Ch. 12 Doppler Applications In Obstetric And Gynecology Sonography

Question 1

1. The primary vessels supplying blood to the pelvic organs are the:
   A. Gonadal arteries
   B. Internal iliac arteries
   C. Spermatic arteries
   D. External iliac arteries

Answer 1

B. Internal iliac arteries (hypogastric arteries)
Internal iliac/hypogastric arteries are the truck arteries that direct blood to all the pelvic organs

Question 2

2. All of the following Doppler ultrasound findings can be associated with ovarian torsion except:
   A. Ovarian hyperemia
   B. Ovarian enlargement
   C. Ovarian mass
   D. Absent ovarian parenchymal blood flow

Answer 2

A. Ovarian hyperemia

Question 3

3. All of the following Doppler ultrasound studies can be useful in helping to predict fetal growth restriction except:
   A. Umbilical artery doppler
   B. Fetal cerebral artery Doppler
   C. Uterine artery Doppler
   D. Internal iliac artery Doppler

Answer 3

D. Internal iliac artery Doppler
*Umbilical, fetal cerebral, and uterine artery Doppler studies are all established methods useful in predicting fetal IUGR. *

Question 4

4. The various Doppler ultrasound modalities used in assessing pelvic organs can demonstrate all of the hemodynamic parameters listed below except:
   A. Pressure of flow
   B. Presence of flow
   C. Flow direction
   D. Pulsatility of flow

Answer 4

A. Pressure of flow
Sphygmomanometers (BP cuffs) can be used externally to obtain pressure; Pressure catheters can be used for internal monitoring of Arterial or Venous pressure

Question 5

5. The Doppler criterion that provides the best indicator for diastolic run off into a distal vascular bed is the:
   A. S/D ratio
   B. End-Diastolic velocity
   C. Resistivity index
   D. Pulsatility index

Answer 5

D. Pulsatility index
Diastolic runoff is a measure of how much blood continues to flow into vascular bed after primary push of systole has subsided; High PI= little diastolic runoff, Low values= more forward flow during diastole

Question 6

6. The diastolic notch is best described as:
   A. Flow reversal in early diastole
   B. Flow reversal in late diastole
   C. Early diastolic flow reduction
   D. Late diastolic flow reduction

Answer 6

C. Early diastolic flow reduction
* If DIASTOLIC NOTCH appears early in gestation, it suggests compromise of placenta circulation *

Question 7

7. The spectral Doppler waveform obtained from arteries supplying trophoblastic tissue will demonstrate:
   A. High-amplitude, low resistance flow
   B. High-amplitude, high resistance flow
   C. High-amplitude, triphasic flow
   D. Low-amplitude, monophasic flow

Answer 7

A. High amplitude, low resistance flow

Question 8

8. Hemodynamic changes occur in the uterine arteries in response to cyclical variations in hormone levels. As the uterus cycles toward menstruation, how do blood flow patterns change?
   A. The resistance decreases
   B. The resistance increases
   C. The pulsatility increases
   D. There is no discernible change

Answer 8

A. The resistance decreases
*Decreasing resistance indicates increase in demand for oxygen and metabolites carried by blood.
As uterus prepares for implantation of a conceptus… the endometrium proliferates under the influence of estrogen *

Question 9

As uterus prepares for implantation of a conceptus… the endometrium proliferates under the influence of ______.

Answer 9

estrogen

Question 10

9. Which of the following is not an ultrasound finding associated with a compromised pregnancy?
   A. Flow reversal in diastole
   B. Increased resistance in serial surveillance
   C. Decreased resistance on serial surveillance
   D. Diastolic notch

Answer 10

C. Decreased resistance on serial surveillance
Decreased resistance is a normal finding as pregnancy progresses

Question 11

10. In performing a uterine artery Doppler study, the spectral range gate (sample volume) should be placed:
    A. Near its origin at the internal iliac artery
    B. Mid-vessel with strongest color signal
    C. Near the cervix
    D. Anywhere along its course

Answer 11

C. Near the cervix

Question 12

Diastolic Notch is of prognostic value ONLY AFTER _____ weeks GA.

Answer 12

24 weeks GA

Question 13

Impedance and resistance _______ during preovulatory & luteal phase

Answer 13

Decrease

Question 14

What things determine sampling of Middle Cerebral Artery?

Answer 14

-IUGR
-Fetal transfusion
-brain sparing
-anemia

Question 15

Siren of an ambulance as it moves toward and away is an example of ____ acoustic ____ effect.

Answer 15

audible acoustic Doppler effect

Question 16

If Doppler frequencies exceed Nyquist limit _______ occurs. Improperly placed information ion the wrong side of the baseline

Answer 16

Aliasing

Question 17

To correct aliasing you:
1.)
2.)

Answer 17

1.) Decrease baseline/imaging depth
2.) Increase PRF | Transducer Frequency

Question 18

The yellow arrow points to: ____.
____ is identified by the red arrows.

Answer 18

-Nyquist limit
-Aliasing

Question 19

The images demonstrate ______ flow.

Answer 19

Venous

Question 20

The images demonstrate ____ flow.

Answer 20

Arterial

Question 21

Image 1 shows: ____
Image 2 is the ______ sign.

Answer 21

—Ovarian Torsion
— Whirlpool sign

Question 22

What is the difference of the Left image from the Right?

Answer 22

Left image = ectopic pregnancy; bc a pseudo sac is present (pt also= pelvic pain and positive pregnancy test)

Right image= corpus luteum cyst

Question 23

This Doppler sample site is for the ______ ______; near the _____.

Answer 23

—Uterine artery
— cervix