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Ob/gyn > Ch. 46,47,48,49,50 > Flashcards

Ch. 46,47,48,49,50 Flashcards

1
Q

Which one of the following statements about infertility is false?
A. Infertility is the inability to conceive within 12 months with regular coitus
B. Infertility affects one in three couples in the US
C. Infertility in 40% of patients is attributable to men
D. Infertility in 20% of patients is attributable to either the man or the woman or is unexplained

A

B. Infertility affects one in three couples in the US

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2
Q

When evaluating a patient who is infertile, in addition to assessing structural anatomy, the sonographer should evaluate the:
A. Endometrium
B. Presence of corpus luteal cysts
C. Presence of follicular cysts
D. Vagina

A

A. Endometrium

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3
Q

The uterine anomaly most frequently associated with a high incidence of infertility is a ____________ uterus.
A. Septate
B. Bicornuate
C. Didelphys
D. T-shaped

A

A. Septate

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4
Q

The triple-line sign is associated with which one of the following structures?
A. Cervix
B. Vagina
C. Endometrium
D. Uterus

A

C. Endometrium

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5
Q

The Fallopian tubes are evaluated by a sonographic and saline examination to determine which one of the following characteristics?
A. Size
B. Patency
C. Length
D. Duplication

A

B. Patency

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6
Q

A dominant follicle grows at a rate of _______ to ________ millimeters per day (mm/day).
A. 0.5; 1
B. 1; 1.5
C. 1; 2
D. 1; 3

A

D. 1; 3

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7
Q

Patients with polycystic ovarian syndrome may have the clinical triad of all the following characteristics except:
A. Oligomenorrhea
B. Hirsutism
C. Bulimia
D. Obesity

A

C. Bulimia

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8
Q

Complications associated with assisted reproductive technologies include all of the following except:
A. Hyperstimulation
B. Multiple gestation
C. Cervical stenosis
D. Ectopic pregnancy

A

C. Cervical stenosis

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9
Q

After ovulation, progesterone is secreted by which one of the following?
A. Graafian follicle
B. Follicular cyst
C. Corpus luteum
D. Hyperstimulation

A

C. Corpus luteum

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10
Q

Endometrial thickness of at least ________ mm is necessary for achieving pregnancy.
A. 4
B. 6
C. 8
D. 10

A

B. 6

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11
Q

Lack of progesterone production is known as which one of the following?
A. Secondary infertility
B. Luteal phase deficiency
C. Polycystic ovarian syndrome
D. Ovarian hyperstimulation syndrome

A

B. Luteal phase deficiency

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12
Q

The T-shaped uterus is a congenital anomaly caused by which one of the following?
A. In utero exposure to diethylstilbestrol (DES)
B. Partial fusion of the muller Ian ducts
C. Incomplete fusion of the mullerian ducts
D. Exposure to radiation

A

A. In utero exposure to diethylstilbestrol (DES)

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13
Q

In the luteal phase, the endometrial lining may be thinner than expected from an inadequate level of which of the following?
A. Estrogen
B. Progesterone
C. Luteinizing hormone
D. Follicular-stimulating hormone

A

B. Progesterone

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14
Q

Which one of the following tends to have a narrow base attachment to the endometrium with a vascular pedicle feeding it?
A Endometrial polyp
B. Submucosal fibroid
C. Endometrial carcinoma
D. Synechiae

A

A. Endometrial polyp

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15
Q

A hyperechoic linear strand of tissue extending from one wall of the uterine cavity to the other describes which one of the following?
A. Adenomyosis
B. Decidua basalis
C. Uterine synechiae
D. Normal proliferative phase

A

C. Uterine synechiae

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16
Q

A normal endometrial response associated with overstimulation is an increasing thickness between 2 to 3 mm and ___________ mm.
A. 7 to 10
B. 10 to 20
C. 12 to 14
D. 20 to 25

A

C. 12 to 14

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17
Q

Producing more luteinizing hormone (LH) than follicular stimulating hormone (FSH) results in which one of the following conditions?
A. Meige syndrome
B. Luteal phase deficiency
C. Polycystic ovarian syndrome
D. Ovarian hyperstimulation syndrome

A

C. Polycystic ovarian syndrome

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18
Q

Which one of the following is used as a substitute for luteinizing hormone (LH) to trigger ovulation?
A. Clomid
B. Estradiol
C. Progesterone
D. Human chorionic gonadotropin (hCG)

A

D. Human chorionic gonadotropin (hCG)

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19
Q

Which one of the following syndromes demonstrates enlarged ovaries with multiple cysts, abdominal ascites and pleural effusion?
A. Polycystic ovarian
B. Fritz-Hugh-Curtis
C. Ovarian hyperstimulation
D. Stein-Leventhal

A

C. Ovarian hyperstimulation

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20
Q

Ovarian induction therapy requires documentation of all follicles greater than ________ mm in both longitudinal and transverse planes.
A. 5
B. 20
C. 15
D. 17

A

B. 20

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21
Q

Which one of the following hormones and follicle size determine the approximate time of ovulation?
A. Follicular stimulating hormone
B. Progesterone
C. Human chorionic gonadotropin
D. Estradiol

A

D. Estradiol

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22
Q

During in vitro fertilization, the optimal placement of the embryos is considered to be within 2 cm of the apex of which one of the following structures?
A. Cervix
B. Uterine body
C. Uterine fundus
D. Cornua

A

C. Uterine fundus

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23
Q

Multiple gestation occur in approximately _______ % of in vitro fertilization (IVF) pregnancies.
A. 15
B. 30
C. 50
D. 75

A

B. 30

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24
Q

Patients who undergo assisted reproduction procedures have an increased risk factor for a(n) _____________ pregnancy.
A. Molar
B. Heterotopic
C. An embryonic
D. Monoamniotic and monochorionic

A

B. Heterotopic

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25
Q

On a baseline pelvic ultrasound, an ovarian cyst greater than ______ mm could interfere with ovarian stimulation.
A. 5
B. 8
C. 10
D. 15

A

D. 15

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26
Q

OB ultrasound allows the clinician to assess all of the following except?
a. muscle tone
b. development
c. growth
d. well being

A

a. muscle tone

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27
Q

Ultrasound is able to determine all of the following except?
a. source of bleeding and status of fetus
b. fetal presentation
c. multiple gestation
d. exact date of delivery

A

d. exact date of delivery

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28
Q

BPP evaluation for fetal well-being includes all of the following except?
a. assessment of amniotic fluid
b. fetal tone
c. muscle tone
d. body and breathing movements

A

c. muscle tone

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29
Q

Limited obstetric ultrasound examinations are ordered for which one of the following reasons?
a. to answer a specific clinical question
b. to determine the fetal gender
c. to screen the fetus for anomalies
d. to rule out an ectopic pregnancy

A

a. to answer a specific clinical question

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30
Q

Which one of the following statements about the gestational sac is false?
a. the earliest structure observed with the sac is yolk sac
b. the embryo may be seen at 4 weeks with trans vag ultrasound
c. blood tests should be positive 7 to 10 hours after conception
d. the placenta is seen as a thickened density along part of the margin of the gestational sac

A

c. blood tests should be positive 7 to 10 hours after conception

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31
Q

Which one of the following statements about the embryo heart rate is false?
a. early in the developmental phase, the heart rate is greater than 190 bpm
b. early in the developmental phase, the heart rate is 90 bpm
c. the rate may increase to 170 bpm in the middle of the first trimester
d. the rate is 120 to 140 bmp in the second and third trimesters

A

a. early in the developmental phase, the heart rate is greater than 190 bpm

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32
Q

Which one of the following statements about the amniotic fluid development is true?
a. the fetal kidneys begin to produce urine in the first trimester
b. in the first trimester, fluid is produced by the placenta
c. the fluid decreases in volume until the 34th week’s gestation
d. the fetus gains two thirds of its weight during the first two trimesters

A

b. in the first trimester, fluid is produced by the placenta

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33
Q

Which one of the following statements about determining fetal age is false?
a. measure the head circumference at the same level as the BPD
b. measure the abdominal circumference at the level of the junction of the umbilical vein and portal sinus
c. measure the femur length on the femur farthest from the transducer
d. measure BPD in the axial plane that includes the thalamus and CSP

A

c. measure the femur length on the femur farthest from the transducer

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34
Q

The dates established by sonography examinations performed in the 2nd trimester typically take precedence over the menstrual age when the discrepancy is greater than ______ days.
a. 5
b. 7
c. 10
d. 15

A

c. 10

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35
Q

The most accurate measurement of gestational age during the 1st trimester is which one of the following?
a. mean sac diameter
b. yolk sac diameter
c. BPD
d. CRL

A

d. CRL

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36
Q

Fetal anatomy may be adequately assessed after ____ weeks gestation?
a. 14
b. 16
c. 18
d. 21

A

c. 18

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37
Q

On transabdominal imaging, an overdistended bladder may give a false impression of which one of the following?
a. incompetent cervix
b. placenta previa
c. fetal position
d. fetal size

A

b. placenta previa

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38
Q

In the 2nd trimester, guidelines recommend images of the fetal head include all of the following except?
a. sylvian fissure
b. lateral cerebral ventricles
c. cerebellum
d. midline falx

A

a. sylvian fissure

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39
Q

The abdominal circumference on a transverse view is measured at the level of all the following structures except?
a. portal sinus
b. fetal stomach
c. fetal kidneys
d. umbilical vein

A

c. fetal kidneys

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40
Q

Interval fetal growth may be determined by sonographic measurements ________ weeks apart?
a. 1 to 2
b. 2 to 3
c. 2 to 4
d. 4 to 6

A

c. 2 to 4

41
Q

Even with a known menstrual date, conception may occur from day _____ to day _____?
a. 1:15
b. 6:27
c. 10:18
d. 15:27

A

b. 6:27

42
Q

The 2nd trimester is between _________ gestational weeks?
a. 12 & 21
b. 12 & 28
c. 13 & 26
d. 15 & 30

A

c. 13 & 26

43
Q

The major biologic effects of ultrasound are believed to be which one of the following?
a. thermal
b. production and collapse of gas-filled bubbles
c. cavitation
d. all of the above

A

d. all of the above

44
Q

A sonographer can minimize thermal effects by which one of the following?
a. not staying in one spot
b. placing the focus on the beam in the near field
c. scanning over the fetal bone
d. increasing acoustic output

A

a. not staying in one spot

45
Q

Which one of the following statements about ultrasound safety is true?
a. no potential biological effects exist
b. the energy produced by ultrasound machines today is lower than that produced by earlier equipment
c. continual research on the bioeffects of ultrasound is no longer necessary
d. studies on the bioeffects of ultrasound are not definitive

A

d. studies on the bioeffects of ultrasound are not definitive

46
Q

Approximately _____ of all pregnant women in the US are examined w/sonography?
a. 50
b. 65
c. 75
d. 100

A

b. 65

47
Q

Diagnostic ultrasound has been in use since late in which one of the following decades?
a. 1940s
b. 1950s
c. 1960s
d. 1970s

A

b. 1950s

48
Q

Fetal sonography with or without Doppler should be performed?
a. on all 2nd trimester pregnancies
b. on all 1st trimester pregnancies
c. w/a valid medical reason
d. for sex determination

A

c. w/a valid medical reason

49
Q

The purpose for certification in diagnostic sonography is to assure the public that the sonographer has which one of the following?
a. necessary knowledge to perform the examination
b. necessary skills to perform examination
c. necessary experience to perform examination
d. all of the above

A

d. all of the above

50
Q

The cavity in which the fetus exists is called the _____ cavity?
a. chorionic
b. amniotic
c. decidual
d. embryonic

A

b. amniotic

51
Q

Which one of the following laboratory tests indicates pregnancy when the values are elevated?
a. FSH
b. LH
c. hCG
d. HL

A

c. hCG

52
Q

maternal serum hCG levels in a normal intrauterine pregnancy less than 7 weeks should increase by doubling every _______?
a. 24 hours
b. 48 hours
c. 3.5 days
d. 1 week

A

c. 3.5 days

53
Q

Which one of the following terms refers to a multiple pregnancy within one chorionic sac?
a. monoembryonic
b. dichorionic
c. diamniotic
d. monochorionic

A

d. monochorionic

54
Q

Which of the following ages refers to the length of time calculated from the first day of the last normal menstrual period to the point at which the pregnancy is being assessed?
a. gestational
b. embryonic
c. menstrual
d. either a or c

A

d. either a or c

55
Q

The interface between the decidua capsularis and echogenic vascular endometrium is which one of the following?
a. decidua capsularis
b. decidua basalis
c. double decidual sign
d. chorionic cavity

A

c. double decidual sign

56
Q

The beta hCG levels plateau & subsequently decline, whereas the gestational sac continues to grow after _____ weeks?
a. 3 to 5
b. 6 to 8
c. 9 to 10
d. 10 to 12

A

c. 9 to 10

57
Q

The fusion of the chorion & amnion occurs between _____ weeks?
a. 9 and 10
b. 11 and 12
c. 14 and 15
d. 20 and 21

A

c. 14 and 15

58
Q

The embryonic heart begins to beat at _____ days?
a. 23
b. 35
c. 43
d. 49

A

b. 35

59
Q

With transvaginal ultrasound, an abnormal pregnancy is suspected when visualizing the yolk sac fails with a minimum mean sac diameter (MSD) of _____ mm?
a. 6
b. 8
c. 10
d. 12

A

b. 8

60
Q

To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used?
a. length x width x height
b. length + width + height
c. (length x width x height)/3
d. (length + width + height)/3

A

d. (length + width + height)/3

61
Q

Using a transvaginal approach, the first structure visualized within a gestational sac is which one of the following structures?
a. primary yolk sac
b. secondary yolk sac
c. amnion
d. embryo

A

b. secondary yolk sac

62
Q

In the first trimester, herniated bowel will return within the abdominal cavity by the ______ week?
a. 8th
b. 10th
c. 12th
d. 15th

A

c. 12th

63
Q

The diameter of the normal yolk sac should never exceed _____ mm.
a. 4
b. 6
c. 8
d. 10

A

b. 6

64
Q

A sonogram at 10 weeks’ gestation demonstrates a cystic area within the posterior cranium. This appearance most likely represents which one of the following?
a. abnormal mesencephalon
b. normal rhombencephalon
c. abnormal reombencephalon
d. normal prosencephalon

A

b. normal rhombencephalon

65
Q

Transvaginal imaging of the female pelvis uses which of the following planes?
a. sagittal and coronal
b. coronal and transverse
c. sagittal and transverse
d. sagittal only

A

a. sagittal and coronal

66
Q

Typically, the yolk sac resorbs and is no longer visible sonographically by ______ weeks?
a. 8
b. 10
c. 12
d. 14

A

c. 12 weeks

67
Q

After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones?
a. estrogen only
b. progesterone only
c. progesterone with some estrogen
d. estrogen with some progesterone

A

c. progesterone with some estrogen

68
Q

The blastocyst typically enters the uterus ____ days after fertilization?
a. 1 to 2
b. 2 to 3
c. 4 to 5
d. 7 to 9

A

c. 4 to 5

69
Q

Implantation into the uterine decidua is completed within ____ days after fertilization?
a. 2
b. 5
c. 10
d. 12

A

d. 12

70
Q

In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG is ________ mega international units per milliliter (mIU/ml)?
a. 500
b. 1000
c. 1500
d. 1800

A

d. 1800

71
Q

The anechoic center of a 5 to 6 week gestation sac represents which one of the following?
a. amniotic cavity
b. chorionic cavity
c. decidual reaction
d. primary yolk sac

A

b. chorionic cavity

72
Q

The villi on the myometrial side of the conceptus is known as which one of the following?
a. double decidual sign
b. decidua basalis
c. decidua capsularis
d. chorion laeve

A

b. decidua basalis

73
Q

In early pregnancy, the gestational sac size grows at a rate of ______ mm/day?
a. 0.5
b. 1
c. 2
d. 2.5

A

b. 1 mm/day

74
Q

The CRL measurement may be used up to the _____ gestational week?
a. 10th
b. 11th
c. 12th
d. 13th

A

c. 12th week

75
Q

Transvaginally, an embryo w/cardiac activity should be identified when the gestational sac measures ______ mm?
a. 5 to 8
b. 8 to 12
c. 10 to 15
d. 16 to 20

A

d. 16 to 20

76
Q

Which one of the following is the most frequent sonographic finding in an ectopic pregnancy?
a. extrauterine gestation w/heart motion
b. adnexal mass
c. echogenic free fluid in Morrison’s Pouch
d. pseudo gestational sac

A

b. adnexal mass

77
Q

Which one of the following is the most common pelvic mass seen in a 1st trimester pregnancy?
a. ovarian dermoid
b. ectopic pregnancy
c. fibroid
d. corpus luteum cyst

A

d. corpus luteum cyst

78
Q

An ovum without an embryo is know as which one of the following?
a. anembryonic pregnancy
b. diamniotic pregnancy
c. ectopic pregnancy
d. pseudogestational sac

A

a. anembryonic pregnancy

79
Q

A congenital fissure that remains open past weeks in the wall of the abdomen just to the right of the umbilical cord is called which one of the following?
a. umbilical hernia
b. gastroschisis
c. omphalocele
d. midgut herniation

A

b. gastroschisis

80
Q

Cranial anatomy is routinely visualized after how many gestational weeks?
a. 8 to 10
b. 9 to 11
c. 10 to 12
d. 12 to 14

A

d. 12 to 14

81
Q

A partial absence of the cranium is called which one of the following abnormalities?
a. iniencephaly
b. anencephaly
c. acrania
d. osteogenesis imperfecta

A

a. acrania

82
Q

Which one of the following abnormalities is most commonly associated with cystic hygroma?
a. spina bifida
b. beckwith-wiedmann syndrome
c. turner syndrome
d. dandy-walker syndrome

A

c. turner syndrome

83
Q

Multiple tiny clusters of grape like echoes within the uterine cavity best describes?
a. pseudogestational sacs
b. ectopic pregnancy
c. incomplete abortion
d. gestational trophoblastic disease

A

d. gestational trophoblastic disease

84
Q

A hemorrhage located between the gestational sac and the myometrium represents which one of the following conditions?
a. placenta abruption
b. subchorionic hemorrhage
c. placental hematoma
d. placental lake

A

b. subchorionic hemorrhage

85
Q

Corpus luteum cysts regress and are typically not seen beyond _______ weeks?
a. 10 to 12
b. 12 to 14
c. 16 to 18
d. 18 to 20

A

c. 16 to 18

86
Q

An ectopic pregnancy most commonly occurs in which one of the following structures?
a. ovary
b. fallopian tube
c. cornua
d. cervix

A

b. fallopian tube

87
Q

The increased risk of massive hemorrhage in an ectopic pregnancy is located?
a. within the adnexa
b. within the peritoneum
c. near the uterine cornua
d. within the ovary

A

c. near the uterine cornua

88
Q

Findings in an ectopic pregnancy include all of the following except?
a. no evidence of IUP
b. adnexal mass
c. intraperitoneal fluid
d. normal increase in serum beta hCG levels

A

d. normal increase in serum beta hCG levels

89
Q

Which one of the following statements about a pseudogestational sac is false?
a. does not contain a yolk sac
b. contains low-level internal echoes
c. is eccentrically located within the endometrium
d. demonstrates a high resistive spectral waveform

A

c. is eccentrically located within the endometrium

90
Q

The best sonographic correlation in the diagnosis of an ectopic pregnancy is the combination of no IUP and which one of the following?
a. adnexal mass
b. complex endometrium
c. ovarian mass
d. anechoic cul de sac fluid

A

a. adnexal mass

91
Q

An increase risk of a complete hysterectomy is present when an ectopic pregnancy is located in which one of the following structures?
a. peritoneum
b. cervix
c. fallopian tube
d. adnexa

A

b. cervix

92
Q

The most common cause of vaginal bleeding in the 1st trimester is which one of the following?
a. placenta previa
b. subchorionic hemorrhage
c. ectopic pregnancy
d. missed abortion

A

b. subchorionic hemorrhage

93
Q

Embryos w/heart rates below ______ bpm generally have a poor prognosis?
a. 90
b. 100
c. 105
d. 110

A

a. 90 bpm

94
Q

The fetal urinary bladder becomes sonographically apparent at _______ weeks?
a. 10 to 12
b. 12 to 13
c. 13 to 14
d. 14 to 15

A

a. 10 to 12 weeks

95
Q

The most potentially life-threatening ectopic gestation is which one of the following?
a. cervical
b. interstitial
c. ovarian
d. peritoneal

A

b. interstitial

96
Q

Nuchal translucency must be measured between ____ weeks and ______ weeks, ______ days?
a. 8. 10, 6
b. 10, 12, 6
c. 11, 13, 6
d. 12, 13, 6

A

c. 11, 13, 6

97
Q

A gestation sac in which the embryo fails to develop is described as which one of the following?
a. blighted ovum
b. missed abortion
c. anembryonic pregnancy
d. blighted ovum or anembryonic pregnancy

A

d. blighted ovum or anembryonic pregnancy

98
Q

The serum level of beta hCG is _________ w/gestational trophoblastic disease?
a. dramatically elevated
b. mildly elevated
c. mildy decreased
d. dramatically decreased

A

a. dramatically elevated

99
Q

A heterotopic pregnancy is which one of the following”
a. form of abdominal pregnancy
b. simultaneous IUP and EUP
c. twin IUPs w/only one viable embryo
d. bilateral ectopic pregnancies

A

b. simultaneous IUP and EUP

Ob/gyn (11 decks)

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