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OBGYN > 2nd and 3rd Trimester > Flashcards

2nd and 3rd Trimester Flashcards

1
Q

During a 32 week OB scan, you measure the AFI and determine that it is 4 cm. Is this within the normal range?

no

yes

A

no

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2
Q

If the adrenal glands are “laying down” in the renal fossa, what is indicated?

normal kidneys

renal cysts

renal agenesis

A

renal agenesis

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3
Q

You are performing a BPP exam on an OB patient who is 36 weeks. You have been observing the fetus for 18 minutes and have yet to observe adequate fetal movement. What should you do?

record the score for fetal movement as 0

call the ordering physician

continue observing for full 30 minutes

send patient to ER

end exam and reschedule patient for another day

A

continue observing for full 30 minutes

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4
Q

Amniotic fluid is performed measured using the __________ of the fluid pocket.

vertical depth

width

A

vertical depth

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5
Q

All of the following are sonographic components of a biophysical profile except:

fetal tone

fetal movement

amniotic fluid

biometric measurements

fetal breathing

A

biometric measurements

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6
Q

ypically, choroid plexus cyst will disappear by ______ weeks

16

24

20

28

A

28

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7
Q

The cisterna magna is a cerebral spinal fluid space located between the _________ and the __________.

cerebellum and occipital bone

cavum septum pellucidum and corpus callosum
cavum septum pellucidum and occipital bone

corpus callosum and frontal bone

A

cerebellum and occipital bone

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8
Q

The fetal heart should occupy ____________ of thoracic cavity.

2/3

1/4 to 1/3

1/3 to 1/2

3/4

1/4

A

1/3 to 1/2

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9
Q

All of the following describe the normal sonographic appearance of fetal lungs except:

slightly more echogenic than liver
granular appearance
homogeneous
heterogeneous

A

heterogeneous

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10
Q

All of the following are possible fetal presentations except:

vernix

breech

cephalic

transverse

variable

A

vernix

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11
Q

If the fetal stomach appears small or absent, which of the following should the sonographer do?

A. immediately inform the patient

C and D

C. check for diaphragmatic hernia

A and B

B. allow sufficient time for stomach to fill

D. complete exam and send patient home without notifying physician

B and C

A

B and C

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12
Q

The fetal thymus gland is located anterior to all of the following except:

SVC

aortic arch

pulmonary trunk

lungs

A

lungs

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13
Q

Which femur is used when obtaining femur length measurement?

vertical femurs

anterior femur

posterior femur

A

anterior femur

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14
Q

The flap of the foramen ovale should open into which fetal heart chamber?

left ventricle

right atrium

right ventricle

left atrium

A

left atrium

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15
Q

Which chamber of the fetal heart is normally located closest to the spine?

left ventricle

left atrium

right ventricle

right atrium

left atrium

A

left atrium

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16
Q

An OB patient has arrived for her 20 week ultrasound exam for fetal anatomy, size, and dates. As part of the assessment, maternal anatomy is also evaluated. You should exam and document which of the following?

A. uterus

B and C

B. adnexa
A and B
A, B, and C

C. cervix

A

A, B, and C

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17
Q

Which of the following fetal assessments is documented using M-mode?

amniotic fluid

placental lakes

cerebral evaluation

cardiac activity

respirations

A

cardiac activity

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18
Q

What is the most common fetal presentation?

shoulder

cephalic

frank breech

complete breech

footling

A

cephalic

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19
Q

The ____________ view is considered to be the single most important view of the fetal heart.

ductal arch

aortic arch

RVOT

4-chamber

A

4-chamber

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20
Q

Which of the following describes the sono appearance of a normal fetal diaphragm?

thick, hyperechoic, arched-line separating the abdomen from chest

thin, hyperechoic, arched-line separating abdomen from chest

thin, hypoechoic, arched-line separating abdomen from chest

A

thin, hypoechoic, arched-line separating abdomen from chest

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21
Q

What is the normal measurement for the lateral ventricles?

less than 1 mm

greater than 20 mm

greater than 10 mm

less than 10 mm

A

less than 10 mm

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22
Q

The sagittal view of the fetal face is obtained whenever possible to demonstrate all of the following except:

forehead

chin

nuchal fold

lips

nasal bone

A

nuchal fold

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23
Q

If the myometrium is less than 3 mm in the lower uterine segment, then the myometrium should be assessed. This is because the patient is at increased risk for ___________.

adenomyosis

endometriosis

uterine rupture

ectopic pregnancy

A

uterine rupture

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24
Q

Which of the following statements regarding a normal fetal heart is not true:

Valves separate both atrium from ventricles

Tricuspid valve inserts on IVS

Ventricles are approx same size (until later in pregnancy when right > left)

Right ventricle lies anteriorly, closest to chest wall

Heart apex points left 45 degrees & touches anterior chest wall

A

Tricuspid valve inserts on IVS

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25
Q

If an ovarian cyst is visualized early in the pregnancy, it is most likely a _____________ cyst.

corpus luteum

dermoid cyst

chocolate cyst

A

corpus luteum

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26
Q

Obliteration of cisterna magna is commonly found with which of the following?

mega-cisterna magna
Down syndrome

spina bifida

rhombencephalo

A

spina bifida

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27
Q

When during a pregnancy should you normally see abdominal wall gut herniation? (I am not asking when it is supposed to return, but when is it supposed to occur).

between 12-16 weeks

between 9-11 weeks

between 4-8 weeks

between 18-20 weeks

A

between 9-11 weeks

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28
Q

What gives fetal kidneys an echogenic border in 3rd trimester?

renal capsule

maturation of renal arteries

renal cysts

renal calculi

A

renal capsule

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29
Q

The thymus gland is normally located in the anterior _____________ of the fetus.

abdomen

cranium

pelvis

mediastinum

A

mediastinum

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30
Q

A nuchal fold measurement greater than 6 mm between 15 and 22 weeks is associated most commonly with _______________.

Meckel-Gruber syndrome

Cleft palate

Trisomy 4X

Turner’s syndrome

Trisomy 21

A

Trisomy 21

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31
Q

Ossification in the fetal spine begins in the ____________ section.

thoracic

cervical

lumbar

sacral

A

thoracic

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32
Q

During the 2nd trimester, the kidneys should appear as ____________ structures adjacent to fetal spine.

anechoic

isoechoic

hyperechoic

A

isoechoic

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33
Q

You are measuring the amniotic fluid on a 34 week gestation. The amniotic fluid in the single largest pocket measured 3 cm. Is this within the normal range?

no

yes

A

yes

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34
Q

A normal ureter is 1-2 mm in diameter and is usually visible during the OB ultrasound exam.

True

False

A

False

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35
Q

A fluid-filled stomach can be used to demonstrate an intact left diaphragm.

True

False

A

True

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36
Q

A transvaginal scan may be performed if placenta previa is suspected or if the cervix is abnormally short.

True

False

A

True

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37
Q

Adnexal cysts are an uncommon finding during gestation.

True

False

A

False

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38
Q

After 16 weeks, renal function becomes the major source of amniotic fluid.

True

False

A

True

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39
Q

Biophysical profile was designed to detect fetal hypoxemia.

True

False

A

True

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40
Q

By 10 to 12 weeks, most of cerebral structures of the fetus can be sonographically identified.

True

False

A

False

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41
Q

By week 11, the kidneys begin to produce urine.

True

False

A

True

42
Q

Each vertebra develops 4 ossification centers.

True

False

A

False

43
Q

Four fetal measurements are taken to assess the gestational age and fetal weight. These four measurements are femur length, BPD, abdominal circumference, and head circumference.

True

False

A

True

44
Q

Presence of choroid plexus cyst is always associated with presence of Trisomy 18.

True

False

A

False

45
Q

The 3 standard views of the fetal brain are thalamic, ventricular, and cerebellar.

True

False

A

True

46
Q

The abdominal circumference should be taken at the level of the stomach and umbilical cord insertion into the abdomen.

True

False

A

False

47
Q

The atrium of the occipital horn of the lateral ventricle is considered the landmark for measuring the lateral ventricle.

True

False

A

True

48
Q

The best time to sonograpically evaluate the fetal heart is between 18 to 24 weeks.

True

False

A

True

49
Q

The head and neck vessels help differentiate the aortic arch from the ductal arch.
True

False

A

True

50
Q

The heart position and axis are variable in a normal fetus.

True

False

A

False

51
Q

ypically, the stomach will fill within a 30 minute exam.

True

False

A

True

52
Q

When measuring femur length, the ossified diaphysis and epiphyseal cartilage are included in the measurement.

True

False

A

False

53
Q

Why is it important to identify the adrenal glands separate from the kidneys?

so bladder failure can be detected

so thyroid function can be assessed

so renal agenesis is not missed

A

so renal agenesis is not missed

54
Q

While obtaining an amniotic fluid measurement, the area should be free of ________________ and ___________________.

umbilical cord

fetal vernix

fetal anatomy

A

umbilical cord
fetal anatomy

55
Q

Which weeks of gestation would it be abnormal to see physiologic gut herniation during an ultrasound exam? select more than one answer.

26

10

14

11

22

A

26
14
22

56
Q

The biparietal diameter measurement is taken at which level or view? What brain structure should be seen?

cerebellar

ventricular

thalamic

A

thalamic

57
Q

Why is it mandatory to image the fetal upper lip?

micrognathia

absent orbit

fetal cleft lip

A

fetal cleft lip

58
Q

Normally, cisterna magna should measure between _____ mm to _____ mm.

.5

10

12

2

A

10
2

59
Q

Diaphragm motion can be visualized sonographically as early as ________ weeks.

30

25

10

A

10

60
Q

This measurement is obtained by measuring the vertical depth of fluid in the 4 quadrants of the uterus. The measurements are then added together to obtain:

single pocket

AFI

A

AFI

61
Q

Why is it important to confirm the fetal stomach is on the left?

to ensure the HC is measured at the correct level

to rule out associated heterotaxy syndromes

to ensure the bladder is filling correctly

A

to rule out associated heterotaxy syndromes

62
Q

What does the thymus parenchyma contain that helps distinguish it sonographically from the lungs?

triangular reflections

spherical aspects

spindle shaped echogenicities

A

spindle shaped echogenicities

63
Q

Typically, ultrasound evaluation of fetal anatomy is performed between 16 and 22 weeks of gestation.

True

False

A

True

64
Q

True or False: When preforming a BPP if the baby preforms breathing for 10 secs you can score them 1 point for that part of exam.

True

False

A

False

65
Q

What are the four components scored in a BPP?

A

Fetal breathing, fetal movement, fetal tone, amniotic fluid

66
Q

f the fetal adrenal gland appear to be “lying down” what can this indicate?

renal agenesis

A

renal agenesis

67
Q

What is fetal renal function related to the production of?

A

amnotic fluid

68
Q

What in the fetus is a thin-walled organ located in the anterior pelvis and has the umbilical arteries coursing laterally to it?

A

Bladder

69
Q

By what fetal gestational age should the bowel be positioned back into the abdomen after rotation?

12 weeks
13 weeks
14 weeks
11 weeks

A

12 weeks

70
Q

At how many weeks gestational age can the diaphragm motion be detected?

6 weeks
13 weeks
10 weeks
12 weeks

A

10 weeks

71
Q

When measuring the femur length which femur should be used?

closest
farthest

A

closest

72
Q

True or False: When measuring the femur you should include the entire length even the epiphyseal cartilage.

True

False

A

False

73
Q

The fetal heart should occupy ___________ of the fetal thoracic cavity. (select all that apply)

3/4
1/3
2/3
1/2
1/4

A

1/3
1/2

74
Q

When measuring amniotic fluid levels the pocket being measured should be free of what two things?

A

umbilical cord, fetal anatomy

75
Q

In fetal development the kidney’s originate in what location of the fetal body?

A

Pelvis

76
Q

A fetal right-sided stomach and right-sided heart is an indication of what?

partial situs inversus

total situs inversus

A

total situs inversus

77
Q

By what gestational week should the fetal stomach be visualized by?

15 weeks
14 weeks
16 weeks
13 weeks

A

14 weeks

78
Q

On what side of the fetus should the stomach lye in normal presentation?

Left
Right

A

Left

79
Q

If the fetal stomach is absent or small what abnormality should be evaluated for?

A

Diaphragmatic hernia

80
Q

True or False: the BPP is a timed exam and you must give the baby a maximum of 30 minutes to preform all aspects of this exam.

False

True

A

True

81
Q

The ossification process of the fetal spine starts in which portion?

sacrum
lower cervical spine
lower thoracic spine
lower lumbar spine

A

lower thoracic spine

82
Q

True of False: A normal fetal ureter is 1-2 mm in diameter and normally is visible during exams.

True

False

A

False

83
Q

In the fetus by what gestational age should the kidneys begin to produce urine?

11 weeks
14 weeks
12 weeks
13 weeks

A

11 weeks

84
Q

True or False: the BPP is done to determine fetal well being.

True
False

A

True

85
Q

The presence of a choroid plexus cyst should normally disappear at 28 weeks gestation.

True
False

A

True

86
Q

What are the three standard view or scan plans of the fetal brain?

thymatic
thalamic
cerebellar
ventricular
fronto-occipital

A

thalamic
cerebellar
ventricular

87
Q

Match the four standard fetal measurements that are used to assess fetal weight and growth with the body part they measure..

BPD
outer parietal bone to inner parietal bone

AC
stomach level around ribs showing portal/umbilical junction

FL
ossified diaphysis of the thigh bone

HC
around the outer skull edge

A

BPD
outer parietal bone to inner parietal bone
AC
stomach level around ribs showing portal/umbilical junction
FL
ossified diaphysis of the thigh bone
HC
around the outer skull edge

88
Q

The three standard fetal brain views can detect what precent of sonographically detectable cerebral anomalies?

85%
75%
95%
90%

A

95%

89
Q

4-26cm is considered the normal range for the measurement of AFI.

True

False

A

False

90
Q

When measuring the FOD which of the following is the correct method?

right to left
outer frontal to outer occipital
all the way around
outer frontal to inner occipital

A

outer frontal to outer occipital

91
Q

What is the most common fetal presentation?

transverse
cephalic
footling
breech

A

cephalic

92
Q

What is measured directly behind the cerebellum and in front of the occipital bone?

cisterna magna
lateral ventricles
CSP

A

cisterna magna

93
Q

The normal measurement of the lateral ventricle is?

greater than 10mm
less than 5mm
greater than 12mm
less than 10mm

A

less than 10mm

94
Q

The fetal lie is determined in relationship of the fetal _____________ axis to the long axis of the mother.

short

long

A

long

95
Q

In what way should a sonographer document fetal heart rate that is ALARA compliant? The only way mentioned on the powerpoint.

color doppler
pulse wave
m-mode
b-mode

A

m-mode

96
Q

When doing the fetal survey exam, the neck area should be evaluated for all of the following except what?

L-spine
c-spine
positioning of the neck
masses

A

L-spine

97
Q

The upper lip should always be imaged during an anatomy scan to rule out a cleft lip.

True
False

A

True

98
Q

Deficiency of amniotic fluid is known as?

Oligohydramnios
Polyhydramnios

A

Oligohydramnios

99
Q

When a patients myometrium appears ____ 3mm, it puts the patient at risk for uterine rupture.

less than
greater than

A

less than

100
Q

If you suspect the patient’s cervical length is short you should not perform a transvaginal exam.

True

False

A

False

101
Q

Which pathologic condition can cause the obliteration of the cisterna magna?

spina bifida
ventriculomegaly
mega cisterna magna
choroid plexus cyst

A

spina bifida

102
Q

At which level of the fetal brain should the Biparietal diameter (BPD) be measured at?

Ventricular level
Cerebellar level
Thalamic level

A

Thalamic level

OBGYN (8 decks)

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