Ch. 49 Normal First Trimester

Question 1

_______ refers to the timing of pregnancy dating from the first day of the last menstrual period

Answer 1

menstrual age

Question 2

______ refers to the timing of pregnancy dating from the date of conception

Answer 2

embryologic age

Question 3

The _____ yolk sac is the one seen on sonography

Answer 3

secondary

Question 4

HCG levels generally peak at about the _____ week of pregnancy

Answer 4

8th

Question 5

When a spontaneous abortion occurs, the HCG levels begin to fall _____ the conceptus is expelled from the uterus

Answer 5

before

Question 6

If a patient presents with an HCG level consistent with at least a 5 week pregnancy and no gestational sac is seen in the uterus, a ______ must be considered

Answer 6

ectopic pregnancy

Question 7

Which of the following patients is least likely to require a first trimester OB sonogram

Answer 7

patient with first time pregnancy

Question 8

Which of the following best describes the sonographic appearance of a 4 week pregnancy

Answer 8

1-2mm sac with echogenic ring around the edge

Question 9

Which of the following best describes the sonographic appearance of a 5 week pregnancy

Answer 9

8mm sac with thick echogenic ring and yolk sac

Question 10

The gestational sac should be located near the _______ of the uterus

Answer 10

fundus

Question 11

In early pregnancy, the gestational sac grows at a rate of about ______ per day

Answer 11

1mm

Question 12

The yolk sac is found _____ the amniotic cavity

Answer 12

outside

Question 13

The yolk sac usually disappears by ______ weeks

Answer 13

12

Question 14

The fetal heart beat is seen at ______ weeks at the earliest

Answer 14

5.5

Question 15

Transvaginally, the amniotic membrane is routinely seen after ______ weeks

Answer 15

5.5

Question 16

During the 6th week (menstrual age) of pregnancy, the embryo folds, creating a constriction between the embryo and the yolk sac, called the

Answer 16

yolk stalk

Question 17

The limb buds and tail are seen sonographically (TV) at about the ______ week of pregnancy

Answer 17

7th

Question 18

Echogenic lines representing the spine are seen at _____ weeks

Answer 18

8

Question 19

The yolk stalk, allantois and connecting stalk are brought together by the _____ creating the umbilical cord

Answer 19

amniotic membrane

Question 20

The upper extremities develop ______ the lower extremities

Answer 20

before

Question 21

Fingers and toes are sonographically recognizable at ______ with transvaginal sonography

Answer 21

11 weeks

Question 22

Part of the embryo’s gut herniates into the base of the umbilical cord until about _____ weeks, when it returns to the abdomen

Answer 22

12

Question 23

Sonographically, the bowel can be seen to be herniated into the umbilical cord from _____ to _____ weeks

Answer 23

8-10

Question 24

A cystic structure in the posterior embryonic cranium from 8-11 weeks is

Answer 24

rhomboid fossa

Question 25

The cerebral hemispheres and midline falx can be seen at about _____ weeks

Answer 25

9

Question 26

The _____ is the first organ to function within the embryo

Answer 26

heart

Question 27

When the embryonic heartbeat is first seen sonographically, it beats at a rate of about ____ bpm

Answer 27

90

Question 28

In the second and third trimesters, the normal fetal heart rate is _____ bpm

Answer 28

120-160

Question 29

High resolution, transvaginal sonography can demonstrate the development of the embryonic heart from a tube to its final 4 chamber configuration

Answer 29

false

Question 30

Sonography is the most accurate method for determining gestational age in the _____ trimester

Answer 30

1st

Question 31

CRL is the method of choice for measuring the fetus through the _____ week

Answer 31

12

Question 32

CRL is accurate to +/- days

Answer 32

5

Question 33

As a rule, the mean gestational sac size is an accurate way of determining gestational age through the _____ week

Answer 33

8th

Question 34

When measuring the gestational sac size, the measurement should include the echogenic ring of the decidual reaction

Answer 34

false

Question 35

Abnormally shaped or unusually large yolk sacs are associated with increased risk of spontaneous abortion

Answer 35

true

Question 36

In ______ of cases, visualization of a normal yolk sac predicts a viable pregnancy

Answer 36

90%

Question 37

The upper limit of normal size for the yolk sac is

Answer 37

5.6mm

Question 38

Multiple pregnancies are always considered high risk pregnancies

Answer 38

true

Question 39

Twins that occur as a result of two ova being fertilized are called _____ twins

Answer 39

fraternal

Question 40

Twins that occur from a single fertilized ovum are called ____ twins

Answer 40

identical

Question 41

A twin pregnancy with two chorions, two amnions and two placentas is called

Answer 41

dichorionic, diamniotic

Question 42

A twin pregnancy with one chorion and two amnions is called

Answer 42

monochorionic, diamniotic

Question 43

A twin pregnancy with one chorion and one amnion is called

Answer 43

monochorionic, monoamniotic

Question 44

Monoamniotic twins have a ____% mortality rate

Answer 44

50

Question 45

Transvaginal scanning enables the visualization of fetal anatomy about _______ earlier than transabdominal scanning

Answer 45

1 week

Question 46

Gestational age=

Answer 46

fertilization age + 2 weeks

Question 47

Embryologists use ______ age

Answer 47

fertilization

Question 48

Sonographers use _______ age

Answer 48

gestational

Question 49

When does the primary yolk sac pinch off forming the secondary yolk sac

Answer 49

23 days menstrual age

Question 50

With EV, the secondary yolk sac is visible at _______ LMP and is almost always seen when the mean sac diameter (MSD) reaches ______

Answer 50

5.5 weeks, 8mm

Question 51

Yolk sac is attached to the embryo by the

Answer 51

vitelline duct

Question 52

Amniotic cavity develops from the ________ of the embryo, also known as the _____

Answer 52

dorsal side, epiblast

Question 53

Which hCG is simply positive or negative

Answer 53

qualitative

Question 54

Which test measure amount of hCG in maternal blood

Answer 54

quantitative

Question 55

Normal hCG but normal uterus

Answer 55

ectopic pregnancy

Question 56

Intrauterine pregnancy can be visualized at about _______ gestational age

Answer 56

5 weeks

Question 57

Side of the endometrium where the conceptus is burrowing in. trophoblast is invading the endometrial tissue

Answer 57

decidua basalis

Question 58

Endometrium that covers over the conceptus once it has burrowed into the endometrium

Answer 58

decidua capsularis

Question 59

two layered echogenic ring around the gestational sac that is formed by the decidua capsularis

Answer 59

double sac sign

Question 60

Which of the following best describes the sonographic appearance of a 6 week pregnancy

Answer 60

15mm sac with fetal pole and yolk sac