My ultrasoundtutor quizzes (Part 2 OB) Flashcards
obstetrics
During pregnancy, what does the corpus luteum produce?
a) hCG
b) PAPP-A
c) blastocyst
d) progesterone
d) progesterone
Which of the following would be a normal measurement for the yolk sac at 7 weeks?
a) 7mm
b) 6.2 mm
c) 5.9 mm
d) 6.5 mm
c) 5.9 mm
- Yolk sac should be < 6mm
A patient is 6 weeks from LMP and current b-hCG is reported at 800 mIU/mL. What is the normally expected finding?
a) Decidual reaction
b) Intrauterine pregnancy
c) viable fetal pole
d) gestational sac with yolk sac
a) Decidual reaction
What are the 2 decidual layers that can be seen as early as 5 weeks gestation?
a) chorion and amnion
b) capsularis and parietalis
c) basalis and chorionis
d) vitelline and capsularis
b) capsularis and parietalis
Implantation occurs how many days after fertilzation?
7-9 days
By what day from the LMP is implantation complete?
28
hCG levels continue to double every 48 hours until how many weeks?
9 weeks
The earliest visible sign of pregnancy is a
decidualized endometrium
In what part of the uterus does fertlization occur?
Ampulla
What is the first definitive sonographic evidence of an IUP?
Gestational sac with yolk sac
Located in the space of the chorionic cavity between the amnion and chorion is the?
Extraembryonic coelem
The secondary yolk sac is responsible for what 3 things?
1) producing AFP
2) angiogenesis
3) hematopoiesis
At how many weeks is a fetal pole seen within the amniotic cavity adjacent to the yolk sac?
6 weeks
what is the most reliable estimation of gestational age in the first trimester?
CRL (crown rump length)
At how many weeks does the formation of limb buds and fetal head appear larger than the body?
7 weeks
The cystic structure noted within the head around 8 weeks is called?
Rhombocephalon
Migration of the midgut/bowel into the base of the umbilical cord should be completed by how many weeks?
12 weeks
Name the 2 things the placenta and umbilical cord are formed by
1) decidua basalis (maternal)
2) chorion frondosum (fetal)
First trimester screening is primarily used for what 2 anomalies?
1) Trisomy 21
2) Trisomy 18
The NT should never measure more than how many mm?
> 3mm
NT may also be enlarged with what 3 things?
1) Trisomy 13
2) Turners
3) Cardiac defects
Which of the following produces hCG?
a) blastocyst
b) morula
c) zygote
d) corpus luteum
a) blastocyst
What time frame is acceptable for perform a nuchal translucency measurement?
a) 11-14 weeks
b) up to 16 weeks
c) 10-13 weeks
d) 9-12 weeks
a) 11-14 weeks
What statement is true regarding first trimester pregnancy?
a) a fetal pole should be visualized by a maximum GS diameter of 10 mm
b) a fetal pole should be visualized by a maximum GS diameter of 25 mm
c) a fetal pole should be visualized at a MSD of 10 mm
d) a fetal pole should be visualized at a MSD of 25 mm
d) a fetal pole should be visualized at a MSD of 25 mm
A pregnancy located anywhere other than the central uterine cavity is called?
Ectopic pregnancy
What is the most common cause of pelvic pain with a positive pregnancy test?
Ectopic pregnancy
Where is the most common location for an ectopic pregnancy?
Within the ampulla of the fallopian tube
Name the 5 risk factors of an ectopic pregnancy
1) assisted reproduction
2) Hx of PID
3) endometriosis
4) IUD
5) previous ectopic
The most dangerous location for an ectopic pregnancy is?
Interstitial/corneal because of risk of rupture and hemorrhage
What is another name for gestational trophoblastic disease?
Molar pregnancy
What is the most common GTD?
complete
Name the 3 types of GTD
1) hydatidiform mole
2) invasive molar
3) choriocarcinoma
What is another name for a blighted ovum?
Anembryonic pregnancy
A large GS without a YS or embryo based on sac size is most likely?
Blighted ovum
Fetal demise is confirmed by a fetal pole _______ with no cardiac activity
> 5mm
What is another name for a miscarriage?
Spontaneous abortion
Termination of pregnancy before viability whether elective or not is referred to as
Abortion
What is referred to as a naturally occurring miscarriage?
Spontaneous abortion
A bleed between the endometrium and gestational sac is termed?
Subchorionic hemorrhage
What is the most common pelvic mass in the first trimester?
Corpus luteum
The corpus luteum is maintained by?
hCG
What hormone does the corpus luteum secrete?
Progesterone
What is the most likely etiology for abnormally low levels of hCG expected for gestational age?
a) blighted ovum
b) embryonic demise
c) ectopic pregnancy
d) incorrect dating
d) incorrect dating
Sonographic findings of a 8mm fetal pole with a heart rate of 80 bpm confirms what diagnosis?
a) missed abortion
b) viable IUP
c) inevitable abortion
d) threatened abortion
d) threatened abortion
What significant abnormality can be diagnosed by the end of the first trimester?
a) absent stomach
b) urinary obstruction
c) bilateral renal agensis
d) acrania
d) acrania
What defines an inevitable abortion?
a) low fetal heart rate with arrhythmia
b) subchorionic hemorrhage covering 30% of the GS
c) elective termination of pregnancy
d) GS located close to an incomplete cervix
d) GS located close to an incomplete cervix
A patient with a history of D&C 1 week prior, currently complains of ongoing bleeding. Lab testing demonstrates an hCG level of 600. What is the expected diagnosis?
a) partial molar
b) ectopic pregnancy
c) retained products of conception
d) complete abortion
c) retained products of conception
What is the most common diagnosis in a patient experiencing acute pelvic pain with a positive pregnancy test?
a) threatened miscarriage
b) ectopic pregnancy
c) GTD
d) blighted ovum
b) ectopic pregnancy
What would be an indication of nonviable IUP?
a) 9 mm YS
b) double decidual sign
c) subchorionic hemorrhage
d) 20 mm GS without fetal pole
a) 9 mm YS
What would be an indication of early pregnancy failure?
a) empty GS with MSD of 9 mm
b) 18 mm GS with YS and no fetal pole
c) 24 mm GS and YS measuring 9 mm
d) empty GS with MSD of 8 mm and subchorionic hemorrhage
c) 24 mm GS and YS measuring 9 mm
Sonographic findings include a MSD of 19 mm and 4.2 mm YS without evidence of a fetal pole. What is the significance of these findings?
a) anembryonic pregnancy
b) normal early gestation
c) missed abortion
d) heterotopic pregnancy
b) normal early gestation
What is the most likely sonographic appearance of an ectopic pregnancy?
a) intra and extrauterine GS
b) GS at the cornu with a thin myometrium rim
c) extrauterine complex mass, adjacent to ovary with no IUP
d) extrauterine GS with live embryo
c) extrauterine complex mass, adjacent to ovary with no IUP
Quantitative b-hCG level is 2400. Based on this information, what is the most likely diagnosis if no defined GS is seen?
a) normal early pregnancy
b) ectopic pregnancy
c) missed abortion
d) threatened miscarriage
b) ectopic pregnancy
What is another name for cephalic?
Vertex
If the baby head is presenting closest to the cervix this is termed?
Cephalic
If the baby feet are first this is termed?
Complete breech
If the buttock is closest to the cervix this is termed?
Frank breech
If one leg is closest to the cervix this is termed?
Footling breech
In the axial view of the abdomen the fetal lie is ______ to the transverse position
perpendicular
When the abdominal organs and chest “match” the fetal lie this is termed?
Fetal situs solitus
Which of the following is produced by the placenta?
a) AFP
b) Estrogen
c) Estriol
d) Progesterone
c) Estriol
What anatomical landmark can be used to confirm normal visceral arrangement?
a) stomach
b) bladder
c) cord insertion
d) spine
a) stomach
A patient 18 weeks from LMP presents with universally decreased lab values on the Quad screen?’
a) neural tube defect
b) incorrect dates
c) chromosomal anomaly
d) non-progressive pregnancy
b) incorrect dates
Upon a 22 week anatomy scan, the fetus is imaged parallel to the mother with the cranium inferior and spine posterior. What is the fetal lie?
a) complete breech facing anteriorly
b) frank breech facing posterior
c) vertex facing anterior
d) transverse with head cephalic
c) vertex facing anterior
-Head is down so that indicates cephalic or vertex lie. If the spine is posterior, then the fetus is facing up or anterior
What condition would most likely correspond to an abnormally elevated AFP?
a) cardiac deformity
b) brain anomaly
c) neural tube defect
d) absent kidneys
c) neural tube defect
An unscreened patient that is 24 weeks from LMP presents for a second trimester anatomy scan. Her quad screen is universally decreased for gestational age. What is the most likely significance of these findings?
a) fetal demise
b) syndromic fetus
c) threatened abortion
d) gestational age less than 24 weeks
d) gestational age less than 24 weeks
What scanning technique is best for confirming fetal presentation?
a) b-mode
b) 3D surface rendering
c) M-mode
d) power doppler
a) b-mode
What lab value is produced by the fetus but can be measured by obtaining a sample of maternal blood?
a) PAPP-A
b) Inhibin-A
c) hCG
d) AFP
d) AFP
What values are included in the quad screen?
a) AFP, hCG, PAPP-A, estriol
b) hCG, estriol, progesterone, AFP
c) AFP, inhibin-A, estriol, hCG
d) PAPP-A, estriol, AFP, inhibin-A
c) AFP, inhibin-A, estriol, hCG
The heart is fully formed by how many weeks?
10 weeks
The heart begins to contract at _____ days gestation which is how many weeks?
36 days and 5 weeks
Normal cardiac position is termed?
Levocardia
Abnormal cardiac situs, apex pointing to the right chest is called?
Dextrocardia
The heart should occupy _____ of the chest
1/3
The apex of the heart is angled to _______ of midline at a ______ angle from the spine
left, 45 degrees
The left and right ventricles are separated by what?
Interventricular septum
The left and right atria are separated by _______ _______ septum which opens at the ________ _______
atrial septum, foramen ovale
The left atria opens into the left ventricle through what valve?
Mitral
The right atria opens into the right ventricle through what valve
Tricuspid
What makes up the left ventricular outflow tract?
a) left ventricle and ductus arteriosus
b) left ventricle and MPA
c) left ventricle and left atrium
d) left ventricle and aorta
d) left ventricle and aorta
What vessels make up the 3VV view?
a) IVC, SVC, Aorta
b) IVC, Aorta, Pulmonary artery
c) SVC, Pulmonary artery, Pulmonary veins
d) SVC, Aorta, Pulmonary artery
d) SVC, Aorta, Pulmonary artery
Where does blood from the IVC empty into?
a) Right atrium
b) Left atrium
c) Right ventricle
d) Left ventricle
a) Right atrium
What is the most posterior chamber?
a) Right atrium
b) Left atrium
c) Left ventricle
d) Right ventricle
b) Left atrium
What describes the function of the ductus venousus?
a) Arteriovenous fistual connection to shunt blood to the right atrium
b) bridge connecting right and left sides of the heart
c) shunting from umbilical vein to IVC
d) shunting from main pulmonary artery to aorta
c) shunting from umbilical vein to IVC
What statement most accurately describes the normal cardiac outflow tracts?
a) the right ventricular outflow leads to the aorta
b) the main pulmonary artery is positioned posterior to the aorta as it exits the right ventricle
c) the left ventricular outflow leads to the pulmonary veins
d) the main pulmonary artery is positioned anterior to the aorta crossing perpendicular to it
d) the main pulmonary artery is positioned anterior to the aorta crossing perpendicular to it
What scanning technique is most useful in evaluating for a cardiac arrhythmia?
a) simultaneous doppler tracing of aortic and mitral flow
b) color flow demonstrating atrial inflow and ventricular outflows
c) M-mode placed through both right and left ventricles
d) consectutive doppler sampling of the main pulmonary artery and aorta at the level of the RVOT
a) simultaneous doppler tracing of aortic and mitral flow
What does the ductus arteriosus connect?
a) main pulmonary artery and aorta
b) umbilical artery and iliac artery
c) umbilical vein and IVC
d) aorta and umbilical artery
a) main pulmonary artery and aorta
What images confirm normal fetal situs?
a) profile, maternal cervix, fetal abdomen
b) 4 chamber heart, LVOT, RVOT
c) fetal lie, fetal abdomen, fetal aorta
d) fetal lie, axial view of stomach, 4 chamber view
d) fetal lie, axial view of stomach, 4 chamber view
A small or absent left ventricle is called what?
Hypoplastic left heart
What heart pathology is the leading cause of death in the neonate?
Hypoplastic left heart failure
Hypoplastic left heart can be associated with what trisomy?
Trisomy 13 or Patau syndrome
A small or absent right ventricle is called what?
Hypoplastic right heart
If the right ventricle is small or absent what will be enlarged?
Left ventricle
Accumulation of fluid in 2 fetal body cavities is called?
Hydrops fetalis
An opening or hole in the ventricular septum is called?
Ventricular septal defects
What is the most common cardiac defect?
Ventricular septal defects
What heart defect must show the 4 chamber heart perpendicular to IVS showing a gap with color flow crossing the septum?
Ventricular septal decfect
What are the 2 other names for atrioventricular septal defects?
1) endocardial cushion defect
2) AV canal defect
Lack of development of the central part of the heart is called?
Atrioventricular septal defects
What is it called when the tricuspid valve is incorrectly positioned apically within the right ventricle?
Ebstein anomaly
