CH 31 ARRT
TRAP SYNDROME MAY ALSO BE REFERRED TO AS:
ACARDIAC TWINNING- "TWIN-REVERSED ARTERIAL PERFUSION" (ABNORMAL ANASTOMOSES OF PLACENTAL VESSELS RESULT IN PARASITIC/ACARDIAC TWIN) -SEVERE FORM OF TTTS -ONE NORMAL FETUS-"PUMP TWIN" & AN ABNORMALLY DEVELOPED FETUS CONTAINING NO HEART -PUMP TWIN HAS PERINATAL MORALITY OF 50% TO 55% SECONDARY TO POLYHYDRAMNIOS AND PREMATURITY SONO: NORMAL PUMP TWIN ACARDIAC TWIN- ABSENT UPPER BODY, HEART AND HYDROPS
THE INNER MEMBRANE SURROUNDING THE FETUS IS REFERRED TO AS:
AMNION (FLUID FILLED SAC CONTAINING EMBRYO)
WHICH TERM RELATES THE NUMBER OF AMNIOTIC SACS?
AMNIONICITY
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. AMNIONITIS D. DICHORIONIC DIAMNIOTIC
B. PULMONARY HYPOPLASIA
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. POOR NUTRITIONAL STATE
WHICH TERM RELATES THE NUMBER OF PLACENTAS?
CHORIONICITY
TWINS WHOSE BODIES ARE CONNECTED AT SOME POINT ARE SAID TO BE:
CONJOINED -RESULTS FROM MONOCHORIONIC MONOAMNIOTIC TWINNING -CAN BE ATTACHED AT HEAD, THORAX, ABDOMEN AND LOWER PART OF BODY -MOST COMMON FORMS= THORACOPAGUS & OMPHALOPAGUS -CHEST & ABDOMEN -40% CHANCE FOR BEING STILLBORN & MANY DYING W/IN FIRST 24 HOURS
WHICH OF THE FOLLOWING CAN OCCUR AS A RESULT OF MONOZYGOTIC TWINNING? A. MONCHORIONIC DIAMNIOTIC TWINS B. MONOCHORIONIC MONOAMNIOTIC TWINS C. DICHORIONIC DIAMNIOTIC TWINS D. ALL OF THE ABOVE
D. ALL OF THE ABOVE
THE TERM THAT INDICATES THE PRESENCE OF TWO SEPARATE AMNIOTIC SACS IS:
DIAMNIOTIC (MOST COMMON FORM OF MONOZYGOTIC TWINS) -RESULTS FROM DIVISION OF INNER CELL MASS B/W 4-8 DAYS -BOTH TWINS SHARE A PLACENTA & ARE POSITIONED WITHIN SEP. AMNIOTIC SACS *WHEN FETUSES SHARE THE SAME PLACENTA, COMPLICATIONS ARE MORE LIKELY TO OCCUR
THE TERM THAT INDICATES THE PRESENCE OF TWO SEPARATE PLACENTAS IS:
DICHORIONIC
TWINS HAVING 2 PLACENTAS AND 2 AMNIOTIC SACS ARE REFERRED TO AS:
DICHORIONIC DIAMNIOTIC
THE SONO EXAM OF TWINS REVEALS A TRIANGULAR EXTENSION OF THE PLACENTA AT THE BASE OF THE MEMBRANE. THIS FINDING IS INDICATIVE OF:
DICHORIONIC DIAMNIOTIC TWINNING (ONE ZYGOTE SPLITS PRIOR TO DAY 4)
WHAT CAN OCCUR AS A RESULT OF DIZYGOTIC TWINNING?
DICHORIONIC DIAMNIOTIC TWINS
TYPICALLY, THE 1ST SONO MANIFESTATION OF TTTS IS:
DISCORDANT FETAL GROWTH TTTS: (TWIN-TWIN TRANSFUSION SYNDROME) -SHUNTING OF VENOUS OR ARTERIAL BLOOD FROM ONE TWIN TO ANOTHER THROUGH PLACENTAL CIRCULATION -DONOR TWIN SUFFERS FROM ANEMIA & GROWTH RESTRICTION WHEREAS RECIPIENT EXPERIENCES HYDROPS & CONGESTIVE HEART FAILURE TX: THERAPEUTIC AMNIOCENTESIS AND ENDOSCOPIC-GUIDED LASER PHOTOCOAGULATION SONO: MONOCHORIONIC TWINNING DISCORDANT FETAL GROWTH OLIGOHYDRAMNIOS AROUND DONOR TWIN POLYHYDRAMNIOS AORUND RECIPIENT TWIN RECIPIENT MAY BE HYDROPIC
ASYMMETRY IN FETAL WEIGHT B/W TWINS IS INDICATIVE OF:
DISCORDANT GROWTH (15%-25% REDUCTION IN ESTIMATED FETAL WEIGHT OF SMALLER FETUS COMPARED TO LARGER)
FRATERNAL TWINS RESULT FROM:
DIZYGOTIC TWINNING
OVULATION INDUCTION DRUGS NOT ONLY INCREASE THE LIKELIHOOD OF MULTIPLE GESTATIONS, BUT ALSO INCREASE THE LIKELIHOOD OF:
HETEROTOPIC PREGNANCIES
THE MOST COMMON FORM OF MONOZYGOTIC TWINS IS:
MONOCHORIONIC DIAMNIOTIC (TWINS SHARE A PLACENTA)
TWINS HAVING ONE PLACENTA AND ONE AMNIOTIC SAC ARE REFERRED TO AS:
MONOCHORIONIC MONOAMNIOTIC
TWINS THAT HAVE THE THREAT OF BEING CONJOINED ARE:
MONOCHORIONIC MONOAMNIOTIC (LEAST PROBABLE MONOZYGOTIC TWINNING TO OCCUR) -LATE SPLIT BEYOND DAY 8 RESULTS IN THIS
CONJOINED TWINS THAT ARE ATTACHED AT THE ABDOMEN ARE REFERRED TO AS:
OMPHALOPAGUS
WHAT CONDITION IS PREGNANCY-INDUCED MATERNAL HIGH BLOOD PRESSURE AND EXCESS PROTEIN IN THE URINE AFTER 20 WEEKS GESTATION?
PREECLAMPSIA
THE ABNORMAL TWIN IN ACARDIAC TWINNING IS ALSO REFERRED TO AS THE :
PUMP TWIN
WHAT IS THE TERM FOR CONJOINED TWINS ATTACHED AT THE SACRAL REGION?
PYOPAGUS
THE TWIN THAT WILL APPEAR LARGER IN TTTS IS THE:
RECIPIENT
WHAT IS IT CALLED WHEN A TWIN FETUS, SUFFERING FROM TTTS, EXPERIENCES SEVERE OLIGOHYDRAMNIOS AND BECOMES CLOSELY ADHERED TO UTERINE WALL?
STUCK TWIN
THE DEMISE OF A TWIN DURING THE 2ND OR 3RD TRIMESTER CAN LEAD TO:
TWIN EMBOLIZATION SYNDROME -VASCULAR PRODUCTS TRAVEL FROM DEMISED TWIN TO SURVIVING TWIN BY MEANS OF COMMON VASCULAR CHANNELS W/IN SHARED PLACENTA -CENTRAL NERVOUS SYSTEM & KIDNEYS ARE AFFECTED IN SURVIVING TWIN W/ A 25% RISK OF DEATH OR NEUROLOGIC DAMAGE FOR SURVIVOR
THE OUTER MEMBRANE OF THE GESTATION IS REFERRED TO AS THE:
CHORION (FORMS PLACENTA)
TWINS THAT RESULT FROM FERTILIZATION OF TWO SEPARATE OVA ARE CALLED:
DIZYGOTIC -MOST COMMON FORM OF TWINNING -FRATERNAL TWINS; HAVE OWN GENETIC STRUCTURE & CAN DIFFER FROM EACH OTHER -RESULTS IN DICHORIONIC DIAMNIOTIC TWINS- TWO AMNIONS & 2 PLACENTAS- MAY FUSE TOGETHER AND LOOK LIKE 1
WHAT IS A TREATMENT THAT SEPARATES ABNORMAL PLACENTAL VASCULAR CONNECTIONS B/W TWINS THAT ARE SUFFERING FROM TTTS?
ENDOSCOPIC-GUIDED LASER PHOTOCOAGULATION
WHICH FORM OF MONOZYGOTIC TWINNING IS LEAST COMMON?
MONOCHORIONIC MONOAMNIOTIC
IDENTICAL TWINS RESULT FROM:
MONOZYGOTIC TWINNING -ARISE FROM A SINGLE ZYGOTE THAT SPLITS -SHARE THEIR DESIGN FROM ONLY 1 FERTILIZED EGG
TWINS HAVING 2 PLACENTAS AND 1 AMNIOTIC SAC ARE REFERRED TO AS:
THIS DOES NOT OCCUR
THE SHUNTING OF BLOOD FROM ONE TWIN TO THE OTHER IS TERMED:
TTTS
THE DEMISE OF A TWIN CAN LEAD TO THE DEVELOPMENT OF NEUROLOGIC COMPLICATIONS IN THE LIVING TWIN AS A RESULT OF:
TWIN EMBOLIZATION SYNDROME
MONOZYGOTIC TWINS RESULT FROM:
A SINGLE ZYGOTE THAT SPLITS
WHICH OF THE FOLLOWING WOULD NOT INCREASE THE LIKELIHOOD OF MULTIPLE GESTATIONS? A. GESTATIONAL DIABETES B. MATERNAL AGE OF >40 YEARS C. MATERNAL HX OF TWINS D. ART
A. GESTATIONAL DIABETES
ACARDIAC TWINNING RESULTS FROM:
ABNORMAL LINKS AMONG THE PLACENTAL VESSELS
