OB- abdo/GI

Question 1

Small or absent fetal stomach is associated with?

Answer 1

• can be normal (allow 30 mins to fill)

associated with:

• aneuplody
• tracheoesophageal fistula
• oilohydranios

Question 2

what is esophageal atresia?

Answer 2

• congenital absence of a segment of the espogus

associated with:
- tracheoesophageal fistula (TEF)

Question 3

What is the most common esophageal fistula?

Answer 3

fistula connecting the distal portion of the esophagus with the trachea (90%)

Question 4

what should an esophageal atresia be suspected?

Answer 4

when an empty or small fetal stomach is seen in the presence of polyhydramnios

Question 5

what is the upper neck pouch sign?

Answer 5

• visualization of the proximally dialated esophagus

Question 6

grouping of anomalies with esophageal atresia is known as?

Answer 6

VACTERL

Question 7

Abnormal gastric dilation is most commonly seen in association with?

Answer 7

duodenal atresia

Question 8

what is the most common site of intestinal atresia?

- what sign is seen?

Answer 8

duodenal atresia

• double bubble sign

Question 9

what is double bubble sign?

Answer 9

• 2 fluid filled bubbles seen with duodenal atresia

- dialated stomach and dialated proximal duodenum

Question 10

what is duodenal atresia associated with?

Answer 10

• coexisting anomalies (50%)

- 1/3rd have tri-21

Question 11

what is the most common etiology associated with jejunoileal atresia?

Answer 11

isolated vascular compromise

Question 12

jejunal-ileal obstruction is diagnosed based on?

Answer 12

dialated loops of bowel

• without dialated stomach
• somtimes with hyper-peristalsis

Question 13

The top normal lumen diameter used to diagnose bowel dilation is?

Answer 13

7mm

Question 14

what is the apple peel sign?

Answer 14

• seen with jejunal atresia

Question 15

cystic fribrosis is a common underlying etiology for what?

Answer 15

• ileal obstruction with or without meconium

Question 16

polyhydramnios is less common in what kind of atresia?

Answer 16

• lower bowel obstructions than in duodenal atresia

Question 17

what is the most common large bowl atresia?

Answer 17

anorectal atresia

Question 18

what has the highest incidence of associated anomalies of any of the GI atresias?

Answer 18

anorectal malformations (48-98%)

Question 19

sonographic diagnosis of anorectal atresia?

Answer 19

0 dialated loops of small bowel or colon in the absence of polyhydramnios

Question 20

management of anorectal atresia?

Answer 20

• fetal echocardigram

- genetic counseling

Question 21

what is echogenic bowel characterized by?

Answer 21

echos of bowel are as echogenic as the iliac crest

Question 22

echogenic bowel: common associated risks? (8)

Answer 22

Aneuploidy
 Cystic fibrosis
 Swallowed fetal blood
 Infection
 Gastrointestinal atresias
Meconium peritonitis
 Intrauterine growth restriction
 Fetal Demise

Question 23

what is the most common anomaly of the abdominal wall?

Answer 23

omphalocele

Question 24

what is omphalocele?

Answer 24

• defect in the anterior abdominal wall and the site of the imbilical cord insertion

Question 25

how is omphalocele identified?

Answer 25

- herniation of abdominal organs (liver and bowel) into the base of the umbilical cord

Question 26

what is associated with omphalocele?

Answer 26

- pentaolgy of cantrell - beckwidth-wiedemann syndrome - may be isolated - heart defects - chromosome anomalies (tri-18 m/c)

Question 27

how are fetal anterior wall abnormalities diagnosed on u/s?

Answer 27

- Ventral mass seen at the cord insertion site - Omphalocele may be small (only bowel) or large (bowel and liver) and appear solid - covered by a membrane, which represents the amnion covering of umbilical cord - Ascites may be seen in peritoneal membrane

Question 28

what is pentalogy of cantrell associated with? (5)

Answer 28

- ectopia cordia - heart defect - diaphragmatic hernia - pericardial defect - omphalocele

Question 29

what is bechwidth- wiedemann syndrome characterized by? (4)

Answer 29

- macrosomia - macroglossia - omphalocele - renal neoplasm

Question 30

what is gastroschisis? | - where is it located?

Answer 30

- cleft defect of the anterior abdominal wall with extrusion of abdominal organs into the amniotic cavity - usually only contains small bowel and is isolated - most commonly to the right of midline at umbilical level

Question 31

what is the main difference between gastrochisis and omphalocele?

Answer 31

in gastroschisis the herniated content is not covered by a membrane and the herniated content is free in the amniotic fluid

Question 32

risk of gastrochisis?

Answer 32

- teenage mothers - tobacco use - drug use - pseudoephedrine

Question 33

what is gastroschisis associated with? (3)

Answer 33

- atresias - stenosis - perforations

Question 34

what 6 things does the fetal abdomen contain?

Answer 34

1. umbilical vein 2. liver 3. IVC 4. descending aorta 5. spleen 6. fetal stomach

Question 34

what 6 things does the fetal abdomen contain?

Answer 34

1. umbilical vein 2. liver 3. IVC 4. descending aorta 5. spleen 6. fetal stomach

Question 35

when can hepatomegly been seen?

Answer 35

- in severe hemolytic diseases - splenomegaly - hydrops

Question 36

splenomegly is associated with?

Answer 36

severe hemolytic disease due to isoimmunization and infection

Question 37

asplenia is associated with?

Answer 37

- situs incersus

Question 38

what is associated with heterotaxy syndromes?

Answer 38

- asplenia | - polysplenia

Question 39

GB may be seen sonographically after what week?

Answer 39

20 weeks GA

Question 40

what is a neuroblastoma?

Answer 40

- a malignant tumor of the adrenal gland - most common neonatal tumor - complex mass and areas of calcifications

Question 41

what is a hemorrhage?

Answer 41

- associated with fetal destress in older fetuses | - simular to adrenal or renal tumor

Question 42

causes of ascites? (7)

Answer 42

``` Genitourinary Gastrointestinal Liver Cardiac Infections Metabolic storage disorders Idiopathic ```

Question 43

causes of pseudoascites?

Answer 43

- gastrointestinal obstruction with bowel perforation - may present as meconium peritonitis and ascites ``` Nongastrointestinal causes include: Immune and nonimmune hydrops Urinary tract obstruction Congenital infection Some abdominal tumors ```

Question 44

psedoasciates on u/s?

Answer 44

Sonolucent band near fetal anterior abdominal wall commonly identified during routine obstetric examinations in fetus over 18 weeks of gestation - band results from normal musculature surrounding abdominal wall - always confined to anterior fetal abdomen and centrally located - never outlines falciform ligament