OB Final2

Implantation of the blastocyst into the uterine decidua is completed within _______ days after fertilization.

12

With transvaginal ultrasound, an abnormal pregnancy is suspected when visualizing the yolk sac fails with a minimum mean sac diameter (MSD) of ______ millimeters (mm).

12

The largest part of the uterus is the: A. Corpus B. Isthmus C. Cervix D. Fundus

A. Corpus

Pelvis muscles appear: A. Echogenic B. Anechoic C. Hypoechoic D. Complex

C. Hypoechoic

Leiomyomas that project from a stalk are termed: A. Submucosal B. Intramural C. Subserosal D. Pedunculated

D. Pedunculated

The embryonic heart begins to beat at __________ days.

35

The blastocyst typically enters the uterus ___________ days after fertilization.

4 to 5

The uterine position in which the corpus tilts forward and comes in contact with the cervix describes: A. Anteflexion B. Anteversion C. Retroflexion D. Retroversion

A. Anteflexion

The right ovarian artery branches off the: A. Aorta B. Right renal vein C. Uterine artery D. Internal iliac artery

A. Aorta

The ligament that houses the vasculature of the uterus is the: A. Cardial ligament B. Ovarian ligament C. Broad ligament D. Suspensory ligament of the ovary

A. Cardial ligament

The innominate bones of the pelvis consists of the: A. Ischium, ilium, and pubic bones B. Ilium, sacrum, and coccyx bones C. Sacrum, ischium, and ilium bones

A. Ischium, ilium, and pubic bones

The pelvic muscle group that is located between the coccyx and the pubis is the: A. Levator ani muscles B. Rectus abdominis muscles C. Obturator interns muscles D. Piriformis muscle

A. Levator ani muscles

A 38-year-old female patient presents to the sonography department of a pelvis sonogram with an indication of pelvic pain. Upon sonography interrogation, the sonographer notes an anechoic mass within the cervix. This mass most likely represents a: A. Nabothian cyst B. Benign follicular cyst C. Dermoid cyst D. Gartner duct cyst

A. Nabothian cyst

Which of the following fibroid locations would most likely result in abnormal uterine bleeding because of its relationship to the endometrium? A. Submucosal B. Intramural C. Subserosal D. Subserosal pedunculated

A. Submucosal

The urinary bladder, uterus, and ovaries are located within the: A. True Pelvis B. False Pelvis

A. True Pelvis

Precocious puberty is defined as the development of pubic hair, breast, and the genitals before the age of: A. 13 B. 8 C. 5 D. 10

B. 8

The inner mucosal lining of the uterus is the: A. Myometrium B. Endometrium C. Serial layer D. Perimetrium

B. Endometrium

A simple fluid accumulation within the vagina secondary to an imperforate hymen is: A. Hydrometrcolpos B. Hydocolpos C. Hematometra D. Hematocolpos

B. Hydocolpos

Anechoic fluid noted distending the uterus and vagina within a pediatric patient is termed: A. Hydrocolpos B. Hydrometrocolpos C. Hydrometra D. Hematometrocolpos

B. Hydrometrocolpos

What section of the uterus is also referred to as the lower uterine segment? A. Cervis B. Isthmus C. Fundus D. Cornu

B. Isthmus

Prolapse of the pelvic organs most often involves: A. Rectus abdominis and obturator internus muscles B. Levator ani and coccygeus muslces C. Obturator interns and levator ani muscles D. Piriformis and iliopsoas muscles

B. Levator ani and coccygeus muslces

A patient presents to the sonography department for a pelvic sonogram with a history of adenomyosis that was diagnosed following an MRI of pelvis. What are the most likely sonographic findings? A. Complex, bilateral adnexal masses B. Myometrial cysts with enlargement of the posterior uterine wall C. Endometrial thinning and cervical dilation D. Uterine atrophy with bilateral ovarian cysts

B. Myometrial cysts with enlargement of the posterior uterine wall

The ovary is supplied blood by the: A. Ovarian artery B. Ovarian artery and uterine artery C. Uterine artery D. Arcuate artery

B. Ovarian artery and uterine artery

Fluid noted posterior to the uterus would most likely be located within the: A. Space of Retzius B. Pouch of Douglas C. Anterior cul-de-sac D. Adnexa

B. Pouch of Douglas

Both the straight and spiral arteries are branches of the: A. Common iliac artery B. Radial artery C. Arcuate artery D. External iliac artery

B. Radial artery

Which of the following would be most indicative of a leiomyosarcoma? A. Vaginal bleeding B. Rapid growth C. Dysuria D. Large hypoechoic mass

B. Rapid growth

The uterine arteries supply blood to all of the following except: A. Fallopian tubes B. Rectum C. Ovaries D. Uterus

B. Rectum

Which of the following are the paired anterior abdominal muscles that extend from the xiphoid process of the sternum to the pubic bone? A. Iliopsoas muscle B. Rectus abdominis muscle C. Obturator interni muscle D. Piriformis muscle

B. Rectus abdominis muscle

The right ovarian vein drains directly into the: A. Right renal vein B. Aorta C. Inferior vena cava D. Common iliac vein

C. Inferior vena cava

The uterine artery branches off the: A. Abdominal aorta B. Uterine plexus C. Internal iliac artery D. External iliac artery

C. Internal iliac artery

The superior portion of the cervix is the: A. Cornu D. Corpus C. Internal os D. External os

C. Internal os

The true pelvis is delineated from the false pelvis by the: A. Space of Retzius B. Adneax C. Linea terminalis D. Iliac crest

C. Linea terminalis

Leiomyosarcoma of the uterus denotes: A. The benign invasion of endometrial tissue into the myometrium B. The ectopic location of endometrial tissue in the adnexa C. The malignant counterpart of a fibroid D. And anechoic, simple cyst located within the cervix

C. The malignant counterpart of a fibroid

Peritoneal spaces located posterior to the broad ligament are referred to as the: A. Rectourterine spaces B. Anterior cul-de-sacs C. Lateral cul-de-sacs D. Adnexa

D. Adnexa

The space of Retzius is located: A. Between the uterus and bladder B. Between the bladder and ilium C. Along the lateral aspect of the uterus D. Between the bladder and pubic bone

D. Between the bladder and pubic bone

Pseudoprecocious puberty may be associated with all of the following except: A. Ovarian tumor B. Adrenal tumor C. Liver tumor D. Brain tumor

D. Brain tumor

All of the following are sonographic findings consistent with adenomyosis except: A. Diffuse, enlarge uterus B. Myometrial cysts C. Hypoechoic areas adjacent to the endometrium D. Complex adnexal mass

D. Complex adnexal mass

The area of attachment of the fallopian tubes to the uterus is the: A. Fundus B. Corpus C. Isthmus D. Cornua

D. Cornua

The interface between the decidua capsularis and echogenic vascular endometrium is which one of the following?

Double decidual sign

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

In the first trimester, herniated bowel will return within the abdominal cavity by the _________ week.

twelfth

Maternal serum hCG levels in a normal intrauterine pregnancy at less than 7 weeks should increase by doubling every _______________.

3.5 days

To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used?

(Length + width + height) ÷ 3

In early pregnancy, the gestational sac size grows at a rate of _____ mm/day.

1

The normal atrium of the lateral ventricle measures ______ mm.

6.5

Normally, the fetal bladder empties at least every ______________.

60 minutes

Pelvic bones, when visualized on sonography, will produce: A. Posterior shadowing B. Posterior enhancement C. Mirror imge artifact D. Minimal enhancement

A. Posterior shadowing

Which vessels supply blood to the deeper layers of the myometrium? A. Radial arteries B. Spiral arteries C. Straight arteries D. Arcuate arteries

A. Radial arteries

The paired muscles that are located lateral to the uterus and anterior to the iliac crest are the: A. iliopsoas muscled B. Rectus abdominis muscle C. Obturator interni muscles D. Piriformis muscle

A. iliopsoas muscled

A partial absence of the cranium is called which one of the following abnormalities?

Acrania

The cavity in which the fetus exists is called the _________ cavity.

Amniotic

Which one of the following terms indicates that the fetal head is toward the fundus of the uterus?

Breech

The normal position of the uterus is: A. Retroverted B. Retroflexed C. Anteverted D. Dysverted

C. Anteverted

The rigid region of the uterus located between the vagina and the isthmus is the: A. Cornu B. Corpus C. Cervix D. Fundus

C. Cervix

Difficult or painful intercourse is referred to as: A. Dysuria B. Dysmenorrhea C. Dyspareunia D. Hydrocolpos

C. Dyspareunia

The recesses of the vagina are the: A. Cornu B. Isthmi C. Fornices D. Parity

C. Fornices

Another name for the rectouterine pouch is the: A. Space of Retzius B. Pouch of Retzius C. Pouch of Douglas D. Anterior cul-de-sac

C. Pouch of Douglas

What is considered the most dependent part of the peritoneal cavity? A. Space of Retzius B. Anterior cul-de-sac C. Pouch of Douglas D. Rectovessicual pouch

C. Pouch of Douglas

The invasion of endometrial tissue into the myometrium of the uterus is referred to as: A. Amenorrhea B. Endometriosis C. Adenomyomatosis D. Adenomyosis

D. Adenomyosis

The peripheral arteries of the uterus are the: A. Radial arteries B. Spiral arteries C. Straight arteries D. Arcuate arteries

D. Arcuate arteries

The outer layer of the endometrium is the: A. Myometrium B. Endometrial cavity C. Functional layer D. Basal layer

D. Basal layer

The most superior and widest portion of the uterus is the: A. Corpus B. Isthmus C. Cervix D. Fundus

D. Fundus

A 13-year-old girl presents to the sonography department with a history of cyclic pain, abdominal swelling, and amenorrhea. Sonograpically, you visualize an enlarged uterus and distended vagina that contain anechoic fluid with debris. What is the most likely diagnosis? A. Cervical stenosis B. Adenomyosis C. Endometriosis D. Hematocolpos

D. Hematocolpos

The location of a fibroid within the myometrium in termed: A. Submucosal B. Intracavitary C. Subserosal D. Intramural

D. Intramural

The left ovarian vein drains directly into the: A. Right renal vein D. Inferior vena cava C. Aorta D. Left renal vein

D. Left renal vein

The paired embryonic ducts that develop into the female urogenital tract are the: A. Fallopian ducts B. Wolffian ducts C. Gartner ducts D. Mullerian ducts

D. Mullerian ducts

The muscles that may be confused with the ovaries on a pelvic sonogram include the: A. Rectus abdominis and obturator interns muscles B. Levator ani and coccygeus muscles Obturator interns and elevator ani muscles D. Piriformis and iliopsoas muscles

D. Piriformis and iliopsoas muscles

The bilateral muscles that are located posterior to and extend from the sacrum to the femoral greater trochanter are the: A. Levator ani muslces B. Rectus abdominis muscles C. Obturator interns muscles D. Piriformis muscles

D. Piriformis muscles

What other term is used to describe the space of Retzius? A. Posterior cul-de-sac B. Anterior cul-de-sac C. Murphy pouch D. Retropubic space

D. Retropubic space

What congenital malformation of the uterus is common and has clear association with an increases risk for spontaneous abortion? A. Anteflexed uterus B. Levoverted uterus C. Dextroverted uterus D. Septate uterus

D. Septate uterus

Which of the following would be considered the more common uterine anomaly? A. Bicornis univernus B. Bicornis bicollis C. Uterus didelphys D. Septate uterus

D. Septate uterus

The pelvis ligament that provides support to the ovary to the pelvic side wall is the: A. Cardinal ligament B. Ovarian ligament C. Broad ligament D. Suspensory ligament of the ovary

D. Suspensory ligament of the ovary

What structure within the female pelvis lies posterior to the urinary bladder and anterior to the rectum? A. Broad ligaments B. Rectus abdominis muscle C. Space of Retzius D. Uterus

D. Uterus

The anterior cul-de-sac is also referred to as the: A. Space of Retzius B. Rectouterine Pouch C. Pouch of Douglas D. Vesicouterine pouch

D. Vesicouterine pouch

The villi on the myometrial side of the conceptus are known as which one of the following?

Decidua basalis

Which one of the following structures shunts blood away from the lungs?

Ductus arteriosus

An ectopic pregnancy most commonly occurs in which one of the following structures?

Fallopian tube

The cerebrospinal fluid (CSF) travels from the lateral ventricles to the third ventricle via which one of the following structures?

Foramen of Monro

The most potentially life-threatening ectopic gestation is which one of the following?

Interstitial

Which one of the following terms refers to a multiple pregnancy within one chorionic sac?

Monochorionic

Which one of the following indicates that the liver is on the right, the stomach is on the left, and the heart apex is on the left?

Normal situs

After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones?

Progesterone with some estrogen

Transvaginal imaging of the female pelvis uses which of the following planes?

Sagittal and coronal

Using a transvaginal approach, the first structure visualized within a gestational sac is which one of the following structures?

Secondary yolk sac

Which one of the following statements about the fetal liver is false?

The right lobe is larger than the left lobe in the fetal liver.

Which one of the following abnormalities is most commonly associated with cystic hygroma?

Turner syndrome

The three vessels found in the umbilical cord are which of the following?

Two arteries and one vein

In the transverse plane, an abnormal fetal spine may appear splayed in all of the following configurations except:

Y-shaped.

The profile view of the fetal face is important to examine to rule out all of the following abnormalities except:

cleft soft palate.

The serum level of beta hCG is __________________ with gestational trophoblastic disease.

dramatically elevated

Which one of the following laboratory tests is used to indicate pregnancy when the values are elevated

hCG

Because of the low-density brain tissue, the texture of the brain may appear ______________.

hypoechoic

The increased risk of massive hemorrhage in an ectopic pregnancy is located:

near the uterine cornua.

Findings in an ectopic pregnancy include all of the following except:

normal increase in serum beta hCG levels.

When evaluating the fetal spine, aligning the transducer in a(n) ___________ axis to the spinal elements is important.

perpendicular

Transvaginally, an embryo with cardiac activity should be identified when the gestational sac measures ____________ millimeters (mm).

16 to 20

Fetal anatomy may be assessed accurately after _________________.

18 menstrual weeks

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

Visualization of the distal femoral epiphysis signifies a gestational age beyond:

33 to 35 weeks.

The best sonographic correlation in the diagnosis of an ectopic pregnancy is the combination of no intrauterine pregnancy and which one of the following?

Adnexal mass

Which one of the following is the most frequent sonographic finding in an ectopic pregnancy?

Adnexal mass

An ovum without an embryo is known as which one of the following?

Anembryonic pregnancy

A gestational sac in which the embryo fails to develop is described as which one of the following?

Blighted ovum or anembryonic pregnancy

An increased risk of a complete hysterectomy is present when an ectopic pregnancy is located in which one of the following structures?

Cervix

The anechoic center of a 5- to 6-week gestational sac represents which one of the following?

Chorionic cavity

Especially in the third trimester, a fetus in the breech position may demonstrate a cranium shape of which one of the following?

Dolichocephalic

Which one of the following structures carries oxygenated blood from the umbilical vein to the inferior vena cava (IVC)?

Ductus venosus

Dilation of the entire ventricular system, including the fourth ventricle, is associated with which one of the following abnormalities?

Spinal defects

Beyond 30 weeks of gestation, a renal pelvis is considered abnormal when measuring greater than _____ millimeters (mm).

10

Typically, the yolk sac resorbs and is no longer visible sonographically by _______ weeks.

12

The cranial bones ossify by ______ weeks of gestation.

12

A patient presents to the sonography department with a history of uterine prolapsed. Which of the following best describes this disorder? A. A condition that results from the weakening of the pelvic diaphragm muscles and allow for the displacement of the uterus, often through the vagina B. A congenital anomaly that results in the duplication of the uterus C. A condition that results in the abnormal invasion of the myometrium through the bladder wall leading to hematuria D. An abnormality that describes the inversion of the myometrium and endometrium

A. A condition that results from the weakening of the pelvic diaphragm muscles and allow for the displacement of the uterus, often through the vagina

Which of the following is typically not a clinical complaint of women who are suffering from adenomyosis? A. Amenorrhea B. Dsymenorrhea C. Dyspareunia D. Menometrorrhagia

A. Amenorrhea

The most common cause of vaginal bleeding in the first trimester is which one of the following?

Subchorionic hemorrhage

The widest transverse diameter of the skull and the proper level to measure the biparietal diameter (BPD) includes which one of the following structures?

Thalamus

Cranial anatomy is routinely visualized after how many gestational weeks?

12 to 14

The fusion of the chorion and amnion occurs between ________ weeks.

14 and 15

Corpus luteum cysts regress and are typically not seen beyond _________ weeks.

16 to 18

Embryos with heart rates below ______ beats per minute (bpm) generally have a poor prognosis.

90

The crown-rump length measurement may be used up through the ______ gestational week.

twelfth

The cavum septum pellucidi is observed anterior to the _______________.

thalamus

The size of the cistern magna is obtained by measuring from the _____________ to the ______________.

vermis; occipital bone

Absence of a menstruation is referred to as: A. Dysuria B. Dysmenorrhea C. Amenorrhea D. Menorrhagia

C. Amenorrhea

The vagina is located ______ to the uterus. A. anterior B. posterior C. inferior D. medial

C. inferior

The presentation of a fetus lying perpendicular to the maternal sagittal axis is in the ____________ position.

Transverse

A congenital fissure that remains open past 12 weeks in the wall of the abdomen just to the right of the umbilical cord is called which one of the following?

Gastroschisis

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 statements about a pseudogestational sac is false?

It is eccentrically located within the endometrium.

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

A heterotopic pregnancy is which one of the following?

Simultaneous intrauterine and extrauterine pregnancies

The diameter of the normal yolk sac should never exceed _______ mm.

6

The abdominal aorta bifurcates into the : A. Internal iliac arteries B. Common iliac arteries C. Ovarian arteries D. External iliac arteries

B. Common iliac arteries

Congenital malformation of the uterus that results in complete duplication of the genital tract is: A. Unicornuate uterus B. Bicornis bicollis C. Uterus didelphys D. Subseptate uterus

C. Uterus didelphys

At what gestational week does the volume of amniotic fluid stop increasing?

34th

Which one of the following is the most common pelvic mass seen in a first-trimester pregnancy?

Corpus luteum cyst

A hemorrhage located between the gestational sac and the myometrium represents which one of the following conditions?

Subchorionic hemorrhage

Nuchal translucency must be measured between _____ weeks and _____ weeks, _____ days.

c. 11; 13; 6

The beta hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow, after _________ weeks.

9 to 10

The inferior portion of the cervix closest to the vagina is the: A. Cornu B. Internal os C. External os D. Inferior fornix

C. External os

The pelvis ligament that extends from the lateral aspect of the uterus to the side walls of the pelvis is: A. Broad ligament B. Ovarian ligament C. Piriformis ligament D. Round ligament

A. Broad ligament

The sonographic pelvic examination of a female patient reveals an extensive amount of ascites in the transverse place, you visualize two echogenic structures extending from the side walls of the uterus to the pelvic side walls bilaterally. These structures are most likely the: A. Broad ligaments B. Cardinal ligaments C. Ovarian ligaments D. Uterosacral ligaments

A. Broad ligaments

Abnormally heavy and prolonged menstrual flow between period is termed: A. Menometrorrhagia B. Menarche C. Menorrhagia D. Dysmenorrhea

A. Menometrorrhagia

All of the following are clinical findings associated with leiomyoma except: A. Myometiral cysts B. Infertility C. Palpable pelvic mass D. Menorrhagia

A. Myometiral cysts

A 24-year-old female patient presents to the sonography department for pelvic sonogram with an indication of pelvic pain. Upon sonographic interrogation, the songrapher notes an anechoic mass within the vagina. This mass most likely represents a: A. Nabothian cyst B. Gartner duct cyst C. Dandy-Walker cyst D. Ovarian cyst

B. Gartner duct cyst

The pelvic ligament that provides support to the ovary and extends from the ovary to the lateral surface of the uterus is the: A. Cardinal ligament B. Ovarian ligament C. Broad ligament D. Suspensory ligament of the ovary

B. Ovarian ligament

The artery that directly supply blood to the functional layer of the endometrium are the: A. Radial arteries B. Spiral arteries C. Straight arteries D> Arcuate arteries

B. Spiral arteries

Upon sonographic evaluation of a patient complaining of abnormal distention, you visualize a large, hypoechoic mass distorting the anterior border of the uterus. What is the most likely location of this mass? A. Intramural B. Subserosal C. Submucosal D. Intracavitary pedunculated

B. Subserosal

Fluid noted anterior to the uterus would most likely be located within the: A. Pouch of Douglas B. Vesicouterine pouch C. Space of Retzius D. Rectouterine pouch

B. Vesicouterine pouch

The layer of the endometrium that is significantly altered as a result of hormonal stimulation during the menstrual cycle is the: A. Myometrium B. Endometrial cavity C. Functional layer D. Basal layer

C. Functional layer

The surgical removal of a fibroid is termed: A. Hysterosonogram B. Total abdominal hysterectomy C. Myomectomy D.Uterine artery embolization

C. Myomectomy

The muscle located lateral to the ovaries is the: A. Iliopsoas muscle B. Rectus abdominis muscle C. Obturator interns muscle D. Piriformis muscle

C. Obturator interns muscle

What leiomyoma location would have an increased risk to undergo torsion? A. Subserosal B. Intracavitary C. Pedunculated D. Submucosal

C. Pedunculated

Pelvic bones, when visualized on sonography, will appear: A. Anechoic B. Hypoechoic C. Dark D. Hyperechoic

D. Hyperechoic