OBGYN final comprehensive review
If while scanning you suspect an ectopic pregnancy, where would you most likely find free fluid in the ABD? a) btwn liver/spleen b) btwn liver/LK c) btwn liver/RK d) btwn liver/diaphragm
btwn liver/RK
A pt is scanned for a BPP. Fetus demonstrates 3 gross movements, 1 episode of tone, absent fetal breathing & largest vertical pocket measuring 4cm. What is BPP score? a) 2/8 b) 4/8 c) 6/8 d) 8/8
6/8
A sonogram demonstrates bilat enlarged echogenic fetal kidneys, no detectable urinary BLDR, & oligohydramnios. What is most likely dx? a) multicystic dysplastic kidneys b) potter syndrome c) ADPKD d) ARPKD
ARPKD
What imaging plane best demonstrates the disparity in chest to ABD size found in thanatophoric dysplasia? a) COR image thru chest & ABD b) SAG image thru chest & ABD c) TRV image of both chest & ABD w/ circumference taken d) axial image of chest & thorax
SAG image thru chest & ABD
50% PID cases are caused by which of the following? a) STDs b) abscessed appendix c) ruptured colonic diverticulum d) multiple sexual partners
STDs
What is most appropriate plane to obtain intraorbital distance? a) TRV plane @ level of thalamus b) SAG plane thru orbits c) COR plan thru fetal face d) TRV plane @ level of orbits
TRV plane @ level of orbits
What does TORCH stand for?
Toxoplasmosis Other Rubella Cytomegalovirus, Herpes
A fetus that presents w/ anal atresia, ventricular septal defects, & a renal anomaly is likely presenting w/ which of the following disorders? a) pentalogy of cantrell b) VACTERL association c) Beckwith-Weidemann syndrome d) tetralogy of fallot
VACTERL association
Absence of CSP is suggestive of which of the following conditions? a) anencephaly b) acrania c) agenesis of corpus callosum d) holoprosencephaly
agenesis of corpus callosum
What is the most common maternal disorder?
diabetes mellitus
Which of the following is an indication for a 1st trimester sonogram? a) assess fetal anatomy b) eval of suspected ectopic pregnancy c) assess amniotic fluid volume d) assess fetal growth
eval of suspected ectopic pregnancy
Pt. presents w/ amenorrhea, cyclic ABD pain, & enlarged UT. Sono demonstrates hydrometrocolpos. Most likely cause? a) imperforate hymen b) vaginal atresia c) unicornuate uterus d) septate uterus
imperforate hymen
A 29y/o pt presents to US department for a pelvic ultrasound for heavy bleeding. She is 2mo postvaculation of a hydatidiform mole. What is the most likely dx based on her h/o & image below? a) PSTT b) choriocarcinoma c) invasive mole d) epithelioid trophoblastic tumor
invasive mole
Which of the following is commonly associated w/ Beckwith-Wiedemann syndrome? a) epignathus b) micrognathia c) microtia d) macroglossia
macroglossia
Rh isoimmunization
maternal antibodies to fetal blood cells
Which of the following measurements is used to estimate GA in 1st trimester? a) BPD b) AC c) mean sac diameter d) yolk sac
mean sac diameter
Definition of primary amenorrhea? a) menarche hasn't occurred by age 16 b) no menstrual cycle in a pregnant pt c) @ least 12mo w/o menstrual cycle in postmenarchal pt d) termination of menstrual cycle prior to menopause
menarche hasn't occurred by age 16
Term used to describe an abnormally small chin? a) micrognathia b) micropthalmia c) microcephaly d) microglossia
micrognathia
What are the sonographic features of achondrogenesis? a) phocomelia, early onset of ossification, large skull, polyhydramnios b) micromelia, narrow chest w/ distended ABD, small skull, polyhydramnios c) micromelia, absent mineralization of fetal bones, enlarged skull, polyhydramnios d) rhizomelia, absent mineralization of skull, oligohydramnios
micromelia, absent mineralization of fetal bones, enlarged skull, polydyramnios
What renal anomaly is caused by obstruction of fetal ureter, usually in 1st trimester? a) pelvic kidney b) Potter syndrome c) multicystic dysplastic kidney d) ARPKD
multicystic dysplastic kidney
Which of the following is a false statement w/ respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma? a) they may be single or multiple b) serial ultrasounds over 6mo will show large size difference in a leiomyosarcoma whereas leiomyoma will likely be unchanged in size c) both can demonstrate a heterogeneous hypoechoic appearance w/ shadowing d) only leiomyosarcoma will be singular
only leiomyosarcoma will be singular
Most common cause of painless vaginal bleeding in 2nd/3rd trimesters? a) placenta previa b) abruption c) cervical cerclage d) ruptured amnion
placenta previa
Most frequent cause of oligohydramnios? a) ABD wall anomalies b) cardiac anomalies c) gastrointestinal anomalies d) renal anomalies
renal anomalies
23y/o pregnant pt should be 5wks 4days. Sono shows no identifiable GS, & identifies an anechoic structure w/in RT ovary. Labwork shows quantitative beta hCG of 2323. What should be next step of care? a) repeat EV ultrasound in 2wks b) repeat beta hCG in 48hrs c) treat for an ectopic pregnancy d) transABD ultrasound to further evaluate uterus
repeat beta hCG in 48hrs
During the _________ phase of the menstrual cycle the endometrium is thickest.
secretory
_______ ______ is the most common congenital uterine anomaly.
septate uterus
Which arteries feed the functional layer of the endometrium? a) arcuate arteries b) spiral arteries c) straight arteries d) radial arteries
spiral & radial arteries
What appears sonographically as a crescent-shaped sonolucent or complex fluid collection btwn gestational sac & uterus? a) subchorionic hemorrhage b) fetal demise c) blighted ovum d) leiomyoma
subchorionic hemorrhage
A fetal sonogram demonstrates a cloverleaf-shaped skull, hydrocephalus, & telephone receiver-shaped long bones. What skeletal dysplasia is most likely? a) achondrogenesis b) achondroplasia c) thanatophoric dysplasia d) osteogenesis imperfecta
thanatophoric dysplasia
How does blood get from placenta to fetal heart? a) umbilical artery-common iliac artery-IVC b) umbilical artery-ductus venosus-LPV-RV c) umbilical vein-ductus venosus-IVC-RV d) umbilical vein-ductus arteriosus-IVC-RV
umbilical vein-ductus venosus-IVC-RV
What complications are associated w/ circumvallate placenta? a) no known complications b) retained products of conception c) vaginal bleeding & placental abruption d) delayed fetal lung maturity
vaginal bleeding & placental abruption
A fetal ultrasound demonstrates a large protruding tongue, hepatoblastoma, & omphalocele. What syndrome does this represent? a) turner syndrome b) down syndrom c) beckwith-weidemann syndrome d) tuberous sclerosis
beckwith-weidemann syndrome
Leading maternal cause of IUGR? a) diabetes b) systemic lupus erythematosus c) sickle cell disease d) hypertension
hypertension
Which of the following disorders results from persistent BLDR outlet obstruction? a) posterior urethral valves b) prune belly syndrome c) potter syndrome d) bladder exstrophy
prune belly syndrome
Bilateral renal agenesis, inadequately functioning kidneys, or obstruction of urinary tract can lead to which of the following? a) limb anomalies b) hydrops c) pulmonary hypoplasia d) anal atresia
pulmonary hypoplasia
Term to describe condition with abnormal # of whole chromosomes? a) diploidy b) aneuploidy c) translocation d) deletions
aneuploidy
Where does fertilization usually occur? a) infundibulum of fallopian tube b) ampulla of fallopian tube c) uterine cornua d) endometrium
ampulla of fallopian tube
A 38y/o pt presents for routine US; triple screen shows low MSAFP, elevated hCG & low estriol. Sonographic findings included absent nasal bone, macroglossia, & clinodactyly. Most likely dx? a) Patau syndrome b) Edward syndrome c) Beckwith-Weidemann syndrome d) Down syndrome
down syndrome
Pt presents for a dating US @ 7wks GA w/ RLQ pain & palpable RT adnexal mass. Sono demonstrates an intrauterine pregnancy & an ovarian cyst w/ thickened wall & internal echoes. What is most likely dx? a) hemorrhagic corpus luteal cyst b) serous cystadenoma c) endometriosis d) ectopic pregnancy
hemorrhagic corpus luteal cyst
Term used to describe widely spaced orbits? a) hypotelorism b) hypertelorism c) anopthalmia d) cyclopia
hypertelorism
The 4-chamber view is best for demonstrating which of the following? a) hypoplastic RT heart b) aortic stenosis c) pulmonary stenosis d) coarctation of aorta
hypoplastic RT heart
27y/o pt w/ h/o G5P0A5, LMP indicates pregnancy should be 8wks 4days. 1st ultrasound showed a viable pregnancy w/ gestational/yolk sac, fetal pole w/ FHR of 155bpm. Upon EV eval, sono again identifies gestational/yolk sac, fetal pole w/ FHR of 85bpm. Based on clinical sono findings, what do you suspect? a) viable pregnancy b) incomplete abortion c) impending fetal demise d) subchorionic hemorrhage
impending fetal demise
What structures make up the posterior boundary of the pelvic cavity? a) sacrum & coccyx b) ilium & pubis symphysis c) ischium & pubic symphysis d) ischium & sacrum
sacrum & coccyx
A pt presents w/ sudden onset of LLQ pain. Her serum hCG is pending, her LMP was 2 1/2 wks ago. Sonographer identifies a 4cm adnexal mass w/ low-level echoes & posterior enhancement. What is the most likely dx? a) endometrioma b) ovarian torsion c) hemorrhagic cyst d) mucinous cystadenoma
hemorrhagic ovarian cyst
What pathology is most likely to be demonstrated in a 12y/o female patient? a) ovarian torsion b) ectopic pregnancy c) PCOS d) PID
ovarian torsion
Which of the following is a false statement w/ respect to spina bifida? a) spina bifida cystica may demonstrate a lumbar myelocele on SAG image of fetal b) spina bifida occulta can be difficult to demonstrate on sonography as the defect is covered w/ skin c) if a meningocele is present, sonography will show a protrusion containing meninges & nerve roots d) splaying of vertebral laminae is easiest to demonstrate on SAG image of spine
splaying of vertebral laminae is easiest to demonstrate on SAG image of spine
How can the sonographer distinguish a nabothian cyst from a cervical carcinoma? a) cervical carcinoma will be a solid mass while a nabothian cyst will be a simple cyst b) nabothian cysts never have internal echoes; however, a cervical carcinoma will always demonstrate internal echoes c) shadowing will always be demonstrated from a cervical carcinoma d) a cervical carcinoma will always be wider than tall
cervical carcinoma will be a solid mass while a nabothian cyst will be a simple cyst
Which ovarian tumor presents w/ elevated serum lactate dehydrogenase & precocious puberty if it presents in a child? a) androblastoma b) endodermal sinus tumor c) yolk sac tumor d) dysgerminoma
dysgerminoma
Which of the following disease processes should NOT be seen in postmeno pt? a) endometriosis b) endometrial hyperplasia c) endometrial carcinoma d) ovarian cancer
endometriosis
What sonographic sign indicates a female fetus? a) turtle sign b) hamburger sign c) ring-of-fire sign d) keyhole sign
hamburger sign
What heart structure contains a natural opening to allow blood to shunt from RT side of heart to LT side of heart in fetus? a) interatrial septum b) interventricular septum c) foramen ovale d) endocardial cushion
interatrial septum
55y/o women presents for pelvic US for bleeding & pelvic pain. Her hx includes prior radiation treatment to her pelvis. Best diagnosis? a) endometrial carcinoma b) cervical cancer c) leiomyosarcoma d) endometrial hyperplasia
leiomyosarcoma
What does the T sign represent? a) dichorionic diamniotic b) dichorionic monoamniotic c) monochorionic diamniotic d) monochorionic monoamniotic
monochorionic diamniotic
What type of twinning is most likely to result in conjoined twins? a) dichorionic diamniotic b) dichorionic monoamniotic c) monochorionic diamniotic d) monochorionic monoamniotic
monochorionic monoamniotic
Which imaging modality has proven to be able to distinguish btwn benign & malignant lesions? a) sonography b) CT c) MRI d) none
none
Term to describe an umbilical cord around fetal neck? a) velamentous cord b) nuchal cord c) battledore cord d) wharton cord
nuchal cord
Term to describe death of a twin fetus in 1st trimester that is reabsorbed? a) vanishing twin b) blighted ovum c) fetus papyraceus d) twin embolization syndrome
vanishing twin
Most common cardiac defect? a) hypoplastic RT heart syndrome b) hypoplastic LT heart syndrome c) atrial septal defect d) ventricular septal defect
ventricular septal defect
Describe echotexture of normal uterus? a) hypoechoic to ovary b) hyperechoic to endometrium c) homogeneous d) inhomogeneous
homogeneous
Newborns affected by IUGR have many problems after birth. Some immediate neonatal risks include all of the following except: a) meconium aspiration b) hyperglycemia c) hypocalcemia d) hypothermia
hyperglycemia
Sono appearance of the proliferative endometrium? a) thin echogenic line <5mm b) 3-line-sign (basal/functional/canal/functional/basal) c) thick echogenic endometrium >15mm d) hypoechoic thin echogenic line 3-7mm
3-line-sign
Which of the following disorders presents w/ vag bleeding, low hCG, decreased symptoms of pregnancy & a poor decidual reaction w/ an empty gestational sac? a) anembryonic pregnancy b) missed abortion c) ectopic pregnancy d) gestational trophoblastic disease
anembryonic pregnancy
A fetal sonogram reveals a lower ABD wall mass inferior to umbilicus, absence of urinary BLDR, & normal amniotic fluid. What disorder does this represent? a) bladder exstrophy b) prune belly syndrome c) potter syndrome d) omphalocele
bladder exstrophy
Which of the following is a transitional cell tumor that often resembles a uterine fibroid? a) brenner tumor b) fibroma c) thecoma d) granulosa cell tumor
brenner tumor
Most common benign ovarian tumor that results from retention of an unfertilized ovum? a) sebaceous cyst b) dermoid c) thecoma d) granulosa cell tumor
dermoid
What does the term polydactyly describe? a) extra digits on hands/feet b) overlapping of 5th digit on hands c) large gap btwn 1st/2nd digit d) webbed fingers & toes
extra digits on hands/feet
This ovarian malignancy most often presents as large multi-loculated cystic masses w/ papillary projections & material. a) serous cystadenoma b) mucinous cystadenoma c) endometrioid tumor d) transitional cell
mucinous cystadenoma
Path of venous drainage from LT ovary? a) ovarian vein-LRV-SV-PV-liver-HV-IVC b) ovarian vein-external iliac vein-common iliac vein-IVC c) ovarian vein-LRV-IVC d) ovarian vein-internal iliac vein-common iliac vein-IVC
ovarian vein-LRV-IVC
What should sonographer do for their pt suffering from supind hypotensive syndrome? a) stop exam immediately & send them back to their obstetrician b) put pt in prone position c) put pt into LLD position d) call 911
put pt into LLD position
Which malignant ovarian tumor is often associated w/ pseudomyxoma peritonei? a) mucinous cystadenocarcinoma b) serous cystadenocarcinoma c) krukenberg tumor d) androblastoma
mucinous cystadenocarcinoma
Which chromosomal abnormality often presents w/ an inconclusive triple screen w/ sonographic features of holoprosencephaly & facial anomalies? a) Down syndrome b) Edward syndrome c) Patau syndrome d) Turner syndrome
patau syndrome
During a fetal heart scan, a hyperechoic mass is identified in LV, multiple hyperechoic masses were also demonstrated in renal cortex of both kidneys. What is most likely dx? a) rhabdomyoma w/ tuberous sclerosis b) angiomyolipoma w/ Down syndrome c) adenocarcinoma w/ angiomyolipoma d) trisomy w/ adenocarcinoma
rhabdomyoma w/ tuberous sclerosis
Why are assisted reproduction pts prone to ovarian hyperstimulation syndrom? a) they have elevated hCG from ovulation induction b) very high levels of estrogen & progesterone induce hyperstimulation of the ovaries c) elevated levels of follicle-stimulating hormone cause the ovaries to overproduce follicles enlarging the ovaries d) theca lutein cysts occur due to elevated levels of estrogen
they have elevated hCG from ovulation induction
Which term describes a straight uterus that tilts forward in the body forming a 90 degree angle w/ the vagina? a) retroverted b) retroflexed c) anteverted d) anteflexed
anteverted
Which imaging modality is often needed to determine uterine anomalies? a) MRI b) CT c) ultrasound d) x-ray
MRI
If multicystic dysplastic kidney disease is bilateral, what are associated sonographic findings? a) bilat multicystic kidneys, normal BLDR & AFV b) bilat multiple smooth-walled noncommunicating cysts of varying sizes in area of renal fossa, absent BLDR, oligohydramnios c) bilat enlarged echogenic kidneys, absent BLDR, oligohydramnios d) normal appearing kidneys, absent BLDR, oligohydramnios
bilat multiple smooth-walled noncommunicating cysts of varying sizes in area of renal fossa, absent BLDR, oligohydramnios
Most common gynecologic malignancy in US? a) endometrial carcinoma b) uterine carcinoma c) ovarian carcinoma d) vaginal carcinoma
endometrial carcinoma
Endometrial cavity is contiguous w/ which other part of female pelvis? a) myometrium b) fallopian tube lumen c) vagina d) ovary
fallopian tube lumen
A sonogram demonstrates a placental cord insert @ edge of placenta w/ vessels lying over internal os. What is this disorder? a) vasa previa b) succenturiate lobe c) placental abruption d) placenta previa
vasa previa
What part of blastocyst implants in endometrium during implantation? a) chorionic villus b) fimbria c) morula d) trophoblast
chorionic villus
Sonographic features of narrowing of aortic arch, enlarged RV & pulmonary artery are characteristics of what heart defect? a) coarctation of aorta b) tetralogy of fallot c) ebstein anomaly d) transposition of great arteries
coarctation of aorta
How can salpingitis be demonstrated on ultrasound if there's no fluid collection in the tube? a) power doppler should be used to show low-resistance flow in wall vessels b) color doppler should be used to demonstrate hyperemic flow c) follow cornua of uterus to tube & document wall thickeness w/ B-mode d) M-mode can be used to measure wall thickness of the tube
color doppler should be used to demonstrate hyperemic flow
What is a secondary method for detecting absence of fetal kidneys? a) absence of urine in fetal BLDR b) color doppler will show absence of renal arteries c) presence of ambiguous genitalia d) demonstration of sirenomelia
color doppler will show absence of renal arteries
A sonographer can BEST distinguish btwn gastroschisis & an omphalocele by visualizing the: a) cord insert b) contents of the mass c) a membrane d) 3VC
cord insert
Presentation of umbilical cord in advance of fetal presenting part during labor & delivery is termed: a) nuchal cord b) hypercoiling c) cord prolapse d) hypocoiling
cord prolapse
Initial source of progesterone & estrogen if fertilization occurs? a) corpus luteum b) uterus c) placenta d) ovum
corpus luteum
Which of the following best describes a thick-walled cystic mass w/ internal echoes that was demonstrated on day 20 of the menstrual cycle & resolved by day 5 of the following cycle? a) follicle b) follicular retention cyst c) corpus luteum d) hemorrhagic cyst
corpus luteum
Term used to describe fusion of orbits? a) cyclopia b) anopthalmia c) hypotelorism d) microtia
cyclopia
Which of the following is NOT considered a physiologic condition of the ovary? a) cystadenoma b) corpus luteum cyst c) thecalutein cyst d) follicular cyst
cystadenoma
What makes up the maternal portion of the placenta? a) chorion frondosum b) decidua basalis c) decidua capsularis d) outer portion of blastocyst
decidua basalis
Which of the following best describes the sonographic appearance of ovarian torsion? a) enlarged, hypoechoic ovaries w/ complete aabsence of blood flow in an area of the ovary b) complete absence of blood flow in a small atrophic ovary c) diminished blood flow along w/ enlarged hypoechoic ovary w/ peripheral follicles d) trace-free fluid in contralateral adnexa
diminished blood flow along w/ enlarged hypoechoic ovary w/ peripheral follicles
Most common type of twinning? a) diamniotic b) dichorionic c) dizygotic d) monozygotic
dizygotic
What is the definitibe sonographic sign of an intrauterine pregnancy? a) pseudogestational sac sign b) demonstration of fetal heart activity c) demonstration of fetal pole d) double sac sign
double sac sign
This pt arrived to US department w/ elevated serum lactate dehydrogenase & precocious puberty. What is most likely diagnosis? a) androblastoma b) endodermal sinus tumor c) yolk sac tumor d) dysgerminoma
dysgerminoma
Possible complication of salpingitis due to PID? a) multiple gestations b) retained products of conception c) pleural effusion d) ectopic pregnancy
ectopic pregnancy
Sonographic features of choroid plexus cysts, micrognathia, rocker bottom feet, omphalocele, & single umbilical artery are consistent w/ what chromosomal abnormality? a) Patau syndrome b) Edwards syndrome c) Down syndrome d) Turner syndrom
edwards syndrome
Most likely explanation for abnormal UT bleeding w/ endometrial measurement of <5mm in a postmeno. pt? a) endometrial hyperplasia b) endometrial cancer c) endometrial atrophy d) submucosal fibroids
endometrial atrophy
Which of the following can be a precursor for endometrial carcinoma? a) nabothian cyst b) cervical cancer c) endometrial hyperplasia d) polyps
endometrial hyperplasia
Which pelvic mass presents sonographically as a cystic mass w/ homogeneous low-level internal echoes? a) fibroma b) brenner tumor c) granulosa cell tumor d) endometrioma
endometrioma
Term used to describe the inner layer of the uterine wall? a) serosal layer b) myometrium c) endometrium d) perimetrium
endometrium
If polyhydramnios is demonstrated on fetal ultrasound, what GI abnormalities are most likely? a) esophageal or duodenal atresia b) omphalocele or gastroschisis c) meconium ileus or anorectal atresia d) omphalocele or anorectal atresia
esophageal or duodenal atresia
A 66y/o pt presents w/ ABD pain, & vaginal bleeding. While scanning the pelvis you notice an ill-defined or sausage shaped solid mass & pelvic ascites. What pathology is present in this patient? a) fallopian tube carcinoma b) serous cystadenoma c) endometriosis d) krukenberg tumor
fallopian tube carcinoma
Which of the following is a true statement w/ respect to fallopian tubes? a) most common location for an ectopic pregnancy is the infundibulum b) fallopian tube is usually only identified if there is an obstruction & it's distended w/ fluid c) infection of fallopian tube is called PID d) adenocarcinoma of fallopian tube should be considered whenever a solid mass is identified w/in adnexa
fallopian tube is usually only identified if there is an obstruction & it's distended w/ fluid
What divides the cerebral RT from LT hemispheres? a) falx cerebri b) corpus callosum c) median sulci d) metopic suture
falx cerebri
Which of the following is consistent w/ a finding of Turner syndrome? a) immune hydrops is often seen b) usually occurs in males c) fetuses present w/ cystic hygroma d) maternal serum screening shows elevated estriol, alpha-fetoprotein, & hCG
fetuses present w/ cystic hygroma
Whil scanning 14y/o transABD pelvis, you notice what appears to be uterine didelphys. What should you do next? a) finish scanning pelvis & end your study b) finish scanning pelvis then move to kidneys c) stop exam immediately & call her doctor d) ask pt. is she has ever been told she has a uterine anomaly
finish scanning pelvis then move to kidneys
Pt presents w/ h/o PID, RUQ pain, fluid in Morison's pouch, & elevated liver enzymes. Sono of RUQ reveals adhesions btwn liver & RT hemi-diaphragm. What is most likely dx? a) pseuodomyxoma peritonei b) fitz-hugh-curtis syndrome c) hepatitis d) cholecystitis
fitz-hugh-curtis syndrom
2 phases of the ovarian cycle? a) follicular & proliferative b) proliferative & secretory c) follicular & luteal d) proliferative & luteal
follicular & luteal
What fetal presentation is observed if fetal buttocks are @ cervix & legs are extended in front of fetal face? a) frank breech b) complete breech c) cephalic d) TRV
frank breech
Which layer of the endometrium is shed each month during menstruation? a) perimetrium b) basal layer c) functional layer d) submucosal layer
functional layer
4 major divisions of the uterus? a) fundus, corpus, cervix, vagina b) fundus, corpus, isthmus, cervix c) fundus, body, corpus, vagina d) fundus, corpus, fallopian tubes, cervix
fundus, corpus, isthmus, cervix
Most common benign vaginal neoplasm in pediatric population? a) gartner cyst b) teratoma c) ambiguous genitalia d) rhabdomyosarcoma
gartner cyst
A fetus is shown to have bowel floating around in amniotic fluid herniated thru a defect on RT side of a normal cord insert. What is most likely dx? a) hirschsprung disease b) anorectal atresia c) gastroschisis d) omphalocele
gastroschisis
Which of the following pathologies has clinical presentation that includes hyperemesis, extremely elevated hCG, enlarged uterus & heavy vaginal bleeding? a) mucinous cystadenoma b) gestational trophoblast disease c) theca lutein cysts d) preeclampsia
gestational trophoblastic disease
Which of the following is a nonlethal skeletal dysplasia that presents w/ rhizomelia, macromelia, frontal bossing, & trident hands? a) limb-body wall complex b) heterozygous achondroplasia c) achondrogenesis d) thanatophoric dysplasia
heterozygous achondroplasia
A fetal ultrasound demonstrated ethomocephaly, cyclopia, & cleft palate. Which of the following disorders is most likely? a) amniotic band syndrome b) beckwith-wiedemann syndrome c) fetal hydrops d) holoprosencephaly
holoprosencephaly
Sono demonstrated a large soft tissue mass w/ low-moderate echoes in uterus containing fluid filled spaces. Pt has elevated hCG & enlarged uterus; her doctor was unable to detect a fetal heartbeat. What is most likely dx? a) hydatidiform mole b) choriocarcinoma c) subchorionic hemorrhage d) missed abortion
hydatidiform mole
A pt presents w/ a lat. ventricle measurement of 22mm, dangling choroid, & BPD/HC measure 3wks greater than GA. Most likely dx? a) hydrocephalus b) ventriculomegaly c) holoprosencephaly d) Dandy-Walker malformation
hydrocephalus
Your pt tests positive for Chlamydia & presents w/ severe pelvic pain. This finding is most typical of? a) hydrosalpinx b) hematometra c) ectopic pregnancy d) ovarian cyst
hydrosalpinx
A fetal heart sonogram demonstrates a small LT ventricle, aortic stenosis, & absent mitral valve. What do these findings suggest? a) trunchus arteriosis b) hypoplastic LT heart syndrome c) hypoplastic RT heart syndrome d) ebstein anomaly
hypoplastic LT heart syndrome
The lateral ventricle measurement on a 21wk fetus is 13mm, what is the implication of this measurement? a) normal for GA b) indicates ventriculomegaly c) indicates choroid plexus cyst d) indicates mesocephalic head
indicates ventriculomegaly
EV sonography is contraindicated for which pt population? a) postmenopausal women b) perimenopausal women c) infants & kids d) women of childbearing age
infants & kids
What is a possible complication of chronic PID? a) chlamydia b) appendicitus c) pyelonephritis d) infertility
infertility
What happens to the corpus luteum if a pregnancy occurs? a) it resolves by 6th week of pregnancy b) it can reach size of up to 10cm but should resolve by 16wks GA c) production of hCG maintains the corpus luteum throughout pregnancy d) it produces estrogen required to maintain pregnancy
it can reach size of up to 10cm but should resolve by 16wks GA
What ovarian neoplasm is a result of a metastases of a GI cancer? a) setoli-leydig cell tumor b) krukenberg tumor c) mucinous cystadenocarcinoma d) granulosa cell tumor
krukenberg tumor
Weakness in which muscles leads to uterine prolapse? a) coccygeus b) iliopsoas c) levator ani d) piriformis
levator ani
Affects of hyperthyroidism on fetus due to extra thyroxine production?
low birth weight, slightly increased mortality
Amniocentesis
monitor bilirubin concentration in amniotic fl
What are the 4 biophysical features used combined w/ NST for a BPP? a) movement, tone, FHR, AFI b) movement, size, FHR, AFI c) movement, tone, breathing, AFI d) measurements, FHR, breathing, tone
movement, tone, breathing, AFI
Least @ least 1 risk factor for developing leiomyosarcoma?
nulliparity, 50 yrs or older, obesity, h/o pelvic radiation, tamoxifen exposure
Path of venous drainage from RT ovary? a) ovarian vein-uterine vein-internal iliac vein-common iliac vein-IVC b) ovarian vein-IVC c) ovarian vein-RRV-IVC d) ovarian vein-internal iliac vein-common iliac vein-IVC
ovarian vein-IVC
Which part of the female pelvis has a dual blood supply? a) uterus b) endometrium c) fallopian tube d) ovary
ovary
Pt presents w/ mittelschmerz. Sono shows small amt of free fluid in RT adnexa. What is the likely cause? a) ovulation b) ruptured hemorrhagic cyst c) rupture of nabothian cyst d) rupture of endometrioma
ovulation
What normal anatomic variant may be seen on a pelvic sonogram? a) hydronephrosis b) ascites c) free fluid in posterior cul-de-sac d) pelvic kidney
pelvic kidney
Which complication is a possilbe complication of introduction of intrauterine contraceptive devices? a) spontaneous abortion b) ectopic pregnancy c) perforation of myometrium d) asherman syndrome
perforation of myometrium
Which of the following is false w/ respect to the placenta? a) early placenta will appear as an echogenic thickened area surrounding part of gestational sac b) chorionic plate is the part of the placenta closest to the fetus c) placenta produces progesterone to maintain corpus luteum d) placenta functions as respiration for fetus
placenta produces progesterone to maintain corpus luteum
Term used to describe more than 5 digits? a) syndactyly b) clinodactyly c) polydactyly d) arthrogryposis
polydactyly
Pt has menstrual cycles 17 days apart, what would you describe this as? a) polymenorrhea b) oligomenorrhea c) amenorrhea d) hypomenorrhea
polymenorrhea
Male fetus is demonstrated to have bilateral hydronephrosis w/ hydroureter, dilated BLDR/urethra. What is the cause of these findings? a) bilat ureteropelvic junction obstruction b) bilateral ureterovesicle obstruction c) bilateral ureterocele d) posterior urethral valves
posterior urethral valves
Where is free fluid most likely to collect in female pelvis? a) vesicouterine pouch b) pouch of douglas c) anterior cul-de-sac d) space of retzius
pouch of douglas
What is defined as the onsey of puberty in girls before age of 8y/o? a) ambiguous genitalia b) precocious puberty c) PID d) gonadal dysgenesis
precocious puberty
Which of the following maternal problems is @ increased risk for mothers expecting multiple gestations? a) preeclampsia & anemia b) pericardial effusion c) gestational diabetes d) intracranial hemorrhage
preeclampsia & anemia
Which pt population has a predisposition for placenta previa? a) advanced maternal age b) maternal diabetes c) previous c-sections d) h/o PID
previous c-sections
Erythroblastosis fetalis
rapid destruction of fetal RBCs & hepatosplenomegaly
Sonogram of a postpubertal woman demonstrated a 5cm simple cyst on LT ovary. Follow-up exam 3 months later demonstrates a normal ovary. What do these findings represent? a) resolution of corpus luteum b) resolution of endometriosis c) resolution of a follicular retention cyst d) resolution of a hemorrhagic cyst
resolution of a follicular retention cyst
Most common malignant neoplasm of vagina & uterus in pediatric female? a) gartner cyst b) yolk sac tumor c) rhabdomysarcoma d) PID
rhabdomyosarcoma
What term describes shortening of the proximal portions of the limbs? a) rhizomelia b) mesomelia c) acromelia d) phocomelia
rhizomelia
Term used to describe an anechoic structure located in fetal head in an 8wk GA? a) choroid plexus b) prosencephalon c) mesencephalon d) rhombencephalon
rhombencephalon
Pt presents w/ elevated hCG, LT sided pelvic pain, & elevated WBC. Sono reveals a large, round, complex mass consuming ovarian parenchyma & undergoing cystic changes. What is the most likely dx? a) ovarian cyst b) leiomyoma c) ruptured ectopic pregnancy d) normal pregnancy
ruptured ectopic pregnancy
An asymptomatic pt presents w/ bilat large anechoic lesions w/ septations & papillary projections. What does this most likely represent? a) cystic teratoma b) endometrioma c) mucinous cystadenoma d) serous cystadenoma
serous cystadenoma
Asymptomatic pt presents w/ bilateral large anechoic lesions w/ septations & papillary projections. What does this most likely represent? a) cystic teratoma b) endometrioma c) mucinous cystadenoma d) serous cystadenoma
serous cystadenoma
Most common malignant ovarian tumor? a) serous cystadenoma b) mucinous cystadenoma c) endometrioid tumor d) transitional cell
serous cystadenoma
What is the cause of hypospadias? a) shortened urethra b) shortened ureters c) undescended testicles d) stimulation from maternal hormones
shortened urethra
If fusion of lower extremities, renal agenesis, & oligohydramnios are demonstrated on sonography, what abnormality is indicated? a) sirenomelia b) radial ray syndrome c) talipes equinovarus d) amniotic band syndrome
sirenomelia
What anatomic landmakrs do sonographers use for AC measurement? a) stomach & umbilical/PV b) cord insert & stomach c) kidneys & GB d) kidneys & stomach
stomach & umbilical/PV
Term to describe a twin that is in close association w/ the uterine wall? a) stuck twin b) fetus papyraceus c) discordant growth d) twin-twin transfusion syndrome
stuck twin
What is leading cause of 1st trimester vag bleeding in presence of a closed cervix? a) blighted ovum b) fetal demise c) complete abortion d) subchorionic hemorrhage
subchorionic hemorrhage
A pt presents w/ an enlarged bulky uterus & menorrhagia. Which of the following is most likely to be the cause? a) subserosal fibroid b) submucosal leiomyoma c) adenomyosis d) bicornuate uterus
submucosal leiomyoma
Term used to describe an additional small lobe of placenta separate from main segment? a) circumvallate placenta b) succenturiate lobe c) placentomegaly d) bilobed placenta
succenturiate lobe
What is an ovarian complication of a molar pregnancy? a) hemorrhagic follicular retention cyst b) theca lutein cyst c) corpus luteum cyst d) serous cystadenocarcinoma
theca lutein cyst
Term to describe disorder w/ extra copy of a chromosome? a) monosomy b) trisomy c) diploidy d) haploidy
trisomy
Most common chromosomal abnormality? a) trisomy 21 b) turner syndrom c) trisomy 18 d) trisomy 13
trisomy 21
What chromosomal abnormality is associated w/ missing nasal bone? a) trisomy 21 b) trisomy 18 c) anencephaly d) encephalocele
trisomy 21
Pt presents w/ fever, leukocytosis & pelvic pain. Sono demonstrates a complex multicystic RT adnexal mass in area of ovary & tube. Both ovary & tube are visualized separately but can't be separated from one another w/ vaginal probe. What does this represent? a) salpingitis b) PID c) tubo-ovarian abscess d) tubo-ovarian complex
tubo-ovarian abscess
Pt presents w/ pelvic pain, infertility, & palpable RT adnexal mass. Sono demonstrated multicystic RT adnexal mass w/ dirty shadowing & bilateral hydrosalpinx. What is most likely dx? a) appendicitus b) vaginitis c) tubo-ovarian abscess d) acute PID
tubo-ovarian abscess
Life-threatening complication resulting from the death of a monochorionic twin? a) vanishing twin b) twin embolization syndrome c) fetus papyraceus d) acardiac twin
twin embolization syndrome
What is a heterotopic pregnancy? a) twin gestation, both embryos in sam amniotic sac b) twin gestation, 2 separate gest. sacs each in its own horn of a bicornuate uterus c) twin gestation, 1 gestation implanted in uterus & other is ectopic d) twin gestation, both sacs implanted in fallopian tube
twin gestation, 1 gestation implanted in uterus & other is ectopic
A twin gestation demonstrates a 25% difference in fetal weight btwn the 2 gestations. Most likely explanation? a) technologist error b) the 2 fetuses implanted @ different times c) twin-twin transfusion syndrome d) chromosomal abnormality in smaller fetus
twin-twin transfusion syndrome
A fetal sonogram demonstrates a normal LK but RT has severely dilated renal pelvis & dilated proximal ureter. Rest of urinary system is normal. Most likely cause? a) urethral agenesis b) hydronephrosis c) ureteropelvic junction obstruction d) posterior urethral valves
ureteropelvic junction obstruction
An IUGR fetus is defined as a sonographic estimated fetal weight less than the ____ percentile for GA. a) 5th b) 7th c) 10th d) 12th
10th
At what GA should physiologic bowel herniation be resolved? a) 8wks b) 10wks c) 12wks d) 16wks
16wks
When is a fetus most susceptible to malformations?
1st trimester
After 20wks gestation, a fundal height difference of > ___ cm is suspicious for growth restriction. a) 1 b) 3 c) 5 d) none of the above
3
How many ossification centers should be present for each vertebrae a) 3 b) 2 c) 1 d) 4
3
If pt has hCG level of 100, in how many days should it be possilbe to visualize a gestational sac? a) 2 days b) 3 days c) 4 days d) 5 days
4 days
What does G4P3A1 represent? a) 4 pregnancies, 3 births @ >20wks GA, 1 failed gestation b) 4 live births from 3 pregnancies c) 4 pregnancies, 3 C-sections d) 4 births, 2 live, 2 stillborn
4 pregnancies, 3 births @ >20wks GA, 1 failed gestation
Fetal hyperinsulinemia results in macrosomia, when fetal weight exceeds?
4500g/9lb 9oz
What is upper limit of normal for renal pelvis diameter in an 18wk fetus? a) 4mm b) 7mm c) 10mm d) 3mm
4mm
What is considered a normal range for amniotic fluid index? a) 10-30cm b) 7-27cm c) 5-25cm d) 3-20cm
5-25cm
Miss Greenfield is 73y/o & asymptomatic. She is NOT on HRT. Her endometrium should not measure more than: a) 1mm b) 2mm c) 3mm d) 5mm`
5mm
At what GA should an ABD wall defect be considered a fetal pathology? a) >12wks b) 8wks c) <22wks d) 27-40wks
>12wks
What criteria is used to classify placentomegaly? a) >4cm b) >5cm c) >8cm d) <2cm
>4cm
What measurements are correlated to determine an estimated fetal weight? a) BPD, HC, AC, FL b) BPD, occipitofrontal diameter, AC, CRL c) mean sac diameter (MSD), BPD, AC, FL d) CRL, MSD, AC, FL
BPD, HC, AC, FL
Which sonographic exam is used to assess fetal hypoxia? a) biometry scan b) anatomical profile c) nuchal translucency d) BPP
BPP
Which of the following is false w/ respect to the nuchal translucency exam? a) increased NT associated w/ trisomy 21, 18, & Turner's b) NT exams can only be performed btwn 11wks & 13wks 6 days c) fetus must be in neutral position in SAG d) CRL must be btwn 40-80mm @ time of exam
CRL must be btwn 40-80mm @ time of exam
What is most accurate sonographic method for dating a pregnancy? a) CRL prior to 14wks GA b) mean sac diameter prior to 10wks GA c) BPD d) cerebellum diameter
CRL prior to 14wks GA
Which fetal brain structures should be visualized in axial plane used to measure BPD? a) thalamus, cerebellum, cisterna magna b) thalamus, falx cerebri, cerebellum c) CSP, thalamus, cerebellum d) CSP, thalamus, falx cerebri
CSP, thalamus, falx cerebri
Term used as a diagnosis to describe an infant that is smaller than expected for gestational age? a) macrosomia b) IUGR c) twins d) microcephaly
IUGR
What is normal situs & lie of fetal heart? a) mid chest w/ apex pointing toward aorta b) LT chest w/ apex forming 45 degree angle w/ fetal spine c) LT chest w/ LA closest to IVC d) RT chest w/ atrium pointing toward LT anterior chest
LT chest w/ apex forming 45 degree angle w/ fetal demise
Pt presents w/ acute LT pelvic pain, vag bleed, low hCG for GA, & low hematocrit. Sono shows small irreg. cystic area in endometrial canal, adnexal ring sign in LT adnexa, & free fluid in cul-de-sacs/adnexas. Most likely dx? a) LT ectopic pregnancy b) pseudosac c) hemorrhagic corpus luteal cyst d) yolk sac tumor
LT ectopic pregnancy
If pt presents w/ free fluid in pelvic spaces, where else should the sonographer interrogate? a) Morison's pouch b) pleural cavity c) pericardial space d) synovial cavity
Morison's pouch
Most common hormonal disorder among reproductive age women? a) amenorrhea b) PCOS c) dysmenorrhea d) menopause
PCOS
Early sexual contact, multiple sex partners, &/or h/o STDs are all risk factors are associated w/ what disease? a) PID b) PCOS c) endometriosis d) leiomyomas
PID
What imaging plane is best to demonstrate absence of the nasal bone? a) COR thru nasal bridge b) SAG midline thru fetal face c) Axial image thru nose/lips d) TRV thru level of nasal bridge
SAG midline thru fetal face
What is most appropriate plane to obtain an intraorbital distance? a) TRV plane @ level of thalamus b) SAG plane thru orbits c) COR plane thru fetal face d) TRV plane at orbit level
TRV plane at orbit level
While scanning an 11wk pregnancy, you come across a mid-gut herniation, this is: a) omphalocele b) gastroschisis c) a normal finding d) ectopia cordis
a normal finding
What is the result of abnormal anastomoses of placental vessels? a) intrauterine death b) monochorionic twin gestation c) conjoined twins d) acardiac twin
acardiac twin
Term used to describe the normal of ovaries? a) adnexa b) vesicouterine space c) uterine fossa d) rectouterine space
adnexa
At what time during development must division of an egg take place for a monochorionic monoamniotic pregnancy to occur? a) prior to day 4 b) btwn day 4-8 c) btwn day 6-8 d) after day 8
after day 8
A fetus is demonstrated to have a horseshoe shaped monoventricle, fused thalami & absent falx. Most likely dx? a) mucinous cystadneoma b) alobar holoprosencephaly c) lobar holoprosencephaly d) Dandy-Walker malformation
alobar holoprosencephaly
Fertilization usually occurs in the _______ portion of the fallopian tube.
ampulla
A fetus demonstrates absence of cornea on COR plane of fetal face. What abnormality does this represent? a) cebocephaly b) micropthalmia c) anopthalmia d) ethmocephaly
anopthalmia
All of the following are risks for developing an ectopic pregnancy except? a) PID b) previous ectopic c) smoking d) anterior placenta
anterior placenta
What part of female pelvis define the vesicouterine space? a) anterior surface of the uterus & posterior surface of BLDR b) posterior surface of uterus & anterior surface of rectum c) anterior surface of BLDR & anterior surface of pubic symphysis d) anterior surface of uterus & anterior surface of BLDR
anterior surface of uterus & posterior surface of BLDR
Which of the following is most likely to increase risk of multiple gestations? a) early menarche b) late menarche c) assisted reproductive therapy d) early maternal age
assisted reproductive therapy
Which type of growth restriction begins in 3rd trimester & is physically characterized as discordant biometric growth pattern? a) symmetric IUGR b) asymmetric IUGR c) small for gestational age d) macrosomia
asymmetric IUGR
Cause of adenomyosis? a) functional layer endometrial tissue invades the myometrium b) basal layer endometrial tissue invades the myometrium c) tiny areas of leiomyoma tissue form in the myometrium c) development of arteriovenous malformations in the myometrium
basal layer endometrial tissue invades myometrium
Which of the following best describes a uterus that has 2 separate endometrial canals but a single cervix? a) septate uterus b) bicornuate uterus c) uterus didelphys d) subseptate uterus
bicornuate uterus
Hemolytic disease severity is directly related to...
bilirubin level in amniotic fluid
What criteria should be observed when assessing both LT & RT VOT? a) aorta & pulmonary artery should crisscross b) aorta should be positioned anterior to pulmonary artery c) location of mitral valve & tricuspid valves should be assessed d) both a & b
both a & b
At what GA should kidneys be visualized on transABD sonography? a) 15wks b) 12wks c) 18wks d) both a & c
both a & c
If fetus has a heart rate of 74 BPM, this is: a) tachycardia b) bradycardia c) acardia d) none of the aboce
bradycardia
A fetus is demonstrated to have very close set orbits & a small nose w/ a single nostril. What does this represent? a) ethmocephaly b) cyclopia c) cebocephaly d) micropthalmia
cebocephaly
24y/o C/O RT shoulder pain (+ hCG). Sono reveals complex fluid collection surrounding an echogenic structure w/ post. shadowing. Also identifies a small, oval, complex structure w/in cervix; bilat. ovaries/adnexas unremarkable. Best dx? a) intramyometrial ectopic pregnancy b) cornual ectopic pregnancy c) cervical ectopic pregnancy d) intrauterine pregnancy
cervical ectopic pregnancy
Most common renal anomaly? a) pelvic kidney b) duplex collecting system c) horseshoe kidney d) urachal cyst
duplex collecting system
