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ob/gyn > Ch. 52,53,54 > Flashcards

Ch. 52,53,54 Flashcards

1
Q

The abdominal circumference (AC) is taken at the _________________.

a. Diameter of the fetal abdomen

b. Level of the stomach, left portal vein, and left umbilical vein

c. Diameter of the fetal abdomen at the level of the kidneys and diaphragm

d. Level of the kidneys and bladder

A

b. Level of the stomach, left portal vein, and left umbilical vein.

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2
Q

Which one of the following sonographic signs refers to the shape of the cerebellum when a spinal defect is present?

a. Sandwich

b. Strawberry

c. Banana

d. Lemon

A

c. Banana

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3
Q

The biparietal diameter (BPD) is the measurement of the fetal head at the level of which of the following structures?

a. Thalamus and cavum septum pellucidum (CSP)

b. Frontal horns and third ventricle

c. Peduncles and septum pellucidum

d. Thalamus and fourth ventricle

A

a. Thalamus and cavum septum pellucidum (CSP)

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4
Q

The condition that shows the fetal head elongated in the transverse diameter and shortened in the anteroposterior diameter is known as which one of the following?

a. Dolichocephaly

b. Elongichocephaly

c. Brachycephaly

d. Minicephaly

A

c. Brachycephaly

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5
Q

Which one of the following measurements is the most accurate for determining gestational age in the first trimester?

a. Crown-rump length (CRL)

b. BPD

c. MSD

d. Yolk sac diameter

A

a. Crown-rump length (CRL)

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6
Q

The plane used for a coronal head circumference (CHC) should include which one of the following structures?

a. CSP and falx cerebri

b. Third ventricle and brainstem

c. Thalamus and brainstem

d. Atrium of the lateral ventricle and thalamus

A

c. Thalamus and brainstem

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7
Q

When measuring the gestational sac, all of the following statements are true except:

a. A distended urinary bladder can compress the sac from round to ovoid.

b. If the sac is round, one diameter should be measured.

c. If the sac is ovoid, measurements cannot be obtained.

d. If the sac is ovoid, the anteroposterior and width is measured to obtain mean diameter.

A

c. If the sac is ovoid, measurements cannot be obtained.

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8
Q

When the gestational mean sac diameter (MSD) exceeds _____ millimeters (mm), an embryo with definite cardiac activity should be clearly seen with transvaginal scanning.

a. 7

b. 10

c. 13

d. 16

A

d. 16

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9
Q

The absence of an embryo in an intrauterine pregnancy of 7 to 8 weeks is consistent with which one of the following?

a. Placenta previa

b. Ectopic pregnancy

c. Anembryonic pregnancy

d. Multiple gestation

A

c. Anembryonic pregnancy

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10
Q

Frontal bones of the cranium that collapse forward describe which one of the following abnormalities?

a. Banana sign

b. Lemon sign

c. Mickey Mouse sign

d. Acrocephaly

A

b. Lemon sign

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11
Q

Which one of the following biometric measurements is more useful as a growth parameter?

a. BPD

b. Head circumference

c. CRL

d. AC

A

d. AC

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12
Q

With normal transvaginal sonography, cardiac activity should be demonstrated when the CRL exceeds ______ mm.

a. 5

b. 6

c. 7

d. 8

A

c. 7

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13
Q

Which one of the following measurements is devised to determine the normality of the fetal head shape?

a. Head circumference

b. BPD

c. Head circumference:abdominal circumference ratio

d. Cephalic index

A

d. Cephalic index

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14
Q

Which one of the following fetal measurements is about as accurate as the BPD in determining gestational age?

a. AC

b. Head circumference

c. Femur length

d. Cephalic index

A

c. Femur length

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15
Q

The fetal orbits should be measured:

a. At the same level as the BPD

b. In a plane slightly caudal to the BPD

c. In a plane slightly cephalic to the BPD

d. In the occipitoanterior position

A

b. In a plane slightly caudal to the BPD

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16
Q

The fetus is categorized into the small, average, or large growth percentiles in which one of the following methods?

a. Intrauterine growth restriction (IUGR)

b. Biophysical profile

c. Growth-adjusted sonar age

d. Age-range analysis

A

c. Growth-adjusted sonar age

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17
Q

Which one of the following statements about the femur length measurement is true?

a. Is taken from the pointed end to the pointed end.

b. Should include the distal femoral epiphysis.

c. Includes only the femoral diaphysis.

d. Should include the femoral head.

A

c. Includes only the femoral diaphysis.

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18
Q

All long bones should be measured if the difference between the femur length and all other biometric parameters is which one of the following?

a. Greater than 3 weeks

b. Greater than 4 weeks

c. Greater than 1 week

d. 2 weeks or greater

A

d. 2 weeks or greater

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19
Q

Which one of the following statements describes the binocular distance (BD)?

a. Includes both orbits at the same time.

b. Is the length between the two orbits.

c. Is the distance of an orbit.

d. Is the depth of both orbits.

A

a. Includes both orbits at the same time.

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20
Q

Gestational age can best be predicted from which one of the following?

a. Interocular distance

b. Orbital diameter

c. Intraocular distance

d. BD

A

d. BD

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21
Q

With transvaginal sonography, the earliest appearance of a normal intrauterine gestational sac should be seen with a serum beta human chorionic gonadotropin (hCG) greater than _____ mega international units per milliliter (mIU/ml).

a. 500

b. 1000

c. 1500

d. 2000

A

a. 500

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22
Q

Measurement of the BD is taken from the ___________ edge of one orbit to the ___________ edge of the contralateral orbit.

a. Outer; inner

b. Inner; inner

c. Outer; outer

d. Inner; outer

A

c. Outer; outer

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23
Q

Linear acceleration of the embryonic heart rate correlates well with gestational age up to _________________ weeks.

a. 8 menstrual

b. 9 gestational

c. 10 menstrual

d. 12 conception

A

b. 9 gestational

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24
Q

A condition in which the fetus is not growing as fast as normal is which one of the following terms?

a. Growth-adjusted sonar age

b. Age-range analysis

c. IUGR

d. Microcephaly

A

c. IUGR

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25
Q

Measurement of the BPD is taken from the __________ edge to the ___________.

a. Outer; inner edge

b. Outer; outer edge

c. Inner; inner edge

d. Outer; falx multiplied by two

A

a. Outer; inner edge

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26
Q
  1. The assessment of the fetus to determine fetal well-being, including an evaluation of a cardiac non-stress test and observation of fetal breathing movement, gross fetal body movements, fetal tone, and amniotic fluid, is known as which one of the following?
    a. apgar score
    b. non stress test
    c. biophysical profile
    d. reflects index
A

C

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27
Q
  1. Asymmetric intrauterine growth (IUGR) may show all of the following except:
    a. placental problem
    b. head measurements correlating with dates
    c. body disproportionately smaller
    d. body and head small for dates
A

D

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28
Q
  1. The normal amniotic fluid idea (AFI) should range between centimeters (cm).
    a. 1 to 5
    b. 5 to 8
    c. 7 to 16
    d.5 to 22
A

D

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29
Q

4.Which one of the following measurements incorporates several fetal growth parameters such as BPD, head circumference HC, AC and femur length FL?
a. estimated fetal weight EFW
b. IUGR
c. biophysical profile
d. fetal growth chart

A

A

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30
Q
  1. One of the growth problems of the diabetic fetus is which one of the following abnormalities?
    a. small for gestational age
    b. macrosomia
    c. microsomia
    d. symmetric IUGR
A

B

31
Q
  1. Significant maternal risk factors for IUGR include all of the following except:
    a. history of fetus with IUGR
    b. Significant hypotension
    c. history of tobacco use
    d. significant placental hemorrhage
A

B

32
Q
  1. Clinical observations for IUGR include all of the following except:
    a. increased fundal height
    b. decreased fetal motion
    c. grade 3 fetal placenta before 36 wks
    d. decreased placental thickness
A

A

33
Q
  1. Which one of the following statements about IUGR is false?
    a. the BPD used alone is poor indication of IUGR
    b. the HC:AC ratio is useful in determining type of IUGR
    c. the FL may decrease in size with symmetric IUGR
    d. the FL:AC ration is a good positive indication predictive value of IUGR
A

D

34
Q
  1. Which one of the following statements about amniotic fluid is false?
    a. oligohydramnios occurs if the fetus cannot urinate
    b. polyhydramnios develops if the fetus cannot swallow
    c. an amniotic fluid pocket greater than 5 cm may represent IUGR
    d. not all oligohydramnios are associated with IUGR
A

C

35
Q
  1. An increased incidence of morbidity and mortality as the result of head and shoulder injuries is found in which one of the following?
    a. microcosmic fetus
    b. neural tube fetus
    c. macrosomic fetus
    d. fetus with radial dysplasia
A

C

36
Q
  1. IUGR is most commonly defined as a fetal birth weight ____ for a given gestational age.
    a. below 10%
    b. at or below 10% (at or below the 10th percentile)
    c. at or below 5%
    d. below the 5%
A

B

37
Q
  1. Which one of the following is not a parameter of a biophysical profile?
    a. non stress test
    b. amniotic fluid volume
    c. fetal swallowing
    d. fetal breathing movement
A

C

38
Q
  1. Increased vascular resistance to the fetus reflected by a(n) _____.
    a. decrease in systolic-tp-diastolic (S/D) ration
    b. decrease in pulsality index
    c. increase in the S/D ratio
    d. decrease in both the S/D ration and the plurality index
A

C

39
Q
  1. An S/D ratio of the umbilical artery can be used to evaluate fetal well-being:
    a. beginning 20 wks gestation
    b. after 25 wks gestation
    c. after 30 wks gestation
    d. throughout pregnancy
A

C

40
Q
  1. Macrosomnia is defined as birth weight of which of the following?
    a. above 90% for estimated gestational age
    b. above 3900 grams
    c. above 95% for estimated gestational age
    d. at or above 95% for estimated gestational age
A

A

41
Q
  1. The S/D ratio cannot be measured when which one of the following conditions is present?
    a. diastolic flow is continuous
    b. systolic flow exceed 100 cm/sec
    c. acceleration time is decreased
    d. diastolic flow is absent
A

D

42
Q
  1. The single most useful biometric parameter to assess fetal growth is which one of the following parameters?
    a. BPD
    b. chest circumference
    c. AC
    d. FL
A

C

43
Q
  1. The placenta of the macrocosmic fetus can become which one of the following?
    a. significantly thin
    b. significantly calcified
    c. extremely small
    d. significantly large
A

D

44
Q
  1. Symmetric IUGR is usually the result of which one of the following?
    a. second trimester infection
    b. placental insufficiency
    c. first trimester insult
    d. maternal renal disease
A

C

45
Q
  1. Asymmetric IUGR is usually caused by which one of the following?
    a. chromosomal abnormalities
    b. maternal malnutrition
    c. placental insuffiency
    d. fetal alcohol syndrome
A

C

46
Q
  1. The single most sensitive indicator of IUGR is which of the following?
    a. last menstrual period
    b. FL
    c. HC:AC ratio
    d. AC
A

D

47
Q
  1. Assessing amniotic fluid volume using the sum of four quadrants is called which of the following?
    a. AFI
    b. amniotic fluid volume
    c. totale uterine volume
    d. pocket idex
A

A

48
Q
  1. An AFI of 9cm is considered which one of the following?
    A. polyhydramnios
    b. oligohydramnios
    c. within lower limits of the moral amniotic fluid volume
    d. premature rupture of membranes
A

C

49
Q
  1. Which one of the following fetal body organs is most severely affected by IUGR?
    a. brain
    b. liver
    c. kidney
    d. heart
A

B

50
Q

The development of conjoined twins occurs when the division of the egg occurs _____ days after conception.
a.
13
b.
3
c.
8
d.
25

A

A
Conjoined twins may occur when the division of the egg occurs 13 days after conception.

51
Q

Twins that arise from two separately fertilized ova are known as which one of the following?
a.
Monozygotic
b.
Monochorionic
c.
Diamniotic
d.
Dizygotic

A

D
Dizygotic twins arise from two separately fertilized ova.

52
Q

Secondary to pregnancy-induced hypertension, a coma and seizures in the patient during the second and third trimesters represents which one of the following?
a.
Erythroblastosis fetalis
b.
Eclampsia
c.
Hydrops
d.
Alloimmune thrombocytopenia

A

B
Eclampsia represents the occurrence of seizures or coma in a preeclamptic patient.

53
Q

Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb into the uterus is a which one of the following?
a.
Spalding sign
b.
Nonimmune hydrops
c.
Fetus papyraceous
d.
Stuck twin

A

C
Fetus papyraceous is a term used to describe a fetus too large for resorption at fetal death. The fetus is significantly flattened from a loss of fluid.

54
Q

Which one of the following complications of pregnancy is characterized by increasing hypertension, proteinuria, and edema?
a.
Preeclampsia
b.
Fetal hydrops
c.
Thrombocytopenia
d.
Diabetes

A

A
Preeclampsia is a complication of pregnancy characterized by increasing hypertension, proteinuria, and edema.

55
Q

Which one of the following terms describes a group of conditions in which hydrops is present in the fetus but is not a result of fetomaternal blood group incompatibility?
a.
Immune hydrops
b.
Toxemia
c.
Hyperemesis gravidarum
d.
Nonimmune hydrops (NIH)

A

D
NIH describes a group of conditions in which hydrops is present in the fetus but is not a result of fetomaternal blood group incompatibility.

56
Q

Hypertensive pregnancies may be associated with which one of the following abnormalities?
a.
Macrosomia
b.
Small placentas
c.
Large placentas
d.
Caudal regression syndrome

A

B
Hypertensive pregnancies maybe associated with small placentas because of the effect of hypertension on the blood vessels.

57
Q

What sonographic finding(s) confirms the presence of a diamniotic pregnancy?
a.
Two yolk sacs
b.
Two fetal poles
c.
Membrane that separates the fetuses
d.
Two placentas

A

C
Documentation of a membrane separating the fetuses confirms the presence of a diamniotic pregnancy.

58
Q

The caudal regression syndrome is found most commonly in patients with which one of the following?
a.
Systemic lupus erythematosus
b.
Premature rupture of membranes
c.
Diabetes
d.
Hypertension

A

C
Caudal regression syndrome is seen almost exclusively in patients with diabetes.

59
Q

Which one of the following is defined as the appearance of overlapping skull bones that indicates fetal death?
a.
Fetus papyraceous
b.
Cranial regression syndrome
c.
Spalding sign
d.
Lemon sign

A

C
The Spalding sign is the appearance of overlapping skull bones, which indicates fetal death.

60
Q

Sonographic findings of fetal hydrops in an isoimmunized pregnancy include all of the following except:
a.
Pleural effusion
b.
Polyhydramnios
c.
Thinning placenta
d.
Pericardial effusion

A

C
Sonographic findings of fetal hydrops in an isoimmunized pregnancy include scalp edema, pleural effusion, pericardial effusion, polyhydramnios, and a thickened placenta.

61
Q

Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate ranging between ______ and ______ beats per minute (bpm).
a.
160; 200
b.
200; 240
c.
210; 250
d.
225; 250

A

B
Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate between 200 and 240 bpm.

62
Q

Maternal obesity has been associated with an increase incidence of which one of the following abnormalities?
a.
Biliary atresia
b.
Hydrocephalus
c.
Neural tube defects
d.
Polycystic kidney disease

A

C
Maternal obesity has been associated with an increase incidence of neural tube defects and may be attributed to a deficiency in the diet.

63
Q

Caudal regression syndrome is described as which one of the following?
a.
Lacks the development of caudal nerves.
b.
Lacks the development of the caudal spine and cord.
c.
Is associated with chromosome abnormalities.
d.
Is observed in systemic lupus erythematosus.

A

B
Caudal regression syndrome is the lack of development of the caudal spine and cord. This syndrome is almost exclusively observed in mothers with diabetes.

64
Q

Skeletal and central nervous system congenital anomalies in infants of diabetic mothers include all of the following except:
a.
Macrocephaly
b.
Neural tube defects
c.
Anencephaly
d.
Caudal regression syndrome

A

A
Skeletal and central nervous system congenital anomalies in infants of diabetic mothers include microcephaly, caudal regression syndrome, neural tube defect

65
Q

Premature labor is defined as the onset of labor before _____ weeks’ gestation.
a.
37
b.
38
c.
39
d.
40

A

A
The onset of labor before 37 weeks’ gestation is considered premature labor.

66
Q

Monochorionic twin pregnancy, during which one fetus develops without a heart or upper body, is which one of the following terms?
a.
Conjoined twins
b.
Stuck twin
c.
Acardiac anomaly
d.
Twin-to-twin transfusion

A

C
Acardiac anomaly occurs in a monochorionic twin pregnancy. During this type of pregnancy, one twin develops without a heart and often an upper body is absent.

67
Q

Which one of the following statements about twin-to-twin transfusion syndrome is true?
a.
The venous blood of one twin is pumped into the arterial system of the other twin.
b.
The arterial blood of one twin is pumped into the venous system of the other twin.
c.
This syndrome is a common complication of multiple gestations.
d.
Twin-to-twin transfusion syndrome occurs between the fetal umbilical cords.

A

B
In monozygotic twin pregnancies with a single placenta and arteriovenous shunting within the placenta, the arterial blood of one twin is pumped into the venous system of the other twin.

68
Q

Poly-Oli sequence is also known as which one of the following anomalies?
a.
Acardiac anomaly
b.
Twin-to-twin transfusion syndrome
c.
Spalding sign
d.
Stuck twin syndrome

A

D
Poly-oli sequence is also known as the stuck twin syndrome.

69
Q

Stuck twin syndrome is usually observed between _____ and _____ weeks’ gestation.
a.
12; 14
b.
12; 24
c.
16; 20
d.
16; 26

A

D
Stuck twin syndrome is usually evident between 16 and 26 weeks’ gestation.

70
Q

A diamniotic and dichorionic twin pregnancy demonstrates which one of the following sonographic findings?
a.
Two gestational sacs and one placenta
b.
Two gestational sacs and two placentas
c.
One gestational sac and two placentas
d.
Two gestational sacs and one embryo

A

B
A diamniotic and dichorionic twin pregnancy demonstrates two gestational sacs and two placentas.

71
Q

Which one of the following is demonstrated if the division of one fertilized egg occurs 4 to 8 days after fertilization?
a.
Two chorions and two amnions
b.
One amnion and two chorions
c.
One chorion and two amnions
d.
One amnion and one chorion

A

C
The division of a fertilized egg 4 to 8 days after fertilization demonstrates one chorion and two amnions.

72
Q

In twin-to-twin transfusion syndrome, which one of the following statements is true?
a.
Both twins are at risk of dying.
b.
An arteriovenous shunting within the placenta is demonstrated.
c.
The recipient twin may demonstrate polyhydramnios.
d.
All of the above statements are true.

A

D
In twin-to-twin transfusion syndrome, both twins are at risk of dying, an arteriovenous shunting is demonstrated within the placenta, and the recipient twin may demonstrate polyhydramnios

73
Q

Predictors of discordance in the growth of twins include all except which one of the following?
a.
Difference in estimated fetal weight greater than 20%
b.
Difference in biparietal diameter of 10 mm or greater
c.
Difference in abdominal circumference of 20 mm or greater
d.
Difference in femur length of 5 mm or greater

A

B
Predictors of discordance in the growth of twins include a difference in biparietal diameter of 6 mm or greater, a difference in estimated fetal weight of greater than 20%, a difference in abdominal circumference of 20 mm or greater, and a difference in femur length of 5 mm or greater.

74
Q

Which one of the following is the most frequent cause of nonimmune hydrops?
a.
Duodenal atresia
b.
Congenital nephrotic syndrome
c.
Umbilical cord anomalies
d.
Cardiovascular lesions

A

D
Cardiovascular lesions are the most frequent cause of nonimmune hydrops.

ob/gyn (11 decks)

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