OB/GYN Seminar Final

What signals the corpus luteum to continue to produce progesterone when a fertilized egg is approaching the endometrium?

The syncytiotrophoblast cells produce hCG which keeps the corpus luteum producing progesterone

Which of the following is a false statement with respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma?

Only leiomyosarcoma will be singular

Which of the following is true with respect to the cerebellum?

The cerebellum is a bilobed structure that is shaped like a dumbbell in the posterior fossa of the cranium.

At what gestational age should physiologic bowel herniation be resolved?

16 weeks

Which of the following disorders presents with vaginal bleeding, low hCG, decreased symptoms of pregnancy, and a poor decidual reaction with an empty gestational sac?

Anembryonic pregnancy

Which of the following terms describes a straight uterus that tilts forward in the body forming a 90 degree angle with the vagina?

Anteverted

Which imaging plane of the fetal heart is best for assessing continuity of the interventricular septum and aortic valve?

Aortic outflow tract

A 23-week pregnant patient presents with right lower quadrant pain, fever, nausea, and leukocytosis. The fetus is normal. What else should be considered as a cause for the pain?

Appendicitis

Which of the following disorders occurs due to the abnormal development of the endocardial cushion?

Atrioventricular septal defect

Which part of the brain produces cerebrospinal fluid?

Choroid plexus

Which of the following is often linked to microtia?

Down syndrome

Which of the following heart anomalies is associated with pentalogy of Cantrell?

Ectopic cordis

Which of the following is consistent with a finding of Turner syndrome?

Fetuses present with cystic hygroma

What sonographic sign indicates a female fetus?

Hamburger sign

A fetal heart sonogram demonstrates a small left ventricle, aortic stenosis, and absent mitral valve. What do these findings suggest?

Hypoplastic left heart syndrome

A patient presents with acute left pelvic pain, vaginal bleeding, low hCG for gestational age, and low hematocrit. Sonography demonstrates a small irregular shaped cystic area in the endometrial canal, an adnexal ring sign in the left adnexa, and free-fluid in the cul-de-sacs and adnexas. What is the most likely diagnosis?

Left ectopic pregnancy

A 49 year old female patient presents with symptoms of night sweats, dyspareunia, hot flashes, and a decrease in libido. What is the most likely cause?

Menopause

Why is it important to document the type of hormone replacement a patient is taking prior to completing their sonogram?

Normal endometrial thickness measurements will vary depending on the type of HRT used.

Which of the following is often associated with chromosomal abnormalities and ascites?

Omphalocele

Which uterine arteries can be demonstrated in the periphery of the uterus in a multigravida patient?

Straight arteries

A patient presents with an enlarged bulky uterus and menorrhagia. Which of the following is most likely to be the cause?

Submucosal leiomyoma

A fetal sonogram demonstrates a cloverleaf-shaped skull, hydrocephalus, and telephone receiver-shaped long bones. What skeletal dysplasia is most likely?

Thanatophoric dysplasia

Which of the following is true with respect to the cerebellum?

The cerebellum is a bilobed structure that is shaped like a dumbbell in the posterior fossa of the cranium

Why does menstruation cease at menopause?

The ovaries stop producing estrogen and progesterone which halts the cycle

Why are assisted reproduction patients prone to ovarian hyperstimulation syndrome?

They have elevated human chorionic gonadotropin levels from ovulation induction.

A fetal sonogram demonstrates a normal left kidney but the right has a severely dilated renal pelvis and dilated proximal ureter, the rest of the urinary system is normal. What is the most likely cause?

Ureteropelvic junction obstruction

Amniocentesis shows a fetus with a 47,XXY karyotype. What abnormalities may be demonstrated sonographically on the routine sonogram?

Usually normal sonogram

Which of the following is a risk factor for developing pelvic inflammatory disease?

Utilization of and intrauterine contraceptive device

Why do endovaginal transducers utilize higher frequency ranges that transabdominal transducers?

Less penetration is required as structures are closer to the transducer

Which pelvic muscles supply support to the pelvic organs?

Levator ani and coccygeus

A 60-year old female patient presents with elevated estrogen levels, ovarian tumor, ascites, and pleural effusion. What is the most likely diagnosis for this ovarian tumor?

Thecoma

Which sonographic exam is used to assess fetal hypoxia?

Biophysical profile

Which ovarian tumor presents with elevated serum lactate dehydrogenase and precocious puberty if it presents in a child?

Dysgerminoma

Which pelvic mass presents sonographically as a cystic mass with homogeneous low level internal echoes?

Endometrioma

A fetal sonogram demonstrated a heterogeneous mass on the anterior neck. Maternal history included an iodine deficiency. What is the most likely differential for this finding?

Fetal goiter

A patient presents with a history of PID, right upper quadrant pain, fluid in Morison's pouch and elevated liver enzymes. Sonography of the RUQ reveals adhesions between the liver and right hemi-diaphragm. What is the most likely diagnosis?

Fitz-Hugh-Curtis syndrome

A fetus is shown to have bowel floating around in the amniotic fluid herniated through a defect on the right side of a normal cord insertion. What is the likely diagnosis?

Gastroschisis

A fetal ultrasound demonstrated ethmocephaly, cyclopia, and cleft palate. Which of the following disorders is most likely?

Holoprosencephaly

Which of the following is not an indication for a pelvic sonogram?

Evaluation of dysmennorhea

Which of the following is often found with a triploid fetus?

Molar pregnancy

What type of twin gestation is most likely to incur complications?

Monochorionic monoamniotic pregnancy

If a patient presents with free fluid in the pelvic spaces, where else should the sonographer interrogate?

Morison pouch

Which of the following can cause a false positive diagnosis for placenta previa?

Myometrial contractions in the lower uterine segment

Which of the following tests can only be performed between 11 and 14 weeks gestation?

Nuchal translucency

Which of the following pathologies is most likely to be demonstrated in a 12 year old female patient?

Ovarian torsion

A patient presents with a history of hirsutism, amenorrhea, and enlarged ovaries. What should the sonographer be looking for on the exam.

Polycystic ovarian syndrome

Which patient population has a predisposition for placenta previa?

Previous cesarean sections

A 25 year old patient presented with hirsutism and abnormal periods. Sonography demonstrated a solid, complex ovarian mass. What is the most likely diagnosis?

Sertoli-Leydig cell tumor

Which of the following disorders will demonstrate a normal maternal serum alpha-fetoprotein value?

Spina bifida occulta

Which of the following statements with respect to the placenta is false?

The placenta produces progesterone to maintain the corpus luteum

At what gestational age should the amnion and chorion be fused?

16 weeks

How many ossification centers should be present for each vertebra?

3

A patient is scanned for a biophysical profile. The fetus demonstrates 3 gross movements, 1 episode of tone, absent fetal breathing and a largest vertical pocket measurement of 4 cm. What is the BPP score?

6/8

At what time during development must division of an egg take place for a monochorionic monoamniotic pregnancy to occur?

After day 8

A fetus is demonstrated to have a horseshoe shaped monoventricle, fused thalami and absent falx. Which of the following is the most likely diagnosis?

Alobar holoprosencephaly

Which term describes a fetal head that is very round (short and wide)?

Brachycephaly

Which of the following procedures can determine fetal karyotype at the earliest gestational age?

Chorionic villi sampling

A 38 year old patient presents for routine ultrasound; triple screen showed low maternal serum alpha fetoprotein, elevated hCG, and low estriol. Sonographic findings included absent nasal bone, macroglossia, and clinodactyly. Which of the following is the most likely diagnosis?

Down syndrome

Which of the following pathologies has clinical presentation that includes hyperemesis, extremely elevated hCG, enlarged uterus and heavy vaginal bleeding?

Gestational trophoblast disease

A patient presents for a dating ultrasound at 7 weeks gestation with right lower quadrant pain and a palpable right adnexal mass. Sonography demonstrates an intrauterine pregnancy and an ovarian cyst with a thickened wall and internal echoes. What is the most likely diagnosis?

Hemorrhagic corpus luteal cyst

Which of the following is a nonlethal skeletal dysplasia that presents with rhizomelia, macrocrania, frontal bossing, and trident hands?

Heterozygous achondroplasia

A patient presents with a lateral ventricle measurement of 22 mm, dangling choroid, and the BPD and HC measure 3 weeks greater than the gestational age. What is the most likely diagnosis?

Hydrocephalus

Which of the following causes of abnormal uterine bleeding is most likely to result in hypomenorrhea?

Hypothyroidism

A patient presents with amenorrhea, cystic abdominal pain, and an enlarged uterus. Sonography demonstrates hydrometrocolpos. What is the most likely cause?

Imperforate hymen

Endovaginal sonography is contraindicated for which of the following patient populations?

Infants and children

Which of the following presents on ultrasound with an entrance and exit echo?

Intrauterine contraceptive device

Why does an ovarian thecoma have the potential to cause endometrial thickening?

It produces estrogen

A female fetus presents with a cystic mass in the left pelvis. The bladder and both kidneys are normal as is the amniotic fluid. What is the most likely diagnosis?

Left ovarian cyst

Weakness in which of the following muscles leads to the prolapse of the uterus?

Levator ani

Which of the following measurements is used to estimate gestational age in the first trimester?

Mean sac diameter

Which of the following measurements is only used in the first trimester?

Mean sac diameter (says correct answer is BPD)

A G2P1 patient presents with a history of previous cesarean section. Sonography demonstrates loss of the normal interface between the placenta and the myometrium and what appears to be placenta along the maternal bladder wall. What does this represent?

Placenta percreta

Which of the following disorders results from persistent bladder outlet obstruction?

Prune belly syndrome

How does an umbilical cord hemangioma present on ultrasound?

Solid hyperechoic mass in the umbilical cord near its attachment site in the placenta

Which of the following exams would require surgical asepsis to be practiced?

Sonohysterogram

Which potential space lies between the urinary bladder and the subic symphysis?

Space of Retzius

A patient presented with pelvic pain, infertility, and a palpable right adnexal mass. Sonography demonstrated a multicystic complex right adnexal mass with dirty shadowing and bilateral hydrosalpinx. What is the most likely diagnosis?

Tubo-ovarian abscess

When scanning a twin gestation, what is the appearance of the T sign?

Twin membrane separating gestations that terminates at the junction of the placentas in a perpendicular formation

A twin gestation demonstrates a 25% difference in fetal weight between the two gestations, what is the most likely explanation?

Twin-twin transfusion syndrome

Which other organs should be interrogated if uterine anomalies are demonstrated?

kidneys

Which of the following best describes the normal appearance of a normal ovary?

<15 mL volume, hypoechoic to myometrium with multiple anechoic follicles

A 3D ultrasound is performed on a 30 week fetus. Facial clefting is demonstrated and the left arm demonstrates an abnormal hand. What disorder is likely the cause?

Amniotic band syndrome

A fetal ultrasound demonstrates a large protruding tongue, hepatoblastoma, and an omphalocele. What syndrome does this represent?

Beckwith-Weidemann syndrome

A fetus is demonstrated to have a mass in the lung that has both cystic and solid components. Pleural effusion is also present. What disorder is indicated?

Cystic adenomatoid malformation

Which of the following is an indication for a first trimester sonogram?

Evaluation of suspected ectopic pregnancy

A patient presents with abnormal uterine bleeding. What is the most common cause?

Fibroid tumors invading endometrial cavity

What is the typical cause of dysfunctional uterine bleeding?

Hormonal imbalances resulting in endometrial changes

A sonogram demonstrates a placental cord insertion at the edge of the placenta with the vessels lying over the internal os. What is the disorder?

Vasa previa

A patient presents with monthly symptoms of menstruation but does not have any bleeding. What is the term used to describe this condition?

Cryptomenorrhea

A sonogram demonstrates a fetus with the abdominal surface connected to the placenta, scoliosis, and no evidence of an umbilical cord. What abnormality does this represent?

Limb-body wall complex

Which of the following syndromes is associated with autosomal recessive polycystic kidney disease, occipital encephalocele, and polydactyly?

Meckel-Gruber syndrome

Which of the following is most likely to correlate with chromosomal abnormalities?

Omphalocele containing only bowel