OB Final1

First trimester

0-12 weeks

transabdominal hCG

1,800 mIU/mL

The transvaginal transducer should be soaked in disinfectant between uses for a minimum of ____________. 3 to 5 minutes 10 to 20 minutes 30 to 60 minutes 1 to 2 hours

10-20 min

transvaginal hCG

1000-2000 mIU/mL

second trimester

13-26 weeks (13-28)

A mature follicle typically measures______cm right before ovulation? 1 1.5 2 3

2

When is a zygote formed?

22-26 hours after fertilization, after sperm merges with ovum

third trimester

27-40 weeks (28-42)

In postmenopausal patients not on hormone replacement therapy, an endometrial thickness less than_______mm is considered within normal limits 2 3 5 10

5

When does implantation occur?

6 days after fertilization

Sonohysterography is usually performed on premenopausal women between days _____ of the menstrual cycle? 3 and 5 6 and 10 10 and 14 21 and 28

6-10

The normal size of the menarchal uterus should measure apx. ______ centimeters (cm) long and _____ cm wide 3; 5 2; 3 8; 4 6; 2

8;4

Precocious puberty is defined as puberty occurring before which age females? 5 yrs 10 yrs 8 yrs 12 yrs

8yrs

Pregnancy length

9 months, 40-42 weeks, 280 days

Fetus Period

9/10 weeks to birth

On transabdominal imaging of the female pelvis, the distended urinary bladder? is an acoustic window to view the pelvic anatomy assists an anteverted uterus into a plane that is more perpendicular to the sound beam displaces the bowel into the false pelvis all of the above

All of the above

The absence or cessation of the menstrual period is known as:

Amenorrhea

Which one of the following portions of the fallopian tube is typically the point of fertilization? infundibulum ampulla isthmus interstitial

Ampulla

When the corpus and fundus are bent or folded anteriorly until the fundus is resting on the cervix, the uterine position is described as? anteflexed retroflexed retroverted anteverted

Anteflexed

Another term for vesicouterine space

Anterior cul-de-sac (posterior to bladder, anterior to uterus)

Bending or tipping forward of the entire uterus is called? Retroflexion Anteversion Anterflexion Retroversion

Anterversion

The thin outer layer of the uterus is separated from the immediate layer by which one of the following? A) Peripheral arteries B) Uterine arteries C) Arcuate vessels D) Radial arteries

Arcuate vessels

Which of the following are small vessels often visualized along the periphery of the uterus that should not be mistaken for pathology? uterine arteries arcuate vessels iliac arteries peripheral vessels

Arcuate vessels

The hormone produced by trophoblastic tissue is? estrogen progesterone luteinizing hormone beta human chorionic gonadotropin

Beta human Chorionic Gonadotropin

What anatomic structure lies just anterior to the uterus? cervix bladder rectum space of Retzius

Bladder

At which embryonic stage does implantation occur? zygote blastocyst morula embryo

Blasocyst

Which one of the following ligaments contains the uterine blood vessels and nerves? Broad Round Uterosacral Endometrial

Broad

The pelvic ligament that extends from the lateral aspect of the uterus to the side walls of the pelvis is the: A. Broad ligament B. Ovarian ligament C. Piriformis ligament D. Round ligament

Broad ligament

Flexion refers to the axis of the uterine body relative to the ___________? fundus cervix vagina cornua

Cervix

The region of the uterus where the fallopian tube passes through the uterine wall and communicates with the uterine cavity is called the? corpus cornua fundus infundibulum

Cornua

In transvaginal scanning, the scanning plane that is 90 degrees from the sagittal plane is the ______________ plane? transverse parasagittal axial coronal

Coronal

Which one of the following refers to an imaging plane parallel to the long axis of the body to image structures from anterior to posterior? transverse axial sagittal coronal

Coronal

Barrier methods of contraception include which of the following? nuvaring IUD diaphragm OCP's

Diaphragm

Which of the following is a typical trend for bHCG in a normally developing pregnancy? double every 48-72 hrs double every 24-48 hrs rises 50% every 24-48hrs triples every 36 hrs

Double every 48-72hrs

What is oogenesis?

Egg production, starts at fetal and ends at menopause

Nabothian cysts are found near which one of the following anatomic structures? isthmus vagina endocervical canal peritoneum

Endocervical Canal

The inner glandular layer of the uterus is termed? myometrium endometrium serosa perimetrium

Endometrium

Which one of the following structures lies above the utero-ovarian ligament, round ligament, and tubo-ovarian ligament? ovary fallopian tube broad ligament Uterine artery

Fallopian Tube

Cycle day 1 is? at ovulation the day menses is complete the day after ovulation the first day of menses

First day of menses

Regarding hormones: Estrogen is secreted by_______ whereas progesterone is secreted by the _______ follicles; corpus luteum corpus albicans; follicles follicles; corpuscle corpus luteum; nabothian

Follicles; corpus luteum

The proliferative phase of the endometrial cycle is similar to which phase of the ovarian cycle? menstrual follicular secretory luteal

Follicular

The uterus and fallopian tubes are formed by the ? fusion of the external gonadal ridge division of the external gonadal ridge fusion of the mullerian ducts division of the mullerian ducts

Fusion of the mullerian ducts

Which of the following is the outermost layer of the ovary? Tunica externa Tunica albuginea Visceral peritoneum Germinal epithelium

Germinal epithelium

A mature follicle is known as a ______follicle? Mullerian Graafian Corpus luteal Stimulated

Graafian

On ultrasound, the skeletal muscles of the abdomen and pelvis appear _____ compared to their surrounding structures? hyperechoic hypoechoic isoechoic anechoic

Hypoechoic

Which muscles do NOT lie within the true pelvis? iliacus muscles piriformis muscles levator ani muscles obturator internus muscles

Iliacus muscles

The vagina can be identified in the _____ portion of the pelvis between the _____ (anteriorly) and the _____ (posteriorly)? posterior; urinary bladder; rectum anterior; anterior cul de sac; urinary bladder inferior; urinary bladder; rectum superior; urinary bladder; posterior cul de sac;

Inferior;urinary bladder;rectum

Which of the following is a chromosomal abnormality associated with sexual ambiguity? Kleifelter's syndrome Down syndrome XYY Zygote

Kleifelter's Syndrome

The left ovarian vein drains into which one of the following veins? inferior vena cava (IVC) uterine left renal external iliac

Left Renal

Which of the following is used to divide the pelvic cavity into the pelvis major (false pelvis) and the pelvis minor (true pelvis)? pubic symphysis linea alba linea terminalis iliac crests

Linea Terminalis

The thickness of the endometrium should be measured in which one of the following planes? transverse longitudinal coronal oblique

Longitudinal

The ovarian cycle term corresponding to the latter part of the cycle is called? post ovulation secretory luteal proliferative

Luteal

Which ovarian phase in a pathologically normal pelvis is the best time to observe blood flow within the ovary? luteal proliferative secretory follicular

Luteal

Abnormally heavy or long menses is termed? dysmenorrhea menorrhagia oligomenorrhea amenorrhea

Menorrhagia

Which duct develops in female genitalia?

Mullerian duct

The middle layer of the uterus is which one of the following? serosa endometrium body myometrium

Myometrium

Which of the following produces the hormones estrogen and progesterone in females? anterior pituitary gland ovarian medulla ovarian follicles hypothalmus

Ovarian Follicles

Which support structure anchors the ovary loosely to the uterine cornu? mesovarium ovarian ligament round ligament cardinal ligament

Ovarian Ligament

The pelvic ligament that provides support to the ovary and extends from the lateral surface of the ovary to the uterus is the: A. Cardinal ligament B. Ovarian ligament C.Broad ligament D. Suspensory ligament of the ovary

Ovarian ligament

The pelvic ligament that provides support to the ovary and extends from the ovary to the lateral surface of the uterus is the: A. Cardinal ligament B. Ovarian ligament C. Broad ligament D. Suspensory ligament

Ovarian ligament

Most common hormonal disorder in women that stops ovulation?

PCOS- polycystic ovarian syndrome

The term "mittelschmerz" describes? long periods painful periods pain with ovulation bleeding with ovulation

Pain with ovulation

Solid areas seen symmetrically and bilaterally in the pelvis are likely to be which of the following? ovarian cysts uterine fibroids pelvic muscles iliac vessels

Pelvic Muscles

Symmetrical bilateral pelvic masses are likely to be which one of the following? A) Ovarian cysts B) Uterine fibroids C) Pelvic muscles D) Iliac vessels

Pelvic muscles

True Pelvis

Piriformis: posterolateral wall Obturator internus: anterolateral wall Muscles of the pelvic diaphragm (levator ani and coccygeus)

The retrouterine space is also known as which one of the following? anterior cul de sac space of Retzius posterior cul de sac pouch of Dodd

Posterior Cul De Sac

Another term for rectouterine space

Posterior cul-se-sac (posterior to uterus, anterior to rectum)

The Doppler measurement that takes the peak systolic minus the peak diastolic divided by the peak systolic is which one of the following? pulsatility index mean doppler gradient pourcelot resistive index mean systolic measurement

Pourcelot resistive index

What is the physiologic status of prepuberty? menarche menopause premenarche postmenarche

Premenarche

The endometrium demonstrates the "three-line" sign in which one of the following endometrial phases? menstrual proliferative secretory luteal

Proliferative

False Pelvis

Psoas major: pelvic sidewall Iliacus: pelvic sidewall

The Doppler measurement that uses peak systole minus end diastole divided by the mean over one cardiac cycle is the ________________ index? pulsatility resistive mean systolic mean diastolic

Pulsatility

The arteries in the uterus that extend through the myometrium to the base of the endometrium are the? spiral arteries arcuate arteries straight arteries radial arteries

Radial Arteries

A benefit to estrogen replacement therapy is reduced risk of bone density loss decrease risk of hyperplasia decrease risk of breast cancer hair and nail growth

Reduced risk of bone density loss

When the uterine body and fundus are folded posteriorly adjacent to the cervix, the uterine position is described as? anteflexed retroflexed retroverted anteverted

Retroflexed

Another term for Space of Retzius

Retropubic (posterior to pubis and anterior to bladder)

With endovaginal sonography in a sagittal plane, the cervix of an anteverted uterus is seen in the _________ of the screen, whereas the fundus of the anteverted uterus is found in the __________ of the screen? upper portion; lower portion right side; lower portion left side; right side right side; left side

Right side; left side

Which one of the following ligaments occupies the space between the layers of another ligament and occurs in front and below the fallopian tubes? Broad Uterosacral Round Tubal

Round

The difference between the peak systole and the end diastole is the __________ ratio? LS ratio S/D ratio D/S ratio CI ratio

S/D ratio

The endometrium is at its greatest thickness and echogenicity with posterior enhancement in which one of the following phases? menses proliferative ovulatory secretory

Secretory/luteal

Sonographically, how will the uterus of a nulliparous (never pregnant) female appear compared to that of a multiparous female?

Smaller

Which one of the following techniques uses a catheter inserted into the endometrial cavity to instill saline and utilizing ultrasound to demonstrate abnormalities within the cavity, uterus or tube? transvaginal perineal sonohysterography hysterosalpingogram

Sonohysterography

The ovaries are laterally supported by the which one of the following ligaments? ovarian broad round suspensory

Suspernsory

ovarian cycle

The 28 days of the menstrual cycle as they apply to events in the ovary. The ovarian cycle has three subphases: follicular phase ovulation phase luteal phase.

Which one of the following statements is false? the ovaries are almond shaped the ovaries are suspended from the anterior aspect of the broad ligaments the ovaries lie in the ovarian fossa the ovaries receive blood from the ovarian and the uterine arteries

The ovaries are suspended from the anterior aspect of the broad ligametns

Which one of the following techniques is the best way to measure the cervical-fundal dimension of the uterus? A) Transvaginal B) Translabial C) Transabdominal D) Endorectal

Transabdominal

Which one of the following planes divides superior from inferior? sagittal axial coronal transverse

Transverse

Which small vessel connects yolk to embryo?

Vitelline duct

Transvaginal imaging of the female pelvis uses which of the following planes? a. sagittal and coronal b. coronal and transverse c. sagittal and transverse d. sagittal only

a. sagittal and coronal

uterine (menstrual) cycle

approximately 28-day cycle of changes in the uterus consisting of a menses phase - endometrium thin proliferative phase- bleeding stops, 3 line endometrium secretory phase- thickness endometrium

In early pregnancy, the gestational sac size grows at a rate of ______ mm/day? a. 0.5 b. 1 c. 2 d. 2.5

b. 1 mm/day

The embryonic heart begins to beat at _____ days? a. 23 b. 35 c. 43 d. 49

b. 35

The diameter of the normal yolk sac should never exceed _____ mm. a. 4 b. 6 c. 8 d. 10

b. 6

With transvaginal ultrasound, an abnormal pregnancy is suspected when visualizing the yolk sac fails with a minimum mean sac diameter (MSD) of _____ mm? a. 6 b. 8 c. 10 d. 12

b. 8

The cavity in which the fetus exists is called the _____ cavity? a. chorionic b. amniotic c. decidual d. embryonic

b. amniotic

The anechoic center of a 5 to 6 week gestation sac represents which one of the following? a. amniotic cavity b. chorionic cavity c. decidual reaction d. primary yolk sac

b. chorionic cavity

The villi on the myometrial side of the conceptus is known as which one of the following? a. double decidual sign b. decidua basalis c. decidua capsularis d. chorion laeve

b. decidua basalis

A sonogram at 10 weeks' gestation demonstrates a cystic area within the posterior cranium. This appearance most likely represents which one of the following? a. abnormal mesencephalon b. normal rhombencephalon c. abnormal reombencephalon d. normal prosencephalon

b. normal rhombencephalon

Using a transvaginal approach, the first structure visualized within a gestational sac is which one of the following structures? a. primary yolk sac b. secondary yolk sac c. amnion d. embryo

b. secondary yolk sac

major parts of the uterus

body and cervix

Typically, the yolk sac resorbs and is no longer visible sonographically by ______ weeks? a. 8 b. 10 c. 12 d. 14

c. 12 weeks

In the first trimester, herniated bowel will return within the abdominal cavity by the ______ week? a. 8th b. 10th c. 12th d. 15th

c. 12th

The CRL measurement may be used up to the _____ gestational week? a. 10th b. 11th c. 12th d. 13th

c. 12th week

The fusion of the chorion & amnion occurs between _____ weeks? a. 9 and 10 b. 11 and 12 c. 14 and 15 d. 20 and 21

c. 14 and 15

Serum maternal hCG levels in a normal intrauterine pregnancy less than 7 weeks should increase by doubling every _______? a. 24 hours b. 48 hours c. 3.5 days d. 1 week

c. 3.5 days

The blastocyst typically enters the uterus ____ days after fertilization? a. 1 to 2 b. 2 to 3 c. 4 to 5 d. 7 to 9

c. 4 to 5

The beta hCG levels plateau & subsequently decline, whereas the gestational sac continues to grow after _____ weeks? a. 3 to 5 b. 6 to 8 c. 9 to 10 d. 10 to 12

c. 9 to 10

The interface between the decidua capsularis and echogenic vascular endometrium is which one of the following? a. decidua capsularis b. decidua basalis c. double decidual sign d. chorionic cavity

c. double decidual sign

Which one of the following laboratory tests indicates pregnancy when the values are elevated? a. FSH b. LH c. hCG d. HL

c. hCG

After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones? a. estrogen only b. progesterone only c. progesterone with some estrogen d. estrogen with some progesterone

c. progesterone with some estrogen

1. Which one of the following ligaments provides support to the cervix? a. Round b. Ovarian c. Suspensory d. Cardinal

cardinal

Uterus version is relation of

cervix to vagina

To image the fundus of an anteverted uterus with transvaginal sonography, the transducer should be angled so that the handle is positioned? closer to the bed farther from the bed lateral to the patient perpendicular to the patient

closer to bed

Conceptual age (embryologic age)

counted of day of conception

To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used? a. length x width x height b. length + width + height c. (length x width x height)/3 d. (length + width + height)/3

d. (length + width + height)/3

Implantation into the uterine decidua is completed within ____ days after fertilization? a. 2 b. 5 c. 10 d. 12

d. 12

In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG is ________ mega international units per milliliter (mIU/ml)? a. 500 b. 1000 c. 1500 d. 1800

d. 1800

Which of the following ages refers to the length of time calculated from the first day of the last normal menstrual period to the point at which the pregnancy is being assessed? a. gestational b. embryonic c. menstrual d. either a or c

d. either a or c

Which one of the following terms refers to a multiple pregnancy within one chorionic sac? a. monoembryonic b. dichorionic c. diamniotic d. monochorionic

d. monochorionic

fimbriae function

directs ovum to Fallopian tubes

Limitations of translabial scanning may be overcome by which one of the following? emptying the patient's bladder elevating the patient's head elevating the patient's hips assuming the left lateral decubitus position

elevating the patient's hips

Depending on the menstrual cycle, the inner lining of the uterine cavity that appears echogenic to hypoechoic on ultrasound is which one of the following structures? myometrium perineum endouterine endometrium

endometrium

ovaries secrete

estrogen, progesterone, inhibin

zygote

from conception to implantation

haploid cell

gamete (female-ova, male-spermatozoa)

Hypothalamus secretes

gonadotropin-releasing hormone (GnRH)

Contraception such as pills, rings and patches may provide all of the following except? hormonal support to maintain a thin endometrium hormonal support to suppress ovulation hormonal support to prevent implantation hormonal support to prevent STIs

hormonal support to prevent STIs

A simple fluid accumulation within the vagina secondary to an imperforate hymen is

hydrocolpos/ hematocolpos

embryonic period

implantation to end of 10 weeks (10w-7d)

The endometrial thickness should be measured? in width using a coronal plane in width using a sagittal plane in AP using a sagittal plane in AP using a coronal plane

in AP using a sagittal plane

A negative effect of estrogen replacement therapy is? increase risk of endometrial cancer increase risk of breast cancer increase risk of osteoporosis hair loss

increase risk of endometrial cancer

Muscles of the pelvic diaphragm

levator ani and coccygeus muscles

gestational age

menstrual age, counted from first day of last period

Vitelline duct

nourish embryo until placenta and umbilical cord are formed. (I vein, 1 artery)

infrequent or light menstrual periods

oligomenorrhea

The release of an egg from the ruptured follicle is termed? menstruation mittleschmerz ovulation corpus luteum

ovulation

The follicular phase of the ovarian cycle lasts until? menses ends ovulation occurs next menses cycle day 20

ovulation occurs

Arcuate artery calcifications may be observed in patients who are A) pregnant B) perimenopausal C) postmenopausal D) premenopausal

postmenopausal

Inflammation of the fallopian tubes is called

salpingitis

What vessel supplies functional layer?

spiral artery

What layer sheds during menstruation?

stratum functionalis

What should be the first step in a pelvic ultrasound protocol? documented image of midline sagittal uterus survey scan to assess anatomy and location documented image of transverse uterus sagittal midline image of the vagina

survey scan to assess anatomy and location

decidua

the endometrium of the uterus during pregnancy. Decidual reaction of endometrium is first sonographic sign.

Menarche may be defined as which one of the following? the state of reaching puberty during which menses occur every 21 to 28 days when menses have ceased permanently time before the onset of menses midcycle

the state of reaching puberty during which menses occur every 21 to 28 days

anterior pituitary gland secrets

thyroid stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), adrenocorticotropin (ACTH), human growth hormone (hGH)

What produces hCG while placenta is developing?

trophoblast

The ovary receives its blood supply from which of the following arteries Internal and external iliac straight and spiral uterine and ovarian arcuate and radial

uterine and ovarian

1. The vagina has two sources of blood supply; they are the: a. aorta and external iliac artery. b. ovarian artery and uterine artery. c. uterine artery and vaginal artery. d. internal iliac artery and vaginal artery.

uterine artery and vaginal artery.

uterus flexion is relation of

uterine body to cervix