Sono topics OB/GYN 22-32
At what gestational age should the stomach always be visualized
14 weeks
At what gestational age should the kidneys always be visualized on transabdominal sonography
15 weeks
At what gestational age should physiologic bowel herniation be resolved
16 weeks
At what gestational age should the amnion and chorion be fused
16 weeks
How often is a two-vessel cord associated with other abnormalities
20%
How many ossification centers should be present for each vertebra
3
If a patient has an human chorionic gonadotropin (hCG) level of 100, in how many days should it be possible to visualize a gestational sac
4 days
What is the upper limit of normal for renal pelvis diameter in an 18-week fetus
4 mm
What does G4P2 represent
4 pregnancies, 2 births at ≥20 weeks gestation, 1 failed gestation
What is the upper limit of normal for a nuchal fold measurement
6 mm
A patient is scanned for a biophysical profile (BPP). 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
What is the normal measurement of the cisterna magna
<10 mm and >2 mm
What criteria is used to classify placentomegaly
> 4 cm
At what gestational age should abdominal wall defects be visualized
>12 weeks
At what gestational age is the nuchal fold measurement no longer of analytic utility
>22 weeks gestation
What distinguishes a cystic hygroma from nuchal thickening
A cystic hygroma has a midline thick fibrous band of tissue dividing it into two separate spaces.
What are the sonographic features of caudal regression syndrome
Absent sacrum, clubfeet
What is the result of abnormal anastomoses of placental vessels
Acardiac twin
At what time during development must division of an egg take place for a monochorionic monoamniotic pregnancy to occur
After day 8
Absence of the cavum septum pellucidum is suggestive of which of the following conditions
Agenesis of the corpus callosum
Maternal exposure to which of the following can cause growth restriction, mental impairment, malformed ears, microcephaly, and immune dysfunction in the fetus
Alcohol
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
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
Where does fertilization usually occur
Ampulla of fallopian tube
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
A G1P0 patient presents for nuchal translucency ultrasound at 12 weeks gestation. She commented to the technologist that she was already feeling fetal movement. maternal serum alpha-fetoprotein bloodwork was elevated. What will likely be demonstrated on ultrasound
Anencephaly
What disorder is characterized as failure of the cervical end of the neural tube to fuse
Anencephaly
What is the term used to describe a condition where there is an abnormal number of whole chromosomes
Aneuploidy
A fetus demonstrates absence of the cornea on a coronal view of the fetal face. What abnormality does this represent
Anopthalmia
What is the most common cause of fetal bowel obstruction
Anorectal atresia
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
What is the most common cause of hydrocephalus in utero
Aqueductal stenosis
Which of the following is most likely to increase the risk of multiple gestations
Assisted reproductive therapy
If Ebstein anomaly is present in a fetus, what sonographic finding will be demonstrated
Atrialized right ventricle
Which of the following disorders occurs due to the abnormal development of the endocardial cushion
Atrioventricular septal defect
A sonogram demonstrates bilaterally enlarged echogenic fetal kidneys, no detectable urinary bladder, and oligohydramnios. What is the most likely diagnosis
Autosomal recessive polycystic kidney disease
A fetal ultrasound demonstrates a large protruding tongue, hepatoblastoma, and an omphalocele. What syndrome does this represent
Beckwith-Weidemann syndrome
A patient presents at 18 weeks gestation for a sonogram, what is a possible reason for performing a transvaginal scan
Better assess placenta location
If multicystic dysplastic kidney disease is bilateral, what are the associated sonographic findings
Bilateral multiple smooth-walled noncommunicating cysts of varying sizes in the area of the renal fossa, absence of bladder, and oligohydramnios.
What is the main feature of Potter syndrome
Bilateral renal agenesis
Which sonographic exam is used to assess fetal hypoxia
Biophysical profile
A fetal sonogram reveals a lower abdominal wall mass inferior to the umbilicus, absence of the urinary bladder, and normal amniotic fluid. What disorder does this represent
Bladder exstrophy
Which term describes a fetal head that is very round (short and wide)
Brachycephaly
On a transverse image of a fetus, the spine is on the left side of the screen with the stomach to the bottom of the screen (transducer was transverse on maternal abdomen). What is the lie of the fetus
Breech
Which fetal brain structures should be visualized in the axial plane used to measure the biparietal diameter
CSP, thalamus, and falx cerebri
If a multifetal pregnancy results from assisted reproduction, what can be done to maximize the success rate of live birth
Careful assessment of amnionicity and chorionicity
Which of the following disorders is associated with uncontrolled pre-gestational maternal diabetes
Caudal regression syndrome
A fetus is demonstrated to have very close set orbits and a small nose with a single nostril. What does this represent
Cebocephaly
What is the likely diagnosis if echogenic foci are seen in the right abdomen that produce acoustic shadowing
Cholelithiasis
Sonography demonstrated a complex mass in the uterus that appears to invade the myometrium. The patient demonstrated elevated hCG and an enlarged UT; her doctor was unable to detect a fetal heartbeat. What is the most likely diagnosis
Chorioadenoma destruens
A patient presents with an elevation in the maternal serum alpha-fetoprotein. Sonography demonstrates a normal fetus and a solid hypoechoic mass within the placenta. What is the likely diagnosis
Chorioangioma
Which of the following procedures can determine fetal karyotype at the earliest gestational age
Chorionic villi sampling
What part of the blastocyst implants in the endometrium during implantation
Chorionic villus
Which part of the brain produces cerebrospinal fluid
Choroid plexus
What is the term used to describe absence of the middle fifth phalanx (often observed in trisomy 21)
Clinodactyly
What term describes the inward curvature of the fifth digit towards the fourth digit
Clinodactyly
Sonographic features of narrowing of the aortic arch, enlargement of the right ventricle, and enlargement of the pulmonary artery are characteristics of what heart defect
Coarctation of the aorta
What is a secondary method for detecting absence of fetal kidneys
Color Doppler will demonstrate absence of renal arteries
How is the level of echogenicity of bowel determined
Compared to the echogenicity of the pelvic bones
What classification of placenta previa describes a placenta that symmetrically covers the internal os
Complete previa
What is the function of the aqueduct of Sylvius
Connects the third and fourth ventricles
What imaging plane(s) are most effective for diagnosing cleft lip/palate
Coronal and axial images of fetal face
What is the most common ovarian mass associated with pregnancy
Corpus luteal cyst
What is the term used to describe premature fusion of the cranial sutures
Craniosynostosis
Which of the following is false with respect to the nuchal translucency (NT) exam
Crown rump length must be between 40 mm and 80 mm at time of exam.
What is the most accurate sonographic method for dating a pregnancy
Crown rump length prior to 14 weeks gestation
What is the term used to describe fusion of the orbits
Cyclopia
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
What abnormality of the fetal neck is often associated with chromosomal abnormalities
Cystic hygroma
What makes up the maternal portion of the placenta
Decidua basalis
What does the twin peak sign indicate about a pregnancy
Dichorionic diamniotic pregnancy
What disorder is demonstrated by the separation of the two lobes of the thalamus on ultrasound
Dilation of the third ventricle
What is the most common type of twinning
Dizygotic twinning
What sonographic feature is the classic presentation for duodenal atresia
Double bubble sign
What is the first definitive sonographic sign of an intrauterine pregnancy
Double sac sign
A 38-year-old patient presents for routine ultrasound; triple screen showed low maternal serum alpha-fetoprotein (MSAFP), elevated human chorionic gonadotropin (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 is often linked to microtia
Down syndrome
What is the shunt in the fetal circulation allowing blood to bypass the fetal lungs after passing through the right ventricle
Ductus arteriosus
What is the most common renal anomaly
Duplex collecting system
Which of the following heart anomalies is associated with pentalogy of Cantrell
Ectopia cordis
Sonographic features of choroid plexus cysts, micrognathia, rockerbottom feet, omphalocele, and single umbilical artery are consistent with what chromosomal abnormality
Edwards syndrome
What is the preparation required for a transvaginal sonogram for early pregnancy
Empty bladder
What is the cause of immune hydrops
Erythroblastosis fetalis
If polyhydramnios is demonstrated on fetal ultrasound, what gastrointestinal abnormalities are most likely
Esophageal or duodenal atresia
Which of the following is an indication for a first-trimester sonogram
Evaluation of suspected ectopic pregnancy
What does the term polydactyly describe
Extra digits on hands and/or feet
What divides the cerebral right hemisphere from the left hemisphere
Falx cerebri
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
Which of the following is consistent with a finding of Turner syndrome
Fetuses present with cystic hygroma.
How can you distinguish a focal myometrial contraction from a leiomyoma
Fibroids consistently alter the shape of the myometrium whereas contractions disappear over time.
What plane of the fetal heart will best demonstrate Tetralogy of Fallot
Four chambers, LVOT and RVOT are all required
What fetal presentation is observed if the fetal buttocks are at the cervix and the legs are extended in front of the fetal face
Frank breech
If echogenic bowel is diagnosed, what other abnormalities should be investigated
Gastrointestinal obstruction
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
Which abdominal wall defect causes a drastic increase in maternal serum alpha-fetoprotein
Gastroschisis
Which of the following pathologies has clinical presentation that includes hyperemesis, extremely elevated hCG, enlarged uterus and heavy vaginal bleeding
Gestational trophoblast disease
What sonographic sign indicates a female fetus
Hamburger sign
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
If a fetus is diagnosed with Beckwith-Weidemann syndrome, which abdominal abnormality should be investigated
Hepatomegaly
What is the most common abnormality of the fetal liver
Hepatomegaly
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 nuchal fold measurement of 8 mm. What does this result indicate
High risk for Down syndrome
What type of sterilization is required for a transvaginal transducer
High-level sterilization
A fetal ultrasound demonstrated ethmocephaly, cyclopia, and cleft palate. Which of the following disorders is most likely
Holoprosencephaly
What is the most common cause of hypotelorism
Holoprosencephaly
A male fetus presents with a large fluid collection in the scrotum. What is the term used to describe this finding
Hydrocele
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
What is the term used to describe orbits that are widely spaced apart
Hypertelorism
A fetal heart sonogram demonstrates a small left ventricle, aortic stenosis, and absent mitral valve. What do these findings suggest
Hypoplastic left heart syndrome
The four-chamber view is best for demonstrating which of the following
Hypoplastic right heart
What is the most common cause of an abnormal triple screen test
Incorrect dates
What heart structure contains a natural opening to allow blood to shunt from the right side of the heart to the left side of the heart in the fetus
Interatrial septum
What measure is used to determine hypotelorism
Interocular diameter
The lateral ventricle measurement on a 21-week fetus is 13 mm, what is the implication of this measurement
It indicates ventriculomegaly.
What is the normal situs and lie of the fetal heart
Left chest with apex forming a 45-degree angle with the fetal spine
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 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
Which of the following abnormalities is associated with Arnold-Chiari Type II malformation
Lemon sign, banana sign, obliterated cisterna magna, and hydrocephalus
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 is commonly associated with Beckwith-Weidemann syndrome
Macroglossia
What is the most common risk factor for intracranial hemorrhage in utero
Maternal platelet disorders
What maternal conditions are linked to development of placental abruption
Maternal smoking
Which of the following pregnancy tests can be completed in the first trimester
MaterniT21Plus
Which of the following measurements is used to estimate gestational age in the first trimester
Mean sac diameter
Which of the following syndromes is associated with autosomal recessive polycystic kidney disease, occipital encephalocele, and polydactyly
Meckel-Gruber syndrome
What is an isolated enlargement of the cisterna magna termed
Mega cisterna magna
What is the term used to describe an abnormally small chin
Micrognathia
What are the sonographic features of achondrogenesis
Micromelia, absent mineralization of the fetal bones, enlarged skull, and polyhydramnios
What imaging plane is used for measuring the nuchal translucency
Midsagittal plane with fetal head in neutral position
What defines a Grade II placenta
Moderate indentations in the chorionic plate with "comma-like" calcifications in the placenta
Which of the following is often found with a triploid fetus
Molar pregnancy
What does the T sign represent
Monochorionic diamniotic pregnancy
What type of twin gestation is most likely to incur complications
Monochorionic monoamniotic pregnancy
What type of twinning is most likely to result in conjoined twins
Monochorionic monoamniotic pregnancy
What renal anomaly is caused by obstruction of the fetal ureter, usually in the first trimester
Multicystic dysplastic kidney
Which of the following can cause a false-positive diagnosis for placenta previa
Myometrial contractions in the lower uterine segment
What is the most common reason for maternal hydronephrosis in the third trimester
Nephrolithiasis
What is the term used to describe an umbilical cord that is around the fetal neck
Nuchal cord
Which of the following tests can only be performed between 11 and 14 weeks gestation
Nuchal translucency
What does the chorionicity determine about a pregnancy
Number of placentas
What measurement can be used in conjuction with the biparietal diameter (BPD) to give a "shape-corrected" BPD
Occipitofrontal diameter
Which of the following is often associated with chromosomal abnormalities and ascites
Omphalocele
Which of the following is most likely to correlate with chromosomal abnormalities
Omphalocele containing only bowel
What lethal skeletal dysplasia has the distinct characteristic of deformation of the skull with transducer pressure
Osteogenesis imperfecta type II
How is the biparietal diameter measured
Outer edge of temporal skull - inner edge of temporal skull
What sonographic feature definitively identifies transposition of the great vessels
Outflow tracts are parallel to each other
What is a complication associated with large ovarian cysts or masses
Ovarian torsion
What is the typical cause of a quadruplet pregnancy
Ovulation induction or in vitro fertilization
Which of the chromosomal abnormalities often presents with an inconclusive triple screen with sonographic features of holoprosencephaly and facial anomalies
Patau syndrome
Which maternal population has a higher risk for developing preeclampsia and/or eclampsia
Patients with hypertension
Which of the following disorders includes omphalocele, ectopia cordis, cleft sternum, diaphragmatic hernia, and pericardial defects
Pentalogy of Cantrell
A first-trimester ultrasound is performed at 9 weeks gestation and herniation of bowel is demonstrated into the base of the umbilical cord. What does this most likely represent
Physiologic midgut herniation
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
What is the most common cause of painless vaginal bleeding in the second and third trimesters
Placenta previa
What is the most likely explanation for painful vaginal bleeding in the second trimester
Placental abruption
What is a possible cause of a thin placenta
Placental insufficiency
Which of the following disorders is caused by an ischemic event or vascular occlusion within the fetal brain
Porencephaly
A male fetus is demonstrated to have bilateral hydronephrosis with hydroureter, dilated bladder, and dilated urethra. What is the cause of these findings
Posterior urethral valves
Which of the following maternal problems is at increased risk for mothers expecting multiple gestations
Preeclampsia and anemia
Which patient population has a predisposition for placenta previa
Previous cesarean sections
Which of the following disorders results from persistent bladder outlet obstruction
Prune belly syndrome
Bilateral renal agenesis, inadequately functioning kidneys, or obstruction of the urinary tract can lead to which of the following
Pulmonary hypoplasia
What should the sonographer do for their patient if they are suffering from supine hypotensive syndrome
Put patient into left lateral decubitus position.
What is the term used to describe conjoined twins that are joined back-to-back in the sacral region
Pyopagus
What is the most frequent cause of oligohydramnios
Renal anomalies
During a fetal heart scan, a hyperechoic mass is identified in the left ventricle; multiple hyperechoic masses were also demonstrated in the renal cortex of both kidneys. What is the most likely diagnosis
Rhabdomyoma with tuberous sclerosis
What term describes shortening of the proximal portions of the limbs
Rhizomelia
What is the term used to describe a cystic structure located in the fetal head in an 8 week gestation
Rhombencephalon
What imaging plane(s) is best for demonstrating a Bochdalek hernia
Sagittal and coronal views of the left abdomen/chest
What imaging plane best demonstrates the disparity in chest to abdomen size found in thanatophoric dysplasia
Sagittal image through chest and abdomen
What imaging plane is best to demonstrate absence of the nasal bone
Sagittal midline image through the fetal face
Which imaging plane will best demonstrate fetal kyphosis
Sagittal spine
What scan planes are typically used to image the fetal spine
Sagittal, coronal, and transverse
What sonographic findings when grouped together indicate Arnold Chiari II malformation
Scalloping of the frontal bones, posteriorly displaced cerebellum, obliteration of the cisterna magna, and enlarged occipital horns of lateral ventricles
What is the term used to describe a lateral curvature of the spine
Scoliosis
What is the cause of hypospadias
Shortened urethra
On a 7-week sonogram, the presence of which of the following structures confirms a monoamniotic twin pregnancy
Single yolk sac with two fetal poles
If fusion of the lower extremities, renal agenesis, and oligohydramnios are demonstrated on sonography, what abnormality is indicated
Sirenomelia
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 disorders will demonstrate a normal maternal serum alpha-fetoprotein value
Spina bifida occulta
Which of the following is a false statement with respect to spina bifida
Splaying of the vertebral laminae is easiest to demonstrate on a sagittal image of the spine.
What is the term used to describe a twin that is in close association with the uterine wall
Stuck twin
What is the leading cause of first-trimester vaginal bleeding in the presence of a closed cervix
Subchorionic hemorrhage
What is the term used to describe an additional small lobe of placenta separate from the main segment
Succenturiate lobe
Which of the following is not a typical use of amniocentesis in the third trimester
Test for fetal lung maturity
A fetal sonogram demonstrates a cloverleaf-shaped skull, hydrocephalus, and telephone receiver-shaped long bones. What skeletal dysplasia is most likely
Thanatophoric dysplasia
What criteria should be observed when assessing both left and right ventricular outflow tracts
The aorta and pulmonary artery should crisscross each other.
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.
Which of the following statements with respect to the placenta is false
The placenta produces progesterone to maintain the corpus luteum.
What is an ovarian complication of a molar pregnancy
Theca lutein cyst
If esophageal atresia is diagnosed, what tracheal abnormality may also be present
Tracheoesophageal fistula
What imaging plane will best demonstrate the abdominal cord insertion to rule out abdominal wall abnormalities
Transverse abdomen just superior to the kidneys
What is the most appropriate plane to obtain an intraorbital distance
Transverse plane at level of orbits
Which of the chromosomal abnormalities typically presents with bilateral theca lutein cysts
Triploidy
What is the term used to describe a disorder where there is an extra copy of a chromosome
Trisomy
An echogenic focus is demonstrated in the left ventricle of the fetal heart. What is this most likely associated with
Trisomy 21
What is the most common chromosomal abnormality
Trisomy 21
An amniocentesis returns results of 45,X, what disorder does this represent
Turner syndrome
Hypoplastic left heart syndrome is associated with which of the following
Turner syndrome
What is a life-threatening complication resulting from the death of a monochorionic twin
Twin embolization syndrome
What is a heterotopic pregnancy
Twin gestation, where one gestation is implanted in the uterus and the other has an ectopic implantation.
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
How does blood get from the placenta to the fetal heart
Umbilical vein > Ductus venosus > IVC > Right ventricle
When percutaneous umbilical cord sampling is performed under ultrasound guidance, what segment of cord is most often accessed
Umbilical vein at placental cord insertion site
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
What is the most common complication of amniocentesis
Uterine contractions and cramping
A fetus that presents with anal atresia, ventricular septal defects, and a renal anomaly is likely presenting with which of the following disorders
VACTERL association
If duodenal atresia is diagnosed, what other abnormalities should be investigated for
VACTERL syndrome, Down syndrome, intrauterine growth restriction, and trisomy 18
What complications are associated with a circumvallate placenta
Vaginal bleeding and placental abruption
What is term used to describe the death of a twin fetus in the first trimester that is reabsorbed
Vanishing twin
A sonogram demonstrates a placental cord insertion at the edge of the placenta with the vessels lying over the internal os. What is this disorder
Vasa previa
What is the most common cardiac defect
Ventricular septal defect
The second trimester is considered which of the following
Weeks 13-26
What term describes the number of eggs that are fertilized
Zygosity
What measurements are correlated to determine an estimated fetal weight
biparietal diameter (BPD), head circumference, abdominal circumference (AC), and femur length (FL)
Which of the following measurements is only used in the first trimester
mean sac diameter
What does advanced maternal age represent
≥ 35 years old
