Review OB Final

Endometrial hyperplasia in a premenopausal female is diagnosed when the endometrial thickness exceeds _____.

1.4cm

The depth of the cisterna magna should NOT measure greater than: The depth of the cisterna magna should NOT measure greater than:

10 mm

Conjoined twins will occur if the cell cleavage occurs any later than day _____ of the gestation.

13

A triploidy fetus has:

3 sets of all 23 chromosomes

In a normal (early) pregnancy, how long does it take the bHCG to double?

48 hours

If fertilization does NOT occur after ovulation, the corpus luteum becomes:

A corpus albicans

The uterus is considered to be:

A retroperitoneal organ bounded anteriorly by the urinary bladder and posteriorly by the rectum.

A follow-up sonographic examination of a 27-week gestation is highly suspicious for intrauterine growth restriction. Which measurement is the best predictor of intrauterine growth restriction?

Abdominal circumference

Phocomelia is defined as:

Absent long bones with the hand and feet arise from the shoulders and hips, respectively.

A sonographic examination of a 20-week fetus is highly suspicious for bilateral renal agenesis. Sonographically, the adrenal glands appear flattened and the renal area is not seen well secondary to anhydramnios. What other sonographic finding would confirm this diagnosis?

Absent renal arteries

Upon sonographic examination of a 22-week fetus, you discover evidence of micromelia, absent mineralization of the skull, spine and pelvis, and polyhydramnios. Based on the sonographic findings, which of the following is most likely?

Achondrogenesis

A patient presents to the ultrasound department with a history of hydronephrosis. Which of the following would be the least likely pelvic cause of this abnormality?

Adenomyosis

Colpocephaly is commonly associated with:

Agenesis of the corpus callosum

Which of the following maternal laboratory values would be elevated in the presence of Trisomy 18?

All laboratory findings are decreased with Trisomy 18

A post pubertal patient with an ovarian yolk sac tumor would most likely have an elevation in what lab?

Alpha-fetoprotein

Upon sonographic interrogation of a 30-week fetus, you discover that the right hand is missing. What is this finding most consistent with?

Amniotic band syndrome

Which portion of the fallopian tube has the highest incidence of ectopic gestations?

Ampullary

Which of the following is another name for the Sertoli-Leydig cell tumor of the ovary?

Androblastoma

A 37-year-old patient presents to the ultrasound department with a history of elevated maternal serum alpha-fetoprotein. The sonographic findings include a single live intrauterine pregnancy. An analysis of the fetal head reveals bulging eyes and absence of the cranial vault. These findings are most consistent with the diagnosis of:

Anencephaly

Which of the following anomalies can be detected in the first trimester with endovaginal scanning?

Anencephaly

The sonographic analysis of a 22-year-old female pelvis reveals that the uterine body tilts forward and comes in contact with the cervix. This uterine position is referred to as:

Anteflexion

What is the best way to differentiate an umbilical cord cyst from an umbilical varix?

Apply color Doppler

The most common cause of cerebrospinal fluid obstruction and ventriculomegaly is:

Aqueductal stenosis

The findings in this image are worrisome for:

Arnold-Chiari II malformation

A sonohysterogram is performed in a 35-year-old patient whose primary clinical complain is infertility. Sonographically, bright bands of tissue are noted traversing the endometrial cavity when saline infusion occurs. These findings most are most indicative of:

Asherman syndrome

A follow-up sonographic examination of a 29-week pregnancy reveals that fetal head has grown at a normal rate but the abdomen has not. What are these findings consistent with?

Asymmetrical IUGR

Upon ultrasound interrogation of the fetal heart, you visualize an opening in the upper one-third of the atrial septum near the ventricular septum. Which of the following would explain this finding?

Atrial septal defect

Which of the following would be the least likely clinical findings in a 40-year-old patient with a history of multiple fibroids?

Atrophic uterus

Which of the following best describes the location of the ductus arteriosus?

Between the pulmonary artery and aortic arch

Rather than preventing pregnancy from occurring, uterine malformations often lead to repeated abortions as a result of structural abnormalities within the uterus. Which of the following is considered to be the most common structural defect of the uterus?

Bicornuate uterus

Which of the following would be most likely associated with sirenomelia?

Bilateral renal agenesis

Which of the following would be considered to be the least accurate measurement in the estimation of gestational age in the presence of dolichocephaly?

Biparietal diameter

When the morula enters the uterine cavity, it becomes a:

Blastocyst

During a sonographic examination of the gravid uterus, you visualize a solid hypoechoic mass within the myometrium. After the study has ended, the mass can no longer be seen. What is the most likely diagnosis?

Braxton-Hicks contractions

Because of their sonographic appearance, which of the following masses would be most likely misdiagnosed as a pedunculated uterine leiomyoma?

Brenner tumor

Which of the following laboratory values would be most likely elevated in the presence of an ovarian cystadenocarcinoma?

CA-125

All of the following would result in an increase in maternal serum alpha-fetoprotein, except:

Cebocephaly

All of the following can be noted at the correct level of the head circumference, except:

Cerebellar vermis

Which of the following are the extensions of trophoblastic tissue that invade the decidualized endometrium?

Chorionic villi

Which of the following would be used to obtain trophoblastic tissue for fetal karyotyping?

Chorionic villi sampling

In the fetus, which of the following is responsible for creating cerebrospinal fluid?

Choroid plexus

Which of the following is a medication that is administered to cause the ovaries to produce follicles?

Clomid

What is the presentation of the cord before the fetus?

Cord prolapse

A patient presents with pelvic pain. She is 12 weeks pregnant with NO signs of bleeding. What findings are displayed on the image of her ovary?

Corpus luteal cyst

A 19-year-old gravid patient presents to the ultrasound department with a history of light vaginal spotting and nausea. Sonographically, a single live intrauterine pregnancy is discovered. Within the right adnexa, a simple appearing cyst with a thick echogenic rim is noted. Interrogation with color Doppler reveals hyperemic flow within the borders of this mass. What is the most likely diagnosis?

Corpus luteum cyst

Which of the following sonographic techniques used for assessment of fetal age and estimated date of confinement is the most accurate?

Crown rump length

The sonographic examination of a 24-week-gestation fetus reveals the presence of a cystic neck mass within the posterior part of the neck that appears to be divided by a thick fibrous band of tissue. These sonographic findings are most consistent with the diagnosis of:

Cystic hygroma

This image is of the left adnexa in a 32-year-old female patient who presented with a palpable adnexal mass on a physical examination by her gynecologist. She did not complain of any pain. Which of the following is most likely?

Cystic teratoma

A patient presents for a follow up ultrasound at 24 weeks after the first exam performed 3 weeks ago was interpreted as small for dates. If IUGR is confirmed on today's exam, what fetal structure can be measured to assess the true gestational age?

Diameter of the fetal cerebellum

Which of the following could NOT result from monozygotic twinning?

Dichorionic monoamniotic

Which of the following types of twin gestation will have the thickest membrane between the fetuses?

Dichorionic/diamniotic

A cephalic index of less than 70 denotes:

Dolichocephaly

Hypoplastic left heart is commonly associated with what other congenital heart defect?

Double outlet right ventricle

Among the list below, which gastrointestinal abnormality is often discovered in the fetus with Down syndrome?

Duodenal atresia

Which of the following results from the calcification of the papillary muscle or chordae tendineae?

Echogenic intracardiac focus

A 39-year-old patient presents to the ultrasound department for a pelvic sonogram with a history of tubal ligation, vaginal bleeding, and a positive pregnancy test. Which of the following would be most likely?

Ectopic pregnancy

You are performing a pelvic sonogram on a 65-year-old patient for pelvic pain. The endometrial thickness appears symmetric, echogenic, and measures 3 mm. Which of the following statements is true?

Endometrial atrophy is the most likely cause of this appearance.

This is a transvaginal image of a 42-year-old patient who complained of intermenstrual bleeding. Which of the following is most likely?

Endometrial polyp

Which of the following would least likely associated with dilation of the fallopian tube?

Endometrial polyp

This mass was noted in the left adnexa in a 29-year-old patient complaining of left adnexal pain, infertility, menorrhagia, and dyspareunia. Which of the following is most likely?

Endometrioma

The use of an intrauterine device has been linked with an increased risk for all of the following, except:

Endometriosis

Which of the following would NOT be a likely cause of postmenopausal bleeding?

Endometriosis

A patient presents to the ultrasound department for an endovaginal sonogram. She is complaining of vaginal bleeding. Which of the following statements is NOT true of endovaginal imaging?

Endovaginal imaging is contraindicated in the bleeding patient.

Which anomaly is almost always associated with a tracheoesophageal fistula?

Esophageal atresia

Which of the following would NOT typically be associated with oligohydramnios?

Esophageal atresia

What hormone initiates the proliferation and thickening of the endometrium by encouraging the growth and expansion of the spiral arteries and glands within the functional layer of the endometrium?

Estrogen

Why would a patient be given progesterone along with estrogen, instead of estrogen alone, for hormone replacement therapy?

Estrogen given in conjunction with progesterone decreases the likelihood of a patient developing endometrial carcinoma.

All of the following could result in an inaccurate biophysical profile scoring, except:

Fetal breathing

Robert's sign indicates:

Fetal demise

This image of the fetal kidney is demonstrating:

Fetal hydronephrosis

If you identify the abnormality seen on the image during a fetal exam, which of the following should also be evaluated for associated findings?

Fetal limbs to rule out anasarca

Demise of a twin in the second trimester with maceration is termed:

Fetus papyraceus

Which of the following ovarian masses would be most likely associated with Meig's syndrome?

Fibroma

Which of the following is a vitamin that has been shown to significantly reduce the likelihood of neural tube defect?

Folate

During the follicular phase of the ovarian cycle, what hormone is produced by the anterior pituitary gland

Follicle stimulating hormone

Which of the following may lead to a right-sided diaphragmatic hernia, in which case the entire liver may herniate into the fetal chest?

Foramen of Morgagni hernia

Which of the following terms describes the opening in the interatrial septum that allows normal shunting between the atria?

Foramen ovale

Which portion of the endometrium varies in thickness throughout the menstrual cycle?

Functional layer

The arrows in this image of the fetal abdomen are indicating the presence of:

Gastroschisis

Which maternal or fetal condition results in a placental appearance seen in the image?

Gestational diabetes

The risk of which of the following would NOT increase with assisted reproductive therapy?

Gestational trophoblastic disease

A two-day old female newborn presents to the ultrasound department with a history of a palpable pelvic mass. Sonographically, the uterus and vagina appear enlarged and both contain simple appearing fluid. This finding is termed:

Hydrometracolpos

A build-up of simple serous fluid within the fallopian tube is termed:

Hydrosalpinx

A sonographic examination of the fetal cranium reveals the presence of a monoventricle and fused thalami. Which of the following facial features would be least likely noted in the presence of these cranial findings?

Hypertelorism

Which of the following maternal diseases can result in early placental maturation?

Hypertension

The uterine arteries are branches of the:

Hypogastric arteries

Doppler assessment of the middle cerebral artery has been shown effective at evaluating for:

Hypoxia in fetuses those are small for dates

Which of the following is the most common congenital cause of the sonographic findings noted in this sagittal image of the 14-year-old female uterus?

Imperforate hymen

Which of the following would be best described as the most proximal segment of the fallopian tube?

Interstitial

Abnormal flow patterns within the uterine artery during pregnancy may indicate an increased risk for which of the following?

Intrauterine growth restriction

Gestational diabetes:

Is associated with polyhydramnios.

Which of the following is the most common location of a diaphragmatic hernia?

Left side

Which of the following is NOT a feature of Tetralogy of Fallot?

Left ventricular hypertrophy

A 42-year-old patient presents to the ultrasound department with a history of a myomectomy and uterine artery embolilzation. These two procedures are used to treat:

Leiomyoma

Which of the following would be considered a hammock-shaped pelvic muscle group located between the coccyx and pubis?

Levator ani muscle

Which of the following best describes the normal ovarian Doppler flow during the secretory phase of the menstrual cycle?

Low-resistance flow pattern

Which of the following locations would be considered the most common location of spina bifida?

Lumbosacral

Which of the following hormones is released by the anterior pituitary gland?

Luteinizing hormone

Which of the following would lead to diagnosis of preeclampsia?

Maternal hypertension and proteinuria

A sonographic examination of a 32-week gestation reveals multiple anechoic fluid collections within the placenta. These most likely represent which of the following?

Maternal lakes

A gravid 37-year-old patient presents to the ultrasound department with a history of "small for dates." Sonographic findings of the 28-week live intrauterine pregnancy include a sixth digit on the left hand, an occipital encephalocele, and bilateral enlarged echogenic kidneys. Which of the following would be most likely?

Meckel-Gruber syndrome

The ovary consists of two parts. Which portion contains the ovarian vasculature and lymphatics?

Medulla

Which of the following would be described as the coverings of the brain and spinal cord?

Meninges

Stein-Leventhal syndrome is characterized by all of the following, except:

Menorrhagia

Which of the following terms is defined as foreshortening of distal long bones (radius, ulna, tib/fib)?

Mesomelia

Which of the following would be best described as fetal demise with a retained fetus?

Missed abortion

Which of the following bests describes the appearance of a Grade II placenta?

Moderate indentations in the chorionic plate with large calcification in the placental substance

Upon ultrasound examination of the pelvis in a patient with free fluid, you discover that fluid has collected between the uterus and the rectum. All of the following are synonyms for this area, except:

Morrison's pouch

All of the following are true regarding an acardiac twin, except:

Most severe form of non-immune fetal hydrops

Which of the following ovarian masses would be most likely associated with pseudomyxoma peritonei?

Mucinous cystadenocarcinoma

This image of the fetal kidney is demonstrating:

Multicystic dysplastic kidney disease

A 26-year-old patient presents to the ultrasound department with a history endometriosis. Which of the following would be the least likely clinical finding for this patient?

Multigravida

Which of the following pelvic muscles would be best described as the paired pelvic muscles located lateral to the ovaries?

Obturator internus muscles

Which of the following would be most likely discovered in the fetus suffering from Beckwith-Wiedemann syndrome?

Omphalocele

This image is demonstrating sonographic features of:

Osteogenesis imperfecta

The OFD of the skull is measured from _____ edge of the skull to _____ edge of the skull.

Outer, outer

Which of the following clinical symptoms would be most common in a patient with these sonographic findings?

Pain, vaginal bleeding, palpable pelvic mass

What is a common clinical finding in a patient with the sonographic findings demonstrated in this image?

Painless vaginal bleeding

A 31-year-old patient presents to the ultrasound department for a pelvic sonogram from the emergency room with a history of pelvic tenderness, dyspareunia, vaginal discharge, and fever. Sonographically, the endometrium appears thickened and irregular. The borders of the uterus and ovaries appear ill-defined and fallopian tubes are dilated and filled with echogenic material. Which of the following is the most likely diagnosis?

Pelvic inflammatory disease

Which of the following includes ectopic cordis as a characteristic finding of the condition?

Pentalogy of Cantrell

Which of the following procedures provides the highest risk of complications to the fetus?

Percutaneous umbilical blood sampling

Delayed postpartum bleeding would be caused by all of the following, except:

Placenta percreta

The sonographic findings of a 28-week pregnancy include fetal ascites and a large placenta. What additional finding is commonly associated with these sonographic findings?

Pleural effusion

A 29-year-old obese patient presents to the ultrasound department for a pelvic sonogram with a history of infertility. Sonographically, her ovaries appear enlarged and have multiple small cysts along their periphery. These findings are most suggestive of:

Polycystic ovary disease

What is the sonographic "string of pearls" sign indicative of?

Polycystic ovary disease

A 28-year-old patient presents to the ultrasound department for a pelvic sonogram with a history of infertility, dysmenorrhea, dyspareunia, and a palpable left adnexal mass. You suspect endometriosis. Sonographically, what is the most common sonographic appearance of the adnexal mass that will be identified in this patient?

Predominantly cystic mass with low-level internal echoes

Which of the following conditions requires immediate communication of the results to the radiologist?

Premature rupture of membranes and placental abruption

If a young lady does NOT experience menarche before age 16, she is said to have:

Primary amenorrhea

Which of the following would NOT increase the likelihood of having multiple gestations?

Prior history of ectopic pregnancy

This transvaginal image is of a non-gravid patient with a regular 28-day menstrual cycle. Based on the sonographic appearance of the endometrium, which phase of the endometrial cycle is this patient in?

Proliferative

Upon sonographic analysis of a 31-week fetus, you visualize an echogenic, triangular-shaped mass within the fetal chest. Which of the following would most likely result in this manifestation?

Pulmonary sequestration

A 32-week gestation fetus appears to have unilateral hydronephrosis. What measurement could be obtained to confirm the presence of this abnormality?

Renal pelvis diameter of greater than 10 mm

A patient with a positive pregnancy test is referred to the ultrasound department with a history of painless vaginal bleeding. Sonographically, you visualize a single live intrauterine gestation. The crown rump length is consistent with an 8 week pregnancy. Within the fetal skull, you visualize a round, anechoic structure. What does this most likely represent?

Rhombencephalon

Which cardiac chamber is normally located most anterior in the fetus?

Right ventricle

A 34-year-old patient presents to the emergency room with a history of gonorrhea and pelvic pain. A pelvic sonogram is ordered to rule out pelvic inflammatory disease. Sonographically, you suspect endometritis. What is the most indicative sonographic finding in the patient with endometritis?

Ring-down artifact recognized posterior to the endometrium

A 34-year-old patient presents to the ultrasound department for a pelvic ultrasound. According to her last menstrual period, she is on day 12 of her current cycle. Sonographically, you visualize a 2.3 cm round, anechoic structure on the left ovary. Which of the following is most likely?

Secondary follicle

The first structure visualized within the gestational sac is the:

Secondary yolk sac

All of the following are branches of the uterine artery, except:

Segmental

Which laboratory value would be most likely elevated in the presence of an ovarian dysgerminoma?

Serum lactate dehydrogenase

Which of the following diagnostic techniques is preferred for the evaluation of endometrial polyps?

Sonohysterography

An elevated maternal serum alpha-fetoprotein level is associated with all of the following, except:

Spina bifida occulta

Endovaginal scan of an 8-week pregnancy with spotting, most probably the abnormality is?

Subchorionic hemorrhage

What is the most likely location of the mass noted in this transvaginal image of the female pelvis?

Subserosal

Which of the following statements is true concerning the normal prepubertal uterus?

The cervix is larger/longer than the uterine fundus (or body).

A patient presents with bright red spotting at 28wks gestation. She states she has a history of vasa previa in a prior pregnancy. Assuming this pregnancy also has vasa previa, what are the expected U/S findings?

The internal os is covered by the umbilical vessel attachment to a low lying or marginal placenta

Days 15-28 of the menstrual cycle correlate with:

The luteal phase of the ovarian cycle.

Blood entering the fetus in the umbilical vein is divided between:

The portal vein and the ductus venosus

A sonographic examination is ordered for a postpartum patient suffering from excessive vaginal bleeding and possible retained products of conception. Sonographically, the uterus appears enlarged. Which of the following statements is true concerning the sonographic appearance of the postpartum uterus?

The postpartum uterus returns to its nongravid size 4 to 6 weeks after delivery.

Concerning the fetal outflow tracts, which of the following is NOT a true statement?

The pulmonary artery should be located more posterior than the aorta and be noted crossing under the aorta to originate at the right ventricle.

Which of the following is NOT a characteristic of twin-twin transfusion syndrome?

The recipient twin is small

This transverse transabdominal image of the gravid pelvis reveals an adnexal mass. The patient presented to the emergency room with a history of vaginal bleeding, hypertension, and excessive vomiting. Her human chorionic gonadotropin was markedly elevated. Within the uterus, a large complex mass with cystic components was identified. What is the most likely diagnosis?

Theca lutein cyst

Which of the following statements is NOT true of theca lutein cysts?

Theca lutein cysts are large cysts that are frequently unilateral.

Which of the following statements is true of dermoids?

They are commonly found in the reproductive age group.

Which of following statements is true concerning the umbilical arteries?

They return deoxygenated blood from the fetus back to the placenta.

Upon ultrasound interrogation of the neck of a 19-week fetus, you discover that the nuchal fold thickness measure 4mm in the anteroposterior dimension. Which of the following should be considered?

This is a normal measurement.

A 31-year-old patient presents to the ultrasound department with a history of an adnexal mass discovered on a CT examination of the pelvis. Sonographically, only the anterior element of the mass is seen, while the greater part of the mass is obscured by shadowing. What are these sonographic findings indicative of?

Tip of the iceberg sign

These two images are used for what reason?

To demonstrate correct situs

The primary role of sonography, as it relates to assisted reproductive therapy, is:

To observe follicular development.

Which of the following would be difficult to recognize in the four-chamber view of the fetal heart?

Transposition of the great vessels

If the radiologist suspects Potter syndrome and requests that you perform a thoracic circumference. How will you perform this task correctly?

Transverse view of the fetal chest at the level of the four-chamber heart with a measurement of the distance around the fetal chest

A normal 4-chamber heart view can rule out all of the following cardiac abnormalities, except:

Truncus arteriosus

A patient at 33 weeks gestation becomes pale and sweaty during the course of a prolonged obstetric sonogram. The patient is in the supine position. What should you do?

Turn the patient on her left side

The sonographic finding demonstrated in this image is a typical feature of:

Turner syndrome

Which of the following can present as unilateral fetal hydronephrosis?

Ureteropelvic junction obstruction

It is most important to establish fetal gender when evaluating a fetus for suspected:

Urinary tract defects

Which of the following would be described as a benign, smooth muscle tumor of the uterus?

Uterine leiomyoma

Which of the following is NOT a division of the uterus?

Vagina

You are performing a 4-week follow up on twins that should be 14 weeks. On today's exam there is only a single normal fetus present and an irregular anechoic area adjacent to the normal sac. The patient has NOT experienced any bleeding. What most likely explains these findings?

Vanishing twin syndrome

Upon ultrasound interrogation of the fetal brain, a midline anechoic tubular mass is noted. Color Doppler reveals turbulent Doppler signal within the cystic mass. These sonographic findings are consistent with:

Vein of Galen aneurysm

Which of the following serum levels will be evaluated when a molar pregnancy is suspected?

bHCG