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Ob/gyn > Ch. 55,56,57,58 > Flashcards

Ch. 55,56,57,58 Flashcards

1
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 hours.

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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2
Q

Cordocentesis is more commonly used for which one of the following procedures?

a. Chromosomal analysis

b. Analysis of fetal lung maturity

c. Cardiovascular analysis

d. Guidance for transfusions to treat fetal isoimmunization

A

d. Guidance for transfusions to treat fetal isoimmunization

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3
Q

Amniocentesis may be used for all of the following except:

a. Analysis of fetal chromosomes

b. Prediction of Rh isoimmunization

c. Documentation of lung maturity

d. Prediction of cardiac abnormalities

A

d. Prediction of cardiac abnormalities

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4
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 alpha-fetoprotein (AFP) level

A

b. Multiple gestations

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5
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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6
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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7
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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8
Q

The quadruple screen evaluates all of the following markers except:

a. AFP

b. Human chorionic gonadotropin (hCG)

c. Unconjugated estriol

d. Fetal lung maturity

A

d. Fetal lung maturity

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9
Q

An abnormality in the number of chromosomes is called which one of the following?

a. Aneuploidy

b. X-linked disorder

c. Multifactorial

d. Mosaicism

A

a. Aneuploidy

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10
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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11
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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12
Q

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

a. Trisomy 13

b. Trisomy 18

c. Trisomy 21

d. Turner syndrome

A

c. Trisomy 21

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13
Q

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

a. Trisomy 13

b. Trisomy 18

c. Trisomy 21

d. Turner syndrome

A

b. Trisomy 18

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14
Q

Holoprosencephaly and proboscis are most likely to be found in a fetus with which one of the following?

a. Trisomy 13

b. Trisomy 18

c. Trisomy 21

d. Turner syndrome

A

a. Trisomy 13

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15
Q

A large cystic hygroma, hydrops, and coarctation of the aorta may be seen in a fetus with which one of the following?

a. Trisomy 13

b. Trisomy 18

c. Trisomy 21

d.Turner syndrome

A

d. Turner syndrome

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16
Q

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

a. Peak from 16 to 20 weeks’ gestation.

b. Increase throughout pregnancy.

c. Decline after 24 weeks’ gestation.

d. Peak from 15 to 18 weeks’ gestation.

A

b. Increase throughout pregnancy.

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17
Q

AFP is produced in early gestation by which one of the following structures?

a. Liver

b. Brain

c. Yolk sac

d. Placenta

A

c. Yolk sac

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18
Q

A common reason for an elevated level of maternal serum AFP (MSAFP) is which one of the following?

a. Neural tube defect

b. Abdominal wall defect

c. Chromosomal abnormality

d. Incorrect dates

A

d. Incorrect dates

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19
Q

The most common aneuploid condition is which one of the following?

a. Trisomy 13

b. Trisomy 18

c. Trisomy 21

d. Turner syndrome

A

c. Trisomy 21

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20
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 portion of the placenta

A

a. Away from the maternal midline

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21
Q

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

a. 14 to 16

b. 15 to 18

c. 18 to 20

d. 16 to 20

A

b. 15 to 18

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22
Q

Free beta-hCG can be assessed in maternal serum in the first trimester to evaluate for an increased risk of which one of the following anomalies?

a. Triploidy

b. Turner syndrome

c. Down syndrome

d. Meckel-Gruber syndrome

A

c. Down syndrome

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23
Q

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

a. Amniotic fluid volume

b. Cervical length

c. Placenta location

d. Fetal cardiac activity

A

d. Fetal cardiac activity

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24
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

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25
Q

Low AFP 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

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26
Q

The fetal membranes are comprised of all of the following except the:
A) blastocyst
B) amnion
C) chorion
D) yolk sac

A

A) blastocyst

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27
Q

The chorionic plate is related to which one of the following?
A) fetal surface of the placenta
B) cotyledons and intervillous spaces
C) allantois of the yolk sac
D) maternal surface of the fetus

A

A) fetal surface of the placenta

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28
Q

The decidual reaction that changes in the endometrium opposite the site of implantation is which one of the following?
A) decidua capsularis
B) decidue basalis
C) decidua vera
D) decidua frondosum

A

C) decidua vera

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29
Q

The major functioning unit(s) of the placenta is(are) which of the following?
A) cotyledons
B) yolk sac
C) amnion
D) chorionic villi

A

D) chorionic villi

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30
Q

The placenta performs all of the following functions except:
A) protection
B) respiration
C) absorption
D) nutrition

A

C) absorption

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31
Q

The velementous placenta refers to a(n):
A) membranous insertion of the cord
B) insertion of the umbilical cord near the edge of the placenta
C) insertion of the umbilical cord at the margin of the placenta
D) arteriovenous anastomosis of the vessels within the placenta

A

A) membranous insertion of the cord

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32
Q

By 9 weeks, the yolk sac should measure _____ millimeters (mm) in diameter:
A) less than 5
B) greater than 2
C) less than 2
D) greater than 5

A

A) less than 5

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33
Q

Fusion of the amnion and chorion usually occurs by _______ weeks’ gestation.
A) 20
B) 16
C) 12
D) 14

A

B) 16

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34
Q

The function of the human chorionic gonadotropin (hCG) is to perform which one of the following?
A) develop Wharton’s jelly around the cord
B) produce amniotic fluid
C) stimulate the yolk sac development
D) maintain the corpus luteum in early pregnancy

A

D) maintain the corpus luteum in early pregnancy

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35
Q

A marginal or an eccentric insertion of the umbilical cord into the placenta is which one of the following?
A) placenta previa
B) battledore placenta
C) vasa previa
D) velamentous placenta

A

B) battledore placenta

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36
Q

The primary cause of placentomegaly is which one of the following abnormalities?
A) maternal diabetes
B) intrauterine infection
C) battledore placenta
D) intrauterine growth restriction (IUGR)

A

A) maternal diabetes

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37
Q

The most common site of fibrin deposition is which one of the following?
A) along the retroplacental area
B) within the hydatidiform mole
C) within the chorioangioma
D) along the subchorionic area

A

D) along the subchorionic area

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38
Q

Complications of placenta previa include all of the following except:
A) postpartum hemorrhage
B) succenturiate placenta
C) maternal hemorrhage
D) premature delivery

A

B) succenturiate placenta

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39
Q

Severe blood loss may occur with placenta ______.
A) increta
B) percreta
C) excreta
D) accreta

A

B) percreta

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40
Q

The presence of one or more accessory lobes connected to the body of the placenta by blood vessels is a ______ placenta.
A) circummarginate
B) succenturiate
C) circumvallate
D) battledore

A

B) succenturiate

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41
Q

Which one of the following statements about placental abruption is false?
A) bleeding in the decidua basalis occurs with separation
B) preterm labor may result
C) the bleed may lead to chorioangioma
D) placental abruption may be retroplacental or marginal abruption

A

C) the bleed may lead to chorioangioma

42
Q

An example of low-pressure bleed is which one of the following?
A) decompression of the uterus
B) trauma to the uterus
C) marginal abruption
D) retroplacental abruption

A

C) marginal abruption

43
Q

The maternal side of the placenta is decidua _______.
A) parietalis
B) capsularis
C) basalis
D) frondosum

A

C) basalis

44
Q

The chorion around the gestational sac on the opposite side of implantation is chorion _______.
A) frondosum
B) vera
C) laeve
D) capsularis

A

C) laeve

45
Q

A marginal placenta previa demonstrates which one of the following?
A) the edge of the placenta is near the internal cervical os
B) the placenta partially covers the internal cervical os
C) the placenta touches but does not cross the internal cervical os
D) the placenta is in the right lateral position

A

C) the placenta touches but does not cross the internal cervical os

46
Q

Which one of the following abnormalities might demonstrate a small placenta?
A) aneuploidy
B) maternal anemia
C) Rh sensitivity
D) maternal diabetes

A

A) aneuploidy

47
Q

Which one of the following occurs when the intramembranous vessels course across the internal cervical os?
A) battledore placenta
B) velamentous placenta
C) vasa previa
D) placenta previa

A

C) vasa previa

48
Q

The growth of the chorionic villi superficially into the myometrium describes which one of the following?
A) placenta increta
B) succenturiate placenta
C) placenta accreta
D) placental migration

A

C) placenta accreta

49
Q

The attachment of the placental membranes to the fetal surface of the placenta describes which one of the following?
A) battledore placenta
B) succenturiate placenta
C) placenta accreta
D) circummarginate placenta

A

D) circummarginate placenta

50
Q

A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appearance most likely represents which one of the following?
A) abruption placenta
B) circumvallate placenta
C) succenturiate placenta
D) chorioangioma

A

D) chorioangioma

51
Q

Which one of the following umbilical cord entanglements in the fetus is the most common?
A) true knot
B) hematoma
C) false knot
D) nuchal cord

A

D) nuchal cord

52
Q

If a single umbilical artery is seen, the sonographer should search for which one of the following?
A) abdominal wall defect
B) genitourinary defect
C) neural tube defect
D) esophageal atresia

A

B) genitourinary defect

53
Q

______ of the cord may be formed when a loop of cord is slipped over the fetal head or shoulders during delivery.
A) hemangioma
B) true knots
C) hematoma
D) false knots

A

B) true knots

54
Q

Which one of the following occurs when the cord inserts into the membranes before it enters the placenta?
A) velamentous insertion
B) vasa previa
C) prolapse
D) battledore placenta

A

A) velamentous insertion

55
Q

Cord prolapse problems can be produced during all of the following obstetric procedures except:
A) velamentous cord insertion
B) disengaging the head
C) version and extraction
D) artificial rupture of membranes

A

A) velamentous cord insertion

56
Q

Which one of the following problems may lead to inadequate fetal descent?
A) short cord
B) twisted cord
C) long cord
D) ruptured cord

A

A) short cord

57
Q

After birth, the ductus venosus turns into which one the following?
A) ligamentum venosum
B) ductus arteriosus
C) falciform ligament
D) coronary ligament

A

A) ligamentum venosum

58
Q

Thrombosis of the umbilical vessels is most common in which one of the following?
A) left umbilical artery
B) umbilical vein
C) hypogastric arteries
D) right umbilical artery

A

B) umbilical vein

59
Q

All of the following statements are correct about a true knot of the cord except:
A) Color Doppler is useful to record flow
B) has been associated with polyhydraminos
C) has been associated with monoamniotic twin gestation
D) is associated with long cords

A

C) has been associated with monoamniotic twin gestation

60
Q

The presence of umbilical vessels crossing the internal os of the cervix is called which one of the following?
A) cord prolapse
B) velamentous cord
C) vaso previa
D) placenta previa

A

C) vaso previa

61
Q

The umbilical cord is formed by the fusion of which one of the following?
A) amnion and yolk sac
B) yolk sac and allantonic ducts
C) allantoic ducts and chorion
D) yolk stalk and allantoic ducts

A

D) yolk stalk and allantoic ducts

62
Q

In the first trimester, the length of the umbilical cord is approximately the same size as which one of the following?
A) mena (gestational) sac diameter
B) crown-rump length
C) femur length
D) biparietal diameter

A

B) crown-rump length

63
Q

The normal length of the umbilical cord measures ______ centimeters (cm).
A) 40 to 60
B) 60 to 90
C) 30 to 50
D) 20 to 35

A

A) 40 to 60

64
Q

A cystic mass in the umbilical cord is usually which one of the following?
A) an omphalocele
B) a false knot of the cord
C) a true knot of the cord
D) allantonic in origin

A

D) allantonic in origin

65
Q

Velamentous umbilical cord insertion is associated with all of the following except:
A) abnormal fetal heart rate
B) low apgar scores
C) macrosomia
D) preterm labor

A

C) macrosomia

66
Q

Which one of the following statements about a single umbilical umbilical artery is false?
A) the incidence of chromosomal abnormalities is increased
B) the incidence of IUGR is increase
C) an increase in prenatal mortality is present
D) the right umbilical artery is absent more often than the left umbilical artery

A

D) the right umbilical artery is absent more often than the left umbilical artery

67
Q

A dilated intraabdominal, extrahepatic portion of the umbilical vein is called which one of the following?
A) persistent right portal vein
B) varix of the umbilical vein
C) aneurysm of the umbilical vein
D) thrombosis of the umbilical vein

A

B) varix of the umbilical vein

68
Q

Conditions predisposing a fetus to cord prolapse include all of the following except:
A) velamentous cord
B) premature rupture of membranes
C) normal fetal presentation
D) polyhydraminos

A

C) normal fetal presentation

69
Q

A short cord measures less than ______ cm.
A) 25
B) 35
C) 30
D) 40

A

B) 35

70
Q

Which one of the following statements about the umbilical cord is false?
A) one umbilical vein and two umbilical arteries make up the umbilical cord
B) the umbilical vein carries oxygenated blood to the fetus
C) the umbilical cord is the essential link from the mother to the fetus
D) the chorion covers the cord and blends with the fetal skin at the umbilicus

A

D) the chorion covers the cord and blends with the fetal skin at the umbilicus

71
Q

A paraumbilical defect involving all layers of the abdominal wall is called which one of the following?
A) omphalocele
B) umbilical herniation
C) gastroschisis
D) amniotic band syndrome

A

C) gastroschisis

72
Q

Coiling of the umbilical cord:
A) has a higher incidence of fetal anomalies when the cord is twisted toward the right
B) is not related to fetal activity
C) is insignificant
D) is abnormal

A

A) has a higher incidence of fetal anomalies when the cord is twisted toward the right

73
Q

False knots of the umbilical cord:
A) occur when the blood vessels are longer than the cord
B) are associated with short cord length
C) are loop of cord slipped over the fetal head
D) are umbilical hernias

A

A) occur when the blood vessels are longer than the cord

74
Q

A long umbilical cord measures greater than _____ cm.
A) 100
B) 120
C) 60
D) 80

A

D) 80

75
Q

A hypoplastic umbilical artery is defined as a three-vessel cord when the artery-to-artery differences is greater than _____.
A) 30%
B) 25%
C) 75%
D) 50%

A

D) 50%

76
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 which of the following?

a. Uterine synechiae

b. Amniotic bands

c. Amniotic sheets

d. Entangled sheets

A

b. Amniotic bands

77
Q

Which one of the following is produced by the umbilical cord and membranes, the fetal lung, skin, and kidney?

a. Amniotic fluid

b. Chorion frondosum

c. Decidua basalis

d. Vernix caseosa

A

a. Amniotic fluid

78
Q

Which one of the following structures forms early in gestation and surrounds the embryo?

a. Chorionic cavity

b. Chorion frondosum

c. Amniotic cavity

d. Fetal cavity

A

c. Amniotic cavity

79
Q

The fetal production of urine and the ability to swallow begin during which of the following weeks’ gestation?

a. 6 to 9

b. 8 to 11

c. 10 to 13

d. 9 to 15

A

b. 8 to 11

80
Q

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

a. Production of the fluid

b. Removal of the fluid by swallowing

c. Fluid exchange within the heart

d. Membranes and cord

A

c. Fluid exchange within the heart

81
Q

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

a. The amniotic fluid increases in the early second trimester by 25 milliliters (ml).

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

c. The amniotic fluid increases in the late second trimester by 50 ml.

d. The amniotic fluid in the third trimester does not change significantly.

A

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

82
Q

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

a. Appearance of a free-floating fetus within the amniotic cavity

b. Accentuated fetal anatomy as increased amniotic fluid improves image resolution

c. Amniotic fluid index (AFI) greater than 20 centimeters (cm)

d. AFI greater than 15 cm

A

d. AFI greater than 15 cm

83
Q

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

a. Diabetes mellitus

b. Fetal macrosomia

c. Tetralogy of Fallot

d. Rh isoimmunization

A

c. Tetralogy of Fallot

84
Q

Oligohydramnios is associated with all of the following except:

a. Renal agenesis

b. Gastrointestinal disorders

c. Premature rupture of the intrauterine membranes (PROM)

d. Postdate pregnancy

A

b. Gastrointestinal disorders

85
Q

. Syndactylism is most likely the result of which one of the following?

a. Synechiae

b. Uterine sheets

c. Amniotic bands

d. Subchorionic hemorrhage

A

c. Amniotic bands

86
Q

Amniotic sheets are believed to be caused by which one of the following?

a. Synechiae

b. Amniotic bands

c. Subchorionic hemorrhage

d. Demise twin pregnancy

A

a. Synechiae

87
Q

Which one of the following methods is used for visual assessment of the AFV?

a. AFI

b. Single-pocket assessment

c. Subjective assessment of fluid

d. Three-dimensional (3-D) determination

A

c. Subjective assessment of fluid

88
Q

Early in gestation, the major source of amniotic fluid is produced by which one of the following?

a. Yolk sac

b. Amniotic membranes

c. Yolk stalk

d. Chorionic villi

A

b. Amniotic membranes

89
Q

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

a. Slightly higher

b. Similar

c. Significantly lower

d. Slightly lower

A

d. Slightly lower

90
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

91
Q

Amniotic fluid may appear generous during ______ weeks’ gestation.

a. 12 to 15

b. 15 to 20

c. 20 to 30

d. 36 to 40

A

c. 20 to 30

92
Q

Which one of the following techniques is both valid and reproducible in assessing the AFV?

a. AFI

b. Single-pocket assessment

c. Maximum vertical pocket

d. 3-D determination

A

a. AFI

93
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

94
Q

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

a. Poor prognosis

b. Average prognosis

c. Good prognosis

d. Prognosis that depends on the underlying cause

A

a. Poor prognosis

95
Q

Scars within the uterus, secondary to previous gynecologic surgery, are called which one of the following?

a. Adenomyosis

b. Amniotic bands

c. Synechiae

d. Uterine polyps

A

c. Synechiae

96
Q

The amniotic fluid generally appears anechoic on ultrasound. Occasionally, however, mobile particles are observed that are most likely which one of the following?

a. Sludge

b. Debris

c. Vernix caseosa

d. Hemorrhage

A

c. Vernix caseosa

97
Q

Using the maximum vertical depth method of assessing the AFV, 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

98
Q

Polyhydramnios is defined as an AFV greater than _______ ml.

a. 1500

b. 1750

c. 2000

d. 2250

A

c. 2000

99
Q

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

a. Two

b. Three

c. Four

d. Five

A

b. Three

100
Q

Nonanomalous conditions causing oligohydramnios include all of the following except:

a. Dysplastic kidney

b. PROM

c. IUGR

d. Postdate pregnancy

A

a. Dysplastic kidney

Ob/gyn (11 decks)

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