OB2 Chp49-55
Stuck twin syndrome is usually observed between
16- and 26-weeks' gestation
In Edwards' syndrome the karyotype demonstrate extra chromosome on
18
Nuchal skin fold thickness of 5 mm or less is normal up to ____ weeks' gestation
20
Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate ranging between
200 and 240 beats per minute.
Placenta only functions at peak performance until about
40 weeks
Normal karyotype consists of
46 chromosomes
Chorionic villus sampling may include all of the following EXCEPT the results are available within
48 hours
Thickness of normal placenta rarely exceeds
4cm
With transvaginal sonography, the earliest appearance of a normal intrauterine gestational sac should be seen with a serum beta human chorionic gonadotropin (hCG) greater than ___ mega international units per millimeter
500
All of the following statements are true about AFP except
AFP levels lower in fetus with gastroschisis than in fetus with?
In multiple gestations with death of co-twin (fetus papyraceous)
AFP may be higher than normal
Ultrasound finding associated with fetal death includes
ALL of the Above (absent fetal heart rate, absent fetal movements, exaggerated curvature of the fetal spine)
Macrosomia is defined as a birth weight of
Above 90% for estimated gestation age.
Menochorionic twin pregnancy, during which one fetus .... body,
Acardiac Anomaly
In twin-to-twin transfusion syndrome, which one of the following statements is TRUE?
All of the above statements are true (both twins are at risk of dying, stuck twin phenomenon is seen in donor twin, the recipient twin may demonstrate polyhydramnios)
An abnormality in the number of chromosomes is called
Aneuploidy
Identify the abnormality demonstrated in this fetus with nonimmune hydrops.
Ascites
The optimal something includes all of the following except
Away from the maternal midline
A marginal or an eccentric insertion of the umbilical cord into the ? of the following
Battledore placenta
AFP is found in all of the following fetal structures except
Brain
What type of test is being performed in the following image?
CVS
Which one of the following is most frequent cause of nonimmune hydrops?
Cardiovascular Lesions
A circumscribed complex mass protruding from the fetal surface of the placenta demonstrated on the following ultrasound image most likely represents
Chorioangioma
Placenta is formed by the proliferation of
Chorionic villi and decidua basalis
Predictors of discordance in the growth of twins include all except
Difference in biparietal diameter of 10 mm or greater.
Twins that arise from two separately fertilized ova are known as
Dizygotic.
Secondary to pregnancy-induced hypertension, a coma and seizures in the patient during the second and third trimesters represents
Eclampsia.
The quad screen evaluated all of the following markers EXCEPT
Fetal Lung Maturity
Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb into the uterus is
Fetus Papyraceous
Cordocentesis is used beside documenting the fetal platelet count before vaginal delivery is also used for
Guidance for Transfusions
Although the organ function remains as minimal, the _____ is the first organ to function
Heart
What do you mean by autosomal recessive?
In this case with each pregnancy the parents have 25% chance with disorder.
Describe the abnormality seen in the patient who is pregnant with triplets?
Incompetent cervix
All of the following are functions of the amniotic fluid except
It secrets progesterone
Normally, the anatomic structure closest to the spine in a four chamber view of the heart is the
Left atrium
Hydrops can be due to Fetal anemia. Doppler of which vessel is used as a tool to predict fetal anemias?
MCA (Middle cerebral artery)
Maternal obesity has been associated with an increase incidence of
Neural Tube Defects.
Which one of the following terms describes a group of conditions in which hydrops is present in the fetus but is not a result of feto-maternal blood group incompatibility?
Nonimmune Hydrops
Sonographic measurements taken between the outer edge of the occipital bone to the outer margin of the skin is called
Nuchal Fold
Which one of the following is demonstrated if the division of one fertilized egg occurs 4 to 8 days after fertilization?
One chorion and two amnions
If delivery of Macrocosmic infants is attempted vaginally, the physician may have difficulty delivery the shoulders of the baby after the head has delivered. This is called
Shoulder Dystocia
Hypertensive pregnancies may be associated with
Small Placentas
Which one of the following is defined as the appearance of overlapping skull bones that indicates fetal death.?
Spaulding Sign
Increased NT has been associated with
Spontaneous miscarriage and perinatal death
Poly-oli sequence is also known as
Stuck Twin Syndrome
Sonographic findings of hydrops include all of the following EXCEPT
Thin Placenta
Sonographic findings of fetal hydrops in an isoimmunized pregnancy include all of the following EXCEPT
Thinning Placenta
Which measurement has been used for accurate reflection of gestation age than BPD in cases of severe oligohydramnios dolichocephaly, breech presentation, or twins, or in the presence of uterine anomaly
Transcerebellar
The most common aneuploid condition is
Trisomy 21
A large cystic hygroma, hydrops, and coarctation of the aorta may be
Turner Syndrome
A diamniotic and dichorionic twin pregnancy demonstrates which one of the following sonographic findings?
Two gestational sacs and two placentas
Which one of the following occurs when the intramembranous vessel ? internal cervical is?
Vasa previa
AFP is produced in early gestation by
Yolk sac
AFP is produced in early gestation by which one of the following?
Yolk sac
To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used?
a. (length + width + height) / 3
The profile view of the fetal face is important to examine to rule out all of the following abnormalities EXCEPT
a. Cleft soft palate
Which one of the following measurements is the most accurate to determining gestation age in the first trimester?
a. Crown Rump Length
Of the following methods of calculating an estimated date of confinement (EDC) which one is the most reliable?
a. Crown rump length
Symmetric IUGR is usually the result of which one of the following?
a. First-trimester insult
All of the following conditions indicate reactive, or normal, NST and score of 2 points EXCEPT
a. Two fetal heart rate decelerations of 15 bpm or more
Significant maternal risk factors for IUGR include all of the following EXCEPT
a. significant hypotension
The placenta performs all of the following functions except
absorption
All of the following statements are true about X-linked disorders except
affected males transmit disorder to sons and all daughters ? Disorders
Ultrasound performed before chorionic villus sampling should
all of the above (determine relationship between lie of uterus and cervix, assess fetus in terms of life, normal morphology, identify uterine masses)
The mean measurement for nuchal translucency is
around 2.18 millimeters
High maternal mortality and morbidity
associated with Percreta / increta
Non-villous part of chorion around gestational sac
chorion laeve
The major functioning endocrine units of the placenta is
chorionic villi
Counting the number of gestational sacs is accurate for
chronicity.
The maternal side of the placenta is
decidua basal plate
Biochemical screening in trisomy 18 fetuses reveals
decreased levels of hCG, AFP, and estriols
All of the following factors are associated with placenta previa EXCEPT
diabetes
Sonographic presence of chorionic "twin pick" sign most likely to represent
diamniotic, dichorionic.
High levels of AFP indicate all of the following except
down syndrome
The quadruple screen evaluates all of the following markers except
fetal lung maturity
The chorionic plate is related to
fetal surface of the placenta.
Biochemical screening in trisomy 21 fetuses reveals
high hCG levels and decreased AFP and estriol levels.
A young patient was referred for ultrasound with history of ? And very serum high HCG levels. Following image was obtained;
hydatidiform mole
All of the following statements are true about Vasa previa except
it is associated with central cord insertion.
Obese women are at increased risk of all of the above
it is associated with central cord insertion.
An example of a low-pressure bleed is
marginal abruption.
Immune hydrops occurs anytime mother is exposed to RBCs antigens different from her own, as under all of the following conditions EXCEPT
mother, fetus Rh-
Small for gestational age is due to all of the following conditions EXCEPT
normal placenta
The growth of the chorionic villi superficially into the myometrium of the
placenta accreta
A 30-year-old gravid patient, 8 months by dates, now presents with painless bleeding that has last for five days. Following image was obtained the thing to rule out by sonography is
placenta previa
Vaginal bleeding in second and third trimester can be associated with
placenta previa and placental abruption
Risks involved with monochorionic multiple gestations and placenta is
placenta vascular anastomosis
Amniocentesis may be used for all of the following except
prediction of cardiac abnormalities
Preeclampsia means when the patient has all of the following EXCEPT
seizures
Obese women are at increased risk of all of the above
severe eclampsia, multiple gestations, urinary tract infections)
Complications of place previa include all of the following except
succenturiate placenta
All of the following are the advantages of Chorionic villus sampling EXCEPT
the results are available within 48 hours
All of the following statements are true about vanishing twin EXCEPT
this occurs in third trimester pregnancy.
A girl with delayed puberty, short stature, webbed neck fits the profile associated
turner syndrome
Patient with gestational trophoblastic disease will present with all of the following except
uterine size smaller than dates.
A female with fetus presented at 26 weeks of gestation with an something period. Following ultrasound reveals
ventriculomegaly
Any ventricle in the fetal brain measuring greater than _______ is considered abnormal and warranting further consultation
a. 10mm
Nuchal translucency must be measured between ____weeks and ______ weeks, ___days
a. 11;13;6
Physiologic herniation of the fetal intestine outside the fetal abdomen should not be seen after gestational age
a. 12 weeks
Rates of approximately _____ through remainder of late first and second trimesters
a. 140 bpm
The fetal bladder should fill and then empty again approximately every:
a. 30-60 minutes
They embryonic heart begins to beat at _____ days
a. 35
A baby is considered as postdate when he/she is delivered after
a. 40 weeks
Serum maternal hCG levels in a normal intrauterine pregnancy less than 7 weeks should increase by doubing every ____
a. 48 hours
Dandy Walker malformation results from cystic dilation of ______
a. 4th ventricle
The normal amniotic fluid index should range between ______ centimeters
a. 5 to 22
Cardiac activity visible with TA US by ____
a. 5.5 to 6.5 weeks
The diameter of the normal yolk sac should never exceed ____mm
a. 6
At what gestational age fetal spine is visualized?
a. 6-10 weeks
The beta hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow after _____ weeks
a. 7 to 8 weeks
Embryos with heart rates below _____ beats per minute at any gestational age within the first trimester generally have a poor prognosis
a. 90
Fetus with heart _____ shows signs of tachycardia, which may lead to heart failure and fetal hydrops
a. >170 bpm
Which one of the following biometric measurements is more useful as a growth parameter?
a. AC
Assessing amniotic fluid volume using the sum of four quadrants is called which one of the following?
a. AFI
When you have demonstrated the fetal stomach transversely at the level of umbilical portion of left portal vein, you are at the appropriate level for
a. Abdominal circumference
Macrosomia is defined as a birth weight of which one of the following?
a. Above 90% for estimated gestational age
What are sonographic findings of gestational sac associated with abnormal IUP
a. Absence of cardiac motion, large yolk sac, and gestational sac growth of < .6mm/day
The fetal kidneys are most commonly located
a. Adjacent to the fetal spine bilaterally
The cavity in which the fetus exists is called the ____ cavity
a. Amniotic
Which one of the following statements about amniotic fluid is FALSE?
a. An amniotic fluid pocket greater than 5 cm may represent IUGR
An abnormality that may be seen near the end of the first trimester when there is absence of the cranium superior to the orbits with preservation of the base of the skull and facial features with the brain projected from the open cranial vault is ___
a. Anencephaly
The assessment of the fetus to determine fetal well being, including an evaluation of a cardia nonstress test and the observation of fetal breathing movement, gross fetal body movements, fetal tone, and amniotic fluid volume, is known as which one of the following?
a. Biophysical profile
The measurements used to assess gestational age in second trimester is
a. Biparietal diameter
A gestational sac in which the embryo fails to develop is described as which one of the following?
a. Blighted ovum or anembryonic pregnancy
Asymmetric intrauterine grown restriction may show all of the following EXCEPT
a. Body and head small for dates
Which one of the following terms indicates that the fetal head is toward the fundus of the uterus
a. Breech
Biparietal diameter/ head circumference should be obtained on an image of the fetal head that contains:
a. Cavum septum pellucidum, thalami, and third ventricle
An increased risk of a complete hysterectomy is present when an ectopic pregnancy is located in which one of the following structures?
a. Cervix
Cerebrospinal fluid is produced in the fetus by
a. Choroid plexus
Which structure is found in the lateral ventricle
a. Choroid plexus
The most common congenital anomaly seen sonographically is first trimester pregnancy is _____
a. Cystic hygroma
The portion of the villi burrowing on the myometrial side of the conceptus is known as which one of the following?
a. Decidua basalis
Which measurement will tell you the early sign of twin to twin transfusion syndrome?
a. Differences in NT measurements
The interface between the decidua capularis and echogenic vascular endometrium is which one of the following?
a. 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?
a. Either gestational or menstrual
In the first 9 menstrual weeks, the conceptus is called ____
a. Embryo
In case of first trimester bleeding, patients benefit from early transvaginal examination to carefully examine uterine cavity to investigate presence of _____
a. Embryo, HR, yolk sac, and retained product
Which one of the following measurements incorporates several fetal growth parameters such as BPD, HC, AC, and FL?
a. Estimated fetal weight
Which one of the following fetal measurements is about as accurate as the BPD in determining gestational age?
a. Femur length
The molar pregnancy develops from
a. Fertilization of one empty ovum with one sperm
which one of the following is not a parameter of a biophysical profile?
a. Fetal swallowing
All of the following are the measurement criteria for nuchal translucency EXCEPT
a. Fetus in transverse plane
All of the following are the associated risk factors for ectopic pregnancy EXCEPT
a. Fibroid uterus
A ______ breech occurs when the hips are extended and one or both feet are the presenting parts to the cervix
a. Footling
The cerebrospinal fluid travels from the lateral ventricles to the third ventricle via which one of the following structures?
a. Foramen of Monro
In a fetal heart the communication between the right and left atria is termed
a. Foramen ovale
In what type of breech presentation the baby can be delivered vaginally?
a. Fran breech
All of the following are the sonographic findings of gestational age associated with abnormal intrauterine pregnancy EXCEPT
a. Gestational sac growth of 1 mm per day
The number of pregnancies including the present one, is _____
a. Gravidity
Because of the low density brain tissue, the texture of the brain may appear
a. Hypoechoic
A condition in which the fetus is not growing as fast as normal is which one of the following terms
a. IUGR
What is the first conclusive sonographic sign of viability of pregnancy?
a. Identifying IUP with or without cardiac activity
When measuring the gestational sac, all of the following statements are true EXCEPT
a. If the sac is ovoid, measurements cannot be obtained
Which one of the following statements describes the binocular distance?
a. Includes both orbits at the same time
Which one of the following statements about the femur length measurement is TRUE?
a. Includes only the femoral diaphysis
Clinical observations for IUGR include all of the following EXCEPT
a. Increased fundal height
Which one the most potentially life-threatening ectopic gestation?
a. Interstitial pregnancy
One of the growth problems of the diabetic fetus is which one of the following abnormalities?
a. Macrosomia
An increased incidence of morbidity and mortality as the result of head and shoulder injuries is found in which one of the following ?
a. Macrosomic fetus
All of the following are the makers for cardiac defect EXCEPT
a. Mitral valve stenosis
The cephalic index is defined as the ratio of the biparietal diameter
a. Occipito-frontal diameter
The fetal heart occupies
a. One-third of the chest cavity pointing towards the left side of the fetus
The most common accepted method for measuring the BPD is from
a. Outer edge to inner edge
Measurement of the binocular is take from the ______ edge of one orbit ot the other ____ edge of the contralateral orbit
a. Outer, outer
Asymmetric IUGR is usually caused by which one of the following?
a. Placental insufficiency
After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones?
a. Progesterone
The term right ventricle outflow tract and left ventricle outflow tract denotes the:
a. Pulmonary artery and ascending aorta
Interface between decidua capsularis and echogenic, highly vascularized decidua on opposite wall of endometrial cavity forms double decidual sac sign, reported to be reliable sign of _____
a. Reliable sign of early IUP
The placenta of the macrosomic fetus can become which one of the following?
a. Significantly large
Sonographically, placental hematomas may be difficult to distinguish from ___
a. Subchorionic hemorrhage
The double line appearance of the spine is referred to as "railway sign" and is generated by
a. The anterior and posterior laminae and the spinal cord
In what anatomic site does fertilization of the ovum usually occur?
a. The fallopian tube
Beside BPD which other parameter has the same accuracy in predicting the fetal gestational age?
a. The femur length
What is the first structure in the early diagnosis of pregnancy by sonography?
a. The gestational sac
Which of the following statements is NOT true concerning the yolk sac?
a. The yolk sac should be included in measurement of crown rump length
Bilateral _____ cysts have been reported in as many as half of molar pregnancies
a. Theca luteal
Longitudinal transverse views of the fetal spine are routine on fetal exam. When the normal fetal spine is imaged transversely, the sonogram demonstrates
a. Three ossification centers, two posterior and one anterior, with two posterior centers pointing towards each other
The presentation of a fetus lying perpendicular to the maternal sagittal axis is in the _____ position
a. Transverse
Thoracic circumference is measured in the:
a. True transverse view at the level of fetal four chamber heart
The three vessels found in the umbilical cord are which of the following?
a. Two arteries and one vein
In ____, the choroid plexus is shown to be "dangling" in the dilated dependent lateral ventricle
a. Ventriculomegaly
If the fetal head is presenting at term, the position is called?
a. Vertex
All of the following statements are correct about AC measurement EXCEPT
a. When taking AC measurement both kidneys are also included
To differentiate an early pregnancy from a pseudogestational sac, it helps to visualize the:
a. Yolk sac
Using a TV approach, the first structure visualized within a gestational sac is which one of the following structures?
a. Yolk sac