Ob Sonography Review: Multiple Choice Questions

What is defined as the area located posterior to the broad ligaments and adjacent to the uterus, which contains the ovaries and fallopian tubes? A. Adnexa B. Paraovarian C. Pouch of Douglas D. Space of Retzius

A. Adnexa

What is the stage of the conceptus that implants within the decidualized endometrium?

A. Blastocyst

In the early gestation, where is the secondary yolk sac located?

A. Chorionic cavity

What is the most common form of GTD?

A. Complete molar pregnancy

In the first trimester, hCG levels will: A. Double every 48 hours B. Triple every 24 hours C. Double every 24 hours D. Double every 12 hours

A. Double every 48 hours

The most common cause of pelvic pain with pregnancy is:

A. Ectopic pregnancy

Typically, with anencephaly, the MSAFP value will be: A. Elevated B. Decreased C. This laboratory finding is not helpful D. Unchanged

A. Elevated

Typically, with gastroschisis, the maternal serum alpha-fetoprotein value will be: A. Elevated B. Decreased C. This laboratory finding is not helpful D. Unchanged

A. Elevated

All of the following would be an indication for a third-trimester sonogram except: A. Evaluate NT B. Evaluate fetal presentation C. Evaluate fetal growth D. Evaluate gestational age

A. Evaluate NT

The second trimester typically refers to weeks: A. 12-26 B. 13-26 C. 10-28 D. 26-42

B. 13-26

Which of the following would not typically produce an elevation in hCG? A. Down syndrome B. Anembryonic pregnancy C. Triploidy D. Molar Pregnancy

B. Anembryonic pregnancy

For the normal biophysical profile, the amniotic fluid pocket should measure: A. Greater than 4 cm in two perpendicular planes B. At least 1 cm in two perpendicular planes C. Greater then 5 cm in two perpendicular planes D. At least 3 cm in two perpendicular planes

B. At least 1 cm in two perpendicular planes

With a normal pregnancy, the first structure noted within the decidualized endometrium is the:

B. Chorionic sac

Sonographically, a normal-apprearing 7-week IUP is identified. Within the adnexa, an ovarian cystic structure with a thick, hyperechoic rim is also discovered. What does this ovarian mass most likely represent?

B. Corpus Luteum Cyst

Typically, with a miscarriage, the serum hCG value will be: A. Elevated B. Decreased C. This laboratory finding is not helpful D. Unchanged

B. Decreased

The dilation of the renal collecting system secondary to the obstruction of normal urine flow defines: A. Nephrocalcinosis B. Hydronephrosis C. Renal calculi D. Urinary stasis

B. Hydronephrosis

Compared with a normal IUP, the ectopic pregnancy will have a: A. High hCG B. Low hCG C. Markedly elevated hCG D. High AFP

B. Low hCG

All of the following would be associated with a lower-than-normal hCG level except: A. Ectopic pregnancy B. Molar pregnancy C. Blighted ovum D. Spontaneous abortion

B. Molar pregnancy

What is described as the number of pregnancies in which the patient has given birth to a fetus at or beyond 20 weeks gestational age or an infant weighting more than 500 grams? A. Gravidity B. Parity C. Primigravida D. Primiparous

B. Parity

The premature separation of the placenta from the uterine wall before birth of the fetus describes: A. placenta previa B. Placental abruption C. Ectopic cordis D. Subchoronic harartoma

B. Placental abruption

What hormone produced by the corpus luteum maintains the thickened endometrium?

B. Progesterone

A myelomeningocele is associated with: A. Down syndrome B. Spina bifida C. Edwards syndrome D. Patau syndrome

B. Spina bifida

All of the following are associated with an abnormal NT except: A. Trisomy 21 B. Trisomy 16 C. Trisomy 18 D. Turner Syndrome

B. Trisomy 16

Which of the following would be least likely associated with an elevation in MSAFP? A. Anencephaly B. Turner Syndrome C. Spina Bifida D. Myelomeningocele

B. Turner Syndrome

The structure created by the union of sperm and egg is the:

B. Zygote

What is the fetal presentation when the fetal buttocks are closest to the cervix? A. footling breech B. frank breech C. complete breech D. transverse

B. frank breech

Fertilization typically occurs within _ after ovulation

C. 24 hours

All of the following are sonographic findings consistent with ectopic pregnancy except: A. Decidual thickening B. Complex free fluid within the pelvis C. Bilateral, multiloculated ovarian cysts D. Complex adnexal mass separate from the ipsilateral ovary

C. Bilateral, multiloculated ovarian cysts

What is the term for the fetal presentation that is head down? A. Breech B. Crown C. Cephalic D. Vertical

C. Cephalic

The physiologic ovarian cyst that develops after ovulation has occurred is the:

C. Corpus luteum cyst

The first sonographically identifiable sign of pregnancy is the:

C. Decidual Reation

Which of the following would be the least likely indication for a first-trimester sonogram? A. Evaluate pelvic pain B. Define the cause of vaginal bleeding C. Gender identification D. Diagnosis of multiple gestations

C. Gender identification

In the TPAL designation, the "L" refers to: A. Living children B. Lethal anomalies C. Live births D. Lost pregnancies

C. Live births

The anechoic space along the posterior aspect of the fetal neck is the

C. Nuchal Translucency

Which of the following locations for an ectopic pregnancy would be least likely? A. Isthmus of the tube B. Ampulla of the tube C. Ovary D. Interstital of the tube

C. Ovary

Which of the following artifacts is caused by attenuation of the sound beam? A. Reverberation artifact B. Comet tail artifact C. Posterior shadowing D. Acoustic enhancement

C. Posterior shadowing

During a first trimester sonogram, you note a round, cystic structure within the fetal head. This most likely represents the:

C. Rhombencephalon

A sonographic examination was performed on a pregnancy patient who complained of vaginal bleeding. Sonographically, a crescent-shaped anechoic area is noted adjacent to the gestational sac. The gestational sac contained a 6-week single live IUP. What is most likely the diagnosis?

C. Subchorionic Hemorrhage

The reduction in blood return to the maternal heart caused by the gravid uterus compressing the maternal inferior vena cava describes: A. Edwards Syndrome B. Pulmonary obstructive syndrome C. Supine hypotensive syndrome D. Recumbent hypotensive syndrome

C. Supine hypotensive syndrome

Which of the following best describes the optimal instance to take the femur length measurement? A. When the epiphyseal plates are clearly identified and the shaft is parallel to the sound beam B. When the diaphysis of the femur is parallel to the sound beam C. When the long axis of the femoral shaft is perpendicular to the sound beam D. When the femoral shaft is parallel to the sound beam

C. When the long axis of the femoral shaft is perpendicular to the sound beam

The normal gestational sac will grow:

D. 1 mm per day

NT measures are typically obtained between:

D. 11 and 14 weeks

Which of the following artifacts is produced when the sound beam is barely attenuated through a fluid or a fluid-containing structure? A. Reverberation artifact B. Comet tail artifact C. Posterior shadowing D. Acoustic enhancement

D. Acoustic enhancement

All of the following are clinical features of an ectopic pregnancy except: A. Pain B. Vaginal bleeding C. Shoulder pain D. Adnexal ring

D. Adnexal ring

All of the following are contributing factors for an ectopic pregnancy except: A. Pelvic inflammatory disease B. Assisted reproductive therapy C. IUCD D. Advanced paternal age

D. Advanced paternal age

Which of the following would not be decreased in the presence of Edwards syndrome? A. Estriol B. hCG C. alpha-fetoprotein D. All would be decreased

D. All would be decreased

The most common site of fertilization is within the:

D. Ampulla of the uterine tube

The most common location of an ectopic pregnancy is the:

D. Ampullary portion of the uterine tube

During a 12 week sonogram, bilateral echogenic structures are noted within the lateral ventricles of the fetal cranium. These structures most likely represent:

D. Choroid plexus

The most common pelvic mass associated with pregnancy is the:

D. Corpus luteum cyst

All of the following may be visualized at the correct level of the head circumference except: A. Third ventricle B. Thalamus C. Cavum Septum Pellucidum D. Falx cerebelli

D. Falx cerebelli

All of the following are observed during a biophysical profile except: A. Fetal tone B. Thoracic movement C. Fetal breahting D. Fetal circulation

D. Fetal circulation

Another name for chorionic sac is:

D. Gestational sac

Fetal presentation is determined by identifying the fetal part that is closest to the: A. Placenta B. External os of the cervix C. Maternal umbilicus D. Internal os of the cervix

D. Internal os of the cervix

All of the following may be sonographic findings in the presence of an ectopic pregnancy except: A. Pseudogestational sac B. Corpus Luteum cyst C. Adnexal ring D. Low beta hCG

D. Low beta hCG

Which of the following is the most likely metastatic location for GTD? A. Rectum B. Pancreas C. Spleen D. Lungs

D. Lungs

What is often used to medically treat an ectopic pregnancy?

D. Methotrexate

The quadruple screen includes an analysis of all of the following except: A. hCG B. alpha-Fetoprotein C. Inhibin A D. PAPP-A

D. PAPP-A

Which of the following is also referred to as Trisomy 13? A. Down Syndrome B. Edwards Syndrome C. Turner Syndrome D. Patau Syndrome

D. Patau Syndrome

All of the following are clinical findings consistent with a complete molar pregnancy except: A. Vaginal bleeding B. Hypertension C. Uterine Enlargement D. Small for dates

D. Small for dates

The abdominal circumference should include all the following except: A. The fetal stomach B. The fetal thoracic spine C. The umbilical vein D. The kidneys

D. The kidneys

Biophysical profile scoring is conducted: A. until the fetus cooperates B. for 10 minutes C. for 45 minutes D. for 30 minutes

D. for 30 minutes

The trophoblastic cells produce:

D. hCG

What hormone maintains the corpus luteum during pregnancy?

D. hCG

All of the following are consistent with a complete hydatidiform mole except: A. Heterogeneous mass within the endometrium B. Bilateral theca lutein cysts C. Hypermesis gravidarum D. low hCG

D. low hCG

Painless second trimester vaginal bleeding is most often associated with A. placental abruption B. ectopic pregnancy C. miscarriage D. placenta previa

D. placenta previa

What structure lies within the extraembryonic coelom?

c. Yolk sac

Which of the following is not part of the biophysical profile? A. Fetal swallowing B. Flexion of the limb C. Amniotic fluid D. Fetal breathing

A. Fetal Swallowing

What is the name of the dominant follicle prior to ovulation?

A. Graafian

The number of pregnancies is defined as: A. Gravidity B. Parity C. Primigravida D. Primiparous

A. Gravidity

The migration of the embryonic bowel into the base of the umbilical cord at 9 weeks is referred to as:

A. Physiologic bowel herniation

The clinical manifestations of supine hypotensive syndrome include all the following except: A. Proteinuria B. Tachycardia C. Nausea D. Pallor

A. Proteinuria

What structure connects the embryo to the yolk sac?

A. Vitelline duct

The first structure noted within the gestational sac is the:

A. Yolk sac

All of the following are produced by the placenta except: A. alpha-fetoprotein B. hCG C. PAPP-A D. Inhibin A

A. alpha-fetoprotein

The protein that is produced by the yolk sac, fetal gastrointestinal tract, and the fetal liver is: A. alpha-fetoprotein B. hCG C. PAPP-A D. Inhibin A

A. alpha-fetoprotein

Which of the following forms of fetal presentation is the most common? A. cephalic B. complete breech C. frank breech D. transverse

A. cephalic

A malignant form of GTD is:

A. choriocarcinoma

The triple screen typically includes an analysis of: A. hCG, alpha-fetoprotein, and estriol B. Fetal NT, alpha-fetoprotein, and inhibin A C. hCG, alpha-fetoprotein, and inhibin A D. hCG, alpha-fetoprotein, and PAPP-A

A. hCG, alpha-fetoprotein, and estriol

Something that is idiopathic is said to be: A. Caused by a functional abnormality B. related to fetal development C. from an unknown cause D. found incidentally

C. from an unknown cause