OBGYN Flashcards
(152 cards)
1
Q
Choose the quantitative pregnancy test
a) thyroxin
b) progesterone
c) serum
d) urine
A
c) serum
2
Q
Name the solid ball of developing cells which occur after fertilization
A
Morula
3
Q
What hormone is secreted by both the syncytiotrophoblast and placenta
A
hCG
4
Q
What process allows for spermatic penetration of the ovum
A
Acrosome disintegration
5
Q
Where does implantation of the embryo occur
A
Endometrium
6
Q
A patient presents as small for gestational age with a known LMP 10 weeks ago. The sonographic exam reveals a gestational sac equivalent to a 6 week gestation. Select the most likely differential
a) Incomplete abortion
b) Miscarriage
c) Blighted Ovum
A
c) Blighted ovum
7
Q
Select the sonographic findings that increase suspicion of a choriocarcinoma
a) soft tissue mass filling the uterine cavity
b) normal fetus and placenta with a cystic vesicular portion
c) hyperechoic shadowing mass within the myometrium
d) mass invasion through the uterine myometrium to the serosa with hypoechoic liver lesions
A
d)
8
Q
What describes an oocyte without maternal chromosomes resulting in proliferation of swollen chorionic villi and the absence of identifiable embryonic structures
A
Complete hydatidiform mole
9
Q
What sonographic finding in the uterus is made up of bleeding from the decidulized endometrium
A
Pseudosac
10
Q
What is the discriminatory cutoff for b-hCG
A
Above 1,500 to 2,500
11
Q
What portion of the fallopian tube has the highest incidence of ectopic gestations
A
Ampullary
12
Q
Which type of ectopic pregnancy implants on previous cearean scars
A
Intramural
13
Q
What measurement from the frontal to the occipital bone is obtained at the level of the thalami
A
Occipito-frontal diameter (OFD)
14
Q
Which cranial bones are the landmarks for measurement of the BPD
A
Parietal bones
15
Q
What is the most common fetal ratio parameter
A
Head circumference/ abdominal circumference (HC/AC)
16
Q
What portion of the humerus does the sonographer measure to obtain the length
A
Ossesous diaphysis
17
Q
Choose the maternal factor that results in delayed placental maturation of a 5 cm placenta
a) Rh dieases
b) Gestational diabetes
c) Syphillis
d) Choriooangioma
A
b) Gestational diabetes
18
Q
Decidual formation defect with abnormal placental attachment to the uterine wall describes
A
Placenta accreta
19
Q
Which of the following describes the sonographic characteristic of excessive Wharton’s jelly
a) small mas adjacent to abdomen
b) irregular protrusion from the cord
c) cystic dilation up to 6 cm, usually located close to the fetus
d) variably echogenic, soft tissue mass with three vessels visible
A
d) variably echogenic, soft tissue mass with three vessels visible
20
Q
What is the chromosomal cause for a thick placenta
A
Triploidy
21
Q
What form of placenta previa lies within 2 cm of the internal cervical os
A
Low-lying placenta
22
Q
Select the differential for an intraplacental lesion
a) Subchorionic hemorrhage
b) Circumvallate placenta
c) Fibrin deposition
d) Vasa previa
A
c) Fibrin deposition
23
Q
At which Carnegie stage does the brain folding begin
A
Stage 9
24
Q
What anatomy is imaged on an axial plane at the cerebellar level
A
Cisterna magna
25
# Choose the sonographic characteristic of a cephalocele
a) nuchal ligament forming a midline segment
b) macrocephaly
c) complex paracranial mass
d) located in the anterior portion of the neck
c) complex paracranial mass
26
What term describes dilation of the renal calices
Caliectasis
27
What term describes the portion of the fetus that will deliver first
Fetal presentation
28
What is the maximum right renal volume for a 30 week fetus
12.0 cm3
29
Which malformation results in failure to identify pulmonary vascular communication with color doppler
a) pulmonary sequestration
b) bronchogenic cyst
c) hirschsprungs disease
d) meconium ileus
a) pulmonary sequestration
30
Identify the sonographic appearance of a Type 3 CCAM
a) unilateral, 4 cm cyst with multiple outpouchings
b) unilateral cysts replacing the lower lobe of one lung
c) solid echogenic mass within the lung
d) spherical homogeneous mass resulting in a midline shift
c) solid echogenic mass within the lung
31
The finding of subcutaneous edema, ascites, a large spleen and liver, and a thick placenta raises suspicion for what process
Fetal hydrops
32
Which of the following is part of Epstein's anomaly
a) underdeveloped left ventricle
b) tricuspid stenosis
c) right ventricular hypoplasia
d) overriding aorta
b) tricuspid stenosis
33
What is an abnormal opening between the right and left atrium
Atrial septal defect
34
What anatomy is imaged on a 4 chamber view
Interventricular septum
35
What heart defect has an increase in right ventricular size, a small aorta, and reversed ductus arteriosus flow
Interrupted aortic arch
36
What dominant category does thanatophoric dysplasia fall into
Micromelia
37
What sonographic findings are seen with thanatophoric dysplasia
a) heart malformations, bone fractures, radial hypoplasia
b) polydactyly, macrocepahly, hypermineralization
c) bowed long bones, wide thorax, syndactyly, rhizomelia
d) narrow thorax, curved or bowed long bones, hypomineralization
d
38
What scanning angle avoids artificial limb shortening when performing biometry
Perpendicular
39
# Choose the maternal indication for performance of a fetal doppler exam
a) hypertension
b) umbilical cord anomaly
c) history of chromosomal anomaly
d) intrauterine growth retardation
a) hypertenstion
40
What is the normal umbilical artery waveform
Low resistance
41
What fetal vessel is sampled above the umbilical sinus and has a normal triphasic flow pattern
Ductus venosus
42
Identify the vessel with flow fluctuations and pulsations in the distressed fetus
a) SVC
b) umbilical vein
c) uterine artery
d) ductus venosus
b) umbilical vein
43
What fetal testing method includes the nonstress test and amniotic fluid volume
Modified biophysical profile
44
What first sonographically observed biophysical change is seen with fetal hypoxia
Gross fetal body movements
45
What is the primary factor for increased multiple births
delayed childbearing
46
Select the maternal complication of a multiple pregnancy
a) preterm birth
b) hypertension
c) fetal death
d) Intrauterine growth restriction
b) hypertension
47
In a twin gestation with a placenta on the anterior wall and a second on the posterior wall, what would be the membrane configuration
Dichorionic/diamniotic
48
Fetal death and the retention of the fetus can result in what type of process
Fetal papyraceus
49
Identify the doppler parameter which confirms the presence of an acardiac twin
a) increased flow velocities in the MCA
b) decreased resistance in umbilical cord flow
c) lack of low in the umbilical artery
d) umbilical cord flow reversal
d) umbilical cord flow reversal
50
Which of the following is a sonographic finding for the donor twin in the TTS pregnancy
a) hypovolemic
b) polyhydramnios
c) macrsomia
d) hydrops
a) hypovolemic
51
What type of placentation occurs with the division of the monozygotic twinning at day 3
dichorionic/diamniotic
52
Which of the following is a perinatal pathology associated with IUGR
a) hypoglycemia
b) hypertenstion
c) diabetes
d) obesity
b) hypertension
53
# Choose the fetal cause of IUGR
a) varicella zoster
b) palcental abruption
c) preterm birth
d) sibling with IUGR
a) varicella zoster
54
What is the doppler finding seen with asymmetric IUGR
Increased RI in aorta
55
What type of cell division results in an individual with 2 genotypes
Mosaicism
56
What term describes a mutation caused by multiple genes
Heterogenous disorder
57
Select the soft sonographic marker for trisomy 21
a) low set ears
b) choroid plexus cysts
c) microcephaly
d) cleft lip
b) choroid plexus cysts
58
How many chromosomes are found in a gamete
23
59
What is the chromosome makeup of a Turner syndrome fetus
45XO
60
What maternal bacterial infection raises the risk of fetal hydrops
Syphilis
61
Immune fetal hydrops include which of the following fetal findings
a) two vessel cord
b) pericardial fluid
c) decreased PI
d) microcephaly
b) pericardial fluid
62
Which placental problem coexists with maternal preeclampsia
a) choriocarcinoma
b) lack of lakes
c) infarcts
d) decreased flow ratio
c) infarcts
63
When does Rh isoimmunization occur
At birth
64
Which of the following is a result of abnormal placental penetration into the myometrium
a) hemorrhage
b) chorioamnionitis
c) involution
d) atony
a) hemorrhage
65
What is the software program used to measure volumes
VOCAL
66
What term describes the display of parallel images
Tomographic
67
What is the surface rendering control
Gradient light
68
How is the uterus situated to the pelvis, bladder and rectum
Medially to the pelvis
Posterior to the bladder
Anterior to the rectum
69
What 3 layers is the uterus composed of
- peritoneum
- myometrium
- endometrium
70
The out layer of the uterus is called
Peritoneum or the serosal layer
71
The muscular portion of the uterus is called
Myometrium
72
The inner layer of the uterus is called
Endometrium
73
What is another name for the posterior cul-de-sac
Pouch of Douglas
74
The peritoneum covers the posterior surface of the uterus and the anterior surface of the rectum which is called what potential space
Posterior cul-de-sac
75
What is the echotexture of the myometrium
Homogenous
76
This type of uterus tilts forward with a 90 degree angle to the posterior vaginal wall
-This is also the most common type of uterus
Anteverted
77
This type of uterus the uterine corpus is flexed anteriorly on the cervix, forming a sharp angle at the cervix
Anteflexed
78
This type of uterus tilts backward without a sharp angle between the corpus and cervix
Retroverted
79
This type of uterus the uterine corpus is flexed posteriorly on the cervix, forming a sharp angle at the cervix
Retroflexed
80
The uterine and ovarian arteries are branches of what artery
Internal iliac (hypogastric)
81
In relationship to the uterus where are the ovaries located
Ovaries are located lateral in the ovarian fossa
82
The ovarian fossa is bound laterally but what artery and vein
Iliac artery and vein
83
What is the normal echo texture of the ovaries
Homogenous
84
What part of the fallopian tube is the narrowest portion
Isthmus
85
What part of the fallopian tube is the most lateral portion
Infundibulum
86
The purpose of this structure is to aid in fertilization and to transport the ova from the ovary to the uterus
Fallopian tube
87
On a sagittal view, this muscle appears as a paired long hypoechoic stripe with echogenic linear lines
Iliopsoas muscle
88
What is the most common uterine tumor
Fibroid
89
What is the most common cause of uterine enlargement in the nonpregnant female
Fibroids
90
What is an invasion of endometrial tissue into the the myometrium > 2 mm
Adenomyosis
91
What is an accumulation of blood within the vagina
Hematocolpos
92
What is an accumulation of blood within the uterine cavity secondary to atrophy of the endocervical canal or cervical stenosis
Hematometra
93
What type of ovarian mass tends to be smooth walled, well- defined, and anechoic with increased posterior acoustic enhancment
Benign cystic masses
94
What are the 3 most common functional cysts of the ovaries
- follicular
- corpus luteal cysts
- theca luteal
95
The twisiting of an ovary and its vessels resulting in occlusion of its blood supply refers to
Ovarian torsion
96
What hormone is normally produced by the placenta and present in the serum and urine of a pregnant woman
Beta hCG
97
What is any pregnancy outside the endometrial cavity called
Ectopic pregnancy
98
Where do most ectopic pregnancies occur
Fallopian tube
99
This describes blood or decidual cast in the uterine cavity mimicking a gestational sac
Pseduogestational sac
100
What is a coexistent intrauterine pregnancy and ectopic pregnancy called
Heterotopic
101
An adnexal ring like mass with increased color flow around its periphery aka ring of fire describes
Unruptured ectopic pregnancy
102
This refers to the space between the back of the neck and the overlying fetal skin
Nuchal translucency
103
A congenital lymphatic obstruction between the lymphatic and venous pathway resulting in lymphatic fluid accumulation in the lymphatic sac within the nuchal region describes
Cystic hygroma
104
What is the most common and benign component of gestational trophoblastic disease that may be partial or complete
Hadatidiform mole
105
This type of Hydatidiform mole the sono findings are an enlarged uterine cavity filled with complex echoes often resembling placental tissue with multiple cystic vesicles
Complete
106
This is associated with a markedly increased beta hCG and may have bilateral theca lutein cysts
Hydatidiform mole
107
The sono appearnace of this hydatidiform mole presents as an enlarged hydropic placenta with focal multicystic anechoic spaces replacing the normal homogenous appearance of placenta
Partial
108
The sono appearance of swiss cheese, snowstorm, vesicular texture, and honey comb describes
Hydatidiform mole
109
This describes a large >2 cm gestational sac without an embryo or yolk sac
Blighted ovum or anembryonic demise
110
This describes an embryo without fetal heart rate motion retained in the uterus before 20 weeks.
Missed abortion
111
This describes a fetus that weighs more than 4,000 g and is often a manifestation of insulin dependent diabetes mellitus
Macrosomia
112
This is defined by ultrasound as weight <10th percentile
Intrauterine growth restriction (IUGR)
113
Which of the folllowing indicates a patient who had a twin pregnancy
a) G2 P2 A2 T0
b) G4 P4 A0 T4
c) G1 P0 A0 T0
d) G3 P3 A2 T2
B
114
An 18 year old presents to the department with complaints of intermittent left lower quadrant pain. Though she has not missed any periods, her clinician ran a pregnancy test came up positive. The sonographic exam revealed a solid mass with calcifications and multiple small cysts in the left side apart from the uterus. What is the most likely cause for these findings
a) endometriod
b) Granulosa theca cell tumor
c) Clear cell carcinoma
d) immature teratoma
d) immature teratoma
115
# Choose the least common malignant ovarian cancer
a) androblastoma
b) krukenberg tumor
c) arrhenoblastoma
d) choriocarcinoma
a) androblastoma
116
Which of the following is a tumor marker for colon, stomach, breast, or ovarian carcinomas
a) CEA
b) BRCA1/BRCA2
c) AFP
d) CA 125
a) CEA
117
How does the fallopian tube image in a patient with stage 2 pelvic inflammatory diease
a) hypoechoic with a cogwheel appearance
b) normal ovary
c) decreased doppler flow to a tubal structure
d) thin wall tubular structure
a) hypoechoic with a cog wheel appearance
118
a discrete adnexal mass with peripheral doppler flow is a sonographic sign of
Endometriosis
119
Cervical motion tenderness is a clinical presentation of
Pelvic inflammatory disease
120
What phase overlaps the menstrual phase
Proliferative phase
121
What is the primary sex hormone produced by the ovarian follicles
Estradiol
122
How long after fertilization does an embryo transfer occur
5-6 days
123
Which of the following is a uterine anatomic cause of infertility
a) ovarian hyperandrogenism
b) endometrial polyp
c) endometriosis
d) hydrosalpinx
b) endometrial polyp
124
This term describes the estimation of the quality and quantity of a womans remaining follicles
Ovarian reserve
125
What is the precursor to the penis and clitoris
Genital tubercle
126
The preembryonic phase occurs during which portion of the gestation
Weeks 1-3
127
A pregnancy in one uterus with a decidual reaction in a second uterus describes what congenital malformation
Didelphic uterus
128
Which of the following is a Class 2 mullerian duct anomaly
a) unicornuate uterus
b) bicornuate uterus
c) DES uterus
d) hypoplasia of the vagina
a) unicornuate uterus
129
What is the hormone that GnRH stimulates the pituitary gland to secrete
LH
130
What hormone resumes with a decrease in estrogen and a positive feedback loop
GnRH
131
What hormone is secreted from the anterior lobe of the pituitary gland
GnRH
132
Which of the following secretes progesterone
a) graafian follicle
b) corpus luteum
c) theca interna
d) theca externa
b) corpus luteum
133
What is the transitional portion of the uterus
Isthmus
134
In the normal bladder, echogenic urine indicates which technical error
High overall gain
135
What is the imaginary line that separates the true and false pelvis
Linea terminalis
136
Select the organ fold in the false pelvis
a) rectum
b) ovaries
c) ileum
d) bladder
c) ileum
137
What vessel drains directly into the left renal vein
Left ovarian vein
138
This doppler measurement takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak
Pourcelot resistive index
139
Where does the uterine artery anastomoses with the ovarian artery
At the uterine cornua
140
What term defines the physiologic process of growing new vessels
Angiogneisis
141
Select the karytype seen with a partial mole
a) 46 XY
b) 46 XX
c) 44 OX
d) 69 XXX
d) 69 XXX
142
What dominant category does thanatophoric dysplasia fall into
Micromelia
143
What scanning angle avoids artificial limb shortening when performing biometry
Perpendicular
144
Describe the normal umbilical artery waveform
Low resistance
145
What fetal vessel is sampled above the umbilical sinus and has a normal triphasic flow pattern
Ductus venosus
146
What is the optimal angle of insonation to obtain a doppler tracing of the fetal MCA
34 degrees
147
What fetal testing method includes the nonstress test and amniotic fluid volume
Modified BPP
148
What is the first sonographically observed biophysical change seen with fetal hypoxia
Gross fetal body movements
149
What is the primary factor for increased multiple births
Delayed child bearing
150
Select the maternal complication of a multiple pregnancy
a) preterm birth
b) hypertension
c) fetal death
d) intrauterine growth restriction
b) hypertension
151
Fetal death and the retention of the fetus can result in what type of process
Fetal papyraceus
152
# Choose the fetal cause of IUGR
a) varicella zoster
b) placental abruption
c) preterm birth
d) silbing with IUGR
a) varicella zoster
