OB/GYN: Midterm Questions
What is the preparation recommended for a transabdominal pelvic sonogram?
-drink 4 8oz glasses of water -full bladder
What is true about identifying the fallopian tubes sonographically?
-the fallopian tubes are not usually identified -can be identified if there is an obstruction and it is distended with fluid
What does G4P3A1 represent?
4 pregnancies, 3 births at >20 weeks gestation, 1 failed gestation
If a patient has a human chorionic gonadotropin (hCG) level of 100, in how many days should it be possible to visualize a gestational sac?
5 days
What best describes the appearance of a normal ovary?
<15 mL volume, hyperechoic to myometrium with multiple anechoic follicles
What does ALARA stand for?
As Low As Reasonably Achieveable
Which of the following is false with respect to the nuchal translucency exam?
CRL must be between mm and 8 mm at the time of the exam
Which imaging modality is often needed to determine uterine anomalies?
MRI
What is the most common hormonal disorder among women of reproductive age?
Polycystic Ovarian Disorder
50% of PID cases are caused by what?
STDs or STIs
While scanning an 11 week pregnancy, you come across a midgut herniation, this is:
a normal finding
What is the sonographic appearance of an invasive mole?
anechoic masses representing hemorrhage
All of the following are risk factors for developing an ectopic pregnancy except?
anterior placenta
What term describes a straight uterus that tilts forward in the body forming a 90 degree angle with the vagina?
anteverted
What is the cause of adenomyosis?
basal layer endometrial tissue invades the myometrium
If while scanning you suspect an ectopic pregnancy, where would you most likely find free fluid in the abdomen?
between the liver and right kidney
Which of the following best describes a uterus that has two separate endometrial canals but a single cervix?
bicornuate uterus
What does the term hematocolpos mean?
blood in the vagina
If a fetus has a heart rate of 74 BPM, this is:
bradycardia
Which of the following best describes a thick-walled cystic mass with internal echoes that was demonstrated on day 20 of the menstrual cycle and resolved by day 5 of the following cycle.?
corpus luteal cyst
What is the initial source of the progesterone and estrogen if fertilization occurs?
corpus luteum
While scanning through the fetal cervical spine in a transverse plane, you notice an area of subcutaneous edema that protrudes from the posterior spine. This most likely represents?
cystic hygroma
What makes up the maternal portion of the placenta?
decidua basalis
What is the first definitive sonographic sign of an intrauterine pregnancy?
double sac sign
What pelvic mass presents sonographically as a cystic mass with homogeneous low-level internal echoes?
endometrioma
What is the term used to describe the inner layer of the uterine wall?
endometrium
Which of the following is an indication for a first trimester sonogram?
evaluation of a suspected ectopic pregnancy
The endometrial cavity is contiguous with which other part of the female pelvis?
fallopian tube lumen
What are the two phases of the ovarian cycle?
follicular and luteal
What normal anatomic variant my be demonstrated on a pelvic sonogram?
free-fluid in the posterior cul-de-sac
What layer of the endometrium is shed every month during menstruation?
functional layer
How would you describe the echotexture of the normal uterus?
homogenous
What is a possible complication of chronic PID?
infertility
What is the most common gestational trophoblastic neoplasia?
invasive mole
Which other organ(s) should be interrogated if uterine anomalies are demonstrated?
kidneys
What ovarian neoplasm is a result of metastases of a GI cancer?
krukenberg tumor
Why do endovaginal transducers utilize a higher frequency range than a transabdominal transducer?
less penetration is required as structures are closer to the transducer
Weakness in which of the following muscles leads to prolapse of the uterus?
levantor ani
List one sonographic appearance of ovarian torsion.
little or no blood supply to the ovary
If a pelvic neoplasm is suspected, you should also image:
liver
Which imaging modality has proven to be able to distinguish between benign and malignant lesions?
none
List at list one risk factor for developing leiomyosarcoma.
obesity
Which if the following pathologies is most likely to be demonstrated in a 12-year old female patient?
ovarian torsion
What is the path of venous drainage from the left ovary?
ovarian vein to left renal vein to IVC
Where would you see enhancement on a normal transabdominal sonogram?
posterior to the bladder
Where is free-fluid most likely to collect in the female pelvis?
pouch of douglas
What should the sonographer do for their patient if they are suffering from supine hypotensive syndrome?
put patient into left lateral decubitus position
Which arteries in the uterus feed the functional layer of the endometrium?
radial/spiral
What is responsible for the development of follicles on the ovaries?
release of follicle-stimulating hormone by the anterior pituitary gland
A sonogram of a post-pubertal woman demonstrated a 5 cm simple cyst on the left ovary. A follow-up exam 3 months later demonstrates a normal ovary. What do these findings likely represent?
resolution of a follicular cyst
A patient with an elevated hCG, left sided pelvic pain, and elevated WBC. What is the most likely diagnosis?
ruptured ectopic pregnancy
An asymptomatic patient presents with a bilateral anechoic lesion that contains septations and papillary projections. What does this most likely represent?
serous cystadenoma
What is the most common malignant ovarian tumor?
serous cystdenoma
What appears sonographically as a crescent-shaped sonolucent or complex fluid collection between the gestational sac and uterus?
subchorionic hemorrhage
A patient presents with an enlarged bulky uterus and menorrhagia. Which of the following is most likely to be the cause?
submucosal leiomyoma
What is an ovarian complication of a molar pregnancy?
theca lutein cyst
What is the sonographic appearance of the proliferative endometrium?
three-line sign
A patient presents with pelvic pain, infertility, and a palpable right adnexal mass. Sonography demonstrated a multicystic complex right adnexal mass with dirt shadowing and bilateral hydrosalpinx. What is the most likely diagnosis?
tubo-ovarian abscess
A patient presents with amenorrhea, cyclic abdominal pain, and an enlarged uterus. Sonography demonstrates hydrometrocolpos. What is the most likely cause?
unicornuate uterus
Which uterine anomaly results in two uterine horns, two cervixes and two vaginas?
uterus didelphys
What is the most common uterine anomaly?
septate uterus
A patient presents for a dating ultrasound a 7 weeks gestation with RLQ pain and a palpable right adnexal mass. Sonography demonstrates an intrauterine pregnancy and an ovarian cyst with thickened wall and internal echos. What is the most likely diagnosis?
hemorrhagic corpus luteal cyst
Define precocious puberty.
onset of early puberty
What is the term used to describe a cystic structure located in the fetal head in an 8 week gestation?
rhombencephalon
List on sonographic finding for fallopian tube cancer.
sausage-shaped mass
What measurements are correlated to determine an estimated fetal weight?
BPD, head circumference, abdominal circumference, femur length
What is the most accurate sonographic method for dating a pregnancy?
CRL prior to 14 weeks gestation
What part of the blastocyst implants in the endometrium during implantation?
chorionic villi
What is the most common gynecological malignancy in the US?
endometrial carcinoma
Which of the following can be a precursor for endometrial carcinoma?
endometrial hyperplasia
What are the three anatomic sections of the uterus?
fundus, body, cervix
A sonogram demonstrates simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent?
gartner duct cyst
What is the most common vaginal neoplasm in the pediatric population?
gartner duct cyst
Sonography demonstrated a large soft tissue mass with low to moderate amplitude achoes in the uterus containing fluid filled spaces. The patient demonstrated elevated hCG and an enlarged UT. Her doctor was unable to detect a fetal heartbeat. What is the most likely diagnosis?
hydatidiform moletheca lutein cyst
How would you describe the echotexture of the normal endometrium?
hyperechoic to the myometrium
A patient presents with amenorrhea, cyclic abdominal pain, and en enlarged uterus. Hydrometrocolpos is present. What is the most likely diagnosis?
imperforate hymen
Endovaginal sonography is contraindicated for which of the following patient populations?
infants and children
A patient presents with acute left pelvic pain, vaginal bleeding, low hCG for gestational age, and low hematocrit. Sonography demonstrates a small irregular shaped cystic area in the endometrial canal, and adnexal ring sign in the left adnexa, and free fluid in the cul-de-sac and adnexa. What is the most likely diagnosis?
left ectopic pregnancy
During which phase of the menstrual cycle is the endometrium at its thickest?
luteal
Which of the following measurements is used to estimate gestational age in the first trimester?
mean sac diameter
What is the definition of primary amenorrhea?
menarche has not occurred by age 16 in a female patient
This ovarian malignancy most often presents as a large multiloculated cystic mass with papillary projects and thick echogenic material.
mucinous cystdenoma
Which of the following is a false statement with respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma?
only leiomyosarcoma will be singular
Which part of the female pelvis has a dual blood supply?
ovary
What is the leading cause of a first-trimester vaginal bleeding in the prescence of a closed cervix?
subchorionic hemorrhage
Absence of the nasal bone is associated with which chromosomal abnormality?
trisomy 21
What is a heterotopic pregnancy?
twin gestation, where one gestation is implanted in the uterus and the other has an ectopic implantation
How can a sonographer distinguish a nabothian cyst from a cervical carcinoma?
a cervical carcinoma will demonstrate a solid mass whereas a nabothian cyst will have all the characteristic of a simple cyst
At what gestational age should physiological bowel herniation be resolved?
12 weeks
Which of the following disorders present with vaginal bleeding, low hCG, decreased symptoms of pregnancy, and a poor decidual reaction with an empty gestational sac?
anembryonic pregnancy
What parts of the female pelvis define the vesicouterine pouch?
anterior surface of the uterus and posterior surface of the bladder
What is the term used to describe the normal location of the ovaries?
adnexa
In what portion of the fallopian tube does fertilization usually occur?
ampulla
Where does fertilization usually occur?
ampulla
Which of the following pathologies has clinical presentation that includes hyperemesis, extremely elevated hCG, enlarged uterus and heavy vaginal bleeding?
gestational trophoblastic disease
A patient presents with mittelschmerz. Sonography demonstrated a small amount of free fluid in the right adnexa. What is the likely cause?
ovulation
Name one common renal anomaly that often occurs along with uterine anomalies.
renal agenesis