SONO 141 Final

Growth of the chorionic villi deep into but not clear through the myometrium describes which of the following?

Placenta increta

Which of the following placental abnormalities is best described as a focal discrete lesion caused by ischemic necrosis?

Placental infarct

Pelvic inflammatory disease can lead to all of the following EXCEPT

Polycystic ovarian disease

Following an intracranial hemorrhage, a cyst is noted within the cerebrum that communicates with the lateral ventricle. Which of the following conditions best describes this condition?

Porencephaly

Craniosynostosis may be defined as which one of the following?

Premature closure of the cranial structures

What hormone is released by the ovary during the second half of the menstrual cycle?

Progesterone

What is the name of the phase of the endometrial cycle that follows the menstrual phase?

Proliferative phase

What phase of the menstrual cycle is the endometrium in when the ovary is in follicular phase?

Proliferative phase

What phase of the menstrual cycle would you expect to measure the endometrium when it is at the thickest diameter?

Secretory phase

A heterotopic pregnancy is which one of the following?

Simultaneous intrauterine and extrauterine pregnancies

What is the name of the image that is obtained to assess amniotic fluid and what is considered a normal amount?

Single pocket assessment and normal is >2cm

What is the term used to describe overlapping of the skull plates in fetal demise?

Spalding's sign

Which artery supplies blood within the functional layer of the endometrium that is altered by the hormones of the ovary?

Spiral artery

Which of the following is the most common cause of vaginal bleeding in the first trimester?

Subchorionic hemorrhage

Which of the following best describes the presence of one or more accessory lobes connected to the body of the placenta by blood vessels?

Succenturiate placenta

Which of the following statements about a placental abruption is FALSE?

The bleed may lead to a chorioangioma

Which of the following might best define the rare uterine pathology leiomyosarcoma?

The malignant counterpart of a fibroid

Which of the following best describes the criteria of a marginal placenta previa?

The placenta edge just reaches the internal os

One of the abnormal pregnancy states is trophoblastic or molar pregnancy. This type of gestational disorder often results in very high levels of hcG. Which of the following ovarian disorders is also associated with abnormally high levels of hcG?

Theca lutein cyst

Which of the following type of ovarian cysts are commonly associated with ovarian hyperstimulation syndrome?

Theca lutein cysts

Which of the following is considered an estrogen-producing ovarian tumor?

Thecomas

Hysterosalpingography (HSG) is used to evaluate the internal os diameter for cervical stenosis, when the diameter is < 1 mm, the cervix is considered stenotic.

True

It is common to see maternal vessels behind the basal plate of the placenta

True

Which one of the following abnormalities is most commonly associated with cystic hygroma?

Turner syndrome

Which vessel of the umbilical cord carries oxygenated blood from the placenta?

Umbilical vein

What is the term for the duplication of the vagina, cervix, and uterus?

Uterus didelphis

What is the most common presenting complication of a patient in the early stage of pregnancy?

Vaginal spotting/bleeding

Assuming the patient seeks medical treatment at the onset of symptoms, which of the following is the most common initial clinical presentation of pelvic inflammatory disease?

Vaginitis

The dangling choroid sign is synonymous with which of the following neural defects?

Ventriculomegaly

What is the name of substance that covers the umbilical cord?

Wharton's jelly

Which of the following best describes a "true knot" in the umbilical cord?

When the fetus passes through a loop of the cord

Which implantation site of an ectopic pregnancy would result in an increased risk of massive hemorrhage if undetected?

Within the uterine cornua

Which one of the following is the most frequent sonographic finding in an ectopic pregnancy?

adnexal mass

Which one of the following neural tube defects is characterized by a lack of development of the cerebral, cerebellar hemispheres, and cranial vault and is an abnormality that is incompatible with life?

anencephaly

Where is luteinizing hormone produced?

anterior pituitary gland

A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appearance most likely represents which one of the following?

chorioangioma

The anechoic center of a 5- to 6-week gestational sac represents which one of the following?

chorionic cavity

The most common congenital anomaly of the face is which one of the following?

cleft lip

The band of tissue that allows communication between the right and left cerebral hemispheres is the

corpus callosum

Which one of the following is the most common pelvic mass seen in a first-trimester pregnancy?

corpus luteum cyst

The villi on the myometrial side of the conceptus are known as which one of the following?

decidua basalis

Which one of the following terms is used to describe the herniation of the meninges and brain through a calvarium defect?

encephalocele

Differentials for thickened endometrium?

endometrial hyperplasia, endometrial carcinoma, endometrial polyps.

An ectopic pregnancy most commonly occurs in which one of the following structures?

fallopian tube

Multiple tiny clusters of grapelike echoes within the uterine cavity best describes which one of the following?

gestational trophoblastic disease

Which one of the following laboratory tests is used to indicate pregnancy when the values are elevated?

hCG

To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used?

(Length + width + height) ÷ 3

What is single umbilical artery associated with?

- Congenital and chromosomal abnormalities - IUGR - prenatal mortality

List 3 features of a normal gestational sac.

- DDS - smooth borders - chorionic cavity

Which of the following best describes a vein of Galen malformation?

- aneurysm of the Galen vein - sporadic event - rare arteriovenous malformation

Patients on tamoxifen therapy have an increased risk of which one of the following reactions?

- endometrial hyperplasia - endometrial polyps - endometrial carcinoma

Which of the following are included in a triple screen of early pregnancy?

- hCG - estriol - alpha-fetoprotein

Which of the following represents a function of the amniotic fluid?

- maintains constant temperature - cushions fetus - prevents adherence

List 3 functions of the placenta

- nutrition - excretion - protection - storage - hormonal production - oxygen - respiration

List 3 sonographic findings associated with fetal hydrops.

- pleural effusion - pericardial effusion - skin edema - ascites

List 3 ways the amount of amniotic fluid is regulated as gestation of fetus progresses

- swallowing - exchange with lungs - membranes and cord

List 3 different "sites" of amniotic fluid production.

- umbilical cord - lungs - skin - membranes - kidneys

In early pregnancy, the gestational sac size grows at a rate of _____ mm/day.

1 mm

Oxygen, nutrients and hormones are delivered to the fetus through the _______________.

1 umbilical vein

What is considered upper limits of normal measurement for the cisterna magna?

10 mm

Cisterna magma should be under

10mm

Cranial anatomy is routinely visualized after how many gestational weeks?

12-14

The crown-rump length measurement may be used up through the ______ gestational week

12th

Which of the following is defined as excessive hair growth in women in areas where hair growth is normally negligible?

hirsutism

Which of the following placental grades is suggested when sonographic evaluation reveals significant calcifications, septations, and lobulations?

3

How many vessels are in a normal umbilical cord?

3 (2 arteries and 1 vein)

According to our text, maternal serum hCG levels in a normal intrauterine pregnancy at less than 7 weeks should increase by doubling every

3.5 days

In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG level is _________ mega international units per milliliter (mIU/ml).

3000

Transvaginally, an embryo with cardiac activity should be identified when the embryo measures ____________ millimeters (mm).

5-8

The beta hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow, after _________ weeks.

9-10 weeks

A condition in which a complete or partial absence of the cranial bones is demonstrated is which one of the following?

Acrania

Which of the following would NOT typically be associated with amenorrhea?

Adenomyosis

Which one of the following terms describes a small chin?

micrognathia

Which one of the following terms refers to a multiple pregnancy within one chorionic sac?

monochorionic

A sonogram at 10 weeks of gestation demonstrates a cystic area within the posterior cranium. This appearance most likely represents which one of the following?

normal rhombencephalon

Evaluation of the nasal triad should include all of the following except

nostril length

Which one of the following umbilical cord entanglements in the fetus is the most common?

nuchal cord

Which of the following is defined as an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes?

pelvic inflammatory disease

Which of the following would most likely be associated with hirsutism?

polycystic ovarian syndrome

Which one of the following is the most severe form of holoprosencephaly, which is characterized by a single common ventricle and malformed brain? Orbital anomalies range from fused orbits to hypotelorism, with frequent nasal anomalies and clefting of the lip and palate.

Alobar

Which of the following invasive procedures would be performed at 16 weeks gestation?

Amniocentesis

Which of the following is best described as multiple fibrous strands of amnion that develop in utero that may entangle fetal parts to cause amputations of malformation of the fetus?

Amniotic bands

The cavity in which the fetus grows is referred to as the __________________.

Amniotic cavity

What is the term used to describe the normal or most common position of the uterus?

Anteverted

What are three complications of a severe case of ovarian hyperstimulation syndrome (OHS)?

Ascites, pleural effusion, and enlarges ovaries with multiple cysts

Which of the following is best description of an endometrial polyp?

Benign nodules of hyperplastic endometrial tissue

The placental position can be altered by the presence of an overly full urinary bladder or a ______________________.

Braxton hicks contraction

What ligament provides support for both the uterus and the ovaries?

Broad ligament

What neural defect is associated with banana shaped cerebellum and lemon shaped cranium?

Chiari II malformation

The fetal surface of the placenta is covered with a strong echogenic covering of the amnion called the ________________.

Chorionic plate

All of the following are sonographic findings consistent with adenomyosis EXCEPT

Complex adnexal mass

During a transabdominal pelvic scan in transverse, what part of the pelvic anatomy helps us locate the ovaries?

Cornua

Differentials for endometrioma

Corpus luteum cyst, hemorrhagic cyst, teratoma

After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones?

progesterone with some estrogen

A hemorrhage located between the gestational sac and the myometrium represents which one of the following conditions?

subchorionic hemorrhage

A 55-year-old post menopausal patient presents to the ultrasound department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic ultrasound reveals a large, complex, loculated cystic mass with papillary projections in the right adnexa, pelvic and abdominal ascites. Based on this history, what is the most likely diagnosis?

Cystic cystadenocarcinoma

Which one of the following central nervous anomalies demonstrates splaying of the cerebellum on ultrasound?

Dandy-Walker

Which cranial anomaly is associated with cystic dilation of the 4th ventricle with dysgenesis or complete agenesis of the cerebellar vermis?

Dandy-Walker malformation

Which of the following is considered the "maternal" side of the placenta?

Decidua basalis

Which of the following best describes the serum beta hCG levels in a patient with gestational trophoblastic disease?

Dramatically elevated

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?

Either gestational or menstrual

What two endometrial pathologies can inhibit implantation?

Endometrial polyps and fibroids

What is the term used to describe the female pelvic disorder that is characterized by the presence of functional, ectopic endometrial tissue outside of the uterus?

Endometriosis

What is the name of the inner mucosal lining of the uterus?

Endometrium

The inferior portion of the cervix closest to the vagina is the

External os

Conceptual age is the term used by sonographers when "dating" a pregnancy.

False

We only do ovarian doppler when concerned about ovarian torsion.

False

When scanning the uterus in short axis, we measure the width at the fundus.

False

Which of the following terms is used to describe a pregnancy between 11 - 40 weeks?

Fetal stage

What nutritional changes were made in prenatal care that has reduced the incidence of the most significant neurological defects?

Folic acid

A congenital fissure in the wall of the abdomen just to the right of the umbilical cord is called which one of the following?

Gastroschisis

Which of the following structures would you expect to visualize first on an early pregnancy exam?

Gestational sac

Proboscis suggests which one of the following abnormalities?

Holoprosencephaly

What neural abnormality is know in layman's terms as "water on the brain"?

Hydrocephalus

Which of the following terms best describes a simple fluid accumulation within the vagina secondary to an imperforate hymen?

Hydrocolpos

What maternal risk factor is present in approximately 50% of placental abruption cases?

Hypertension

Which type of fetal hydrops is associated with Rh isoimmunization?

Immune hydrops

What is the most common reason for a patient's cervix mucosal layer to be considered "hostile?"

Inaccurate timing

how to measure nuchal translucency

Inner to inner, do not include amnion

What is the term used to describe the location of a fibroid within the myometrium?

Intramural

What is considered the gold standard when evaluating for endometriosis and pelvic adhesions?

Laparoscopy

The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following?

Leiomyoma

What uterine pathology is considered the most common pelvic tumor?

Leiomyoma (fibroid)

What two measurements can you take for a transabdominal longitudinal image of the uterus?

Length and AP

Which female reproductive hormone typically surges or dramatically increases at the time of ovulation?

Luteinizing hormone

A cloverleaf-shaped skull is related to

thanatophoric dysplasia

Which one of the following statements about the umbilical cord is false?

the chorion covers the cord and blends with the fetal skin at the umbilicus

All of these statements are true when talking about transvaginal scanning EXCEPT?

we never do a transvaginal scan on a patient under 21

The velamentous placenta refers to a(n):

Membranous insertion of the cord

What is the term used to describe cessation of menstruation for at least 12 months that is associated with advanced age?

Menopause

Which of the following types of spina bifida is best characterized by the protrusion of spinal cord through a bony defect of the spine?

Myelomeningocele

What is the name of an anechoic, simple cyst located within the cervix?

Nabothian cyst

Findings in an ectopic pregnancy include all of the following except:

Normal increase in serum beta hCG levels

List 2 measurements or observations taken in the first trimester that might help assess the embryo for Down syndrome.

Nuchal translucency and nasal bone

What term is used to describe an AFI of < 5cm?

Oligohydramnios

Which of the following best describes the correct caliper placement on the skull for making a BPD measurement?

Outer to inner

What is the name of the ligament that connects the lower pole of the ovary to the lateral surface of the uterus?

Ovarian ligament

What abnormality results from the ovary twisting on its mesenteric or vascular connection?

Ovarian torsion

A 24-year-old female patient presents to the emergency department with severe left lower quadrant pain, nausea, and vomiting. The sonographic examination reveals an enlarged left ovary with no detectable Doppler signal. What is the most likely diagnosis AND what other specific sonographic sign should you look for?

Ovarian torsion and whirlpool sign

What ovarian disorder is sonographically characterized by the appearance of "string of pearls" when visualizing the ovaries?

PCOS

In a transvaginal Transverse/coronal plane, the left side of the screen is _______________ and the right side of the screen is ________________

Patient's right, patient's left

What three muscle groups are in the true pelvis?

Piriformist, obturator internus, and pelvic diaphragm