OBGYN final comprehensive review

If while scanning you suspect an ectopic pregnancy, where would you most likely find free fluid in the ABD? a) btwn liver/spleen b) btwn liver/LK c) btwn liver/RK d) btwn liver/diaphragm

btwn liver/RK

A pt is scanned for a BPP. Fetus demonstrates 3 gross movements, 1 episode of tone, absent fetal breathing & largest vertical pocket measuring 4cm. What is BPP score? a) 2/8 b) 4/8 c) 6/8 d) 8/8

6/8

A sonogram demonstrates bilat enlarged echogenic fetal kidneys, no detectable urinary BLDR, & oligohydramnios. What is most likely dx? a) multicystic dysplastic kidneys b) potter syndrome c) ADPKD d) ARPKD

ARPKD

What imaging plane best demonstrates the disparity in chest to ABD size found in thanatophoric dysplasia? a) COR image thru chest & ABD b) SAG image thru chest & ABD c) TRV image of both chest & ABD w/ circumference taken d) axial image of chest & thorax

SAG image thru chest & ABD

50% PID cases are caused by which of the following? a) STDs b) abscessed appendix c) ruptured colonic diverticulum d) multiple sexual partners

STDs

What is most appropriate plane to obtain intraorbital distance? a) TRV plane @ level of thalamus b) SAG plane thru orbits c) COR plan thru fetal face d) TRV plane @ level of orbits

TRV plane @ level of orbits

What does TORCH stand for?

Toxoplasmosis Other Rubella Cytomegalovirus, Herpes

A fetus that presents w/ anal atresia, ventricular septal defects, & a renal anomaly is likely presenting w/ which of the following disorders? a) pentalogy of cantrell b) VACTERL association c) Beckwith-Weidemann syndrome d) tetralogy of fallot

VACTERL association

Absence of CSP is suggestive of which of the following conditions? a) anencephaly b) acrania c) agenesis of corpus callosum d) holoprosencephaly

agenesis of corpus callosum

What is the most common maternal disorder?

diabetes mellitus

Which of the following is an indication for a 1st trimester sonogram? a) assess fetal anatomy b) eval of suspected ectopic pregnancy c) assess amniotic fluid volume d) assess fetal growth

eval of suspected ectopic pregnancy

Pt. presents w/ amenorrhea, cyclic ABD pain, & enlarged UT. Sono demonstrates hydrometrocolpos. Most likely cause? a) imperforate hymen b) vaginal atresia c) unicornuate uterus d) septate uterus

imperforate hymen

A 29y/o pt presents to US department for a pelvic ultrasound for heavy bleeding. She is 2mo postvaculation of a hydatidiform mole. What is the most likely dx based on her h/o & image below? a) PSTT b) choriocarcinoma c) invasive mole d) epithelioid trophoblastic tumor

invasive mole

Which of the following is commonly associated w/ Beckwith-Wiedemann syndrome? a) epignathus b) micrognathia c) microtia d) macroglossia

macroglossia

Rh isoimmunization

maternal antibodies to fetal blood cells

Which of the following measurements is used to estimate GA in 1st trimester? a) BPD b) AC c) mean sac diameter d) yolk sac

mean sac diameter

Definition of primary amenorrhea? a) menarche hasn't occurred by age 16 b) no menstrual cycle in a pregnant pt c) @ least 12mo w/o menstrual cycle in postmenarchal pt d) termination of menstrual cycle prior to menopause

menarche hasn't occurred by age 16

Term used to describe an abnormally small chin? a) micrognathia b) micropthalmia c) microcephaly d) microglossia

micrognathia

What are the sonographic features of achondrogenesis? a) phocomelia, early onset of ossification, large skull, polyhydramnios b) micromelia, narrow chest w/ distended ABD, small skull, polyhydramnios c) micromelia, absent mineralization of fetal bones, enlarged skull, polyhydramnios d) rhizomelia, absent mineralization of skull, oligohydramnios

micromelia, absent mineralization of fetal bones, enlarged skull, polydyramnios

What renal anomaly is caused by obstruction of fetal ureter, usually in 1st trimester? a) pelvic kidney b) Potter syndrome c) multicystic dysplastic kidney d) ARPKD

multicystic dysplastic kidney

Which of the following is a false statement w/ respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma? a) they may be single or multiple b) serial ultrasounds over 6mo will show large size difference in a leiomyosarcoma whereas leiomyoma will likely be unchanged in size c) both can demonstrate a heterogeneous hypoechoic appearance w/ shadowing d) only leiomyosarcoma will be singular

only leiomyosarcoma will be singular

Most common cause of painless vaginal bleeding in 2nd/3rd trimesters? a) placenta previa b) abruption c) cervical cerclage d) ruptured amnion

placenta previa

Most frequent cause of oligohydramnios? a) ABD wall anomalies b) cardiac anomalies c) gastrointestinal anomalies d) renal anomalies

renal anomalies

23y/o pregnant pt should be 5wks 4days. Sono shows no identifiable GS, & identifies an anechoic structure w/in RT ovary. Labwork shows quantitative beta hCG of 2323. What should be next step of care? a) repeat EV ultrasound in 2wks b) repeat beta hCG in 48hrs c) treat for an ectopic pregnancy d) transABD ultrasound to further evaluate uterus

repeat beta hCG in 48hrs

During the _________ phase of the menstrual cycle the endometrium is thickest.

secretory

_______ ______ is the most common congenital uterine anomaly.

septate uterus

Which arteries feed the functional layer of the endometrium? a) arcuate arteries b) spiral arteries c) straight arteries d) radial arteries

spiral & radial arteries

What appears sonographically as a crescent-shaped sonolucent or complex fluid collection btwn gestational sac & uterus? a) subchorionic hemorrhage b) fetal demise c) blighted ovum d) leiomyoma

subchorionic hemorrhage

A fetal sonogram demonstrates a cloverleaf-shaped skull, hydrocephalus, & telephone receiver-shaped long bones. What skeletal dysplasia is most likely? a) achondrogenesis b) achondroplasia c) thanatophoric dysplasia d) osteogenesis imperfecta

thanatophoric dysplasia

How does blood get from placenta to fetal heart? a) umbilical artery-common iliac artery-IVC b) umbilical artery-ductus venosus-LPV-RV c) umbilical vein-ductus venosus-IVC-RV d) umbilical vein-ductus arteriosus-IVC-RV

umbilical vein-ductus venosus-IVC-RV

What complications are associated w/ circumvallate placenta? a) no known complications b) retained products of conception c) vaginal bleeding & placental abruption d) delayed fetal lung maturity

vaginal bleeding & placental abruption

A fetal ultrasound demonstrates a large protruding tongue, hepatoblastoma, & omphalocele. What syndrome does this represent? a) turner syndrome b) down syndrom c) beckwith-weidemann syndrome d) tuberous sclerosis

beckwith-weidemann syndrome

Leading maternal cause of IUGR? a) diabetes b) systemic lupus erythematosus c) sickle cell disease d) hypertension

hypertension

Which of the following disorders results from persistent BLDR outlet obstruction? a) posterior urethral valves b) prune belly syndrome c) potter syndrome d) bladder exstrophy

prune belly syndrome

Bilateral renal agenesis, inadequately functioning kidneys, or obstruction of urinary tract can lead to which of the following? a) limb anomalies b) hydrops c) pulmonary hypoplasia d) anal atresia

pulmonary hypoplasia

Term to describe condition with abnormal # of whole chromosomes? a) diploidy b) aneuploidy c) translocation d) deletions

aneuploidy

Where does fertilization usually occur? a) infundibulum of fallopian tube b) ampulla of fallopian tube c) uterine cornua d) endometrium

ampulla of fallopian tube

A 38y/o pt presents for routine US; triple screen shows low MSAFP, elevated hCG & low estriol. Sonographic findings included absent nasal bone, macroglossia, & clinodactyly. Most likely dx? a) Patau syndrome b) Edward syndrome c) Beckwith-Weidemann syndrome d) Down syndrome

down syndrome

Pt presents for a dating US @ 7wks GA w/ RLQ pain & palpable RT adnexal mass. Sono demonstrates an intrauterine pregnancy & an ovarian cyst w/ thickened wall & internal echoes. What is most likely dx? a) hemorrhagic corpus luteal cyst b) serous cystadenoma c) endometriosis d) ectopic pregnancy

hemorrhagic corpus luteal cyst

Term used to describe widely spaced orbits? a) hypotelorism b) hypertelorism c) anopthalmia d) cyclopia

hypertelorism

The 4-chamber view is best for demonstrating which of the following? a) hypoplastic RT heart b) aortic stenosis c) pulmonary stenosis d) coarctation of aorta

hypoplastic RT heart

27y/o pt w/ h/o G5P0A5, LMP indicates pregnancy should be 8wks 4days. 1st ultrasound showed a viable pregnancy w/ gestational/yolk sac, fetal pole w/ FHR of 155bpm. Upon EV eval, sono again identifies gestational/yolk sac, fetal pole w/ FHR of 85bpm. Based on clinical sono findings, what do you suspect? a) viable pregnancy b) incomplete abortion c) impending fetal demise d) subchorionic hemorrhage

impending fetal demise

What structures make up the posterior boundary of the pelvic cavity? a) sacrum & coccyx b) ilium & pubis symphysis c) ischium & pubic symphysis d) ischium & sacrum

sacrum & coccyx

A pt presents w/ sudden onset of LLQ pain. Her serum hCG is pending, her LMP was 2 1/2 wks ago. Sonographer identifies a 4cm adnexal mass w/ low-level echoes & posterior enhancement. What is the most likely dx? a) endometrioma b) ovarian torsion c) hemorrhagic cyst d) mucinous cystadenoma

hemorrhagic ovarian cyst

What pathology is most likely to be demonstrated in a 12y/o female patient? a) ovarian torsion b) ectopic pregnancy c) PCOS d) PID

ovarian torsion

Which of the following is a false statement w/ respect to spina bifida? a) spina bifida cystica may demonstrate a lumbar myelocele on SAG image of fetal b) spina bifida occulta can be difficult to demonstrate on sonography as the defect is covered w/ skin c) if a meningocele is present, sonography will show a protrusion containing meninges & nerve roots d) splaying of vertebral laminae is easiest to demonstrate on SAG image of spine

splaying of vertebral laminae is easiest to demonstrate on SAG image of spine

How can the sonographer distinguish a nabothian cyst from a cervical carcinoma? a) cervical carcinoma will be a solid mass while a nabothian cyst will be a simple cyst b) nabothian cysts never have internal echoes; however, a cervical carcinoma will always demonstrate internal echoes c) shadowing will always be demonstrated from a cervical carcinoma d) a cervical carcinoma will always be wider than tall

cervical carcinoma will be a solid mass while a nabothian cyst will be a simple cyst

Which ovarian tumor presents w/ elevated serum lactate dehydrogenase & precocious puberty if it presents in a child? a) androblastoma b) endodermal sinus tumor c) yolk sac tumor d) dysgerminoma

dysgerminoma

Which of the following disease processes should NOT be seen in postmeno pt? a) endometriosis b) endometrial hyperplasia c) endometrial carcinoma d) ovarian cancer

endometriosis

What sonographic sign indicates a female fetus? a) turtle sign b) hamburger sign c) ring-of-fire sign d) keyhole sign

hamburger sign

What heart structure contains a natural opening to allow blood to shunt from RT side of heart to LT side of heart in fetus? a) interatrial septum b) interventricular septum c) foramen ovale d) endocardial cushion

interatrial septum

55y/o women presents for pelvic US for bleeding & pelvic pain. Her hx includes prior radiation treatment to her pelvis. Best diagnosis? a) endometrial carcinoma b) cervical cancer c) leiomyosarcoma d) endometrial hyperplasia

leiomyosarcoma

What does the T sign represent? a) dichorionic diamniotic b) dichorionic monoamniotic c) monochorionic diamniotic d) monochorionic monoamniotic

monochorionic diamniotic

What type of twinning is most likely to result in conjoined twins? a) dichorionic diamniotic b) dichorionic monoamniotic c) monochorionic diamniotic d) monochorionic monoamniotic

monochorionic monoamniotic

Which imaging modality has proven to be able to distinguish btwn benign & malignant lesions? a) sonography b) CT c) MRI d) none

none

Term to describe an umbilical cord around fetal neck? a) velamentous cord b) nuchal cord c) battledore cord d) wharton cord

nuchal cord

Term to describe death of a twin fetus in 1st trimester that is reabsorbed? a) vanishing twin b) blighted ovum c) fetus papyraceus d) twin embolization syndrome

vanishing twin

Most common cardiac defect? a) hypoplastic RT heart syndrome b) hypoplastic LT heart syndrome c) atrial septal defect d) ventricular septal defect

ventricular septal defect

Describe echotexture of normal uterus? a) hypoechoic to ovary b) hyperechoic to endometrium c) homogeneous d) inhomogeneous

homogeneous

Newborns affected by IUGR have many problems after birth. Some immediate neonatal risks include all of the following except: a) meconium aspiration b) hyperglycemia c) hypocalcemia d) hypothermia

hyperglycemia

Sono appearance of the proliferative endometrium? a) thin echogenic line <5mm b) 3-line-sign (basal/functional/canal/functional/basal) c) thick echogenic endometrium >15mm d) hypoechoic thin echogenic line 3-7mm

3-line-sign

Which of the following disorders presents w/ vag bleeding, low hCG, decreased symptoms of pregnancy & a poor decidual reaction w/ an empty gestational sac? a) anembryonic pregnancy b) missed abortion c) ectopic pregnancy d) gestational trophoblastic disease

anembryonic pregnancy

A fetal sonogram reveals a lower ABD wall mass inferior to umbilicus, absence of urinary BLDR, & normal amniotic fluid. What disorder does this represent? a) bladder exstrophy b) prune belly syndrome c) potter syndrome d) omphalocele

bladder exstrophy

Which of the following is a transitional cell tumor that often resembles a uterine fibroid? a) brenner tumor b) fibroma c) thecoma d) granulosa cell tumor

brenner tumor

Most common benign ovarian tumor that results from retention of an unfertilized ovum? a) sebaceous cyst b) dermoid c) thecoma d) granulosa cell tumor

dermoid

What does the term polydactyly describe? a) extra digits on hands/feet b) overlapping of 5th digit on hands c) large gap btwn 1st/2nd digit d) webbed fingers & toes

extra digits on hands/feet

This ovarian malignancy most often presents as large multi-loculated cystic masses w/ papillary projections & material. a) serous cystadenoma b) mucinous cystadenoma c) endometrioid tumor d) transitional cell

mucinous cystadenoma

Path of venous drainage from LT ovary? a) ovarian vein-LRV-SV-PV-liver-HV-IVC b) ovarian vein-external iliac vein-common iliac vein-IVC c) ovarian vein-LRV-IVC d) ovarian vein-internal iliac vein-common iliac vein-IVC

ovarian vein-LRV-IVC

What should sonographer do for their pt suffering from supind hypotensive syndrome? a) stop exam immediately & send them back to their obstetrician b) put pt in prone position c) put pt into LLD position d) call 911

put pt into LLD position

Which malignant ovarian tumor is often associated w/ pseudomyxoma peritonei? a) mucinous cystadenocarcinoma b) serous cystadenocarcinoma c) krukenberg tumor d) androblastoma

mucinous cystadenocarcinoma

Which chromosomal abnormality often presents w/ an inconclusive triple screen w/ sonographic features of holoprosencephaly & facial anomalies? a) Down syndrome b) Edward syndrome c) Patau syndrome d) Turner syndrome

patau syndrome

During a fetal heart scan, a hyperechoic mass is identified in LV, multiple hyperechoic masses were also demonstrated in renal cortex of both kidneys. What is most likely dx? a) rhabdomyoma w/ tuberous sclerosis b) angiomyolipoma w/ Down syndrome c) adenocarcinoma w/ angiomyolipoma d) trisomy w/ adenocarcinoma

rhabdomyoma w/ tuberous sclerosis

Why are assisted reproduction pts prone to ovarian hyperstimulation syndrom? a) they have elevated hCG from ovulation induction b) very high levels of estrogen & progesterone induce hyperstimulation of the ovaries c) elevated levels of follicle-stimulating hormone cause the ovaries to overproduce follicles enlarging the ovaries d) theca lutein cysts occur due to elevated levels of estrogen

they have elevated hCG from ovulation induction

Which term describes a straight uterus that tilts forward in the body forming a 90 degree angle w/ the vagina? a) retroverted b) retroflexed c) anteverted d) anteflexed

anteverted

Which imaging modality is often needed to determine uterine anomalies? a) MRI b) CT c) ultrasound d) x-ray

MRI

If multicystic dysplastic kidney disease is bilateral, what are associated sonographic findings? a) bilat multicystic kidneys, normal BLDR & AFV b) bilat multiple smooth-walled noncommunicating cysts of varying sizes in area of renal fossa, absent BLDR, oligohydramnios c) bilat enlarged echogenic kidneys, absent BLDR, oligohydramnios d) normal appearing kidneys, absent BLDR, oligohydramnios

bilat multiple smooth-walled noncommunicating cysts of varying sizes in area of renal fossa, absent BLDR, oligohydramnios

Most common gynecologic malignancy in US? a) endometrial carcinoma b) uterine carcinoma c) ovarian carcinoma d) vaginal carcinoma

endometrial carcinoma

Endometrial cavity is contiguous w/ which other part of female pelvis? a) myometrium b) fallopian tube lumen c) vagina d) ovary

fallopian tube lumen

A sonogram demonstrates a placental cord insert @ edge of placenta w/ vessels lying over internal os. What is this disorder? a) vasa previa b) succenturiate lobe c) placental abruption d) placenta previa

vasa previa

What part of blastocyst implants in endometrium during implantation? a) chorionic villus b) fimbria c) morula d) trophoblast

chorionic villus

Sonographic features of narrowing of aortic arch, enlarged RV & pulmonary artery are characteristics of what heart defect? a) coarctation of aorta b) tetralogy of fallot c) ebstein anomaly d) transposition of great arteries

coarctation of aorta

How can salpingitis be demonstrated on ultrasound if there's no fluid collection in the tube? a) power doppler should be used to show low-resistance flow in wall vessels b) color doppler should be used to demonstrate hyperemic flow c) follow cornua of uterus to tube & document wall thickeness w/ B-mode d) M-mode can be used to measure wall thickness of the tube

color doppler should be used to demonstrate hyperemic flow

What is a secondary method for detecting absence of fetal kidneys? a) absence of urine in fetal BLDR b) color doppler will show absence of renal arteries c) presence of ambiguous genitalia d) demonstration of sirenomelia

color doppler will show absence of renal arteries

A sonographer can BEST distinguish btwn gastroschisis & an omphalocele by visualizing the: a) cord insert b) contents of the mass c) a membrane d) 3VC

cord insert

Presentation of umbilical cord in advance of fetal presenting part during labor & delivery is termed: a) nuchal cord b) hypercoiling c) cord prolapse d) hypocoiling

cord prolapse

Initial source of progesterone & estrogen if fertilization occurs? a) corpus luteum b) uterus c) placenta d) ovum

corpus luteum

Which of the following best describes a thick-walled cystic mass w/ internal echoes that was demonstrated on day 20 of the menstrual cycle & resolved by day 5 of the following cycle? a) follicle b) follicular retention cyst c) corpus luteum d) hemorrhagic cyst

corpus luteum

Term used to describe fusion of orbits? a) cyclopia b) anopthalmia c) hypotelorism d) microtia

cyclopia

Which of the following is NOT considered a physiologic condition of the ovary? a) cystadenoma b) corpus luteum cyst c) thecalutein cyst d) follicular cyst

cystadenoma

What makes up the maternal portion of the placenta? a) chorion frondosum b) decidua basalis c) decidua capsularis d) outer portion of blastocyst

decidua basalis

Which of the following best describes the sonographic appearance of ovarian torsion? a) enlarged, hypoechoic ovaries w/ complete aabsence of blood flow in an area of the ovary b) complete absence of blood flow in a small atrophic ovary c) diminished blood flow along w/ enlarged hypoechoic ovary w/ peripheral follicles d) trace-free fluid in contralateral adnexa

diminished blood flow along w/ enlarged hypoechoic ovary w/ peripheral follicles

Most common type of twinning? a) diamniotic b) dichorionic c) dizygotic d) monozygotic

dizygotic

What is the definitibe sonographic sign of an intrauterine pregnancy? a) pseudogestational sac sign b) demonstration of fetal heart activity c) demonstration of fetal pole d) double sac sign

double sac sign

This pt arrived to US department w/ elevated serum lactate dehydrogenase & precocious puberty. What is most likely diagnosis? a) androblastoma b) endodermal sinus tumor c) yolk sac tumor d) dysgerminoma

dysgerminoma

Possible complication of salpingitis due to PID? a) multiple gestations b) retained products of conception c) pleural effusion d) ectopic pregnancy

ectopic pregnancy

Sonographic features of choroid plexus cysts, micrognathia, rocker bottom feet, omphalocele, & single umbilical artery are consistent w/ what chromosomal abnormality? a) Patau syndrome b) Edwards syndrome c) Down syndrome d) Turner syndrom

edwards syndrome

Most likely explanation for abnormal UT bleeding w/ endometrial measurement of <5mm in a postmeno. pt? a) endometrial hyperplasia b) endometrial cancer c) endometrial atrophy d) submucosal fibroids

endometrial atrophy

Which of the following can be a precursor for endometrial carcinoma? a) nabothian cyst b) cervical cancer c) endometrial hyperplasia d) polyps

endometrial hyperplasia

Which pelvic mass presents sonographically as a cystic mass w/ homogeneous low-level internal echoes? a) fibroma b) brenner tumor c) granulosa cell tumor d) endometrioma

endometrioma

Term used to describe the inner layer of the uterine wall? a) serosal layer b) myometrium c) endometrium d) perimetrium

endometrium

If polyhydramnios is demonstrated on fetal ultrasound, what GI abnormalities are most likely? a) esophageal or duodenal atresia b) omphalocele or gastroschisis c) meconium ileus or anorectal atresia d) omphalocele or anorectal atresia

esophageal or duodenal atresia

A 66y/o pt presents w/ ABD pain, & vaginal bleeding. While scanning the pelvis you notice an ill-defined or sausage shaped solid mass & pelvic ascites. What pathology is present in this patient? a) fallopian tube carcinoma b) serous cystadenoma c) endometriosis d) krukenberg tumor

fallopian tube carcinoma

Which of the following is a true statement w/ respect to fallopian tubes? a) most common location for an ectopic pregnancy is the infundibulum b) fallopian tube is usually only identified if there is an obstruction & it's distended w/ fluid c) infection of fallopian tube is called PID d) adenocarcinoma of fallopian tube should be considered whenever a solid mass is identified w/in adnexa

fallopian tube is usually only identified if there is an obstruction & it's distended w/ fluid

What divides the cerebral RT from LT hemispheres? a) falx cerebri b) corpus callosum c) median sulci d) metopic suture

falx cerebri

Which of the following is consistent w/ a finding of Turner syndrome? a) immune hydrops is often seen b) usually occurs in males c) fetuses present w/ cystic hygroma d) maternal serum screening shows elevated estriol, alpha-fetoprotein, & hCG

fetuses present w/ cystic hygroma

Whil scanning 14y/o transABD pelvis, you notice what appears to be uterine didelphys. What should you do next? a) finish scanning pelvis & end your study b) finish scanning pelvis then move to kidneys c) stop exam immediately & call her doctor d) ask pt. is she has ever been told she has a uterine anomaly

finish scanning pelvis then move to kidneys

Pt presents w/ h/o PID, RUQ pain, fluid in Morison's pouch, & elevated liver enzymes. Sono of RUQ reveals adhesions btwn liver & RT hemi-diaphragm. What is most likely dx? a) pseuodomyxoma peritonei b) fitz-hugh-curtis syndrome c) hepatitis d) cholecystitis

fitz-hugh-curtis syndrom

2 phases of the ovarian cycle? a) follicular & proliferative b) proliferative & secretory c) follicular & luteal d) proliferative & luteal

follicular & luteal

What fetal presentation is observed if fetal buttocks are @ cervix & legs are extended in front of fetal face? a) frank breech b) complete breech c) cephalic d) TRV

frank breech

Which layer of the endometrium is shed each month during menstruation? a) perimetrium b) basal layer c) functional layer d) submucosal layer

functional layer

4 major divisions of the uterus? a) fundus, corpus, cervix, vagina b) fundus, corpus, isthmus, cervix c) fundus, body, corpus, vagina d) fundus, corpus, fallopian tubes, cervix

fundus, corpus, isthmus, cervix

Most common benign vaginal neoplasm in pediatric population? a) gartner cyst b) teratoma c) ambiguous genitalia d) rhabdomyosarcoma

gartner cyst

A fetus is shown to have bowel floating around in amniotic fluid herniated thru a defect on RT side of a normal cord insert. What is most likely dx? a) hirschsprung disease b) anorectal atresia c) gastroschisis d) omphalocele

gastroschisis

Which of the following pathologies has clinical presentation that includes hyperemesis, extremely elevated hCG, enlarged uterus & heavy vaginal bleeding? a) mucinous cystadenoma b) gestational trophoblast disease c) theca lutein cysts d) preeclampsia

gestational trophoblastic disease

Which of the following is a nonlethal skeletal dysplasia that presents w/ rhizomelia, macromelia, frontal bossing, & trident hands? a) limb-body wall complex b) heterozygous achondroplasia c) achondrogenesis d) thanatophoric dysplasia

heterozygous achondroplasia

A fetal ultrasound demonstrated ethomocephaly, cyclopia, & cleft palate. Which of the following disorders is most likely? a) amniotic band syndrome b) beckwith-wiedemann syndrome c) fetal hydrops d) holoprosencephaly

holoprosencephaly

Sono demonstrated a large soft tissue mass w/ low-moderate echoes in uterus containing fluid filled spaces. Pt has elevated hCG & enlarged uterus; her doctor was unable to detect a fetal heartbeat. What is most likely dx? a) hydatidiform mole b) choriocarcinoma c) subchorionic hemorrhage d) missed abortion

hydatidiform mole

A pt presents w/ a lat. ventricle measurement of 22mm, dangling choroid, & BPD/HC measure 3wks greater than GA. Most likely dx? a) hydrocephalus b) ventriculomegaly c) holoprosencephaly d) Dandy-Walker malformation

hydrocephalus

Your pt tests positive for Chlamydia & presents w/ severe pelvic pain. This finding is most typical of? a) hydrosalpinx b) hematometra c) ectopic pregnancy d) ovarian cyst

hydrosalpinx

A fetal heart sonogram demonstrates a small LT ventricle, aortic stenosis, & absent mitral valve. What do these findings suggest? a) trunchus arteriosis b) hypoplastic LT heart syndrome c) hypoplastic RT heart syndrome d) ebstein anomaly

hypoplastic LT heart syndrome

The lateral ventricle measurement on a 21wk fetus is 13mm, what is the implication of this measurement? a) normal for GA b) indicates ventriculomegaly c) indicates choroid plexus cyst d) indicates mesocephalic head

indicates ventriculomegaly

EV sonography is contraindicated for which pt population? a) postmenopausal women b) perimenopausal women c) infants & kids d) women of childbearing age

infants & kids

What is a possible complication of chronic PID? a) chlamydia b) appendicitus c) pyelonephritis d) infertility

infertility

What happens to the corpus luteum if a pregnancy occurs? a) it resolves by 6th week of pregnancy b) it can reach size of up to 10cm but should resolve by 16wks GA c) production of hCG maintains the corpus luteum throughout pregnancy d) it produces estrogen required to maintain pregnancy

it can reach size of up to 10cm but should resolve by 16wks GA

What ovarian neoplasm is a result of a metastases of a GI cancer? a) setoli-leydig cell tumor b) krukenberg tumor c) mucinous cystadenocarcinoma d) granulosa cell tumor

krukenberg tumor

Weakness in which muscles leads to uterine prolapse? a) coccygeus b) iliopsoas c) levator ani d) piriformis

levator ani

Affects of hyperthyroidism on fetus due to extra thyroxine production?

low birth weight, slightly increased mortality

Amniocentesis

monitor bilirubin concentration in amniotic fl

What are the 4 biophysical features used combined w/ NST for a BPP? a) movement, tone, FHR, AFI b) movement, size, FHR, AFI c) movement, tone, breathing, AFI d) measurements, FHR, breathing, tone

movement, tone, breathing, AFI

Least @ least 1 risk factor for developing leiomyosarcoma?

nulliparity, 50 yrs or older, obesity, h/o pelvic radiation, tamoxifen exposure

Path of venous drainage from RT ovary? a) ovarian vein-uterine vein-internal iliac vein-common iliac vein-IVC b) ovarian vein-IVC c) ovarian vein-RRV-IVC d) ovarian vein-internal iliac vein-common iliac vein-IVC

ovarian vein-IVC

Which part of the female pelvis has a dual blood supply? a) uterus b) endometrium c) fallopian tube d) ovary

ovary

Pt presents w/ mittelschmerz. Sono shows small amt of free fluid in RT adnexa. What is the likely cause? a) ovulation b) ruptured hemorrhagic cyst c) rupture of nabothian cyst d) rupture of endometrioma

ovulation

What normal anatomic variant may be seen on a pelvic sonogram? a) hydronephrosis b) ascites c) free fluid in posterior cul-de-sac d) pelvic kidney

pelvic kidney

Which complication is a possilbe complication of introduction of intrauterine contraceptive devices? a) spontaneous abortion b) ectopic pregnancy c) perforation of myometrium d) asherman syndrome

perforation of myometrium

Which of the following is false w/ respect to the placenta? a) early placenta will appear as an echogenic thickened area surrounding part of gestational sac b) chorionic plate is the part of the placenta closest to the fetus c) placenta produces progesterone to maintain corpus luteum d) placenta functions as respiration for fetus

placenta produces progesterone to maintain corpus luteum

Term used to describe more than 5 digits? a) syndactyly b) clinodactyly c) polydactyly d) arthrogryposis

polydactyly

Pt has menstrual cycles 17 days apart, what would you describe this as? a) polymenorrhea b) oligomenorrhea c) amenorrhea d) hypomenorrhea

polymenorrhea

Male fetus is demonstrated to have bilateral hydronephrosis w/ hydroureter, dilated BLDR/urethra. What is the cause of these findings? a) bilat ureteropelvic junction obstruction b) bilateral ureterovesicle obstruction c) bilateral ureterocele d) posterior urethral valves

posterior urethral valves

Where is free fluid most likely to collect in female pelvis? a) vesicouterine pouch b) pouch of douglas c) anterior cul-de-sac d) space of retzius

pouch of douglas

What is defined as the onsey of puberty in girls before age of 8y/o? a) ambiguous genitalia b) precocious puberty c) PID d) gonadal dysgenesis

precocious puberty

Which of the following maternal problems is @ increased risk for mothers expecting multiple gestations? a) preeclampsia & anemia b) pericardial effusion c) gestational diabetes d) intracranial hemorrhage

preeclampsia & anemia

Which pt population has a predisposition for placenta previa? a) advanced maternal age b) maternal diabetes c) previous c-sections d) h/o PID

previous c-sections

Erythroblastosis fetalis

rapid destruction of fetal RBCs & hepatosplenomegaly

Sonogram of a postpubertal woman demonstrated a 5cm simple cyst on LT ovary. Follow-up exam 3 months later demonstrates a normal ovary. What do these findings represent? a) resolution of corpus luteum b) resolution of endometriosis c) resolution of a follicular retention cyst d) resolution of a hemorrhagic cyst

resolution of a follicular retention cyst

Most common malignant neoplasm of vagina & uterus in pediatric female? a) gartner cyst b) yolk sac tumor c) rhabdomysarcoma d) PID

rhabdomyosarcoma

What term describes shortening of the proximal portions of the limbs? a) rhizomelia b) mesomelia c) acromelia d) phocomelia

rhizomelia

Term used to describe an anechoic structure located in fetal head in an 8wk GA? a) choroid plexus b) prosencephalon c) mesencephalon d) rhombencephalon

rhombencephalon

Pt presents w/ elevated hCG, LT sided pelvic pain, & elevated WBC. Sono reveals a large, round, complex mass consuming ovarian parenchyma & undergoing cystic changes. What is the most likely dx? a) ovarian cyst b) leiomyoma c) ruptured ectopic pregnancy d) normal pregnancy

ruptured ectopic pregnancy

An asymptomatic pt presents w/ bilat large anechoic lesions w/ septations & papillary projections. What does this most likely represent? a) cystic teratoma b) endometrioma c) mucinous cystadenoma d) serous cystadenoma

serous cystadenoma

Asymptomatic pt presents w/ bilateral large anechoic lesions w/ septations & papillary projections. What does this most likely represent? a) cystic teratoma b) endometrioma c) mucinous cystadenoma d) serous cystadenoma

serous cystadenoma

Most common malignant ovarian tumor? a) serous cystadenoma b) mucinous cystadenoma c) endometrioid tumor d) transitional cell

serous cystadenoma

What is the cause of hypospadias? a) shortened urethra b) shortened ureters c) undescended testicles d) stimulation from maternal hormones

shortened urethra

If fusion of lower extremities, renal agenesis, & oligohydramnios are demonstrated on sonography, what abnormality is indicated? a) sirenomelia b) radial ray syndrome c) talipes equinovarus d) amniotic band syndrome

sirenomelia

What anatomic landmakrs do sonographers use for AC measurement? a) stomach & umbilical/PV b) cord insert & stomach c) kidneys & GB d) kidneys & stomach

stomach & umbilical/PV

Term to describe a twin that is in close association w/ the uterine wall? a) stuck twin b) fetus papyraceus c) discordant growth d) twin-twin transfusion syndrome

stuck twin

What is leading cause of 1st trimester vag bleeding in presence of a closed cervix? a) blighted ovum b) fetal demise c) complete abortion d) subchorionic hemorrhage

subchorionic hemorrhage

A pt presents w/ an enlarged bulky uterus & menorrhagia. Which of the following is most likely to be the cause? a) subserosal fibroid b) submucosal leiomyoma c) adenomyosis d) bicornuate uterus

submucosal leiomyoma

Term used to describe an additional small lobe of placenta separate from main segment? a) circumvallate placenta b) succenturiate lobe c) placentomegaly d) bilobed placenta

succenturiate lobe

What is an ovarian complication of a molar pregnancy? a) hemorrhagic follicular retention cyst b) theca lutein cyst c) corpus luteum cyst d) serous cystadenocarcinoma

theca lutein cyst

Term to describe disorder w/ extra copy of a chromosome? a) monosomy b) trisomy c) diploidy d) haploidy

trisomy

Most common chromosomal abnormality? a) trisomy 21 b) turner syndrom c) trisomy 18 d) trisomy 13

trisomy 21

What chromosomal abnormality is associated w/ missing nasal bone? a) trisomy 21 b) trisomy 18 c) anencephaly d) encephalocele

trisomy 21

Pt presents w/ fever, leukocytosis & pelvic pain. Sono demonstrates a complex multicystic RT adnexal mass in area of ovary & tube. Both ovary & tube are visualized separately but can't be separated from one another w/ vaginal probe. What does this represent? a) salpingitis b) PID c) tubo-ovarian abscess d) tubo-ovarian complex

tubo-ovarian abscess

Pt presents w/ pelvic pain, infertility, & palpable RT adnexal mass. Sono demonstrated multicystic RT adnexal mass w/ dirty shadowing & bilateral hydrosalpinx. What is most likely dx? a) appendicitus b) vaginitis c) tubo-ovarian abscess d) acute PID

tubo-ovarian abscess

Life-threatening complication resulting from the death of a monochorionic twin? a) vanishing twin b) twin embolization syndrome c) fetus papyraceus d) acardiac twin

twin embolization syndrome

What is a heterotopic pregnancy? a) twin gestation, both embryos in sam amniotic sac b) twin gestation, 2 separate gest. sacs each in its own horn of a bicornuate uterus c) twin gestation, 1 gestation implanted in uterus & other is ectopic d) twin gestation, both sacs implanted in fallopian tube

twin gestation, 1 gestation implanted in uterus & other is ectopic

A twin gestation demonstrates a 25% difference in fetal weight btwn the 2 gestations. Most likely explanation? a) technologist error b) the 2 fetuses implanted @ different times c) twin-twin transfusion syndrome d) chromosomal abnormality in smaller fetus

twin-twin transfusion syndrome

A fetal sonogram demonstrates a normal LK but RT has severely dilated renal pelvis & dilated proximal ureter. Rest of urinary system is normal. Most likely cause? a) urethral agenesis b) hydronephrosis c) ureteropelvic junction obstruction d) posterior urethral valves

ureteropelvic junction obstruction

An IUGR fetus is defined as a sonographic estimated fetal weight less than the ____ percentile for GA. a) 5th b) 7th c) 10th d) 12th

10th

At what GA should physiologic bowel herniation be resolved? a) 8wks b) 10wks c) 12wks d) 16wks

16wks

When is a fetus most susceptible to malformations?

1st trimester

After 20wks gestation, a fundal height difference of > ___ cm is suspicious for growth restriction. a) 1 b) 3 c) 5 d) none of the above

3

How many ossification centers should be present for each vertebrae a) 3 b) 2 c) 1 d) 4

3

If pt has hCG level of 100, in how many days should it be possilbe to visualize a gestational sac? a) 2 days b) 3 days c) 4 days d) 5 days

4 days

What does G4P3A1 represent? a) 4 pregnancies, 3 births @ >20wks GA, 1 failed gestation b) 4 live births from 3 pregnancies c) 4 pregnancies, 3 C-sections d) 4 births, 2 live, 2 stillborn

4 pregnancies, 3 births @ >20wks GA, 1 failed gestation

Fetal hyperinsulinemia results in macrosomia, when fetal weight exceeds?

4500g/9lb 9oz

What is upper limit of normal for renal pelvis diameter in an 18wk fetus? a) 4mm b) 7mm c) 10mm d) 3mm

4mm

What is considered a normal range for amniotic fluid index? a) 10-30cm b) 7-27cm c) 5-25cm d) 3-20cm

5-25cm

Miss Greenfield is 73y/o & asymptomatic. She is NOT on HRT. Her endometrium should not measure more than: a) 1mm b) 2mm c) 3mm d) 5mm`

5mm

At what GA should an ABD wall defect be considered a fetal pathology? a) >12wks b) 8wks c) <22wks d) 27-40wks

>12wks

What criteria is used to classify placentomegaly? a) >4cm b) >5cm c) >8cm d) <2cm

>4cm

What measurements are correlated to determine an estimated fetal weight? a) BPD, HC, AC, FL b) BPD, occipitofrontal diameter, AC, CRL c) mean sac diameter (MSD), BPD, AC, FL d) CRL, MSD, AC, FL

BPD, HC, AC, FL

Which sonographic exam is used to assess fetal hypoxia? a) biometry scan b) anatomical profile c) nuchal translucency d) BPP

BPP

Which of the following is false w/ respect to the nuchal translucency exam? a) increased NT associated w/ trisomy 21, 18, & Turner's b) NT exams can only be performed btwn 11wks & 13wks 6 days c) fetus must be in neutral position in SAG d) CRL must be btwn 40-80mm @ time of exam

CRL must be btwn 40-80mm @ time of exam

What is most accurate sonographic method for dating a pregnancy? a) CRL prior to 14wks GA b) mean sac diameter prior to 10wks GA c) BPD d) cerebellum diameter

CRL prior to 14wks GA

Which fetal brain structures should be visualized in axial plane used to measure BPD? a) thalamus, cerebellum, cisterna magna b) thalamus, falx cerebri, cerebellum c) CSP, thalamus, cerebellum d) CSP, thalamus, falx cerebri

CSP, thalamus, falx cerebri

Term used as a diagnosis to describe an infant that is smaller than expected for gestational age? a) macrosomia b) IUGR c) twins d) microcephaly

IUGR

What is normal situs & lie of fetal heart? a) mid chest w/ apex pointing toward aorta b) LT chest w/ apex forming 45 degree angle w/ fetal spine c) LT chest w/ LA closest to IVC d) RT chest w/ atrium pointing toward LT anterior chest

LT chest w/ apex forming 45 degree angle w/ fetal demise

Pt presents w/ acute LT pelvic pain, vag bleed, low hCG for GA, & low hematocrit. Sono shows small irreg. cystic area in endometrial canal, adnexal ring sign in LT adnexa, & free fluid in cul-de-sacs/adnexas. Most likely dx? a) LT ectopic pregnancy b) pseudosac c) hemorrhagic corpus luteal cyst d) yolk sac tumor

LT ectopic pregnancy

If pt presents w/ free fluid in pelvic spaces, where else should the sonographer interrogate? a) Morison's pouch b) pleural cavity c) pericardial space d) synovial cavity

Morison's pouch

Most common hormonal disorder among reproductive age women? a) amenorrhea b) PCOS c) dysmenorrhea d) menopause

PCOS

Early sexual contact, multiple sex partners, &/or h/o STDs are all risk factors are associated w/ what disease? a) PID b) PCOS c) endometriosis d) leiomyomas

PID

What imaging plane is best to demonstrate absence of the nasal bone? a) COR thru nasal bridge b) SAG midline thru fetal face c) Axial image thru nose/lips d) TRV thru level of nasal bridge

SAG midline thru fetal face

What is most appropriate plane to obtain an intraorbital distance? a) TRV plane @ level of thalamus b) SAG plane thru orbits c) COR plane thru fetal face d) TRV plane at orbit level

TRV plane at orbit level

While scanning an 11wk pregnancy, you come across a mid-gut herniation, this is: a) omphalocele b) gastroschisis c) a normal finding d) ectopia cordis

a normal finding

What is the result of abnormal anastomoses of placental vessels? a) intrauterine death b) monochorionic twin gestation c) conjoined twins d) acardiac twin

acardiac twin

Term used to describe the normal of ovaries? a) adnexa b) vesicouterine space c) uterine fossa d) rectouterine space

adnexa

At what time during development must division of an egg take place for a monochorionic monoamniotic pregnancy to occur? a) prior to day 4 b) btwn day 4-8 c) btwn day 6-8 d) after day 8

after day 8

A fetus is demonstrated to have a horseshoe shaped monoventricle, fused thalami & absent falx. Most likely dx? a) mucinous cystadneoma b) alobar holoprosencephaly c) lobar holoprosencephaly d) Dandy-Walker malformation

alobar holoprosencephaly

Fertilization usually occurs in the _______ portion of the fallopian tube.

ampulla

A fetus demonstrates absence of cornea on COR plane of fetal face. What abnormality does this represent? a) cebocephaly b) micropthalmia c) anopthalmia d) ethmocephaly

anopthalmia

All of the following are risks for developing an ectopic pregnancy except? a) PID b) previous ectopic c) smoking d) anterior placenta

anterior placenta

What part of female pelvis define the vesicouterine space? a) anterior surface of the uterus & posterior surface of BLDR b) posterior surface of uterus & anterior surface of rectum c) anterior surface of BLDR & anterior surface of pubic symphysis d) anterior surface of uterus & anterior surface of BLDR

anterior surface of uterus & posterior surface of BLDR

Which of the following is most likely to increase risk of multiple gestations? a) early menarche b) late menarche c) assisted reproductive therapy d) early maternal age

assisted reproductive therapy

Which type of growth restriction begins in 3rd trimester & is physically characterized as discordant biometric growth pattern? a) symmetric IUGR b) asymmetric IUGR c) small for gestational age d) macrosomia

asymmetric IUGR

Cause of adenomyosis? a) functional layer endometrial tissue invades the myometrium b) basal layer endometrial tissue invades the myometrium c) tiny areas of leiomyoma tissue form in the myometrium c) development of arteriovenous malformations in the myometrium

basal layer endometrial tissue invades myometrium

Which of the following best describes a uterus that has 2 separate endometrial canals but a single cervix? a) septate uterus b) bicornuate uterus c) uterus didelphys d) subseptate uterus

bicornuate uterus

Hemolytic disease severity is directly related to...

bilirubin level in amniotic fluid

What criteria should be observed when assessing both LT & RT VOT? a) aorta & pulmonary artery should crisscross b) aorta should be positioned anterior to pulmonary artery c) location of mitral valve & tricuspid valves should be assessed d) both a & b

both a & b

At what GA should kidneys be visualized on transABD sonography? a) 15wks b) 12wks c) 18wks d) both a & c

both a & c

If fetus has a heart rate of 74 BPM, this is: a) tachycardia b) bradycardia c) acardia d) none of the aboce

bradycardia

A fetus is demonstrated to have very close set orbits & a small nose w/ a single nostril. What does this represent? a) ethmocephaly b) cyclopia c) cebocephaly d) micropthalmia

cebocephaly

24y/o C/O RT shoulder pain (+ hCG). Sono reveals complex fluid collection surrounding an echogenic structure w/ post. shadowing. Also identifies a small, oval, complex structure w/in cervix; bilat. ovaries/adnexas unremarkable. Best dx? a) intramyometrial ectopic pregnancy b) cornual ectopic pregnancy c) cervical ectopic pregnancy d) intrauterine pregnancy

cervical ectopic pregnancy

Most common renal anomaly? a) pelvic kidney b) duplex collecting system c) horseshoe kidney d) urachal cyst

duplex collecting system