O.B. Review
subchorionic hemorrhagia is a common consequence of
Implantation of the conceptus
Describe the typical sonographic appearance of Asherman syndrome
Inability to distinguish an endometrial cavity
What fetal position is at most risk for cord prolapse
Incomplete breech
When measuring the mean sac diameter, the calipers should be placed from the:
Inner wall to inner wall
Which segment of the fallopian tube connect with the uterus
Interstitial
The innermost layer of the myometrium is termed the:
Junctional Zone
Levels of follicle-stimulating hormone begin declining in the:
Late follicular phase
Which portion of the fetal heart is located closest to spine
Left atrium
Abdominal Circumference is measured at the level of the
Liver
The material collecting in the fetal intestines is termed:
Meconium
An ovarian mass combined with pleural effusion and ascites resolving after surgery is known as:
Meigs syndrome
A patient complains of heavy menstrual cycles. This is most consistent with:
Menorrhagia
Krukenberg tumors are a result of
Metastatic disease
Acute pelvic pain during the periovulatory phase is termed
Mittelschmerz
Obstruction of an inclusion cyst results in a(n)
Nabothian cyst
What uterine anomaly is not likely to cause infertility
Nabothian cyst
A fetus presents with multicystic dysplastic renal disease. The amniotic fluid volume is expected to appear
Normal
What is a sonographic finding in cases of asymmetric intrauterine growth restriction
Normal biparietal diameter
Describe the expected sonographic findings with asymmetric intrauterine growth restriction
Normal head circumference and decrease in abdominal circumference
Which pelvic ligament extends from the cornua of the uterus to the medial aspect of the ovary?
Ovarian ligament
What pelvic structure is not lined by the peritoneum
Ovary
Visualization of a corpus luteal cyst indicates
Ovulation has occurred
A small echogenic focus within the left ventricle of the fetal heart is most likely the
Papillary muscle
A cystic structure located in the inferior broad ligament is most suspicious for a(n)
Parovarian cyst
Fixation of the ovaries posterior to the uterus is a sonographic finding associated with
Pelvic Inflammatory Disease
Ovarian Volume is the highest during the:
Peri-ovulatory Phase
Hirsutism is a clinical symptom of
Polycystic ovarian disease
Which hormone helps to prepare the endometrium for implantation of the blastocyst
Progesterone
What are the functions of amniotic fluid
Protect fetus from injury allow free fetal movement maintains intrauterine temperature
A nodular tubular adnexal mass demonstrating posterior acoustic enhancement is most suspicious for
Salpingitis
Inflammation within the fallopian tube is termed
Salpingitis
Progesterone levels increase in the:
Secretory Phase
Approximately 15% of postmenopausal patients will exhibit a(n)
Simple ovarian cyst
A patient presents with a history of a leiomyoma. Which location will most likely cause infertility
Submucosal
What fibroid location is most likely to cause menorrhagia
Submucosal
Insertion of the umbilical cord into the abdominal wall of the fetus is located at a level
Superior to the bladder
A small cluster of ovarian cysts is a common sonographic finding associated with
Surface Epithelial cysts
If a patient displays an endometrial thickness of 2.0cm, it is considered:
Suspicious for proliferation of the endometrium
Scarring within the endometrium caused by invasive procedures is termed
Synchiae
What best describes the intention of the cephalic index
The cephalic index helps to determine the normality of the fetal head shape
Accurately description of the perimetrium
The serosal surface of the uterus is termed the "perimetrium"
Hyperstimulation of the ovaries will likely result in:
Theca Lutein Cysts
What ovarian neoplasms will most likely demonstrate posterior acoustic shadowing
Thecoma
Describe the expected appearance of the endometrium in a patient using oral contraceptives
Thin echogenic line
The endometrial cavity in patients using hormone contraceptive therapy appears on ultrasound as a:
Thin, echogenic linear structure
In the transverse plane, the normal fetal spine appears on ultrasound
Three equidistant ossification centers surrounding the spinal canal
If a fetus is lying perpendicular to the maternal sagittal plane, the fetal presentation is:
Transverse
Retained products of conception can be a contributing factor of:
Trophoblastic Disease
What structure secretes human chorionic gonadotropin
Trophoblastic tissue
A 25-year old woman presents with high-grade fever, pelvic pain and leukocytosis. An ill-defined, complex mass is identified in the left adnexa. Based on this clinical history, the sonographic finding is most suspicious for:
Tuboovarian abscess
Secondary blood supply to the ovaries is through the:
Uterine Arteries
What most accurately describes an endometrioma
a collection of ectopic endometrial tissue
Presence of an embryo without visualization of the amnion is considered
a normal finding
echogenic debris swirling within the amniotic cavity is:
a normal sonographic finding
The single most sensitive indicator of intrauterine growth restriction is:
abdominal circumference
The single most useful biometric parameter to assess fetal growth is the
abdominal circumference
The region including the ovary and fallopian tube is termed
adnexa
Which of the following lines the chorion and contains the fetus
amnion
Which technique is both valid and reproducible when assessing amniotic fluid volume
amniotic fluid index
Which portion of the biophysical profile study is a chronic marker of fetal hypoxia
amniotic fluid volume
The best diagnostic accuracy of intrauterine growth restriction is offered when evaluating the:
amniotic fluid volume, estimated fetal weight and maternal blood pressure
Which uterine postion displays the fundus of the uterus anterior to the cervix
anteflexion
Cavum septum pellucidi is located in the
anterior portion of the fetal brain
Multiple serpentine vascular structures within the myometrium in a patient complaining of abnormal bleeding following a recent dilation currettage procedure is most suspicious for which abnormality
arteriovenous fistula
Left ventricular outflow tract denotes the
ascending aorta
Assessment for the presence of an ovarian cyst or dominant follicle is scheduled
before initiating ovarian induction therapy
What structure implants into the endometrium
blastocyst
What term indicates the fetal head is located in the uterine fundus
breech
What is the best description of the sonographic appearances of uterine synechiae
bright band of echoes within the endometrium
Which of the following is the 1st system to function in the developing embryo
cardiovascular
Head circumference is measured at a level to include the:
cavum septum pellucidi and tentorium
Nuchal thickness is measured in a plane to include the:
cerebellum, cisterna magna, cavum septum pellucidi
If the maternal alpha-fetoprotein level is decreased, the sonographer should carefully evaluate for:
chromosomal abnormalities
In a biophysical profile, which of the following will document fetal tone
complete episode of flexion to extension and back to flexion
What plane demonstrates the normal fetal spine as three parallel hyperechoic lines on ultrasound
coronal
Which of the following is the most accurate method of measuring gestational age yolk sac diameter mean sac diameter crown-rump length biparietal diameter
crown-rump length
A hyperechoic focus within a mature follicle most likely represents
cumulus
An ill-defined multilocular, complex ovarian mass is most suspicious for...
cystadenocarcinoma
A 50 year old patient presents with a history of abdominal distention. In the left adnex, a 10cm, multilocular mass is identified. This mass most likely represents:
cystadenoma
A rapid inreasing pelvic mass is most suspicious for a(n)
cystadenoma
A reproductive-age patient demostrates a complex adnexal mass with a diffusely bright internal echoes. These sonographic findings most likely describe a:
cystic teratoma
Which of the following is the most common benign ovarian neoplasm: Fibroma cystoadenoma cystic teratoma endometrioma
cystic teratoma
Which ovarian abnormalities may contain skin and hair
cystic teratoma
If fertilization does not occur, the corpus luteum will:
decrease in size and progesterone levels will decrease
Macrosomia and polyhydramnios encountered in the third trimester should raise suspicious of maternal
diabetes mellitus
A patient presents with a history of an intramural leiomyoma. An intramural leiomyome
distorts the myometrium
A fetus presenting in the breech position during the third trimester may demonstrate a cranial shape that is termed
dolichocephalic
Normal human chorionic gonadotropin levels should
double every 30 to 48 hours
The most common ovarian malignancy occuring in childhood is a:
dysgerminoma
When measuring endometrial thickness, calipers should be placed from...
echogenic interface to echogenic interface
The mean sac diameter measures gestational age before visualization of the
embryo
gestational week 6 through 10 constitute the
embryonic phase
Tamoxifen therapy is most likely to affect which of the following structures
endometrium
The spiral artery provides the primary blood supply to what structure
endometrium
Which hormones reflects the activity of the ovaries
estradiol
Which fertility assistance program inserts oocytes and sperm into the fallopian tube
gamete intrafollicular transfer
Metastatic lesions in the adnexa are more commonly associated with a primary malignancy of the
gastrointestinal tract
Which of the following abnormalities is most likely a consequence of pelvic inflammatory disease
hydrosalpinx
Sonographic appearance of a normal small bowel during the second trimester is described as:
hyperechoic compared to the liver
Visualization of pelvic ligaments appears on sonography as:
hyperechoic linear structures
What complication is most likely associated with ovulation induction therapy
hyperstimulation syndrome
The most common maternal factor associated with intrauterine growth restriction is...
hypertension
A common sonographic finding associated with an endometrioma
hypoechoic, homogenous adnexal mass
The pelvis is divided into the true and false pelvis by the:
iliopectineal line
Regeneration of the endometrium occurs as a result of
increase in estrogen levels
Oligohydramnios in the third trimester is most likely a result of
infantile polycystic renal disease
The umbilical arteries arise from which vessels
internal iliac arteries
The most common location for a uterine leiomyoma to develop is:
intramural
Sonographic appearance of ovarian carcinoma is generally described as a(n)
irregular, hypoechoic ovarian mass
The secondary yolk sac
is located in the chorionic cavity
Congenital uterine anomalies are associated with co-existing anomalies of the
kidneys
A patient presents with a history of postmenopausal bleeding. A heterogenous intrauterine mass is identified on sonography. On the basis of the clinical history, the sonographic findings are most suspicious for:
leiomyosarcoma
Which of the following formulas calculates the mean sac diameter of the gestational sac? length + height + width length + Width/ Height length + Height + Width/3 length x Height x Width/3
length+height+width/3
Intrauterine growth restriction most severely affects which fetal body organ
liver
Which ovarian phase has a constant life span
luteal
Ovarian volume is lowest during the...
luteal phase
What hormone stimulates ovulation
luteinizing hormone
What condition increases fetal risk of injury during vaginal delivery
macrosomia
A solid mass of cells formed by proliferation of a fertilized ovum is termed the:
morula
Which of the following complications is commonly associated with in vitro fertilization hyperstimulation multiple gestations ectopic pregnancy spontaneous abortion
multiple gestations
The pelvic floor is formed by pelvic...
muscles and ligaments
Chorionic villi are more prolific
near the implantation site
Subcutaneous accumulation of fluid behind the fetal neck measuring 3mm in thickness is a(n)
normal finding in the late 1st trimester
Risk factors associated with developing endometrial carcinoma include
obesity, diabetes mellitus and nulliparity
Which of the following muscles abuts the lateral walls of the urinary bladder: iliopsoas; piriformis; levator ani; obturator internus
obturator internus
With the gamete intrafollicular transfer technique, the
oocytes and sperm are transferred to the fallopian tube
A large multicystic ovarian mass, in an ovarian stimulated patient, is most suspicious for
ovarian hyperstimulation syndrome
An early onset of puberty may be the result of a(n)
ovarian neoplasm
A coexisting adnexal mass is commonly associated with which of the following ovarian pathologies
ovarian torsion
Mittelschmerz is associated with
ovulation
The surface region located below the pelvic floor is called
perineum
A patient presents with lower abdominal pain and a palpable pelvic mass. A septated fluid collection surrounds a normal appearing right ovary. The patient has a previous history of a ruptured appendix. Based on this clinical history, the sonographic finding is most suspicious for which pathology?
peritoneal inclusion cyst
When measuring amniotic fluid volume, the transducer must remain
perpendicular to the maternal coronal plane and parallel to the maternal sagittal plane
Luteinizing hormone is secreted by the
pituitary gland
A transverse fetal position in the late third trimester of pregnancy is most likely associated with
placenta previa
What is the most common cause of painless vaginal bleeding during the third trimester
placenta previa
Asymmetric intrauterine growth restriction is usually a result of:
placental insufficiency
A patient presents with a positive pregnancy test and an hGC level of 750 mIU/mL. Based on this clinical history, what would best describe the sonographic findings
possible small gestational sac on transvaginal imaging
The flanged portions of the iliac bones form the...
posterior border of the false pelvis
A pregnancy is post-term when the:
pregnancy is longer than 42 weeks
The section of time previous to the onset of menstruation is termed
premenarche
If fertilization occurs, the corpus luteum will continue to secrete
progesterone
On serial examinations, a parovarian cyst will
remain unchanged
It is common to visualize a small amount of free fluid in the the:
retrouterine pouch or pouch of douglas
The endometrium displays the greatest thickness during the:
secretory phase
Which congenital uterine anomaly does not distort the normal contour of the fundus
septate uterus
What most accurately describes the sonographic appearance of a peritoneal inclusion cyst
septated fuid collection surrounding an ovary
Decreases in estrogen in postmenopausal patients can decrease cervical mucus and can also:
shorten vaginal length
Fluid within the endometrial cavity is:
should not be included in the endometrial measurement
a rapid decline in serial hCG levels will most likely correlate with a(n)
spontaneous abortion
A fibroid is most likely to cause irregular uterine bleeding in which location
submucosal
which uterine anomaly most likely demonstrates a small dimple in the fundus
subseptate
The most common location of a cystic teratoma is
superior to the fundus
The uterosacral ligament extends from the lateral margins of the sacrum to the...
superior uterus
The ovary is attached to the pelvic sidewall by the...
suspensory ligament
Doppler of the umbilical artery evaluates fetal well-being using the
systolic/diastolic ratio
Which imaging plane is optimal for evaluating the fetus for facial cleft
tangential
Visualization of the fetal gallbladder signifies
the presence of a biliary tree
Describe the sonographic appearance of the endometrium during the late proliferation phase
thick, hypoechoic functional layer and a hyperechoic basal layer
hyperemesis is a common clinical finding associated with:
trophoblastic disease
A total breakdown of the normal adnexal anatomy is a sonographic finding associated with
tuboovarian abscess
In premenarche, the size of the uterus cervix is expected to be:
twice as large as the corpus
Which area of the embryo attaches to the amnion
umbilical insertion
Oxygenated blood enters the fetus through the:
umbilical vein
Failure of the Mullerian ducts to fuse will most likely result in...
uterine didelphys
The cornua of the uterus is located between the:
uterine fundus and fallopian tube
What is a common clinical symptom associated with adenomyosis
uterine tenderness
Partial fusion of the caudal Mullerian ducts will most likely result in an anomaly of the:
uterus
Which of the following is an abnormal finding in a 1st trimester pregnancy: prominent cystic structure in the posterior brain visualization of the amnion without an embryo fetal heart rate of 100 beats per minute herniation of the fetal bowel into the umbilical cord
visualization of the amnion without an embryo
The biophysical profile is a sonographic method of evaluating fetal
well-being
A garner cyst is located
within the vagina
During ovarian induction therapy, follicles are only measured when exceeding
1.0 cm
Normal measurement of the laternal ventricle atria should not exceed
10mm
The anterior - posterior diameter of the cisterna magna should not exceed
10mm
Ventriculomegaly is suspected when the lateral ventricle measurement exceeds
10mm
Human chorionic gonadotropin peaks at the
10th gestational week
Initial visualization of the hyperechoic choroid plexuses is expected near the
10th gestational week
The term embyro is used to describe a developing zygote through the:
10th gestational week
during the mid luteal phase full luteal function is expected if the endometrial thickness is at least
11 mm
The optimal gestational age for measuring fetal nuchal translucency is from
11 weeks 0 days to 13 weeks 6 days
Ossification of the cranium begins around the:
11th gestational week
Infertility is suggested when conception does not occur within
12 months
In the menarche patient, the endometrial thickness should not exceed...
14 mm
Maternal hypertension is defined as a systolic pressure above
140 mm/Hg
Normally, the chorionic cavity should no longer be visible after how many gestational weeks
16
On transvaginal imaging, in a normal pregnancy, cardiac activity must be identified within a gestational sac with a mean sac diameter of
16mm
The normal length of the cervical os will vary, but it measures a minimum of
2.5cm
Measurement of the nuchal thickness is accurate up to
20 weeks
During the ovulatory phase, normal estradiol levels range between
200 and 400 pg/ml
The length of a normal menstrual cycle ranges between
21 and 35 days
Choroid plexus cysts will normally regress by:
23 weeks
Polyhydramnios demonstrates an amniotic volume index greater than
24 cm
Interval fetal growth can be determined with sonographic examinations performed a minimum of how many weeks apart
3
The distal femoral epiphysis is consistently visualized by:
32 weeks
Visualization of the proximal tibial epiphysis first occurs around
35 weeks' gestation
The biparietal diameter measurement is taken at the level of the
3rd Ventricle
Macrosomia is defined as a newborn weight
4000g
In the late second trimester, anterior - posterior diameter of the normal renal pelvis should not exceed:
4mm
What structure is not identified in the biparietal diameter
4th Ventricle
Oligohydramnios is defined as an amniotic fluid index below
5 cm
The endometrium is generally thinnest between days
6-9
Biophysical Profile Results: 35 week fetus demonstrates a complete extension and flexion of lower extremities, four separate fetal movements, amniotic fluid volume of 10cm and a normal stress test. Fetal diaphragm or breathing motion is not identified. The BPP score would be...
8
Thickness of an asymptomatic postmenopausal endometrium denying hormone replacement therapy should not exceed
8mm
Overall accuracy in sonographic estimation of fetal weight during the third trimester is:
95%
What measurement is a good predictor of fetal growth
Abdominal circumference
What is a possible cause for elevated maternal alpha-fetoprotein
Abdominal wall defect
What is the most accurate description of endometriosis is
Active endometrial tissue invading the peritoneal cavity
Multiparity is a risk factor associated with what abnormality
Adenomyosis
Ovarian torsion is commonly associated with a coexisting:
Adnexal mass
What structure(s) produces small amounts of estrogen
Adrenal Gland
When can a systolic to diastolic ratio of the umbilical artery be used to evaluate fetal well-being
After the 30th week of gestation
What provides important information about fetal renal function
Amniotic Fluid Volume
Assessing the total amount of amniotic fluid within the gestational sac using the sum of four equal quadrants is termed:
Amniotic fluid index
The fallopian tube divides into which segments
Ampulla, interstitial, infundibulum, Isthmus
Polycystic ovarian disease can result from:
An endocrine imbalance
Which of the following correctly measures endometrial thickness: A-P Dimension in coronal plane Transverse dimension in coronal A-P Dimension in sagittal plane A-P Diameter in the transverse plane
Anterior - Posterior dimension in sagittal plane
The Vesicouterine pouch is located
Anterior to the uterus and posterior to the urinary bladder
Prominent anechoic structures near periphery of the uterus most likely represent...
Arcuate vessels
Inability to distinguish the endometrial cavity is an identifiable sonographic finding in:
Asherman syndrome
Intrauterine growth restriction is defined as a fetal weight
At or below the 10th percentile for gestational age
An asymptomatic postmenopausal patient displays a 3.0cm simple ovarian cyst. This finding is considered
Benign
What is most widely used when determining gestational age in the second trimester
Biparietal diameter
Estimated fetal weight is most commonly calculated using what biometric parameter
Biparietal diameter, head circumerence and abdominal circumference
Which of the following attaches to the ovary: Peritoneum Broad ligament Tunica Albuginea Ovarian Ligament
Broad ligament
Documentation of fetal position demonstrates a frank breech presentation. This means the fetal head is located in the superior portion of the uterus and the:
Buttocks presenting with fetal feet near the head
Visualization of which brain structure excludes most midline brain abnormalities
Cavum Septum Pellucidum
The most common maternal cause of macrosomia is:
Diabetes Mellitus
The decidua capsularis and decidua parietalis produce the
Double Decidua sign
What maternal condition is most likely to result in a growth restricted fetus
Drug abuse
A common symptom of endometriosis is
Dysmenorrhea
The fetus becomes the major producer of amniotic fluid in the:
Early Second trimester
Which if the following endometrial phases demonstrates the thinnest dimension
Early proliferation
A corpus luteum is most likely misdiagnosed as a(n)
Ectopic Pregnancy
Hypervascularity within the endometrium is a characteristic finding in:
Endometritis
Which of the following is an acquired cause of infertility endometritis bicornuate uterus meigs syndrome Gartner duct cyst
Endometritis
Monitoring of which hormone is routine during ovarian induction therapy
Estradiol
Which of the following is an abnormal sonographic finding during the 1st trimester of pregnancy no amnion adjacent to an embryo no yolk sac within a MSD of 10mm no yolk sac within a MSD of 15mm no embryo within a MSD of 20mm
Failure to demonstrate a yolk sac within a MSD of 10mm when using the transvaginal approach
Ectopic pregnancies are commonly located in the
Fallopian Tube
pseudocyesis is a condition associated with
False pregnancy
What ovarian neoplasms demonstrates sonographic characteristics similiar to a leiomyoma
Fibroma
Symmetric intrauterine growth restriction is more commonly a result of
First trimester insult
Which of the following is not a sonographic finding in pelvic inflammatory disease Normal - appearing pelvis complex tubular adnexal mass Focal hypoechoic adnexal mass thick and hypervascular endometrium
Focal hypoechoic adnexal mass
Which of the following hormone levels can be slightly higher after menopause estrogen progesterone luteinizing hormone follicle-stimulating hormone
Follicle-stimulating hormone (FSH)
What ovarian phase coincides with the proliferation phase of the endometrium
Follicular
Pelvic Inflammatory disease is best described an a(n)
General classification of inflammatory conditi0ons
Estrogen is primarily secreted by the
Graafian follicle
Comparison of the abdominal circumference to the head circumference during the early third trimester demonstrates
Head circumference slightly larger than the abdominal circumference
Abnormal accumulation of blood within the vagina is termed
Hematocolpos
An extrauterine and intrauterine pregnancy is termed
Heterotopic pregnancy
With ovarian induction therapy, intramuscular injection of what hormone triggers ovulation
Human Chorionic Gonadotropin
A large cystic mass posterior and lateral to the uterus in a patient with a history of a previous pelvic infection is most suspicious for a(n)
Hydrosalpinx