OB/GYN: Midterm Questions

What is the preparation recommended for a transabdominal pelvic sonogram?

-drink 4 8oz glasses of water -full bladder

What is true about identifying the fallopian tubes sonographically?

-the fallopian tubes are not usually identified -can be identified if there is an obstruction and it is distended with fluid

What does G4P3A1 represent?

4 pregnancies, 3 births at >20 weeks gestation, 1 failed gestation

If a patient has a human chorionic gonadotropin (hCG) level of 100, in how many days should it be possible to visualize a gestational sac?

5 days

What best describes the appearance of a normal ovary?

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

What does ALARA stand for?

As Low As Reasonably Achieveable

Which of the following is false with respect to the nuchal translucency exam?

CRL must be between mm and 8 mm at the time of the exam

Which imaging modality is often needed to determine uterine anomalies?

MRI

What is the most common hormonal disorder among women of reproductive age?

Polycystic Ovarian Disorder

50% of PID cases are caused by what?

STDs or STIs

While scanning an 11 week pregnancy, you come across a midgut herniation, this is:

a normal finding

What is the sonographic appearance of an invasive mole?

anechoic masses representing hemorrhage

All of the following are risk factors for developing an ectopic pregnancy except?

anterior placenta

What term describes a straight uterus that tilts forward in the body forming a 90 degree angle with the vagina?

anteverted

What is the cause of adenomyosis?

basal layer endometrial tissue invades the myometrium

If while scanning you suspect an ectopic pregnancy, where would you most likely find free fluid in the abdomen?

between the liver and right kidney

Which of the following best describes a uterus that has two separate endometrial canals but a single cervix?

bicornuate uterus

What does the term hematocolpos mean?

blood in the vagina

If a fetus has a heart rate of 74 BPM, this is:

bradycardia

Which of the following best describes a thick-walled cystic mass with internal echoes that was demonstrated on day 20 of the menstrual cycle and resolved by day 5 of the following cycle.?

corpus luteal cyst

What is the initial source of the progesterone and estrogen if fertilization occurs?

corpus luteum

While scanning through the fetal cervical spine in a transverse plane, you notice an area of subcutaneous edema that protrudes from the posterior spine. This most likely represents?

cystic hygroma

What makes up the maternal portion of the placenta?

decidua basalis

What is the first definitive sonographic sign of an intrauterine pregnancy?

double sac sign

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

endometrioma

What is the term used to describe the inner layer of the uterine wall?

endometrium

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

evaluation of a suspected ectopic pregnancy

The endometrial cavity is contiguous with which other part of the female pelvis?

fallopian tube lumen

What are the two phases of the ovarian cycle?

follicular and luteal

What normal anatomic variant my be demonstrated on a pelvic sonogram?

free-fluid in the posterior cul-de-sac

What layer of the endometrium is shed every month during menstruation?

functional layer

How would you describe the echotexture of the normal uterus?

homogenous

What is a possible complication of chronic PID?

infertility

What is the most common gestational trophoblastic neoplasia?

invasive mole

Which other organ(s) should be interrogated if uterine anomalies are demonstrated?

kidneys

What ovarian neoplasm is a result of metastases of a GI cancer?

krukenberg tumor

Why do endovaginal transducers utilize a higher frequency range than a transabdominal transducer?

less penetration is required as structures are closer to the transducer

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

levantor ani

List one sonographic appearance of ovarian torsion.

little or no blood supply to the ovary

If a pelvic neoplasm is suspected, you should also image:

liver

Which imaging modality has proven to be able to distinguish between benign and malignant lesions?

none

List at list one risk factor for developing leiomyosarcoma.

obesity

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

ovarian torsion

What is the path of venous drainage from the left ovary?

ovarian vein to left renal vein to IVC

Where would you see enhancement on a normal transabdominal sonogram?

posterior to the bladder

Where is free-fluid most likely to collect in the female pelvis?

pouch of douglas

What should the sonographer do for their patient if they are suffering from supine hypotensive syndrome?

put patient into left lateral decubitus position

Which arteries in the uterus feed the functional layer of the endometrium?

radial/spiral

What is responsible for the development of follicles on the ovaries?

release of follicle-stimulating hormone by the anterior pituitary gland

A sonogram of a post-pubertal woman demonstrated a 5 cm simple cyst on the left ovary. A follow-up exam 3 months later demonstrates a normal ovary. What do these findings likely represent?

resolution of a follicular cyst

A patient with an elevated hCG, left sided pelvic pain, and elevated WBC. What is the most likely diagnosis?

ruptured ectopic pregnancy

An asymptomatic patient presents with a bilateral anechoic lesion that contains septations and papillary projections. What does this most likely represent?

serous cystadenoma

What is the most common malignant ovarian tumor?

serous cystdenoma

What appears sonographically as a crescent-shaped sonolucent or complex fluid collection between the gestational sac and uterus?

subchorionic hemorrhage

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

submucosal leiomyoma

What is an ovarian complication of a molar pregnancy?

theca lutein cyst

What is the sonographic appearance of the proliferative endometrium?

three-line sign

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

tubo-ovarian abscess

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

unicornuate uterus

Which uterine anomaly results in two uterine horns, two cervixes and two vaginas?

uterus didelphys

What is the most common uterine anomaly?

septate uterus

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

hemorrhagic corpus luteal cyst

Define precocious puberty.

onset of early puberty

What is the term used to describe a cystic structure located in the fetal head in an 8 week gestation?

rhombencephalon

List on sonographic finding for fallopian tube cancer.

sausage-shaped mass

What measurements are correlated to determine an estimated fetal weight?

BPD, head circumference, abdominal circumference, femur length

What is the most accurate sonographic method for dating a pregnancy?

CRL prior to 14 weeks gestation

What part of the blastocyst implants in the endometrium during implantation?

chorionic villi

What is the most common gynecological malignancy in the US?

endometrial carcinoma

Which of the following can be a precursor for endometrial carcinoma?

endometrial hyperplasia

What are the three anatomic sections of the uterus?

fundus, body, cervix

A sonogram demonstrates simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent?

gartner duct cyst

What is the most common vaginal neoplasm in the pediatric population?

gartner duct cyst

Sonography demonstrated a large soft tissue mass with low to moderate amplitude achoes in the uterus containing fluid filled spaces. The patient demonstrated elevated hCG and an enlarged UT. Her doctor was unable to detect a fetal heartbeat. What is the most likely diagnosis?

hydatidiform moletheca lutein cyst

How would you describe the echotexture of the normal endometrium?

hyperechoic to the myometrium

A patient presents with amenorrhea, cyclic abdominal pain, and en enlarged uterus. Hydrometrocolpos is present. What is the most likely diagnosis?

imperforate hymen

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

infants and children

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, and adnexal ring sign in the left adnexa, and free fluid in the cul-de-sac and adnexa. What is the most likely diagnosis?

left ectopic pregnancy

During which phase of the menstrual cycle is the endometrium at its thickest?

luteal

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

mean sac diameter

What is the definition of primary amenorrhea?

menarche has not occurred by age 16 in a female patient

This ovarian malignancy most often presents as a large multiloculated cystic mass with papillary projects and thick echogenic material.

mucinous cystdenoma

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

only leiomyosarcoma will be singular

Which part of the female pelvis has a dual blood supply?

ovary

What is the leading cause of a first-trimester vaginal bleeding in the prescence of a closed cervix?

subchorionic hemorrhage

Absence of the nasal bone is associated with which chromosomal abnormality?

trisomy 21

What is a heterotopic pregnancy?

twin gestation, where one gestation is implanted in the uterus and the other has an ectopic implantation

How can a sonographer distinguish a nabothian cyst from a cervical carcinoma?

a cervical carcinoma will demonstrate a solid mass whereas a nabothian cyst will have all the characteristic of a simple cyst

At what gestational age should physiological bowel herniation be resolved?

12 weeks

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

anembryonic pregnancy

What parts of the female pelvis define the vesicouterine pouch?

anterior surface of the uterus and posterior surface of the bladder

What is the term used to describe the normal location of the ovaries?

adnexa

In what portion of the fallopian tube does fertilization usually occur?

ampulla

Where does fertilization usually occur?

ampulla

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

gestational trophoblastic disease

A patient presents with mittelschmerz. Sonography demonstrated a small amount of free fluid in the right adnexa. What is the likely cause?

ovulation

Name one common renal anomaly that often occurs along with uterine anomalies.

renal agenesis