Scanning OB final 12/19

What does the T sign represent?

Monochorionic diamniotic pregnancy

What renal anomaly is caused by obstruction of the fetal ureter, usually in the first trimester?

Multicystic dysplastic kidney

Which of the following can cause a false-positive diagnosis for placenta previa?

Myometrial contractions in the lower uterine segment

Which patient population has a predisposition for placenta previa?

Previous cesarean section

What should the sonographer do for their patient if they are suffering from supine hypotensive syndrome?

Put patient into left lateral decubitus position.

What is the term used to describe conjoined twins that are joined back-to-back in the sacral region?

Pyopagus

What is the definition of primary amenorrhea?

Termination of menstrual cycle prior to menopause.

Which of the following is often found with a triploid fetus?

Molar pregnancy

What is the term used to describe an umbilical cord that is around the fetal neck?

Nuchal cord

Which of the following tests can only be performed between 11 and 14 weeks gestation?

Nuchal translucency

What measurement can be used in conjuction with the biparietal diameter (BPD) to give a "shape-corrected" BPD?

Occipitofrontal diameter

Which of the following is often associated with chromosomal abnormalities and ascites?

Omphalocele

A G2P1 patient presents with a history of previous cesarean section. Sonography demonstrates loss of the normal interface between the placenta and the myometrium and what appears to be placenta along the maternal bladder wall. What does this represent?

Placenta percreta

Which of the following is true with respect to the cerebellum?

The cerebellum is a bilobed structure that is shaped like a dumbbell in the posterior fossa of the cranium.

Which of the following is false with respect to the nuchal translucency (NT) exam?

Crown rump length must be between 40 mm and 80 mm at time of exam.

What makes up the maternal portion of the placenta?

Decidua basalis

What disorder is demonstrated by the separation of the two lobes of the thalamus on ultrasound?

Dilation of the third ventricle

What fetal presentation is observed if the fetal buttocks are at the cervix and the legs are extended in front of the fetal face?

Frank breech

A sonogram demonstrates a simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent?

Gartner duct cyst

A patient presents with a nuchal fold measurement of 8 mm. What does this result indicate?

High risk for Down syndrome

What is the typical cause of dysfunctional uterine bleeding?

Hormonal imbalances resulting in endometrial changes

A male fetus presents with a large fluid collection in the scrotum. What is the term used to describe this finding?

Hydrocele

Why does an ovarian thecoma have the potential to cause endometrial thickening?

It produces estrogen.

Which of the following syndromes is associated with autosomal recessive polycystic kidney disease, occipital encephalocele, and polydactyly?

Meckel-Gruber syndrome

Which of the following disorders results from persistent bladder outlet obstruction?

Posterior urethral valves

What is the most frequent cause of oligohydramnios?

Renal anomalies

What term describes shortening of the proximal portions of the limbs?

Rhizomelia

What imaging plane(s) is best for demonstrating a Bochdalek hernia?

Sagittal and coronal views of the left abdomen/chest

What imaging plane is best to demonstrate absence of the nasal bone?

Sagittal midline image through the fetal face

What scan planes are typically used to image the fetal spine?

Sagittal, coronal, and transverse

How does an umbilical cord hemangioma present on ultrasound?

Solid hyperechoic mass in the umbilical cord near its attachment site in the placenta

Which of the following disorders will demonstrate a normal maternal serum alpha- fetoprotein value?

Spina bifida occulta

Which of the following conditions is characterized by amenorrhea, hirsutism, and obesity?

Stein-Leventhal syndrome

Why are assisted reproduction patients prone to ovarian hyperstimulation syndrome? They have elevated human chorionic gonadotropin levels from ovulation induction.

They have elevated human chorionic gonadotropin levels from ovulation induction.

Which of the chromosomal abnormalities typically presents with bilateral theca lutein cysts?

Triploidy

An amniocentesis returns results of 45,X, what disorder does this represent?

Turner syndrome

Amniocentesis shows a fetus with a 47,XXY karyotype. What abnormalities may be demonstrated sonographically on the routine sonogram?

Usually normal sonogram

What is the most common complication of amniocentesis?

Uterine contractions and cramping

What is term used to describe the death of a twin fetus in the first trimester that is reabsorbed?

Vanishing twin

What term describes the number of eggs that are fertilized? Zygosity

Zygosity

Maternal exposure to which of the following can cause growth restriction, mental impairment, malformed ears, microcephaly, and immune dysfunction in the fetus?

alcohol

When scanning a twin gestation, what is the appearance of the T sign?

twin membrane separating gestations that terminates at the junction of the placentas in a perpendicular formation

At what gestational age should the amnion and chorion be fused?

16 weeks

Where does fertilization usually occur?

Ampulla of fallopian tube

A sonogram demonstrates bilaterally enlarged echogenic fetal kidneys, no detectable urinary bladder, and oligohydramnios. What is the most likely diagnosis?

Autosomal recessive polycystic kidney disease

A fetal ultrasound demonstrates a large protruding tongue, hepatoblastoma, and an omphalocele. What syndrome does this represent?

Beckwith-Weidemann syndrome

What is the result of abnormal anastomoses of placental vessels?

Acardiac twin

Which of the following disorders occurs due to the abnormal development of the endocardial cushion?

Atrioventricular septal defect

If a multifetal pregnancy results from assisted reproduction, what can be done to maximize the success rate of live birth?

Careful assessment of amnionicity and chorionicity

A fetus is demonstrated to have very close set orbits and a small nose with a single nostril. What does this represent?

Cebocephaly

What is the likely diagnosis if echogenic foci are seen in the right abdomen that produce acoustic shadowing?

Cholelithiasis

A patient presents with an elevation in the maternal serum alpha- fetoprotein. Sonography demonstrates a normal fetus and a solid hypoechoic mass within the placenta. What is the likely diagnosis?

Chorioangioma

What part of the blastocyst implants in the endometrium during implantation?

Chorionic villus

Which part of the brain produces cerebrospinal fluid?

Choroid plexus

What term describes the inward curvature of the fifth digit towards the fourth digit?

Clinodactyly

How is the level of echogenicity of bowel determined?

Compared to the echogenicity of the pelvic bones

What abnormality of the fetal neck is often associated with chromosomal abnormalities?

Cystic hygroma

A 3D ultrasound is performed on a 30-week fetus. Facial clefting is demonstrated and the left arm demonstrates an abnormal hand. What disorder is likely the cause?

Amniotic band syndrome

Which of the following disorders presents with vaginal bleeding, low hCG, decreased symptoms of pregnancy, and a poor decidual reaction with an empty gestational sac?

Anembryonic pregnancy

What is the term used to describe a condition where there is an abnormal number of whole chromosomes? Aneuploidy

Aneuploidy

What is the most common cause of fetal bowel obstruction?

Anorectal atresia

What is the shunt in the fetal circulation allowing blood to bypass the fetal lungs after passing through the right ventricle?

Ductus arteriosus

What is the most common renal anomaly?

Duplex collecting system

Which of the following heart anomalies is associated with pentalogy of Cantrell?

Ectopia cordis

A sonohysterogram demonstrated a mass projecting into the endometrium with a defined stalk. What is demonstrated?

Endometrial polyp

A fetal sonogram demonstrated a heterogeneous mass on the anterior neck. Maternal history included an iodine deficiency. What is the most likely differential for this finding?

Fetal goiter

A fetus is shown to have bowel floating around in the amniotic fluid herniated through a defect on the right side of a normal cord insertion. What is the likely diagnosis?

Gastroschisis

Which abdominal wall defect causes a drastic increase in maternal serum alpha- fetoprotein?

Gastroschisis

The lateral ventricle measurement on a 21-week fetus is 13 mm, what is the implication of this measurement?

It indicates ventriculomegaly.

What is the normal situs and lie of the fetal heart?

Left chest with apex forming a 45-degree angle with the fetal spine

Which part of the pelvic space contains the uterus and ovaries?

Lesser pelvis

What is the most common chromosomal abnormality?

Trisomy 21

What is a life-threatening complication resulting from the death of a monochorionic twin?

Twin embolization syndrome

What is the term used to describe a cyst located in the broad ligament?

Paraovarian cyst

A fetus that presents with anal atresia, ventricular septal defects, and a renal anomaly is likely presenting with which of the following disorders?

VACTERL association

How often is a two-vessel cord associated with other abnormalities?

20%

What is the average age for climacteric to occur?

51

A patient is scanned for a biophysical profile (BPP). The fetus demonstrates 3 gross movements, 1 episode of tone, absent fetal breathing and a largest vertical pocket measurement of 4 cm. What is the BPP score?

6/8

At what time during development must division of an egg take place for a monochorionic monoamniotic pregnancy to occur?

After day 8

Which of the following terms describes a straight uterus that tilts forward in the body forming a 90° angle with the vagina?

Anteverted

A 23-week pregnant patient presents with right lower quadrant pain, fever, nausea, and leukocytosis. The fetus is normal. What else should be considered as a cause for the pain?

Appendicitis

Which of the following is most likely to increase the risk of multiple gestations?

Assisted reproductive therapy

Which term describes a fetal head that is very round (short and wide)?

Brachycephaly

What is the term used to describe absence of the middle fifth phalanx (often observed in trisomy 21)?

Clinodactyly

What imaging plane(s) are most effective for diagnosing cleft lip/palate?

Coronal and axial images of fetal face

A patient presents with abnormal uterine bleeding. What is the most common cause?

Fibroid tumors invading the endometrial cavity

What criteria is used to classify placentomegaly?

Greater than 4 cm

What sonographic sign indicates a female fetus?

Hamburger sign

A patient presents for a dating ultrasound at 7 weeks gestation with right lower quadrant pain and a palpable right adnexal mass. Sonography demonstrates an intrauterine pregnancy and an ovarian cyst with a thickened wall and internal echoes. What is the most likely diagnosis?

Hemorrhagic corpus luteal cyst

The four-chamber view is best for demonstrating which of the following?

Hypoplastic right heart

What heart structure contains a natural opening to allow blood to shunt from the right side of the heart to the left side of the heart in the fetus?

Interatrial septum

What happens to the corpus luteum if a pregnancy occurs?

It can reach a size of up to 10 cm but should resolve by 16 weeks of gestation.

What is the most common risk factor for intracranial hemorrhage in utero?

Maternal platelet disorders

How is the biparietal diameter measured?

Outer edge of temporal skull - inner edge of temporal skull

Which of 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 - left renal vein - IVC

Which part of the female pelvis has a dual blood supply?

Ovary

What is the typical cause of a quadruplet pregnancy?

Ovulation induction or in vitro fertilization

What is the most common cause of painless vaginal bleeding in the second and third trimesters?

Placenta previa

What is the preparation recommended for a transabdominal pelvic sonogram?

Have patient drink 32 oz of water 1 hour prior to exam

What is the most common abnormality of the fetal liver?

Hepatomegaly

Which of the following is a nonlethal skeletal dysplasia that presents with rhizomelia, macrocrania, frontal bossing, and trident hands?

Heterozygous achondroplasia

A patient presents with amenorrhea, cyclic abdominal pain, and an enlarged uterus. Sonography demonstrates hydrometrocolpos. What is the most likely cause?

Imperforate hymen

A sonogram demonstrates a fetus with the abdominal surface connected to the placenta, scoliosis, and no evidence of an umbilical cord. What abnormality does this represent?

Limb-body wall complex

A patient presents with a history of hirsutism, amenorrhea, and enlarged ovaries. What should the sonographer be looking for on the exam?

Polycystic ovary syndrome (PCOS)

A male fetus is demonstrated to have bilateral hydronephrosis with hydroureter, dilated bladder, and dilated urethra. What is the cause of these findings?

Posterior urethral valves

A patient presents with fever, leukocytosis and pelvic pain. Sonography demonstrates a complex multicystic right adnexal mass in the area of the ovary and tube. Both ovary and tube are visualized separately but cannot be separated from one another with the vaginal probe. What does this represent?

Tubo-ovarian complex

When percutaneous umbilical cord sampling is performed under ultrasound guidance, what segment of cord is most often accessed?

Umbilical vein at placental cord insertion site

Which sonographic exam is used to assess fetal hypoxia?

Biophysical profile

A fetal sonogram reveals a lower abdominal wall mass inferior to the umbilicus, absence of the urinary bladder, and normal amniotic fluid. What disorder does this represent?

Bladder exstrophy

At what gestational age is the nuchal fold measurement no longer of analytic utility?

>22 weeks gestation