Final (Review Class) Flashcards
The most accurate sonographic method of establishing gestational age is?
crown-rump length meaaurement
The trophoblasts of the blastocyst become the _______.
chorion
When a sonographer discovers a bicorunate uterus, which area should also be evaluated?
kidneys
All of the following are associated with lower than expected levels of serum hCG execpt:
a. hydatidaform mole
b. incorrect dates
c. embryonic demise
d. missed abortion
hydatidaform mole
The foramen ovale permits blood to pass from the _______ to the _______.
right atrium ; left atrium
Where is the yolk sac located?
between the amnion and chorion
The dominant hormone in the luteal phase of the ovary is?
progesterone
The nuchal fold should not exceed ______ mm in a normal pregnancy, when measured prior to 21 weeks.
6
Which of the following sonographic measurements is least accurate for determing gestational age?
a. FL
b. CRL
c. AC
d. BPD
e. HC
AC
The ratio of BPD to OFD determines the _____.
CI (cephalic index)
Days 6-13 in the ovary are which ovarian phase?
Follicular
The portions of the uterine body and fundus to the uterine cervix in the adult are?
2/3 body/fundus ; 1/3 cervix
The lateral ventricular atrial width is considered abnormal if it exceeds ________.
10mm
The cisterna magna should not exceed ____ cm in AP dimension.
1
The hormone primarily responsible for ovulation is _____.
LH
Which of the following is not routinely visualized at the proper level for measurement of the abdominal circumference?
a. aorta
b. spine
c. stomach
d. umbilical cord insertion
e. portal sinus of the umbilical vein
umbilical cord insertion
Which of the following is not routinely images at the proper level for BPD measurement?
a. cerebellum
b. cavum septum pellucidum
c. falx cerebri
d. thalamus
cerebellum
The endometrium appears thickest during the ____ portion of the menstrual cycle.
secretory
The inner cell mass of the blastocyst develops into all the following except: a. embryonic disk b. chorion c. amnion d, yolk sac
chorion
The yolk sac visually sonographically is the ____.
secondary yolk sac
An identifiable embryo without cardiac activity is referred to as a ______ abortion.
missed
The anechoic structure visualized sonographically in the posterior portion of the embryonic cranium transvaginal between 8-11 weeks is:
rhombencephalon
The existence of a fetus with a hydatidiform mole is:
partial mole
Which of the following vessels is known as the hypogastric artery?
a. ovarian artery
b. internal iliac artery
c. internal iliac vein
d. external iliac artery
internal iliac artery
The vessels normally found in the umbilical cord are _________.
two arteries and one vein
The optimal period to examine fetal cardiac anatomy is _________.
18-24 weeks
When examining a patient referred for “lost IUD string”, it would be possible to see which of the following sonographically?
a. a normal endometrium without evidence of IUD
b. uterine perforation by IUD
c. IUD properly situated in the uterine fundus
d. all of the above
all of the above
Chorioamniotic seperation is normal until _____ menstrual weeks.
16
A patient who has never had a menstrual period is said to have ______.
primary amenorrhea
A fibroid is sonographically indistinguishable from ________.
leiomyosarcoma
In a patient complaining of pelvic pain, fever and an increased WBC, a complex adenexal mass would most likey represent?
TOA (tubal ovarian abcess)
If a mucinous ovarian malignancy ruptures, it could lead to the development of ?
pseudomyxoma peritonei
All of the following are true for sonographers when interacting with obstetric patients except:
a. maintain a steady flow of conversation
b. prognosis should be given to allow for planning
c. general descriptions should be used
d. treat the patient with respect in any circumstance
prognosis should be given to allow for planning
A blood test used to screen for ovarian cancer is?
CA-125
A cystic mass seen between the fetal anterior wall and the fetal bladder most likely represents?
urachal cyst
The abdominal circumference measurement should be taken at the level of?
stomach and portal sinus of umbilical vein
Which of the following anatomic structures should routinely be visulaized at the BPD level?
cavum septum pellucidum
While scanning a petient in her 34th week, she complains of becoming nauseated, diaphoretic and light-headed. What action should be taken by the sonographer?
place patient in left lateral decubitus
While scanning a 14yr old patient who has not yet reached menarche, a distended vagina is seen, filled with low-level echoes. This sonographic appearance most likely represents _______, secondary to ______.
hematocolpos ; imperforate hymen
Serial sonographers are requested for a patient on Perganol. On day 27 of the cycle, multiple large septated cysts are seen bilaterally. This ovarian finding most likely represents?
theca lutein cysts
Sonographic findings suspicious for ectopic pregnancy include all of the following except:
a. sac eccentric to endometrial cavity
b. free fluid in posterior cul-de-sac
c. sac within endometrial cavity
d. adnexal ring
sac eccentric to endometrial cavity
Reverberation artifact is responsible for all of the following except:
a. echoes in the anterior portion of the maternal urinary bladder
b. echoes in the anterior amniotic fluid
c. swirling echoes within the amniotic fluid
d. decreased visualization of the cerebral hemisphere closest to the transducer
swirling echoes within the amniotic fluid
The BPD measurment is most accurate _________.
from 12 to 33 weeks LMP
Which CI is indicative of dolichocephaly?
67%
The most common tumor of the female pelvis is?
myoma
The first action a sonographer should take when placing the transducer on the maternal abdomen is to determine _______.
presence of fetal cardiac activity
Fetal blood passes from the umbilical vein to the portal vein to the IVC via the:
ductus venosus
The broad ligaments are best demonstrated sonographically:
in the presence of ascites
The most dependent recess in the body is the ____.
pouch of Douglas
Which of the following ovarian masses does not secreate hormones:
a. corpus luteum
b. arrhenoblastoma
c. theca lutein cyst
d. thecoma
theca lutein cyst
Fertilization occurs at which site normally?
ampulla of fallopian tube
Which of the following ovarian tumores is assocaiated with GI primary malignancy?
a. dysgerminoma
b. Krukenberg tumor
c. Brenner tumor
d. struma ovarii
Krukenberg tumor
What term describes a patient who has never been pregnant?
nulligravida
Fetal lung maturity can be detected via amniocentesis by presence of _____________.
phosphatidyl-glycerol
Increased serum estrogen levels clinically can be associated with all of the following sono findings except:
a. thickened endo
b. ovarian mass
c. multiple ovarian follicles
d. hydrosalpinx
hydrosalpinx
The most common location for an encepalocele is _______.
occipital
The presenece of an asymmetric encephalocele raises suspicion for ______.
limb body wall complex
Failure of fusion of the Mullerian ducts can lead to all of the following except:
a. bicornuate uterus
b. uterus didelphys
c. T-shaped uterus
d. arcuate uterus
T-shaped uterus
The ligament which attaches the ovary to the lateral pelvic wall and transits the ovarian vessel is _________.
infundibulopelvic ligament
The best scan plan to demenstrate spina bifida in a fetus is?
transverse
Which of the following is least likely to be a sonographic finding in a fetus with Trisomy 21?
clenched hands
True knots in the umbilical cord are most likely seen sonographically in ?
monoamniotic twins
The most dangerous location for an ectopic pregnancy is ______.
cornual
The placenta is considered thickened when it measures greater than ____ cm AP.
5
Biophysical profile assessment with ultrasound does not inculde?
umbilical cord doppler
Which AFI is indicative of oligohydramnios? a. 4.3cm b 9.2cm c. 16.5 cm d. 25.6cm
4.3cm
Painless vaginal bleeding is the hallmark of ________.
placenta previa
An 80yr old patient presents for sonographic evaluation for vaginal bleeding. What is the most important to obtain?
endometrial thickness measurement
_________ is not a cause of non-immune hydrops.
Rh isoimmunization
Skeletal anomalies are suspected when the long bones measure more than ____ SD below the mean.
2
The hormone responsible for proliferation of the endometrium is _____.
estrogen
Indications for saline infusion sonohysterography do not include:
a. active PID
b. infertility
c. Asherman’s syndrome
d. suspected septate uterus
active PID
The recipient twin in twin-to-twin transfusion syndrome exhibits:
hydrops
Sonographic visualization of a seperating membrane is evidence of a ______ gestation.
diamniotic
Which of the following is most suggestive of an ovarian malignancy?
a. mural nodules
b. thin septations
c. anechoic
d. increased vascular impedance
mural nodules
Which of the following will appear as a cyst in the cervical region of the uterus?
a. Gartner’s duct cyst
b. cervical carcinoma
c. nabothian cyst
d. cervical myoma
nabothian cyst
The tricuspid valve inserts ______ to the mitral valve.
inferior
A non-functioning mass of lung tissue with its own blood supply from the aorta is?
pulmonary sequestration
The most common congenital heart defect is _______.
ventricular septal defect
Which of the following pelvic muscles is routinely imaged on pelvic sonography?
a. levator ani muscle
b. piriformis muscle
c. coccygeus muscle
d. quadratus lumborum muscle
levator ani muscle
Locations of uterine fibroids do not include ______.
tubal
Oligohydramnios is associated with all the following except:
a. IUGR
b. preterm labor
c. fetal demise
d. bilateral renal agenesis
preterm labor
All of the following are associated with an elevated MS-AFP level except:
a. anencephaly
b. gastroschisis
c. maternal hepatocellular carcinoma
d. placental chorioangioma
e. cystic hygroma
cystic hygroma
TORCH infections do not include?
hepatitis
Meig’s syndrome does not include _____.
uterine myoma
The appropriate method of measuring the endometrium is ____ on a ____ image.
AP ; Sagittal
Lack of sonographic visualization of the cerebral hemispheres and cranium is diagnostic of ______.
anencephaly
Which skeletal anomaly is assocaited with in-utero fractures?
osteogenesis imperfecta type II
The left ovarian vein drains into the _______, and the right ovarian vein drains into the ____.
left renal vein, IVC
While scannig a patient who is 16 weeks by known menstrual dates, the sonographer notes a large cystic mass at the posterior aspect of the fetal neck. The mass appears to contain septations. The intracranial structures are normal. This finding most likely represents:
cystic hygroma
The fallopian tubes extend from which part of the uterus?
cornua
Which of the following potential peritoneal spaces is also known as the pouch of Douglas?
a. space of Retzius
b. vesicouterine pouch
c. rectouterine pouch
d. anterior cul-de-sac
rectouterine pouch
Sonographic findings in hydrops fetalis do not include fetal _____.
hydronephrosis
RhoGam is administered to the mother during pregnancy to prevent ______.
erithroblastosis fetalis
All of the following may be seen sonographically in maternal diabetes except:
a. prematurely mature placenta
b. macrosomia
c. placentomegaly
d. cardiac anomalies
prematurely mature placenta
A 24yr old patient is scanned for routine dating of pregnancy. Examination of the fetal head reveals non-fused thalami, presence of the falx cerebri and a fluid filled cranium. The choroid plexi are present. These sono findings most likely indicate?
hydrocephalus
The longest bone in the forearm is the ____.
ulna
Orbital distance measurement would be most helpful in which condition?
holoprosencephaly
Fetal bradycardia is less than _____ beats per minute.
100
Prominent endometrial echo complex may be seen due to all the following except:
a. hydrometra
b. ovarian granulosa cell tumor
c. endometrial carcinoma
d. enometritis
hydrometra
What ovarian mass does not secrete hormones?
theca lutein cyst
_______ is a non-lethal long bone dysplasia.
Type I osteogenesis imperfecta
Factors associated with placental abruption do not include?
primigravida
Which of the following would be least likely in which the mother had an abnormal hemoglobin A1C at 10 weeks of pregnancy?
a. bilateral renal agenesis
b. caudal regression syndrome
c. ventriculoseptal defect
d. placental abruption
placental abruption
The echogenic structure seen normally in the right ventricle is the ________.
moderator band
Which of the following components of the biophysical profile would not be assessed with ultrasound?
a. amniotic fluid
b. fetal breathing motion
c. fetal heart accelerations
d. fetal tone
fetal heart accelerations
Failure of the forebrain to divide results in ________.
holoprosencephaly
The gutters at the top of the vagina, which surround the cervix, are the _____.
fornices
The beginning of menses is known as _____.
menarche
If the pre-implantation blastocyst splits during the first week of gestation, it results in a ____________ pregnancy.
monochorionic diamniotic
Fetal blood passes from the pulmonary trunk to the aorta via the ______.
ductus arteriosus
Which of the following is not a sign of pre-eclampsia?
a. elevated blood pressure
b. proteinuria
c. edema
d. abnormal glucose tolerance test
abnormal glucose tolerance test
Premature separation of the placenta from the uterine wall is placenta ______.
abruption
The discriminatory zone at which a gestational sac should be seen using transvaginal sonography in the presence of an intrauterine pregnancy is when the serum BhCG level reaches _______ mlu/ml 3IRP.
1000-2000
The most common fetal thoracic abnormality is __________.
pleural effusion
Which stage of endometriosis invloves the ovaries?
3
The term “chocolate cyst” refers to a(n):
endometrioma
The S/D ratio in the umbilical artery should not exceed ____ in the third trimester.
3:1
Sonographic visulization of the tibia and fibula in the same scanning plane as the metatarsals of the foot is associated with ________.
clubfoot
Fetal cells can be retrieved for karyotyping by all the following methods except:
a. amniocentesis
b. CVS
c. umbilical blood sampling
d. FISH
FISH
The “quad screen” derives a statistical risk of trisomies 21 and 18 by using all of the maternal serum values except:
a. alpha feto protein
b. PAPP-A
c. estriol
d. human chorionic gonadotropin
e. inhibin-A
PAPP-A
Chronic maternal hypertension causes what placental changes?
prematurely mature
The effects of maternal infection on the fetus do not include?
macrosomia
The outer serosal layer of the uterus is the ________.
perimetrium
Days 6-13 in the uterus are considered the ______ phase.
proliferative
The heart should occupy approximately ____ of the fetal thorax.
1/3
Fetal skin thickening, called anasarca, is considered when the skin thickness reaches or exceeds _____cm.
0.5
hCG is secreted by?
trophoblast/chorion
Pathologic features of Trisomy 18 include all of the following except:
a. single umbilical artery
b. clenched fists
c. large choroid plexus cysts
d. thickened nuchal folds
thickened nuchal folds
Asymmetric intrauterine growth restriction is not associated with?
maternal infection
Sonographic detection of overlapping cranial bones, associated with fetal demise, is called _________ sign.
Spauldings
All the following are sono findings in spina bifida except:
a. banana sign
b. lemon sign
c. splaying of posterior elements
d. strawberry cranium
strawberry cranium
False positive sonographic impression of placenta prvia can be created by all of the following except:
a. transperineal scanning
b. focal myometrial contraction
c. lower uterine segment myoma
d. overdistended maternal urinary bladder
transperineal scanning
Amnionicity and chorionicity are most easily determined sonographically:
in the first trimester
The normally herniated midgut usually returns to the fetal abdomen by ____ weeks.
12
Which of the following would be least useful to evaluate in a fetus with suspected skeletal dysplasia?
a. mineralization of spine
b. size and shape of thorax
c. fetal gender
d. hands and feet
e. amniotic fluid index
fetal gender
which of the following would least likely be associated with thanatophoric dysplasia?
a. cloverleaf skull
b. severe micromelia
c. polyhydramnios
d. bowing of bones secondary to fractures
bowing of bones secondary to fractures
The most common anomaly caused by failure of the Mullerian ducts to fuse is?
bicornuate uterus
Which of the following would least likely exhibit posterior acoustic enhancement?
a. endometrioma
b. theca lutein cyst
c. parovarian cyst
d. ovarian fibroma
ovarian fibroma
All the following could cause a clinical diagnosis of “large for dates” except:
a. multiple gestation
b. IUGR
c. H mole
d. polyhydramnios
IUGR
Placental tissue covering the internal cervical os is known as?
placenta previa
A 21yr old primigravida is referred for a sonographic examination for elevated MS-AFP. The sonographer notes echogenic mass lateral to the umbilical cord insertion. The mass is not contained within a membrane. This finiding is most likely?
gastroschisis
Decreased intraorbital distance is?
hypotelorism
A dilated fetal urinary bladder with a “key hole sign” in a male fetus is indicative of?
posterior urethral valve obstruction
All the following practices employ the ALARA principle in OB scanning except:
a. scanning for the shortest time possible
b. scanning when medically indicated
c. increasing the mechanical index
d. decreasing the output power
increasing the mechanical index
The most common pelvis mass encountered during pregnancy is?
corpus luteal cyst
The hormone responsible for the final maturation of the follicle and for ovulation is?
LH
Measurement of the yolk sac is performed?
inner to inner
The “double bubble” sign is associated with ?
duodenal atresia
The intracranial findings in spina bifida are secondary to?
Arnold Chiari
