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OB Pathology > OB Midterm > Flashcards

OB Midterm Flashcards

1
Q

The caudal regression syndrome is found most commonly in patients with:

A

Diabetes

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2
Q

The development of conjoined twins occurs when the division of the egg occurs after ________ days after conception.

A

13

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3
Q

Twins that arise from two separately fertilized ova are known as:

A

Dizygotic

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4
Q

Secondary to pregnancy-induced hypertension, a coma and seizures in the patient during the 2nd and 3rd trimesters represents what?

A

Eclampsia

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5
Q

Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb into the uterus is:

A

Fetus papyraceous

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6
Q

What complication of pregnancy is characterized by increasing hypertension, proteinuria, and edema?

A

Preeclampsia

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7
Q

What term describes a group of conditions in which hydrops is present in the fetus, but is not a result of fetomaternal blood group incompatibility?

A

Nonimmune hydrops (NIH)

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8
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. Small placentas

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9
Q

What sonographic finding(s) confirms the presence of a diamniotic pregnancy?

A

Membrane that separates the fetuses

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10
Q

What is defined as the appearance of overlapping skull bones?

A

Spalding’s sign

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11
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. Thinning placenta

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12
Q

Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate ranging between _______ and _______ beats per minute (bpm).

A

200; 240

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13
Q

Maternal obesity has been associated with an increase incidence of what abnormality?

A

Neural tube defects

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14
Q

What is caudal regression syndrome described as?

A

Lack of the development of the caudal spine and cord

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15
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. Macrocephaly

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16
Q

Premature labor is defined as the onset of labor before _______ weeks’ gestation.

A

37

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17
Q

Monochorionic twin pregnancy, during which one fetus develops without a heart or upper body is:

A

Acardia anomaly

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18
Q

What happens in twin-to-twin transfusion syndrome?

A

The arterial blood of one twin is pumped into the venous system of the other twin.

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19
Q

Poly-Oli sequence is also known as:

A

Stuck twin syndrome

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20
Q

Stuck twin syndrome is usually observed between _______ and _______ weeks’ gestation.

A

16; 26

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21
Q

A diamniotic and dichorionic twin pregnancy demonstrates:

A

Two amniotic sacs and two placentas

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22
Q

What is demonstrated if the division of one fertilized egg occurs 4 to 8 days after fertilization?

A

One chorion and two amnions

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23
Q

In twin-to-twin transfusion syndrom, 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. All of the above statements are true

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24
Q

Predictors of discordance in the growth of twins include all of the following exept:

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. Difference in biparietal diameter of 10 mm or greater

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25
Q

What is the most frequent cause of nonimmune hydrops?

A

Cardiovascular legions

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26
Q

Chorionic villus sampling (CVS) may include all of the following advantages except:

a. It is performed in the first trimester
b. The results are available within 48 hrs
c. The results are available within 1 week
d. Early results allow more options for parents

A

b. The results are available within 48 hours.

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27
Q

What is cordocentesis commonly used for?

A

Guidance for transfusions to treat fetal isoimmunization

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28
Q

Amniocentesis may be used for all of the following except:

a. Analysis of fetal chromosomes
b. Prediction of Rh immunization
c. Documentation of lung maturity
d. Prediction of cardiac abnormalities

A

d. Prediction of cardiac abnormalities

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29
Q

Reasons to perform an amniocentesis include all of the following except:

a. Maternal age
b. Multiple gestations
c. Previous child with chromosomal abnormality
d. Abnormal AFP level

A

b. Multiple gestations

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30
Q

Sonographic findings that may suggest a chromosomal anomaly include all of the following except:

a. Reduced movement
b. Hand clenching
c. Thickened nuchal fold
d. Omphalocele

A

a. Reduced movement

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31
Q

AFP is found in all of the following fetal structures except:

a. Spine
b. Liver and gastrointestinal tract
c. Brain
d. Kidneys

A

c. Brain

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32
Q

High levels of AFP indicate all of the following except:

a. Anencephaly
b. Down Syndrome
c. Open spina bifida
d. Gastroschisis

A

b. Down Syndrome

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33
Q

The quadruple screen evaluates all of the following markers except:

a. AFP
b. hCG
c. Unconjugated estriol
d. Fetal lung maturity

A

d. Fetal lung maturity

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34
Q

What is the term meaning an abnormality in the number of chromosomes?

A

Aneuploidy

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35
Q

Anencephaly is an example of which one of the following conditions?

a. Aneuploidy
b. X-linked disorder
c. Multifactorial
d. Mosaicism

A

c. Multifactorial

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36
Q

An early noninvasive means of assessing the risk of aneuploidy is which one of the following?

a. Facial analysis
b. Nuchal translucency
c. Fetal position
d. Biophysical profile

A

b. Nuchal translucency

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37
Q

The following sonographic findings of increased nuchal thickening, shortened femurs, cardiac anomalies, and pyelectasis may be found in which one of the following?

a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome

A

c. Trisomy 21

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38
Q

The sonographic findings of strawberry shaped head, choroid plexus cysts, facial abnormalities, and rocker bottom feet may be found in which one of the following?

a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome

A

b. Trisomy 18

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39
Q

Holoprosencephaly and proboscis are most likely to be found in a fetus with:

a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome

A

a. Trisomy 13

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40
Q

A larger cystic hygroma, hydrops, and coarctation of the aorta may be seen in a fetus with:

A

Turner syndrome

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41
Q

Pregnancy-associated plasma protein A (PAPP-A) levels:

A

Increase throughout pregnancy

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42
Q

What is AFP produced by in early gestation?

A

Yolk sac

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43
Q

A common reason for an elevated level of maternal serum AFP (MSAFP) is:

A

Incorrect dates

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44
Q

One of the most common aneuploid conditions is which one of the following?

a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome

A

c. Trisomy 21

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45
Q

The optimal collection site in an amniocentesis includes all of the following except:

a. Away from the maternal midline
b. Away from the fetus
c. Away from the umbilical cord
d. Away from the central position of the placenta

A

a. Away from the maternal midline

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46
Q

MSAFP levels increase with advancing gestational age and peak at _______ weeks’ gestation.

A

15 to 18

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47
Q

Free beta-hCG can be assessed in maternal serum in the first trimester to evaluate for increased risk of:

A

Down syndrome

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48
Q

After amniocentesis, the sonographer should demonstrate and document which one of the following?

a. Amniotic fluid level
b. Cervical length
c. Placenta location
d. Fetal cardiac activity

A

d. Fetal cardiac activity

49
Q

Continuous monitoring during an amniocentesis with ultrasound is invaluable in patients with which one of the following abnormalities?

a. Posterior placenta location
b. Polyhydramnios
c. Placenta previa
d. Premature rupture of membranes

A

d. Premature rupture of membranes

50
Q

Low MSAFP levels have been found in which one of the following?

a. Fetus older than expected
b. Anencephaly
c. Fetus younger than expected
d. Omphalocele

A

c. Fetus younger than expected

51
Q

The fetal membranes are comprised of all of the following except:

a. Chorion
b. Amnion
c. Blastocyst
d. Yolk sac

A

c. Blastocyst

52
Q

The chorionic plate is related to which one of the following?

a. Maternal surface of the fetus
b. Fetal surface of the placenta
c. Allantois of the yolk stalk
d. Cotyledons and intervillous spaces

A

b. Fetal surface of the placenta

53
Q

The decidual reaction that changes in the endometrium opposite the site of implantation is:

A

Decidua vera

54
Q

The major functioning unit(s) of the placenta is (are) which of the following?

a. Chorionic villi
b. Yolk sac
c. Amnion
d. Cotyledons

A

a. Chorionic villi

55
Q

The placenta performs all of the following functions except:

a. Protection
b. Absorption
c. Nutrition
d. Respiration

A

b. Absorption

56
Q

The velamentous placenta refers to a(n):

A

Membranous insertion of the cord

57
Q

Fusion of the amnion and chorion usually occurs by _______ weeks’ gestation.

A

16

58
Q

The function of hCG is to perform:

A

Maintain the corpus luteum in early pregnancy

59
Q

A marginal or an eccentric insertion of the umbilical cord into the placenta is:

A

Battledore placenta

60
Q

The primary cause of placentomegaly is which one of the following abnormalities?

a. IUGR
b. Battledore placenta
c. Maternal diabetes
d. Intrauterine infection

A

c. Maternal diabetes

61
Q

The most common site of fibrin deposition is which one of the following?

a. Along the subchorionic area
b. Along the retroplacental area
c. Within the chorioangioma
d. Within the hydatidiform mole

A

a. Along the subchorionic area

62
Q

Complications of placenta previa include all of the following except:

a. Premature delivery
b. Maternal hemorrhage
c. Postpartum hemorrhage
d. Succenturiate placenta

A

d. Succenturiate placenta

63
Q

Penetration of the chorionic villi through the uterus is known as placenta _______.

A

Percreta

64
Q

The presence of one or more accessory lobes connected to the body of the placenta by blood vessels is a ________ placenta.

A

Succenturiate

65
Q

Which one of the following statements about a placental abruption is false?

a. Bleeding in the decidua basalis occurs with separation
b. Placental abruption may be a retroplacental or marginal abruption
c. The bleed may lead to a chorioanioma
d. Preterm labor may result

A

c. The bleed may lead to a chorangioma

66
Q

An example of a low-pressure bleed is which one of the following?

a. Marginal abruption
b. Retroplacental abruption
c. Decompression of the uterus
d. Trauma to the uterus

A

a. Marginal abruption

67
Q

The maternal side of the placenta is the decidua ________.

A

Basalis

68
Q

The chorion around the gestational sack on the opposite side of implantation is chorion ________.

A

Laeve

69
Q

A marginal placenta previa demonstates:

A

The placenta touches but does not cross the internal cervical os.

70
Q

Which one of the following might demonstrate a small placenta?

a. Maternal anemia
b. Rh sensitivity
c. Maternal diabetes
d. Aneuploidy

A

d. Aneuploidy

71
Q

Which one of the following occurs when the intramembranous vessels course along the internal cervical os?

a. Placenta previa
b. Battledore placenta
c. Vasa previa
d. Velamentous placenta

A

c. Vasa previa

72
Q

The growth of the chorionic villi superficially into the myometrium describes:

A

Placenta accreta

73
Q

The attachment of the placental membranes to the fetal surface of the placenta describes:

A

Circummarginate placenta

74
Q

A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appearance most likely represents a:

A

Chorioangioma

75
Q

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

a. Nuchal cord
b. True knot
c. False knot
d. Hematoma

A

a. Nuchal cord

76
Q

What occurs when the cord inserts into the membranes before it enters the placenta?

A

Velamentous insertion

77
Q

Cord prolapse problems can be produced during all of the following obstetric procedures except:

a. Velamentous cord insertion
b. Artificial rupture of membranes
c. Disengaging the head
d. Version and extraction

A

a. Velamentous cord insertion

78
Q

Which one of the following problems may lead to inadequate fetal descent?

a. Long cord
b. Twisted cord
c. Short cord
d. Ruptured cord

A

c. Short cord

79
Q

What does the ductus venosus turn into after birth?

A

Ligamentum venosum

80
Q

Thrombosis of the umbilical vessels is most common in which one of the following?

a. Right umbilical artery
b. Left umbilical artery
c. Umbilical vein
d. Hypogastric arteries

A

c. Umbilical vein

81
Q

What is the presence of umbilical vessels crossing the internal os of the cervix called?

A

Vasa previa

82
Q

The umbilical cord is formed by the fusion of:

A

Yolk stalk and allantoic ducts

83
Q

In the first trimester, the length of the umbilical cord is approximately the same size as:

A

Crown-rump length

84
Q

A cystic mass in the umbilical cord is usually which one of the following?

a. Allantoic in origin
b. An omphalocele
c. A false knot of the cord
d. A true knot of the cord

A

a. Allantoic in origin

85
Q

Velamentous umbilical cord insertion is associated with all of the following except:

a. Preterm labor
b. Abnormal fetal heart rate
c. Low Apgar scores
d. Macrosomia

A

d. Macrosomia

86
Q

Which one of the following statements about a single umbilical artery is false?

a. The incidence of IUGR is increased
b. The right umbilical artery is absent more than the left umbilical artery
c. An increase in prenatal mortality is present
d. The incidence of chromosomal abnormalities is increased

A

b. The right umbilical artery is absent more often than the left umbilical artery

87
Q

A dilated intrabdominal, extrahepatic portion of the umbilical vein is called:

A

Varix of the umbilical vein

88
Q

Conditions predisposing a fetus to cord prolapse include all of the following except:

a. Velamentous cord
b. Premature rupture of membranes
c. Polyhydramnios
d. Normal fetal presentation

A

d. Normal fetal presentation

89
Q

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

a. The chorion covers the cord & blends with the fetal skin at the umbilicus
b. The umbilical vein carries oxygenated blood to the fetus
c. One umbilical vein and 2 umbilical arteries make up the umbilical cord
d. The umbilical cord is the essential link from the mother to the fetus

A

a. The chorion covers the cord and blends with the fetal skin at the umbilicus

90
Q

A right paraumbilical defect involving all layers of the abdominal wall is called:

A

Gastroschisis

91
Q

Coiling of the umbilical cord:

a. Is abnormal
b. Is not related to fetal activity
c. Has a higher incidence of fetal anomalies when the cord is twisted toward the right
d. Is insignificant

A

c. Has a higher incidence of fetal anomalies when the cord is twisted toward the right

92
Q

False knots of the umbilical cord:

a. Are associated with short cord length
b. Occur when the blood vessels are longer than the cord
c. Are loops of cord slipped over the fetal head
d. Are umbilical hernias

A

Occur when the blood vessels are longer than the cord

93
Q

A hypoplastic umbilical artery is defined as a three-vessel cord when the artery-to-artery difference is greater than _______.

A

50%

94
Q

The multiple fibrous strands of amnion that develop in utero and may entangle fetal parts to cause amputations or malformation of the fetus are described as:

A

Amniotic bands

95
Q

What is produced by the umbilical cord and membranes, the fetal lung, skin and kidney?

A

Amniotic fluid

96
Q

What structure is formed early in gestation and surrounds the embryo?

A

Amniotic cavity

97
Q

During what weeks of gestation does the fetal production of urine and the ability to swallow begin?

A

8 to 11

98
Q

The amount of amniotic fluid is regulated by all of the following except:

a. Production of the fluid
b. Removal of the fluid by swallowing
c. Fluid exchange within the heart
d. Membranes of the cord

A

c. Fluid exchange within the heart

99
Q

Which of the following statements about the amniotic fluid volume (AFV) is false?

a. The amniotic fluid increases in the early 2nd trimester by 25 ml
b. The amniotic fluid increases in the 3rd trimester by 50 ml
c. The amniotic fluid increases in the late 2nd trimester by 50 ml
d. The amniotic fluid in the 3rd trimester doesn’t change significantly

A

b. The amniotic fluid increases in the 3rd trimester by 50 ml

100
Q

Signs of polyhydramnios include all of the following sonographic demonstrations except:

a. Appearance of free-floating fetus within the amniotic cavity
b. Accentuated fetal anatomy as increased amniotic fluid improves image resolution
c. AFI greater than 20 centimeters
d. AFI greater than 15 cm

A

d. AFI greater than 15 cm

101
Q

Maternal conditions associated with polyhydramnios include all of the following except:

a. Diabetes mellitus
b. Fetal macrosomia
c. Tetralogy of Fallot
d. Rh immunization

A

c. Tetraology of Fallot

102
Q

Oligohydramnios is associated with all of the following except:

a. Renal agenesis
b. Gastrointestinal disorders
c. Premature rupture of the intrauterine membranes
d. Postdate pregnancy

A

b. Gastrointestinal disorders

103
Q

Syndactylism is most likely the result of:

A

Amniotic bands

104
Q

What are amniotic sheets believed to be caused by?

A

Synechiae

105
Q

What method is used for visual assessment of the AFV?

A

Subjective assessment of fluid

106
Q

Early in gestation, what is the major source of amniotic fluid produced by?

A

Amniotic membranes

107
Q

Twin pregnancies have a _______ median AFI than a singleton pregnancy.

A

Slightly lower

108
Q

Which one of the following is not a function of the amniotic fluid?

a. Allowing the fetus to move freely
b. Maintaining intrauterine temperature
c. Developing fetal swallowing
d. Protecting the fetus from injury

A

c. Developing fetal swallowing

109
Q

Amniotic fluid may appear generous during _______ weeks’ gestation.

A

20 to 30

110
Q

What technique is both valid and reproducible in assessing the AFV?

A

AFI

111
Q

Congenital anomalies associated with polyhydramnios include all of the following except:

a. Cystic hygroma
b. Coarctation of the aorta
c. Anencephaly
d. Infantile polycystic kidney disease

A

d. Infantile polycystic kidney disease

112
Q

Persistent oligohydramnios in the 2nd trimester, regardless of the cause carries a(n):

A

Poor prognosis

113
Q

Scars within the uterus, secondary to previous gynecologic surgery, are called:

A

Synechiae

114
Q

The amniotic fluid generally appears anechoic on ultrasound. Occasionally, however, mobile particle are observed that are most likely:

A

Vernix caseosa

115
Q

Using the maximum vertical depth method of assessing the, a pocket _________.

a. Less than 3 cm indicates oligohydramnios
b. Greater than 7 cm indicates polyhydramnios
c. Between 1 and 7 cm is considered normal
d. Between 2 and 8 cm is considered normal

A

d. Between 2 and 8 cm is considered normal

116
Q

Polyhydramnios is defined as an AFV greater than _______ ml.

A

2000

117
Q

The AFI may be approximated by multiplying the largest pocket of amniotic fluid by _______.

A

Three

118
Q

Nonanomalous conditions causing oligohydramnios include ll of the following except:

a. Dysplastic kidney
b. PROM
c. IUGR
d. Postdate pregnancy

A

a. Dysplastic kidney

OB Pathology (16 decks)

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