormalities
I - IUGR
P - post dates
P - PROM
P - pre-eclampsia/eclampsia

What are the maternal complications of multiple gestations? HAPPPP

H - HTN
A - anemia
P - pre-eclampsia/eclampsia
P - placental abruption
P - post-partum hemorrhage
P - preterm labor

Twin-to-Twin Transfusion Syndrome - RECIPIENT - sono - HEELP

H - hydrops
E - edema
E - enlarged viscera
L - large for dates
P - polyhydramnios

Twin-to-Twin Transfusion Syndrome - DONOR - sono - SOS

S - small for dates
O - oligohydramnios
S - "Stuck" Twin
Separating membrane between sacs may not be visualized because it is on stuck twin

Twin Embolization Syndrome - sono - HIP PE IV

H - hyrops
I - intrauterine death of co-twin
P - polyhydramnios

P - porencephaly
E -enlarged,echogenic kidneys

I - intraparenchymal hemorrhage
V - ventriculomegaly

Acardiac Twinning - DONOR TWIN (pump twin) may develop: He Hyd Card

He -heart Failure
Hyd - hydrops
Card - cardiomegaly
(Due to increased cardiac burden)
Usually normal sonographically

Acardiac Twin - sono - No MAML

No - no cardiac motion
M - multiple structural anomalies
A - anencephaly or small head
M - may grow and move
L - limited upper extremity development
Cystic Hygroma

What are the fetal complications of multiple gestations? HI PE DIC

H - hypoxia
I - increased risk of fetal anomalies

P - prolapse
E - entanglement/compression of umbilical cord

D - difficult delivery (due to presentation)
I - IUGR (due to PL insufficiency)
C - cord knots in monoamniotic twins

Non-Immune Hydrops causes: CIC CAT

C - cardiac anomalies (arrhythmias)
I - infection (TORCH) (Fifth Disease)
C - Chromosome abnormalities

C - Congenital hematologic disorders
A - Abdominal or pulmonary masses leading to venous
obstruction.
T - TTTS

Hydrops Fetalis - sono - HAPPP F

H - hepatosplenomegaly
A - ascites
P - PL thickening
P - pleural effusion
P - polyhydramnios

F - fetal skin thickening (anasarca) (>5cm)

DM - congenital anomalies : NGGCCSS

N - neural tube defects
G - GI anomalies
G - GU anomalies
C - Cardiovascular anomalies
C - caudal regression syndrome
S - Single umbilical artery
S - skeletal anomalies

DM - fetal complications: RHHIM

R - respiratory distress syndrome
H - hypoglycemia
H - hypocalcemia
I - IUGR
M - macrosomia

What are the maternal signs of Eclampsia? HAS HAG

H - HTN
A - ankle swelling
S - sudden excessive weight gain

H - headaches
A - abdominal pain and vomiting
G - generalized edema

Eclampsia - sono - FO PIIS

F - fetal demise
O - oligo

P - premature PL
I - IUGR
I - increased risk of abruption
S - sono used to track fetal growth

HELLP Syndrome (complications of pre-eclamspia)

H - hemolysis (breakdown of RBC's)
E - elevated
L - liver enzymes
L - low
P - platelets

TORCH Infections

T - toxoplasmosis
O - other (syphilis)
R - rubella
C - cytomegalovirus
H - herpes

Toxoplasmosis may result in what? JIMMI CHTT

J - jaundice
I - IUGR
M - micropthalami
M - microcephaly
I - intracranial calcifications

C - CNS calcifications
H - hydrocephalus
T - thickened PL
T - thrombocytopenia

Maternal infections - sono - HII CCV

H - hydrops
I - IUGR
I - increased or decrease PL thickness

C - cranial/cerebral anomalies
C - cardiac anomalies
V - visceral calcifications (brain, liver)

What are the types of maternal anemias? IF DAT

I - iron deficiency (95%)
F - folic acid deficiency

D - drug induced hemolytic anemia
A - aplastic anemia
T - thalassemia

What are the etiologies of Preterm Labor? HUMMPP SAM

H - heavy smoking
U - UT anomalies
M - multiple gestation
M - maternal stress
P - poly
P - previous UT surgery

S - systemic infections (appendicitis with sepsis)
A - antepartum bleeding (previa, abruption)
M - maybe idiopathic

Trisomy 13 - What is associated with it? HIPS C

H - holoprosencephaly
I - IUGR
P - polydactyly
S - single umbilical artery

C - cleft lip/palate (esp median cleft)

What else is associated with Trisomy 13? TACO V

T - truncus arteriosus
A - agenesis of corpus callosum
C - cystic renal dysplasia
O - omphalocele

V - VSD

What pathologic abnormalities are associated with Trisomy 18 ? VAMPIR SOCS

V - VSD
A - ASD
M - micrognathia
P - polyhydramnios
I - IUGR
R - rocker bottom foot

S - "strawberry" shaped cranium
O - overlapping fingers
C - CP cysts
S - single umbilical artery

What else is associated with Trisomy 18? HODE

H - hydronephrosis
O - omphalocele
D - diaphragmatic hernia
E - enlarged CM

Trisomy 21 - sono - DAVE TRENCH SPC

D - duodenal atresia
A - ASD
V - VSD
E - endocardial cushion defect

T - thickened nuchal fold
R - renal pyeliectasis
E - echogenic intracardiac focus
N - non-immune hydrops
C - cystic hygroma
H - hyperechoic bowel

S - small/absent nasal bone
P - pleural effusion
C - cinodactyly

VATER / VACTERL

V - vertebral anomalies
A - anal atresia
C - cardiac anomalies
T - tracheo-
E - esophageal fistula
R - renal & radial ray anomalies
L - limb deformities

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