ARRT CH 31
advanced maternal age
35 or older
21. conjoined twins that are attached at the abdomen are referred to as a. omphalopagus b. thoracopagus c. ileopagus d. craniopagus
a
singleton pregnancy
a single developing fetus
twin reversed arterial perfusion sequence
acardiac twinning
16. identical twins result from a. monozygotic twinning b. dizygotic twinning c. heterotopic pregnancies d. monochorionic pregnancies
a
18. asymmetry in fetal weight between twins is indicative of a. discordant growth b. preeclampsia c. dichorionic diamniotic twinning d. intrauterine infections
a
2. twins that have the threat of being conjoined are a. monoc monod b. monoc diamniotic c. dizygotic d. dic dia
a
22. monozygotic twins result from a. a single zygote that splits b. two zygotes that are fertilized by same sperm c. two morulla d. a single zygote that is fertilized by two sperm
a
24. the term that indicates the presence of two separate placentas a. dichorionic b. bichorionic c. monoamniotic d. diamniotic
a
26. the shunting of blood from one twin to the other is termed a. TTTS b. twin embolization syndrome c. twin peak sign d. conjoined twins
a
35. the most common form of monozygotic twins is a. monoc dia b. dic monoa c. monoc monoa d. none of above
a
40. the demise of a twin can lead to the development of neurologic complications in the living twin as a result of a. twin embolization syndrome b. TTTS c. TRAP syndrome d. dichorionicity
a
8. which of the following would not increase the likelihood of multiple gestations a. gestational diabetes b. maternal age >40 c. maternal history of twins d. ART
a
acardiac twin
abnormally developed twin that has an absent upper body and no heart
parasitic twin
acardiac twin
23. demise of a twin during the second or third trimester can lead to a. TTTS b. twin embolization syndrome c. twin peak sign d. acardiac twinning
b
3. which of the following would a newborn most likely suffer from if he or she were born prior to 32 weeks as a result of multiple gestation complications? a. ascites b. pulmonary hypoplasia c. amnnionitis d. preeclampsia
b
30. the abnormal twin in acardiac twinning is also referred to as a. pump twin b. parasitic twin c. stuck twin d. vanishing twin
b
31. the twin that will appear larger in TTTS is the a. donor b. recipient c. both will be same d. both will be demised
b
32. fraternal twins result from a. monozygotic twinning b. dizygotic twinning c. heterotopic pregnancies d. monochorionic pregnancies
b
36. all of the following complications are associated with multiple gestations except a. preterm delivery b. high birth weight c. maternal anemia d. maternal preeclampsia
b
39. which form of monozygotic twinning is least common? a. monoc dia b. monoc monoa c. dic dia d. dic bia
b
5. twins that result from the fertilization of two separate ova are called a. diamniotic b. dizygotic c. monozygotic d. monochorionic
b
6. what condition is pregnancy induced maternal high blood pressure and excess protein in the urine after 20 weeks gestation a. gestational diabetes b. preeclampsia c. proencephaly d. maternal mirror syndrome
b
13. which term relates the number of amniotic sacs? a. chorionicity b. placentation c. amnionicity d. embryology
c
17. the sonographic examination of twins reveals a triangular extension of the placenta at the base of the membrane. this finding is indicative of a. monoc monoa twins b. monoc dia twins c. dic dia twins d. monoc dia twins
c
33. what is the term for conjoined twins attached at the sacral region a. sacralpagus b. omphaloagus c. pyopagus d. thoracopagus
c
37. acardiac twinning results from a. poor maternal nutrition b. dizygotic gestations c. abnormal links between placental vessels d. twin embolization syndrome
c
38. ovulation induction drugs not only increase likelihood of multiple gestations, but also increase likelihood of a. maternal diabetes b. ovarian prolapse c. heterotopic pregnancies d. choriocarcinoma
c
4. the inner membrane surrounding the fetus is referred to as the a. placenta b. chorion c. amnion d. yolk sac
c
zygote
cell formed by the union of two gametes, first stage of fertilized ovum
heterotopic pregnancy
coexisting ectopic and intrauterine pregnancies
monozygotic
coming from one fertilized ovum or zygote, later split beyond day 8 postconception will result in mono mono twins
anemia
condition of having a deficient number of red blood cells
omphalopagus
conjoined twins attached at the abdomen
thoracopagus
conjoined twins attached at the chest
pyopagus
conjoined twins joined back to back in the sacral region
1. which of the following is not a sonographic sign of a dichorionic diamniotic gestation? a. twin peak sign b. lambda sign c. delta sign d. t sign
d
11. twins having two placentas and one amniotic sac are referred to as a. monoc dia b. monoa dic c. dic monoa d. this does not occur
d
34. which of the following can occur as a result of monozygotic twinning a. monochorionic diamniotic twins b. monoc monoa twins c. dic dia twins d. all of the above
d
hydrops (fetal)
an abnormal accumulation of fluid in at least two fetal body cavities
discordant fetal growth
asymmetric fetal weight between twins
25. what is a treatment that separates abnormal placental vascular connections between twins that are suffering from TTTS a. cleavage laser resection treatment b. endoscopic guided laser photocoagulation c. endemic translocation of placental vessels d. circumvallate resection of shared placental vasculature
b
7. the outer membrane of the gestation is referred to as the a. placenta b. chorion c. amnion d. yolksac
b
9. twins whose bodies are connected at some point are said to be a. fraternal b. conjoined c. identical d. stuck
b
19. twins having two placentas and two amniotic sacs referred to as a. monoc dia b. bia dic c. dic dia d. dic bia
c
27. factors that increase the likelihood of having multiple gestations include all of the following except a. advanced maternal age b. ovulation induction drugs c. poor nutritional state d. maternal predisposition for twins
c
29. which of the following can occur as a result of dizygotic twinning? a. monochorionic diamnioti twins b. monochorioni monoamniotic twins c. dichorionic diamniotic twins d. all of the above
c
10. the term that indicates the presence of two separate amniotic sacs a. dichorionic b. bichorionic c. monoamniotic d. diamniotic
d
12. what is it called when a twin fetus, suffering from TTTS, experiences severe oligohydramnios and becomes closely adhered to the uterine wall a. acardiac monster b. vanishing twin c. acardiac twin d. stuck twin
d
14. twins having one placenta and one amniotic sac is referred to as a. dic monoa b. dic dia c. monoc dia d. monoc monoa
d
20. typically the first sonographic manifestation of TTTS is a. oligo b. poly c. dichorionic twinning d. discordant fetal growth
d
28. TRAP syndrome may also be referred to as a. TTS b. vanishing twin syndrome c. twin embolization syndrome d. acardiac twinning
d
stillborn
dead at birth
cleavage
division of a cell
amniotic sac
fluid filled space, created by amnion, surrounding developing embryo or fetus
vanishing twin
death and reabsorption of a twin
fetus papyraceus
death of one fetus in twin pregnancy that is mainteined throughout the pregnancy, means paperlike fetus
craniopagus
twins joined at the cranium
fraternal twins
twins that result from the fertilization of two separate ova and have dissimilar characteristics
diamniotic
two amniotic sacs
twin embolization syndrome
when vascular products travel from a demised twin to the surviving twin by means of the common vascular channels within the shared placenta
porencephaly
development of a cystic cavity within the cerebrum, may be result of intraparenchymal hemorrhage
factors that increase the likelihood of multiple gestations
elevated HCG compared to singleton pregnancy, large for dates, twins have 4times higher risk of fetal mortality and 6times high neonatal morbidity rate, maternal history of multiple gestations, assisted reproductive therapy, ovulation induction drugs, advanced maternal age, and maternal obesity increase probability,
placentation
formation or structure of a placenta, structural organization, and mode of attachment of fetal to maternal tissues during placental formation
amnion
inner sac that contains the embryo and amniotic fluid, echogenic curvilinear structure that may be seen during first trimester within gestational sac
delta sign
lambda sign
twin peak sign
lambda sign
conjoined twins
monoamniotic, monochorionic twins that are attached at the head, thorax, abdomen, or lower body, most common forms of conjoined twinning are thoracopagus and omphalopagus, 40% chance of being stillborn with many dying within first 24 hours
monoamniotic
one amniotic sac
monochorionic
one chorion
monochorionic monoamniotic
one placenta one amniotic sac
monochorionic diamniotic
one placenta two amniotic sacs
chorion
outer membrane of a gestation that surrounds the amnion and developing embryo
preeclampsia
pregnancy induced maternal high blood pressure and excess protein in the urine after 20 weeks gestation
mortality
rate of actual deaths
zygosity
related to the number of zygotes (fertilized ovum)
amnionicity
relates to number of amnion in a multiple gestation
chorionicity
relates to the number of chorions and the type of placentation in a multiple gestation
morbidity
relative frequency of occurrence of a disease
hypoxia
shortage of oxygen or decreased oxygen in the blood
twin twin transfusion syndrome
shunting of venous or arterial blood from one twin to another through placental circulation, donor twin often suffers from anemia and growth restriction where recipient experiences hydrops and CHF
findings of twin twin syndrome
sonographic: monochorionic twinning, discordant fetal growth, oligo around donor twin, poly around recipient twin, recipient may be hydropic
findings of acardiac twin
sonographic: normal pump twin, acardiac twin- absent upper body, absent heart, and hydrops
assisted reproductive therapy
techniques used to treat infertility
endoscopic guided laser photocoagulation
treatment that uses lasers to separate abnormal placental vascular connections between twins that are suffering from twin-twin transfusion syndrome
lambda sign
triangular extension of the placenta at the base of the membrane is indicative of a dichorionic diamniotic pregnancy, also called delta sign or twin peak sign or "t" sign
identical twins
twins that result from the split of a single zygote and share the same genetic structure
dizygotic
two ova are fertilized by two sperms
dichorionic
two placentas
dichorionic diamniotic
two placentas and two amniotic sacs
therapeutic amniocentesis
type of amniocentesis used to remove a large amount of amniotic fluid around a fetus suffering form polyydramnios
pulmonary hypoplasia
underdevelopment of the lungs
stuck twin
when a twin fetus, suffering from twin to twin transfusion syndrome, experiences severe oligohydroamnios and is closely adhered to the uterine wall
15. which term relates the number of placentas a. chorionicity b. zygocity c. amnionicity d. cleavage
a
ovum
unfertilized egg
anastomoses
vascular connections