SONO 141 Final
Growth of the chorionic villi deep into but not clear through the myometrium describes which of the following?
Placenta increta
Which of the following placental abnormalities is best described as a focal discrete lesion caused by ischemic necrosis?
Placental infarct
Pelvic inflammatory disease can lead to all of the following EXCEPT
Polycystic ovarian disease
Following an intracranial hemorrhage, a cyst is noted within the cerebrum that communicates with the lateral ventricle. Which of the following conditions best describes this condition?
Porencephaly
Craniosynostosis may be defined as which one of the following?
Premature closure of the cranial structures
What hormone is released by the ovary during the second half of the menstrual cycle?
Progesterone
What is the name of the phase of the endometrial cycle that follows the menstrual phase?
Proliferative phase
What phase of the menstrual cycle is the endometrium in when the ovary is in follicular phase?
Proliferative phase
What phase of the menstrual cycle would you expect to measure the endometrium when it is at the thickest diameter?
Secretory phase
A heterotopic pregnancy is which one of the following?
Simultaneous intrauterine and extrauterine pregnancies
What is the name of the image that is obtained to assess amniotic fluid and what is considered a normal amount?
Single pocket assessment and normal is >2cm
What is the term used to describe overlapping of the skull plates in fetal demise?
Spalding's sign
Which artery supplies blood within the functional layer of the endometrium that is altered by the hormones of the ovary?
Spiral artery
Which of the following is the most common cause of vaginal bleeding in the first trimester?
Subchorionic hemorrhage
Which of the following best describes the presence of one or more accessory lobes connected to the body of the placenta by blood vessels?
Succenturiate placenta
Which of the following statements about a placental abruption is FALSE?
The bleed may lead to a chorioangioma
Which of the following might best define the rare uterine pathology leiomyosarcoma?
The malignant counterpart of a fibroid
Which of the following best describes the criteria of a marginal placenta previa?
The placenta edge just reaches the internal os
One of the abnormal pregnancy states is trophoblastic or molar pregnancy. This type of gestational disorder often results in very high levels of hcG. Which of the following ovarian disorders is also associated with abnormally high levels of hcG?
Theca lutein cyst
Which of the following type of ovarian cysts are commonly associated with ovarian hyperstimulation syndrome?
Theca lutein cysts
Which of the following is considered an estrogen-producing ovarian tumor?
Thecomas
Hysterosalpingography (HSG) is used to evaluate the internal os diameter for cervical stenosis, when the diameter is < 1 mm, the cervix is considered stenotic.
True
It is common to see maternal vessels behind the basal plate of the placenta
True
Which one of the following abnormalities is most commonly associated with cystic hygroma?
Turner syndrome
Which vessel of the umbilical cord carries oxygenated blood from the placenta?
Umbilical vein
What is the term for the duplication of the vagina, cervix, and uterus?
Uterus didelphis
What is the most common presenting complication of a patient in the early stage of pregnancy?
Vaginal spotting/bleeding
Assuming the patient seeks medical treatment at the onset of symptoms, which of the following is the most common initial clinical presentation of pelvic inflammatory disease?
Vaginitis
The dangling choroid sign is synonymous with which of the following neural defects?
Ventriculomegaly
What is the name of substance that covers the umbilical cord?
Wharton's jelly
Which of the following best describes a "true knot" in the umbilical cord?
When the fetus passes through a loop of the cord
Which implantation site of an ectopic pregnancy would result in an increased risk of massive hemorrhage if undetected?
Within the uterine cornua
Which one of the following is the most frequent sonographic finding in an ectopic pregnancy?
adnexal mass
Which one of the following neural tube defects is characterized by a lack of development of the cerebral, cerebellar hemispheres, and cranial vault and is an abnormality that is incompatible with life?
anencephaly
Where is luteinizing hormone produced?
anterior pituitary gland
A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appearance most likely represents which one of the following?
chorioangioma
The anechoic center of a 5- to 6-week gestational sac represents which one of the following?
chorionic cavity
The most common congenital anomaly of the face is which one of the following?
cleft lip
The band of tissue that allows communication between the right and left cerebral hemispheres is the
corpus callosum
Which one of the following is the most common pelvic mass seen in a first-trimester pregnancy?
corpus luteum cyst
The villi on the myometrial side of the conceptus are known as which one of the following?
decidua basalis
Which one of the following terms is used to describe the herniation of the meninges and brain through a calvarium defect?
encephalocele
Differentials for thickened endometrium?
endometrial hyperplasia, endometrial carcinoma, endometrial polyps.
An ectopic pregnancy most commonly occurs in which one of the following structures?
fallopian tube
Multiple tiny clusters of grapelike echoes within the uterine cavity best describes which one of the following?
gestational trophoblastic disease
Which one of the following laboratory tests is used to indicate pregnancy when the values are elevated?
hCG
To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used?
(Length + width + height) ÷ 3
What is single umbilical artery associated with?
- Congenital and chromosomal abnormalities - IUGR - prenatal mortality
List 3 features of a normal gestational sac.
- DDS - smooth borders - chorionic cavity
Which of the following best describes a vein of Galen malformation?
- aneurysm of the Galen vein - sporadic event - rare arteriovenous malformation
Patients on tamoxifen therapy have an increased risk of which one of the following reactions?
- endometrial hyperplasia - endometrial polyps - endometrial carcinoma
Which of the following are included in a triple screen of early pregnancy?
- hCG - estriol - alpha-fetoprotein
Which of the following represents a function of the amniotic fluid?
- maintains constant temperature - cushions fetus - prevents adherence
List 3 functions of the placenta
- nutrition - excretion - protection - storage - hormonal production - oxygen - respiration
List 3 sonographic findings associated with fetal hydrops.
- pleural effusion - pericardial effusion - skin edema - ascites
List 3 ways the amount of amniotic fluid is regulated as gestation of fetus progresses
- swallowing - exchange with lungs - membranes and cord
List 3 different "sites" of amniotic fluid production.
- umbilical cord - lungs - skin - membranes - kidneys
In early pregnancy, the gestational sac size grows at a rate of _____ mm/day.
1 mm
Oxygen, nutrients and hormones are delivered to the fetus through the _______________.
1 umbilical vein
What is considered upper limits of normal measurement for the cisterna magna?
10 mm
Cisterna magma should be under
10mm
Cranial anatomy is routinely visualized after how many gestational weeks?
12-14
The crown-rump length measurement may be used up through the ______ gestational week
12th
Which of the following is defined as excessive hair growth in women in areas where hair growth is normally negligible?
hirsutism
Which of the following placental grades is suggested when sonographic evaluation reveals significant calcifications, septations, and lobulations?
3
How many vessels are in a normal umbilical cord?
3 (2 arteries and 1 vein)
According to our text, maternal serum hCG levels in a normal intrauterine pregnancy at less than 7 weeks should increase by doubling every
3.5 days
In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG level is _________ mega international units per milliliter (mIU/ml).
3000
Transvaginally, an embryo with cardiac activity should be identified when the embryo measures ____________ millimeters (mm).
5-8
The beta hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow, after _________ weeks.
9-10 weeks
A condition in which a complete or partial absence of the cranial bones is demonstrated is which one of the following?
Acrania
Which of the following would NOT typically be associated with amenorrhea?
Adenomyosis
Which one of the following terms describes a small chin?
micrognathia
Which one of the following terms refers to a multiple pregnancy within one chorionic sac?
monochorionic
A sonogram at 10 weeks of gestation demonstrates a cystic area within the posterior cranium. This appearance most likely represents which one of the following?
normal rhombencephalon
Evaluation of the nasal triad should include all of the following except
nostril length
Which one of the following umbilical cord entanglements in the fetus is the most common?
nuchal cord
Which of the following is defined as an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes?
pelvic inflammatory disease
Which of the following would most likely be associated with hirsutism?
polycystic ovarian syndrome
Which one of the following is the most severe form of holoprosencephaly, which is characterized by a single common ventricle and malformed brain? Orbital anomalies range from fused orbits to hypotelorism, with frequent nasal anomalies and clefting of the lip and palate.
Alobar
Which of the following invasive procedures would be performed at 16 weeks gestation?
Amniocentesis
Which of the following is best described as multiple fibrous strands of amnion that develop in utero that may entangle fetal parts to cause amputations of malformation of the fetus?
Amniotic bands
The cavity in which the fetus grows is referred to as the __________________.
Amniotic cavity
What is the term used to describe the normal or most common position of the uterus?
Anteverted
What are three complications of a severe case of ovarian hyperstimulation syndrome (OHS)?
Ascites, pleural effusion, and enlarges ovaries with multiple cysts
Which of the following is best description of an endometrial polyp?
Benign nodules of hyperplastic endometrial tissue
The placental position can be altered by the presence of an overly full urinary bladder or a ______________________.
Braxton hicks contraction
What ligament provides support for both the uterus and the ovaries?
Broad ligament
What neural defect is associated with banana shaped cerebellum and lemon shaped cranium?
Chiari II malformation
The fetal surface of the placenta is covered with a strong echogenic covering of the amnion called the ________________.
Chorionic plate
All of the following are sonographic findings consistent with adenomyosis EXCEPT
Complex adnexal mass
During a transabdominal pelvic scan in transverse, what part of the pelvic anatomy helps us locate the ovaries?
Cornua
Differentials for endometrioma
Corpus luteum cyst, hemorrhagic cyst, teratoma
After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones?
progesterone with some estrogen
A hemorrhage located between the gestational sac and the myometrium represents which one of the following conditions?
subchorionic hemorrhage
A 55-year-old post menopausal patient presents to the ultrasound department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic ultrasound reveals a large, complex, loculated cystic mass with papillary projections in the right adnexa, pelvic and abdominal ascites. Based on this history, what is the most likely diagnosis?
Cystic cystadenocarcinoma
Which one of the following central nervous anomalies demonstrates splaying of the cerebellum on ultrasound?
Dandy-Walker
Which cranial anomaly is associated with cystic dilation of the 4th ventricle with dysgenesis or complete agenesis of the cerebellar vermis?
Dandy-Walker malformation
Which of the following is considered the "maternal" side of the placenta?
Decidua basalis
Which of the following best describes the serum beta hCG levels in a patient with gestational trophoblastic disease?
Dramatically elevated
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?
Either gestational or menstrual
What two endometrial pathologies can inhibit implantation?
Endometrial polyps and fibroids
What is the term used to describe the female pelvic disorder that is characterized by the presence of functional, ectopic endometrial tissue outside of the uterus?
Endometriosis
What is the name of the inner mucosal lining of the uterus?
Endometrium
The inferior portion of the cervix closest to the vagina is the
External os
Conceptual age is the term used by sonographers when "dating" a pregnancy.
False
We only do ovarian doppler when concerned about ovarian torsion.
False
When scanning the uterus in short axis, we measure the width at the fundus.
False
Which of the following terms is used to describe a pregnancy between 11 - 40 weeks?
Fetal stage
What nutritional changes were made in prenatal care that has reduced the incidence of the most significant neurological defects?
Folic acid
A congenital fissure in the wall of the abdomen just to the right of the umbilical cord is called which one of the following?
Gastroschisis
Which of the following structures would you expect to visualize first on an early pregnancy exam?
Gestational sac
Proboscis suggests which one of the following abnormalities?
Holoprosencephaly
What neural abnormality is know in layman's terms as "water on the brain"?
Hydrocephalus
Which of the following terms best describes a simple fluid accumulation within the vagina secondary to an imperforate hymen?
Hydrocolpos
What maternal risk factor is present in approximately 50% of placental abruption cases?
Hypertension
Which type of fetal hydrops is associated with Rh isoimmunization?
Immune hydrops
What is the most common reason for a patient's cervix mucosal layer to be considered "hostile?"
Inaccurate timing
how to measure nuchal translucency
Inner to inner, do not include amnion
What is the term used to describe the location of a fibroid within the myometrium?
Intramural
What is considered the gold standard when evaluating for endometriosis and pelvic adhesions?
Laparoscopy
The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following?
Leiomyoma
What uterine pathology is considered the most common pelvic tumor?
Leiomyoma (fibroid)
What two measurements can you take for a transabdominal longitudinal image of the uterus?
Length and AP
Which female reproductive hormone typically surges or dramatically increases at the time of ovulation?
Luteinizing hormone
A cloverleaf-shaped skull is related to
thanatophoric dysplasia
Which one of the following statements about the umbilical cord is false?
the chorion covers the cord and blends with the fetal skin at the umbilicus
All of these statements are true when talking about transvaginal scanning EXCEPT?
we never do a transvaginal scan on a patient under 21
The velamentous placenta refers to a(n):
Membranous insertion of the cord
What is the term used to describe cessation of menstruation for at least 12 months that is associated with advanced age?
Menopause
Which of the following types of spina bifida is best characterized by the protrusion of spinal cord through a bony defect of the spine?
Myelomeningocele
What is the name of an anechoic, simple cyst located within the cervix?
Nabothian cyst
Findings in an ectopic pregnancy include all of the following except:
Normal increase in serum beta hCG levels
List 2 measurements or observations taken in the first trimester that might help assess the embryo for Down syndrome.
Nuchal translucency and nasal bone
What term is used to describe an AFI of < 5cm?
Oligohydramnios
Which of the following best describes the correct caliper placement on the skull for making a BPD measurement?
Outer to inner
What is the name of the ligament that connects the lower pole of the ovary to the lateral surface of the uterus?
Ovarian ligament
What abnormality results from the ovary twisting on its mesenteric or vascular connection?
Ovarian torsion
A 24-year-old female patient presents to the emergency department with severe left lower quadrant pain, nausea, and vomiting. The sonographic examination reveals an enlarged left ovary with no detectable Doppler signal. What is the most likely diagnosis AND what other specific sonographic sign should you look for?
Ovarian torsion and whirlpool sign
What ovarian disorder is sonographically characterized by the appearance of "string of pearls" when visualizing the ovaries?
PCOS
In a transvaginal Transverse/coronal plane, the left side of the screen is _______________ and the right side of the screen is ________________
Patient's right, patient's left
What three muscle groups are in the true pelvis?
Piriformist, obturator internus, and pelvic diaphragm