Shared Flashcard Set

Details

Ch 31 Chromosomal Abnormalities-Martin's Notes
Ch 31 Chromosomal Abnormalities-Martin's Notes
110
Other
Not Applicable
06/16/2011

Additional Other Flashcards

 


 

Cards

Term
Between weeks 6 & 10
Definition
Organogenesis
Term
Which of the following is not a something that is looked for during a 1st or 2nd trimester screening test: 1.Trisomy 13, 2.Trisomy 18, 3.Trisomy 21, 4.Triploidy, 5.Burner's Syndrome, 6.Genetic Sonographic Markers
Definition
5 (It is Turner's not Burner's)
Term
Prenatal diagnosis is important to prepare for disabilities and ___________.
Definition
Medical needs
Term
Screening methods for Trisomy 13, 18, & 21,Triploidy, & Turner's syndrome include Ultrasound, Nuchal Translucency screening, Lab values, & _____________.
Definition
Invasive screening
Term
Invasive screening methods include CVS (Chorionic Villi Sampling), Amniocentesis, _____________
Definition
Cordocentesis
Term
causing development of 1+ abnormal structures in an embryo/fetus
Definition
Teratogen
Term
Two types are: 1. Physical agents & 2. Drugs & Chemical Agents
Definition
Teratogens
Term
These (2) physical agents (teratogens) causes malformations
Definition
Radiation & heat
Term
This physical agent (teratogen) consists of uterine anomalies, fibroids, oligohydramnios, & amnionic bands
Definition
Mechanical
Term
This drug/chemical agent (teratogen) can cause FAS.
Definition
Alcohol (Fetal Alcohol Syndrome)
Term
This drug/chemical agent (teratogen) can cause heart/spine malformations.
Definition
Thalidomide
Term
Development of physical defects in an embryo (During fetal development, certain fetal structures are affected by teratogens during specific times of development)
Definition
Teratogenesis
Term
Which of the following is NOT a drug/chemical agent (teratogen): 1.alcohol, 2.methotrexate [malignant or neoplastic disease and abortion], 3.antithyroid drugs, 4.DES, 5.radiation, 6.thalidomide [sedative, leprosy], 7. coumadin
Definition
5 (This is a physical agent)
Term
Which of the following is NOT a physical agent (teratogen): 1.Radiation, 2.Coumadin, 3.Heat, 4.Mechanical
Definition
2 (This is drug/chemical agent)
Term
chromosomes are arranged in pairs in descending order of size/position
Definition
Karyotype
Term
Normal human karyotypes contain _____ pairs of autosomal chromosomes & one pair of sex chromosomes.
Definition
22
Term
Normal karyotypes for women contain two X chromosomes & are denoted _______
Definition
46,XX
Term
Men have both an X & a Y chromosome denoted __________.
Definition
46,XY
Term
Any variation from the standard __________ may lead to developmental abnormalities.
Definition
karyotype
Term
performed to i.d. absence or presence of a normal karyotype
Definition
Genetic Testing
Term
complete sets of chromosomes (23 sets)
Definition
Euploidy
Term
abnormal # of chromosomes
Definition
Aneuploidy
Term
3 chromosomes per cell instead of 2
Definition
Trisomy
Term
genetically/environmentally)
Definition
Phenotype
Term
basic combination of genes in a person
Definition
Genotype
Term
presence of cells of 2 different genetic materials in same individual
Definition
Mosaicism
Term
too much or too little chromosome material
Definition
Chromosome disorder
Term
affected parent or results from a new mutation. Transmitted to 50% of offspring.
Definition
Dominant disorder
Term
Caused by a pair of defective genes, 1 inherited from each parent. 25% chance of passing to offspring.
Definition
Recessive disorder
Term
inherited by boys from their mother. Not transmitted to sons by affected males; all affected males daughters are carriers. Son of F carrier-50% of being affected; daughter of F carrier-50% of being carrier
Definition
X-linked disorder
Term
major protein in fetal serum produced by YS early & by liver later (Can be found in fetal spine, GI tract, liver, kidneys)
Definition
AFP (Alpha-fetoprotein)
Term
Protein carried into amn fl by fetal urination & reaches maternal blood through fetal membranes; Measured in maternal serum or from amn fl
Definition
AFP (Alpha-fetoprotein) (MSAFP/AFAFP)
Term
AFP levels that increase w/ GA
Definition
MSAFP
Term
AFP levels that decrease w/ fetal age
Definition
AFAFP
Term
Elevated or Low MSAFP (Maternal Serum Alpha-fetoprotein)? incorrect dates, multiples, ONTD, ventral wall defects, etc.
Definition
Elevated
Term
Elevated or Low MSAFP (Maternal Serum Alpha-fetoprotein)? incorrect dates, Trisomies 13, 18, 21, fetal demise
Definition
Low
Term
A glycoprotein secreted from placental trophoblastic cells
Definition
hCG (Human chorionic gonadotropin)
Term
biochemical marker evaluated as part of triple & quad screen; hormone produced by fetal liver & placenta
Definition
uE3 (Unconjugated estriol)
Term
biochemical marker evaluated as part of quad screen; a protein derived from the placenta
Definition
Inhibin-A
Term
ideal; accurate dates important; not commonly used due to Quad screen
Definition
Triple Screen
Term
1st tri serum marker. Glycoprotein derived from trophoblastic tissue & diffused into maternal circulation. The levels increase during preg & decreased w/ aneuploidy.
Definition
PAPP-A (Pregnancy-Associated Plasma Protein A)
Term
glycoprotein derived from placenta that can be assessed in maternal serum in 1st trimest that is used to evaluate for increased risk of Down's
Definition
Free Beta hCG (Free beta human chorionic gonadotropin)
Term
Screening tests that occur in order; one after another
Definition
Sequential Screening
Term
What Trimester: Lab values: PAPP-A (Pregnancy-Associated Plasma Protein A) & Free BhCG combined with US for NT?
Definition
1st
Term
What Trimester: Maternal serum quad screen (can increase detection of Down's vs. triple screen) {AFP, unconjugated estriol, B-hCG, inhibin-A}
Definition
2nd
Term
Maternal serum screen is performed between 15-20 weeks/between ______ weeks is ideal; accurate dates are IMPORTANT!!!
Definition
16-18
Term
Maternal Age: Older mother=increased risk of trisomy T13, T18, T_____
Definition
21
Term
Risk for _______ & Turner's is not necessarily related to maternal age
Definition
triploidy
Term
Nuchal translucency scan is ______ week 6 day scan (1st trimester) There are stringent criteria & a certified individual performs NT
Definition
40860
Term
NT (Nuchal Translucency) measurement will ________ with the CRL
Definition
increase
Term
CRL (Crown Rump Length) should be between 45 & ____ millimeters to do a NT
Definition
84
Term
some consider NT>____mm abnormal
Definition
3
Term
Fluid collection between the soft tissue over the cervical spine and the skin edge
Definition
NT (Nuchal translucency)
Term
Trisomy 21: Combination of maternal age, NT, maternal serum PAPP-A & free BhCG gives a detection rate of _______%
Definition
85-90
Term
CVS (Chorionic Villi Sampling): ____ week minimum: increased chance to detect major fetal defects; early CVS carries risk of limb reduction defects
Definition
11
Term
CVS (Chorionic Villi Sampling): ____ weeks 6 days maximum: 1st trimester termination option; abnormal amount of nuchal fluid decreased at 14-18 weeks
Definition
13
Term
Which of the following is not a machine requirement for an NT: 1.high resolution, 2.video loop capability, 3.calipers to 2 decimal points
Definition
3 (1 decimal point)
Term
_____% of NT scans are successful TA
Definition
95
Term
Operators are considered Proficient once they have scanned approximately ___ scans TA & approximately 100 scans TV
Definition
80
Term
_________ is associated with: heart defects, diaphragmatic hernia, body stalk anomalies, abdominal wall defects, T13, T18, & Turner's Syndrome
Definition
Thickened NT (Nuchal Translucency)
Term
Perform 3 NT (nuchal translucency) measurements and take the ________
Definition
largest
Term
There is a greater chance of detecting T______ with the nasal bone, NT, free BhCG, & PAPP-A in the first trimester.
Definition
21 (Down Syndrome)
Term
Fairly severe growth restriction is indicative of what chromosomal abnormalities?
Definition
T18 (Edwards') & Triploidy
Term
Mild growth restriction is indicative of what chromosomal abnormalities?
Definition
T13 (Patau's) & Turner's
Term
Fairly normal growth is indicative of what chromosomal abnormality?
Definition
T21 (Downs)
Term
At 10-13 weeks 6 days Tachycardia is associated with which chromosomal abnormalities?
Definition
T13 (Patau's) & Turner's
Term
At 10-13 weeks 6 days Mild Tachycardia is associated with which chromosomal abnormality?
Definition
T21 (Downs)
Term
At 10-13 weeks 6 days Bradycardia is associated with which chromosomal abnormalities?
Definition
T18 (Edwards') & Triploidy
Term
Which chromosomal abnormalities are associated with an umbilical vein with 90% pulsatile venous flow?
Definition
T13 (Patau's) & 18 (Edwards')
Term
Fetal Doppler studies include the _________, ductus venosus (Which is tedious & requires skill) and fetal tricuspid flow
Definition
Umbilical vein
Term
What does DV stand for?
Definition
Ductus Venosus
Term
What does UV stand for?
Definition
Umbilical Vein
Term
Includes Maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), & Inhibin-A. Accurate dates are important.
Definition
Quadruple Screen (multiple marker screen)
Term
Trisomy 21-hCG &/or inhibin A are _________ and alpha-fetoprotein &/or estriol _________
Definition
elevated; decreased
Term
_______-all from the quadruple screen tend to be decreased
Definition
T18
Term
Approximately 1 in 500 live births; Most common aneuploidy to result in a live birth; Extra chromosome 21
Definition
T21 (Down's)
Term
The nasal bones first appear at a CRL of ____mm and increase linearly with gestation.
Definition
42
Term
The gestational period for assessment of the fetal nasal bone must be _____ to 13 weeks and 6 days.
Definition
11
Term
Nasal Bone: The magnification of the fetus must be such that only the head & ________ are present on the screen.
Definition
upper thorax
Term
To assess the fetal nasal bone a ________ section of the fetal profile must be obtained with the angle of insonation perpendicular to to the plane of the nose. The US txr should be gently tilted from side to side to ensure that the nasal bone is seen separate from the nasal skin.
Definition
mid-sagittal
Term
The echogenicity of the nasal bone should be ______ than that of the skin overlying it. In this respect, the correct view of the nasal bones should demonstrate three distinct lines.
Definition
greater
Term
A third line, almost in continuity with the skin, but at a higher level represents the _____ of the nose.
Definition
tip
Term
The first two lines, which are proximal to the forehead, are horizontal and parallel to each other, resembling an "equal sign". The top line represents the skin and the bottom one, which is thicker and more echogenic than the overlying skin, represents the ____________.
Definition
nasal bone
Term
Absence of the bottom line of the "equal sign" represents the absence of the fetal ______________.
Definition
nasal bone
Term
When the nasal bone line appears as a thin line, less echogenic than the overlying skin, it suggests that the nasal bone is not yet __________, and it is therefore classified as being absent.
Definition
ossified
Term
Which of the following is NOT a sonographic sign of T21/Down Syndrome: 1.Thickened nuchal fold > 6 mm between 15 & 21 weeks; 2.Nasal hypoplasia; 3.Cardiac defects; 4.Shortened femur/humerus; 5.Holoprosencephaly; 6.Duodenal atresia; 7.Mild ventriculomegaly; 8.Echogenic bowel; 9.Hypoplastic 5th digit (clinodactyly); 10.Pyelectasis; 11.Echogenic Intracardiac focus
Definition
5 (This is T13)
Term
2nd Most common multiple-malformation syndrome. Extra chromosome 18. Many die in utero, 50% die within one week, & 90-95% die within one year.
Definition
T18 (Edwards' Syndrome)
Term
Which of the following is NOT a sonographic sign of T18/Edwards' Syndrome: 1.overlapping index finger over clenched hand; 2.rocker-bottom or clubfeet; 3.Heart defects; 4.Diaphragmatic hernias; 5.Micrognathia-small chin (underdeveloped jaw); 6.Choroid plexus cysts; 7.strawberry shaped skull, 8.abnormal cbl or CM; 9.Nasal hypoplasia; 10.Facial cleft
Definition
9 (This is T21)
Term
If the stomach and heart are on the same level what is it called? What condition is this associated with?
Definition
Diaphragmatic Hernia; T18
Term
1:12,000 live births; Extra chromosome 13; Extremely poor prognosis; 45% die w/in first month; 90% by 6 mo; Survivors are retarded
Definition
T13 (Patau's Syndrome)
Term
Which of the following is NOT a sonographic sign of T13/Patau's Syndrome: 1.Echogenic Intracardiac focus 2.Holoprosencephaly; 3.Facial abnormalities including clefts; 4.Microcephaly; 5.Cardiac anomalies; 6.Renal anomalies; 7.Exomphalos/Omphalocele; 8.NTD's
Definition
1 (This is T21)
Term
Extra set of chromosomes (69); Majority: spontaneous ab; Most common-2 sperm fertilize ova (partial mole); rarely persists past 20 wk rd
Definition
Triploidy
Term
Double maternal chromosome-pregnancy may persist to 3rd trimester; small, growth-restricted fetus w/ small, non-cystic placenta
Definition
Triploidy
Term
Which of the following is NOT a sonographic sign of Triploidy: 1.Severe asymmetrical growth restriction; 2.Cardiac anomalies; 3.Clinodactyly; 4.Abnormal Placenta; 5.Oligohydramnios; 6.NTD's; 7.Omphalocele; 8.Renal anomalies
Definition
3 (This is T21...Triploidy is associated with Syndactyly)
Term
Genetic abnormality marked by absence of X chromosome; 1:2000-5000 live births; Most abort spontaneously; Prognosis depends on extent of assoc anomalies; Survivors have a short stature & ovarian dysgenesis
Definition
Turner Syndrome (45, X)
Term
Cystic hygroma is one of most indicative findings. Additional findings include Cardiac anomalies, Horseshoe kidney, Generalized edema, pleural effusions, & ascites.
Definition
Turner Syndrome (45, X)
Term
Usually performed in 2nd trimester; specific, targeted exam for aneuploidy searching for fetal anomalies, as well as aneuploidy markers and abnormal biometry; info gained can guide pt to decide if an invasive test (amnio) will be performed
Definition
Genetic sonogram
Term
variations in normal anatomy (which except for their relationship with aneuploidy) are unlikely significant; many normal fetuses exhibit soft markers
Definition
soft sonographic markers
Term
Ideally performed around 20 weeks; Used in conjunction with other screening (quad screen), to assess pt risk; Considerable expertise required; Sensitivity depends on: markers i.d., Gestational Age, maternal hx, quality of exam & interpretation;Some recommend use only for high-risk persons and to be performed in specialized centers
Definition
Genetic Sonogram
Term
CPC (Choroid Plexus Cyst)(T18), Nuchal Fold Thickening(T21), Ventriculomegaly(T21), Nasal bone hypoplasia/aplasia(T21), EIF (Echogenic Intracardiac Focus)(T21), Echogenic bowel(T21), Pelviectasis(T21), SUA (Single Umbilical Artery), Shortened long bones(T21), Brachycephaly(T21), Small ear length(T21)
Definition
Soft Markers
Term
Round, cystic area in CP > 2 mm, Usu resolved by 28 wk, Found in appx 40-60% T 18; may be larger size in T18
Definition
CPC (Choroid Plexus Cyst)
Term
Ideal meas betw 15-21 wk w/ plane including CSP, cerebral peduncles, & cbl; Meas outer bone to outer skin; Upper limit is 5 mm; > 6 mm abnormal; varies w/ age (refer to tables)
Definition
Nuchal Thickening
Term
Vents > 10 mm (internal wall to wall meas); CNS anomalies; Assoc w/ T 21
Definition
Ventriculomegaly
Term
position
Definition
EIF (Echogenic Intracardiac Focus)
Term
Homogeneous, hyperechoic (same as bone and more echogenic than liver) area in lower abd that doesn't shadow and usu resolves in few wk; Assoc w/ T 21
Definition
Echogenic Bowel
Term
Dilation of fetal renal pelvis 4-5 mm or > 4-5 mm; Mild is common, usu w/ no significant long term complications; Assoc w/ Down's (T21) so look closely
Definition
Pelviectasis
Term
2-v cord; Assoc w/ renal & cardiac abn; May be assoc w/ chromosomal abn
Definition
Single Umbilical Artery
Term
Associated with T21; Shortened _______ bones
Definition
long
Term
Brachycephaly [elongated transverse (BPD) & shortened AP diameter (OFD)] is associated with which chromosomal abnormality?
Definition
T21 (Down's)
Term
Small ear length is associated with which chromosomal abnormality?
Definition
T21 (Down's)
Supporting users have an ad free experience!