Ch. 62,63,64 Flashcards

1
Q

The rupture of the amnion that leads to entrapment or entanglement of the fetal parts by the “sticky” chorion is called which one of the following?
A) Beckwith-Wiedemann syndrome
B) amniotic band syndrome
C) pentalogy of Cantrell
D) gastroschisis

A

B) amniotic band syndrome

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2
Q

A defect in the lower abdominal wall and anterior wall of the urinary bladder is which one of the following?
A) cloacal exstrophy
B) amniotic band syndrome
C) umbilical hernia
D) ectopic bladder

A

A) cloacal exstrophy

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3
Q

An anomaly with large cranial defects, facial cleft, large body-wall defects, and limb abnormalities is called which one of the following?
A) pentalogy of Cantrell
B) Beckwith-Wiedemann syndrome
C) Dandy-Walker malformation
D) limb-body wall complex

A

D) limb-body wall complex

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4
Q

Evaluation of the fetal abdominal wall that demonstrates evisceration of the bowel to the right of the umbilical cord is most representative of which one of the following?
A) gastroschisis
B) omphalocele
C) limb-body wall defect
D) umbilical hernia

A

A) gastroschisis

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5
Q

If omphalocele and scoliosis are found in the fetus, which one of the following conditions should be considered?
A) pentalogy of Cantrell
B) skeletal dysplasia
C) limb-body wall complex
D) amniotic band syndrome

A

C) limb-body wall complex

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6
Q

If a low omphalocele is found in the fetus, other anomalies may include all of the following except:
A) bladder or cloacal exstrophy
B) anal atresia
C) esophageal atresia
D) spina bifida

A

C) esophageal atresia

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7
Q

Beckwith-Wiedemann syndrome includes all of the following except:
A) organomegaly
B) macroglossia
C) omphalocele
D) gastroschisis

A

D) gastroschisis

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8
Q

Gastroschisis is a consequence of atrophy of which one of the following vessels?
A) right umbilical vein
B) left umbilical vein
C) right umbilical artery
D) left umbilical artery

A

A) right umbilical vein

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9
Q

Bladder exstrophy is characterized by a defect in the lower abdominal wall and anterior wall of the urinary bladder. This abnormality may be accompanied by all of the following except:
A) omphalocele
B) inguinal hernia
C) gastroschisis
D) undescended testes

A

C) gastroschisis

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10
Q

Which of the following types of anterior abdominal wall defects are the most common?
A) gastroschisis, inguinal hernia, and ectopia cordis
B) omphalocele, ectopia cordis, and umbilical hernia
C) gastroschisis, umbilical hernia, and omphalocele
D) omphalocele, gastroshisis, and limb-body wall complex

A

C) gastroschisis, umbilical hernia, and omphalocele

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11
Q

A critical part of the process of closing the abdominal wall is which one of the following?
A) herniation of the midgut
B) folding
C) shortening of the neural tube
D) expansion of the amniotic cavity

A

B) embryonic folding

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12
Q

The normal embryologic herniation of the bowel permits which one of the following?
A) expansion of the thorax
B) development of the intraabdominal organs
C) development of the umbilical cord
D) development of the diaphragm

A

B) development of the intraabdominal organs

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13
Q

Which one of the following statements about an omphalocele is correct?
A) the herniation is covered by a membrane that consists of amnion and chorion
B) omphaloceles that contain only bowel have a higher risk for chromosomal abnormalities
C) the maternal serum alpha-fetoprotein (MSAFP) level will be significantly elevated
D) an omphalocele is a periumbilical defect located to the right of the umbilicus

A

B) omphaloceles that contain only bowel have a higher risk for chromosomal abnormalities

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14
Q

A 19-week fetus with elevated MSAFP shows herniated, free-floating bowel loops, which most likely represents a(n) _____.
A) omphalocele
B) umbilical hernia
C) gastroschisis
D) jejunoileal atresia

A

C) gastroschisis

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15
Q

The five defects of pentalogy of Cantrell include which of the following?
A) omphalocele, ectopic lung, proximal sternum defect, diaphragmatic hernia, and anterior pericardium
B) gastroschisis, ectopic heart, proximal sternum defect, diaphragmatic hernia, and anterior pericardium
C) omphalocele, ectopic heart, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium
D) gastroschisis, ectopic lung, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium

A

C) omphalocele, ectopic heart, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium

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16
Q

Which one of the following statements about a gastroschisis is false?
A) gastroschisis is found more frequently in males
B) gastroschisis is located next to the normal cord insertion
C) MSAFP levels are significantly elevated
D) small bowel is not always found in the herniation

A

D) small bowel is not always found in the herniation

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17
Q

The prognosis for an infant with an uncomplicated gastroschisis is which one of the following?
A) excellent
B) moderate
C) poor
D) extremely poor

A

A) excellent

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18
Q

The most dramatic finding in ectopia cordis is which one of the following?
A) cleft lip palate
B) umbilical vein separate from the umbilical arteries
C) heart outside of the thoracic cavity
D) omphalocele

A

C) heart outside of the thoracic cavity

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19
Q

A high or superumbilical omphalocele is usually the primary finding in which one of the following conditions?
A) limb-body wall complex
B) Beckwith-Wiedemann syndrome
C) Meckel-Gruber syndrome
D) pentalogy of Cantrell

A

D) pentalogy of Cantrell

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20
Q

Limb-body wall defects are more common:
A) on the right side than the left side
B) on the left side than the right side
C) in females
D) anteriorly than posteriorly

A

B) on the left side than the right side

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21
Q

Common anomalies coexisting with a gastroschisis include which one of the following?
A) cleft lip
B) renal agenesis
C) cardiac defects
D) none of the above

A

D) none of the above

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22
Q

Notably dilated, free-floating bowel loops may suggest which one of the following?
A) infarction
B) amniotic band syndrome
C) intrauterine growth restriction
D) hydrops

A

A) infarction

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23
Q

The herniation of an omphalocele is covered by a membrane that consists of the _____ and _____.
A) amnion and chorion
B) amnion and peritoneum
C) chorion and Wharton’s jelly
D) amnion and Wharton’s jelly

A

B) amnion and peritoneum

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24
Q

The umbilical vein drains all of the following except:
A) placenta
B) body stalk
C) yolk sac
D) evolving abdominal all

A

C) yolk sac

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25
Q

The hepatic bud enlarges and the right umbilical vein atrophies during the _____ gestational week.
A) sixth
B) seventh
C) eight
D) ninth

A

B) seventh

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26
Q

A fetus w/partial situs inversus demonstrates which of the following abnormalities?
a. stomach on the right & heart on the left
b. stomach on the left & heart on the left
c. gallbladder on the right & spleen on the left
d. stomach is on left & gallbladder on right

A

a. stomach on right & heart of left

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27
Q

In transverse image, evidence of the “double bubble” sign in a fetus with trisomy 21 represents which one of the following conditions?
a. jejunoileal stenosis
b. meconium ileus
c. multicystic dysplastic kidney
d. duodenal atresia

A

d. duodenal atresia

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28
Q

A fetus w/dilated loops of echogenic bowel should be evaluated for all of the following except?
a. cystic fibrosis
b. meconium peritonitis
c. duodenal atresia
d. bowel obstruction

A

c. duodenal atresia

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29
Q

The spleen is visualized on a transverse plane, just ____?
a. anterior to the liver
b. posterior to the liver
c. posterior and left of the stomach
d. anterior and left of the stomach

A

c. posterior and left of the stomach

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30
Q

Causes of echogenic areas in the fetal abdomen may be all of the following except?
a. peritoneal calcification
b. meconium peritonitis
c. duodenal atresia
d. hydrometrocolpos

A

c. duodenal atresia

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31
Q

A cystic growth of the CBD is?
a. choledochal cyst
b. cholelithiasis
c. pseudocyst
d. biliary atresia

A

a. choledochal cyst

32
Q

Haustral folds can be found within which one of the following structures?
a. small bowel
b. colon
c. liver
d. stomach

A

b. colon

33
Q

A remnant of the proximal part of the yolk sac is which one of the following?
a. choledochal cyst
b. meconium peritonitis
c. meckel diverticulum
d. urachal cyst

A

c. meckel diverticulum

34
Q

A sonographic demonstration of the normal esophagus in the second and third trimesters appears as a ___________?
a. multilayered pattern
b. hockey stick pattern
c. mickey mouse configuration
d. double bubble pattern

A

a. multilayered pattern

35
Q

Which one of the following malformations of the midgut is most common?
a. umbilical hernia
b. meckel diverticulum
c. omphalocele
d. gastroschisis

A

b. meckel diverticulum

36
Q

The distinction of the large bowel from the small bowel is possibly as early as ______ weeks’ gestation?
a. 16
b. 20
c. 24
d. 28

A

b. 20

37
Q

Which one of the following statements about the fetal stomach is incorrect?
a. most fetuses greater than 14 to 16 weeks demonstrate fluid in their stomach
b. a significant variation in the size of the stomach may be seen
c. echogenic debris may be seen in the dependent portion of the stomach
d. an esophageal anomaly is the most common cause of nonvisualization of the stomach

A

d. an esophageal anomaly is the most common cause of nonvisualization of the stomach

38
Q

A transposition of the liver & stomach, an absence of the gall bladder, multiple spleens & a disruption of the IVC describes which one of the following conditions?
a. asplenia
b. pentalogy of cantrell
c. polysplenia
d. bisplenia

A

c. polysplenia

39
Q

A sonolucent band identified near the fetal anterior abdominal wall represents which one of the following?
a. fetal hydrops
b. pseudo ascites
c. ascites
d. ABS

A

b. pseudo ascites

40
Q

The most reliable criterion for diagnosing dilated bowel is which one of the following?
a. bowel diameter
b. double bubble sign
c. polyhydramnios
d. megacolon

A

c. polyhydramnios

41
Q

Causes of the double bubble sign include all of the following except?
a. diaphragmatic hernia
b. annular pancreas
c. choledochal cyst
d. duodenal stenosis

A

a. diaphragmatic hernia

42
Q

Co-existing anomalies of fetuses w/esophageal atresia include all of the following except?
a. vertebral defects
b. renal anomalies
c. cardiac defects
d. ascites

A

d. ascites

43
Q

The derivatives of the hind gut include all of the following except?
a. descending colon
b. sigmoid colon
c. cecum
d. urethra

A

a. descending colon

44
Q

The normal diameter of the fetal small bowel is less than or equal to ____ mm?
a. 3
b. 4
c. 5
d. 6

A

c. 5

45
Q

The sonographic criterion for choledochal cyst include all the following except?
a. close proximity of the cyst to the neck of the gall bladder
b. decreased size of a cyst and gallbladder on serial examinations
c. ovoid right upper-quadrant cyst with an entering bile duct
d. absence of peristalsis within the cyst

A

d. absence of peristalsis within the cyst

46
Q

Peritoneal calcifications noted in a fetus at 30 weeks’ gestation may represent which one of the following?
a. echogenic meconium
b. cholelithiasis
c. anorectal atresia
d. meconium peritonitis

A

a. echogenic meconium

47
Q

VACTERL is a group of anomalies associated w/which one of the following?
a. duodenal atresia
b. esophageal atresia
c. jejunoileal atresia
d. anorectal atresia

A

b. esophageal atresia

48
Q

Which one of the following statements about the fetal liver is incorrect?
a. the fetal liver is large compared w/other intra-abdominal organs
b. the hepatic veins and fissures are formed by the end of the first trimester
c. the right lobe is larger than the left lobe
d. the liver occupies most of the upper abdomen

A

c. the right lobe is larger than the left lobe

49
Q

Which one of the following describes situs inverses?
a. heart is on right, liver on left, gallbladder on right
b. heart is on right, liver on left, spleen on right
c. spleen is on right, heart on left, gallbladder on left
d. liver is on right, spleen on left, heart on right

A

b. heart is on right, liver on left, spleen on right

50
Q

A complex disorder of the bowel and genitourinary tract is called which one of the following abnormalities?
a. hirschsprung disease
b. jejunoileal atresia
c. anorectal atresia
d. meconium peritonitis

A

c. anorectal atresia

51
Q

Kidneys should be sonographically documented in all fetuses beginning at _____ weeks’ gestation.
A) 12
B) 15
C) 18
D) 20

A

c. 18

52
Q

Protrusion of the posterior wall of the urinary bladder, which contains the trigone of the bladder and the ureteric orifices, is called which one of the following?
A) Limb-body wall syndrome
B) Prune belly syndrome
C) cryptorchidism
D) exstrophy of the bladder

A

D) exstrophy of the bladder

53
Q

A condition in which both ovarian and testicular tissues are present is _____.
A) cryptorchidism
B) hermaphroditism
C) hydrometrocolpos
D) hypospadias

A

B) hermaphroditism

54
Q

Sonographic findings in complete renal agenesis include all of the following except:
A) oligohydramnios
B) absence of urine in the fetal bladder
C) dilated fetal bladder
D) small thorax

A

C) dilated fetal bladder

55
Q

Renal agenesis, oligohydramnios, pulmonary hypoplasia, abnormal faces, and malformed hands and feet may be found in which one of the following conditions?
A) Potter’s syndrome
B) infantile polycystic disease
C) Meckel-Gruber syndrome
D) Beckwith-Wiedemann syndrome

A

A) Potter’s syndrome

56
Q

Which one of the following characteristics of multicystic dysplastic kidney disease is most common?
A) distinct renal pelvis
B) multiple non-communicating cysts of variable size
C) large kidneys with hyperechoic parenchyma
D) oligohydramnios

A

B) multiple non-communicating cysts of variable size

57
Q

Which one of the following sites of hydronephrosis in the neonate is the most common?
A) ureterovesical junction
B) level of the urethra
C) ureteropelvic junction (UPJ)
D) junction of the pyramids and the major capsule

A

C. Ureteropelvic junction (UPJ)

58
Q

All of the following findings are observed in hydronephrosis except:
A) anteroposterior (AP) renal pelvic diameter is greater than 5 to 10 millimeters (mm)
B) rim of renal parenchyma is preserved
C) calyceal distention is seen with central pelvis communication
D) renal enlargement is found

A

D) renal enlargement is found

59
Q

A dilated bladder with a “keyhole” appearance is most likely which one of the following conditions?
A) ureterovesical junction obstruction
B) posterior urethral valve obstruction
C) reflux of the ureter into the bladder
D) UPJ obstruction

A

B) posterior urethral valve obstruction

60
Q

Sonographic findings in prune belly syndrome include all of the following except:
A) oligohydramnios
B) pulmonary hypoplasia
C) fetal ascites
D) renal agenesis

A

D. Renal Agenesis

Sonographic findings in prune belly syndrome include oligohydramnios, pulmonary hypoplasia, fetal ascites, and mild-to-severe bilateral hydronephrosis.

61
Q

The renal system fails to develop in which one of the following conditions?
A) posterior urethral valve
B) Potter syndrome
C) Prune belly syndrome
D) renal agenesis

A

D. Renal agenesis

Renal agenesis means a virtual absence of one or both kidneys.

62
Q

The permanent kidneys arise from the _____.
A) pronephros
B) metanephros
C) mesonephroi
D) mesoderm

A

B. Metanephros

63
Q

The bladder wall thickness in a fetus is normally _____ mm.
A) 2
B) 3
C) 4
D) 5

A

A. 2

The normal bladder wall can be measured and should be thin (2 mm or less)

64
Q

The kidneys initially lie in which one of the following positions?
A) far apart in the pelvis
B) very close together in the pelvis
C) close together in the upper abdomen
D) far apart in the upper abdomen

A

B. Very close together in the pelvis

65
Q

Which one of the following conditions develops if the lumen of the allantois persists while the urachus forms?
A) urachal fistula
B) urachal cyst
C) exstrophy of the bladder
D) urachal sinus

A

A. Urachal fistula

66
Q

An anechoic cystic structure within the fetal bladder is most likely a _____.
A) diverticulum
B) ureterocele
C) urachal cyst
D) ueterovesical obstruction

A

b. ureterocele

67
Q

The normal AP diameter of the renal pelvis at 20 weeks’ gestation should not exceed _____ mm.
A) 4
B) 5
C) 7
D) 10

A

A. 4

The upper limits of normal AP measurement of the renal pelvis should not exceed 4 mm up to 33 weeks’ gestation

68
Q

Normal amniotic fluid volume cannot exclude renal agenesis before _____ weeks’ gestation.
A) 12 to 14
B) 20 to 24
C) 14 to 16
D) 18 to 20

A

C. 14 to 16

69
Q

The most likely cause of bilateral hydronephrosis in the fetus is which one of the following?
A) elviureteric obstruction
B) Meckel-Gruber syndrome
C) multicystic renal dysplasia
D) bladder outlet obstruction

A

D) bladder outlet obstruction

70
Q

Sonographic findings in posterior urethral valve obstruction include all of the following except:
A) hydroureter
B) oligohydramnios
C) thinning of the bladder wall
D) hydronephrosis

A

C. Thinning of the bladder wall

Posterior urethral valve obstruction causes bladder dilation with a thickening of the bladder walls

71
Q

The ureteric bud gives rise to all of the following except:
A) ureter
B) renal pelvis
C) Bowman capsule
D) calyces

A

C) Bowman capsule

72
Q

Which one of the following statements about a fetal ovarian cyst is incorrect?
A) a fetal ovarian cyst often appears multiseptated
B) a fetal ovarian cyst often appears bilaterally
C) a fetal ovarian cyst results from maternal hormone stimulation
D) a fetal ovarian cyst has no diagnostic significance

A

D) a fetal ovarian cyst has no diagnostic significance

73
Q

When the fetal kidneys appear enlarged and echogenic, the sonographer should suspect which one of the following conditions?
A) multicystic renal dysplasia
B) infantile polycystic disease
C) renal duplication
D) congenital hydronephrosis

A

B. Infantile polycystic disease

74
Q

Renal malformations may be divided into which of the following two categories?
A) cystic and solid
B) cystic and obstructive
C) congenital and obstructive
D) congenital and cystic

A

C. Congenital and obstructive

75
Q

The testes are not visible within the scrotal sac until approximately _____ weeks’ gestation.
A) 25
B) 28
C) 32
D) 36

A

B. 28