Ob book review questions Flashcards
1
Q
Which of the following is a computerized system that stores patient information for the complete patient record?
A. Radiology information system
B. Hospital information system
C. Picture arching and communication system
D. Modality worklist
A
B
2
Q
How many live pregnancies has a patient had with the following obstetric coding?
G4 P3 A0 T3
A
4
3
Q
Which of the following indicates a patient who had a twin pregnancy?
A. G3P3A0T4
B. G3P3A2T2
C. G1P0A0T0
D. G2P2A2T0
A
A
4
Q
Which of the following defines an exam protocol?
A. Order in which images are obtained
B. Images required for a complete study
C. Sonographic examination
D. Obtaining a patient history
A
B
5
Q
What is the landmark of an adequately filled bladder for a gynecologic examination?
A
Uterine Fundus
6
Q
Triplex imaging uses which of the following image modes?
A. Panoramic, 2D, chroma
B. 2D, spectral Doppler
C. 3D, color, and spectral Doppler
D. 2D, spectral, and color Doppler
A
D
7
Q
Select the transducer that would be the best selection to image a thin patient.
A. 7.5 MHz linear
B. 5.0 MHz curved linear
C. 2.5 MHz curved linear
D. 10 MHz sector
A
B
8
Q
Select the current gold standard for sonographer certification in the United States.
A. AIUM
B. ARRT
C. CCI
D. ARDMS
A
D
9
Q
Select the system which is concurrent with the urinary system.
A. Cardiac
B. Neural
C. Ocular
D. Reproductive
A
D
10
Q
What fetal feature is involved in Carnegie embryo staging?
A
Morphology
11
Q
In a patient with unilateral hematocolpos, what organ system would be imaged?
A
Renal
12
Q
How long does the pre-embryonic stage last?
A
1-3 weeks
13
Q
When do germ cells migrate from the yolk sac to the embryo?
A
Carnegie stage 17
14
Q
Select the structure that becomes the embryonic kidneys.
A. Gonadal cords
B. Allantois
C. Mesonephros
D. Ectoderm
A
C
15
Q
What is another term for the paramesonephric ducts?
A
Müllerian ducts
16
Q
What structure is a transverse fold of the peritoneum?
A
Broad ligament
17
Q
Which segment of the vagina does the Urogenital sinus form? The lower vagina is formed by the:
A
Lower
18
Q
Select the precursor to the labia minora.
A. Mons pubis
B. Labioscrotal folds
C. Genital tubercle
D. Frenulum
A
C
19
Q
Select the benefit of obtaining previous obstetric sonographic studies.
A. Decreases diagnostic errors
B. Reduces scan time
C. Ensures exam continuity
D. Allows growth trending
A
D
20
Q
The main idea behind the ALARA principle is to reduce which of the following?
A. Operating costs
B. Equipment wear and tear
C. Patient fetal/maternal bonding time
D. Exposure to ultrasound energy
A
D
21
Q
Select the normal chromosome number for a sperm.
A. 46XY or 46XX
B. 22X or 22Y
C. 23XO
D. 46XXY
A
B
22
Q
Where does fertilization occur?
A
Fallopian tube
23
Q
What hormone stimulates ovarian follicle maturation?
A
FSH
24
Q
Select the hormone released by the corpus luteum.
A. Progesterone
B. HcG
C. Estrogen
D. Free beta-hcG
A
A
25
Name the single diploid cell that is the result of fertilization
Zygote
26
Identify the blastocyst layer that eventually develops into the embryo,
Embryoblast
27
What process allows for implantation of the conceptus into the endometrium?
Decidualization
28
What is the first structure visualized within the gestational sac?
Yolk sac
29
Name the structure that connects the fetal bladder to the Allantois.
Urachus
30
Select the gestational age when all the rudimentary forms of organs and structures are in place.
A. Carnegie stage 20
B. 11 weeks
C. 5 weeks
D. Carnegie stage 11
B
31
Which of the following are projections from the blastocyst that eventually becomes the placenta?
A. Chorionic villi
B. Chorion laeve
C. Embryonic ectoderm
D. Decidua basalis
A
32
Choose the qualitative pregnancy test.
A. Amniotic fluid
B. Serum
C. Urine
D. Beta-hCG
C
33
Which of the following is the failure of a pregnancy to develop?
A. Anembryonic
B. Blighted ovum
C. Inevitable abortion
D. Abortion
A
34
Which term describes an abnormally slow heart rate?
Bradycardia
35
Select the term describing an abnormal triploidy chromosomal number, fetus, and placenta
Partial hydatidform mole
36
Sonographic appearance of an inevitable abortion
Empty low lying gestational sac and an open cervix
37
During the sonographic examination on a first trimester pregnancy, a crescent shaped complex fluid collection images between the gestational sac and uterus. What is the most likely differential?
Subchorionic hemorrhage
38
How does a second trimester hydatid form mole image during the sonographic examination?
Large soft tissue mass of low to moderate amplitude echoes filling the uterine cavity and containing fluid filled space
39
Which of the following central nervous system malformations identifiable in the first trimester?
A. Omphacele
B. Cystic hygroma
C. Spina Bifida
D. Ectopia cordis
C
40
Define hematocolpos.
accumulation of menstrual blood in the vagina resulting from a lower vaginal obstruction or imperforate hymen.
41
Which of the following corrects Mullerian duct malformation?
a. metroplasty
b. apoptosis
c. Bc12 gene suppresion
d. paramesonephric removal
d
42
Which of the following results in one vagina, two cervices, and two uterine horns?
a. bicornuate uterus
b. arcuate uterus
c. uterus bicornis bicollis
d. uterus didelphys
c
43
Which of the following is a Class III mullerian duct anomaly?
a. noncommunicating unicornuate uterus
b. uterine hypoplasia
c. uterus didelphys
d. arcuate uterus
c
44
Select the sonographic appearance in a patient with hydrocolpos?
a. hematocolpos or hematometrocolpos
b. pear-shaped mass without vaginal echoes adjacent and posterior to the bladder
c. enlarged vagina
d. anechoic small mass in anterolateral vagina
b
45
During pregnancy, which malformation results in eccentric implantation of the gestational sac?
bicornuate uterus
46
Which term describes forward tiliting of the uterus?
anteverted
47
The term for describing the absence of menstruation
amenorrhea
48
Which structure secretes estrogen?
a. Graafian follicle
b. Theca externa
c. Theca interna
d. Corpus luteum
c
49
The hormone that thickens the endometrium
progesterone
50
Which structure makes up most of the uterine broad ligament?
mesometrium
51
Define negative feedback
a system of glands and cells that produce hormones released directly into the circulatory system
52
Which of the following is the muscular inner layer of the uterus?
a. endometrium
b. mesometrium
c. perimetrium
d. myometrium
d
53
The term describing the top portion of the uterus
fundus
54
The "control center" of the endocrine system
hypothalamus
55
What is secreted from the posterior lobe of the pituitary gland?
Antidiuretic hormone
56
Which endocrine gland promotes follicular growth and development?
anterior pituitary gland
57
What hormone is secreted by the hypothalamus that results in release of FSH
GnRH
58
What hormone stops with an increase in progesterone and a negative feedback loop?
LH
59
What is the physiological response to rising estrogen levels?
production of cervical mucus
60
Which of the following is present in the postmenopausal woman?
a. estrogen
b. estradiol
c. estrone
d. estriol
c
61
What is the function of progesterone?
Blocks development of new follicles
62
Which phase of the ovarian cycle begins with the first day of menstrual bleeding?
follicular phase
63
What produces human chorionic gonadotropin early in pregnancy?
cells surrounding the zygote
64
Identify the potential space located between the uterus and urinary bladder/
anterior cul-de-sac
65
What tissues replaces the corpus luteum?
corpora albicantia
66
Define linea terminalis
line drawn from the pubic crest to the arcuate line dividing the true and false pelvis
67
Ipsilateraly anatomy
on the same side of the body
68
Select the organ found in the true pelvis.
a. ileum
b. sigmoid colon
c. ovaries
d. right kidney
c
69
Select the muscle located in the false pelvis.
a. iliacus
b. psoas minor
c. levator ani
d. obturator internus
a
70
Which variant has the uterus displaced to the right?
dextoposition
71
Select the technical parameter, which increases image detail during the endovaginal exam.
decrease depth
72
Select the result of using a high-power output level during a transabdominal pelvic exam.
high-power output level
73
Inferior portion of the uterus
cervix
74
Which ligament attaches the cervix to the sacrum?
cardinal ligaments
75
Which organ is entirely inside the peritoneal sac?
a. fallopian tubes
b. ovary
c. sigmoid
d. uterus
b
76
Which ligament anchors the posterior surface of the ovary?
mesovarium
77
Which term describes the abnormal connection between veins and arteries?
arteriovenous malformation
78
This Doppler measurement uses the peak systolic velocity minus peak diastole divided by the mean.
pulsatility index
79
When does the secretory phase occur?
15 to 28 days
80
Which vessel couse in the uterine periphery?
arcuate vessels
81
Where should the sonographer obtain the uterine vein Doppler?
adjacent to the uterine artery
82
Normal ovarian follicular phase spectral Doppler flow velocity
0.92 +/- 0.08
83
Abnormal ovarian artery spectral Doppler finding
high diastolic flow
84
Which of the following is a qualitiative Doppler method?
a. Color Doppler
b. Systolic/Diastolic ratio
c. Resistance index
d. pulsatility index
a
85
Definition of high-resistance arterial flow
High A/B ratio
86
Suboptimal angle of incidence to obtain a spectral tracing
90 degrees
87
What color indicatres flow away from the transducer/
blue
88
Where do the arcuate arteries originate?
uterine artery
89
Normal measurement for the uterine artery in the nongravid patient
<5 mm
90
Which of the following describes color Doppler flow found surrounding the corpus luteal cyst.
a. 0.88 +/- 0.05 cm/sec
b. 0.44 +/- 0.08 cm/sec
c. increased peripheral vascularty
d. low-resistance flow
c
91
What is the result of ovarian vein variscosities?
pelvic congestion
92
the term describing the loss of primordial germ cells in the embryonic gonads.
gonadal dysgenesis
93
Where does a Rokitansky nodule develop?
at the thickened dermoid cyst wall
94
What is the cause for a T shaped uterus?
DES
95
Identify the method that reduces image motion.
decrease frame rate
96
What is the approximate size of an ovary in an 8 year old?
1.2 to 2.1 cm ^3 (+/- 0.05)
97
Sonographic findings for a hemorrhagic ovarian cyst.
thick-walled or septated cyst, homogeneous internal low-level echoes
98
Select the best method to determine whether an ovary is normal in size in the pediatric patient.
a. average two orthogonal measurements
b. use the L x W x H
c. calculate a volume
d. use the surface-rendering mode in a 3D volume
c
99
What is the most common benign lesion of the vagina in the pediatric patient?
Gartner's duct cyst
100
Sonographic appearance of hydrocolpos in the pediatric patient?
cystic, pear-shaped mass in the midline
101
What is the most common pelvic finding in the pediatric population?
ovarian cyst
102
Separation of the myometrium at a scar location
uterine dehiscence
103
infrequent ovulation,
oligoanovulation
104
Genetically abnormal pregnancy that develops into a grape-like mass within the uterus
hydatidform mole
105
Fluid filled mass located in the anterolateral wall of the vagina
Gartner's duct cyst
106
Focal area of increased echogenicity within the endometrium
endometrial polyps
107
Nonphysiological cyst
peritoneal inclusion
108
Congenital condition associated with polycystic ovaries
lipatrophic diabetes
109
Sonographic appearance of a serous cystadenoma
multiloculated, septated cyst with papillary projections
110
A 30 year old woman presents to the emergency department for a pelvic examination with a history of Cushing syndrome, scant to no menses. During the sonographic examination, a unilateral echogenic mass images on her right ovary. What is the most likely differential for these findings?
Sertoli-Leydig cell tumor
111
A 45 year old woman presents to the emergency department with an acute onset of pain with bloating and a palpable mass. During the sonographic examination, a large, multiseptate tumor with regular wall thickness images. The tumor appears fixed within large amounts of abdominal fluid. What is the most likely differential for these findings?
mucinous cystadenoma
112
Least common benign ovarian tumor
Brenner tumor
113
Identify the sonographic appearance of the myometrium in the patient with uterine dehhiscence.
1.5 mm lower uterine segment
114
Hypoechogfenic myometrial masses with a whorled internal architecture describe:
leiomyoma
115
A patient presents complaining of right lower quadrant pain, nausea, and fever. Sonographic imaging demonstrates a complex mass with dirty shadowing, fluid in the right pericolic gutter, and a noncompressible bulls-eye structure without a blind end. What is the most likely cause for this finding?
appendiceal abscess
116
A 30 year old patient presents with complaints of right lower pain, nausea, and vomiting. Her clinician palpated a large, tender ovary on the right side. Pregnancy test is pending. The sonographic examination revealed a large, complex mass on the ovary. What step should the sonographer take to aid in diagnosis?
check for flow with Doppler
117
A 32 year old presents to the emergency department with a history of infertility, lack of periods, and the development of hirsutism. The sonographic examination revealed bilateral large ovaries with mulitple, small peripheral cysts. What is the most likely cause for this finding?
PCOS
118
Most common gynecological malignancy occurring in developed countries.
endometrial carcinoma
119
Risk factor associated with endometrial cancer
obesity
120
Tamoxifen therapy for breast cancer increases the risk of ____.
endometrial carcinoma
121
Staging of endometrial carcinoma includes which of the following?
a. involvment of the vagina
b. extension into the breast lymph nodes
c. ethnicity
d. the depth of the myometrial invasion
d
122
What is the differential for sonographic findings of hematometra or hydrometra in a 60 year old female patient.
endometrial carcinoma
123
A rapid increase in a uterine mass in a postmenopausal woman raisese suspicion for:
leiomyosarcoma carcinoma
124
Breakthrough bleeding is a symptom of _____ cancer.
endometrial
125
DES not only results in uterine malformations but also increases the risk of _____ cancer.
cervical
126
Karyotype seen with a complete mole
46XX
127
The lack of chorionic villi is characteristic of a(n):
choriocarcinoma
128
Ovarian cyst which occurs in the first trimester of pregnancy
corpus lutein
129
______ is used to treat trophoblastic disease.
methotrexate
130
Sonographic finding of cervical cancer
multiple cystic areas within a solid mass
131
What is a tumor marker for carcinomas of embryonic origin?
AFP
132
Identify the malignant ovarian tumor arising from undifferentiated germ cells.
Dysgerminoma
133
What describes the triad of pleural effusion, ascites, and an ovarian mass?
Meigs syndrome
134
Risk factor for developing ovarian cancer
nullipariry
135
Which neoplasm is associated with heredity site-specific ovarian cancer?
epithelial ovarian cancer
136
Most common malignant ovarian cancer
mucinous cystadenocarcinoma
137
A 16 year old presents to the emergency department because of a positive urine pregnancy test. She indicates she is not sexually active but has missed periods and has noticed an increase in abdominal girth. During the sonographic examination, a 20 cm solid mass with cystic areas images outside the uterus. What is the most likely cause for these findings?
endodermal sinus tumor
138
How does ovarian cancer spread outside the pelvis?
lymphatic spread
139
painful intercourse
dyspareunia
140
The presence of endometrial glands within the myometrium
adenomyosis
141
infection of the peritoneum
peritonitis
142
The foul smelling vaginal discharge seen with PID
odorous lochia
143
the inability to identify the ovary and tube due to infection or adhesions
tubo-ovarian complex
144
Etiology for endometriosis
retrograde menstruation
145
diffuse imflammation of the upper genital tract
PID
146
How does the fallopian tube image with chronic pelvic inflammatory disease?
hydrosalpinx
147
Sonographic finding of adenomyosis
heterogeneous myometrium
148
During sonographic examination, a complex tubular structure images to the right of the uterus. What is the most likely differential for this finding?
pyosalpinx
149
A 35 year old patient presents to the emergency department with reports of pain with defecation and intercourse, infertility, and painful periods. This image demonstrates a complex mass on the right ovary. Select the most likely differential for this finding.
endometrioma
150
A 40 year old woman is G3P3A0 presents with complaints of dysmenorrhea. Upon clinical examination, she complained of a tender uterus. Select the differential for the patient symptoms and imaging findings.
adenomyosis
151
What is the product of conception called that is 2 days after fertilization?
cleavage stage embryo
152
Which portion of the menstrual cycle does the progesterone levels increase resulting in endometrial thickening?
secretory phase
153
What occurs in the ovarian follicular phase as FSH levels increase?
ovarian follicle maturation
154
What type of fertilization occurs outside the body?
in vitro fertilization
155
Most common female cause of infertility
tubal pathology
156
tubal cause for infertility
adhesions
157
What formula calculates the mean follicular diameter?
L + H + W /3
158
The benefit of obtaining previous obstetric sonographic studies
allows growth trending
159
Normal chromosome number for a sperm
22X or 22Y
160
Where does fertilization occur?
fallopian tube
161
What hormone stimulates ovarian follicle maturation?
FSH
162
Hormone released by the corpus luteum
progesterone
163
Name the single diploid cell that is the result of fertilization
zygote
164
Identify the blastocyst layer that eventually develops into the embryo
embryoblast
165
What process allows for implantation of the conceptus into the endometrium?
decidualization
166
What is the first structure visualized within the gestational sac?
yolk sac
167
Name the structure that connects the fetal bladder to the allantois
urachus
168
Gestational age when all the rudimentary forms of organs and structures are in place
11 weeks
169
Projections from the blastocyst that eventually becomes the placenta
chorionic villi
170
Qualitative pregnancy test
urine
171
Failure of a pregnancy to develop
anembryonic
172
abnormally slow heart rate
bradycardia
173
abnormaly triploidy chromosomal number, fetus, and placenta
partial hydatadidform mole
174
sonographic appearance of an inevitable abortion
empty low-lying gestational sac and an open cervic
175
During the sonographic examination on a first-trimester pregnancy, a crescent shaped complex fluid collection images between the gestational sac and uterus. What is the most likely differential?
subchorionic hemorrhage
176
How does a second trimester hydatidform mole image during the sonographic examination?
large soft tissue mass of low- to moderate-amplitude echoes filling the uterine cavity and containing fluid-filled spaces
177
Which of the following central nervous system malformations is identifiable in the first trimester?
a. ectopia cordis
b. cystic hygroma
c. omphalocele
d. spina bifida
d
178
Select the risk factor for an ectopic implantation of a pregnancy.
a. young maternal age
b. PID
c. ovarian atrophy
d. prior cervical surgery
b
179
Beta-hCG levels plateau at ____ weeks.
9-11
180
Describe the discriminatory cutoff for beta-hCG
the level when an embryo visualizes on ultrasound
181
Most common location for an ectopic pregnacny
fallopian tube
182
Which of the following types of ectopic pregnancy has myometrium surrounding the pregnancy?
a. cornual
b. abdominal
c. intramural
d. interstitial
d
183
Which of the following types of ectopic pregnancy has an implantation site within the myometrium?
a. abdominal
b. heterotopic
c. interstitial
d. intramural
df
184
Definitive sonographic finding with an ectopic pregnancy
embryonic cardiac activity outside the uterus
185
Identify the sonographic finding representing the decidual reaction surrounding the normal IUP?
double decidual sign
186
What type of pregnancy is indicated by movement of an hourglass-shaped gestational sac with pressure from the endovaginal transducer?
pending miscarriage
187
A 24 year old, G3P1A1, presents to the emergency department with left lower quadrant pain. Her beta-hCG is 2000, and she is 8 weeks by LMP. The sonographer images a fluid collection within the endometrial canal. The left ovary demonstrates increased color Doppler flow in a ring-like pattern. What is the most likely differential for this patient history and sonographic findings?
ectopic pregnancy
188
Maternal side of the placenta
decidua basalis
189
What impact can maternal disease have on placenta?
change in size
190
A patient presents for routine second-trimester examination. What approach would you start to evaluate anterior placenta?
transperineal
191
Placental change seen with gestational diabetes
delayed placental maturation
192
Fetal cause for a placenta greater than 5 cm
hydrops
193
definition for placenta increta
myometrium partially invaded by the chorionic villi
194
Which of the following is a differential for an interuterine septation?
a. synechia
b. succenturiate lobe
c. placental lakes
d. septal cyst
a
195
Placental type that has the most villi infiltration into the myomentrium
percreta
196
A 30 year old, G3P1A1, patient presents to the emergency department with reports of pain and bleeding after a motor vehicle accident. She is considered high risk because of her heavy smoking, and sonographic examination demonstrates she is 25 weeks. What is the most likely cause for the sonographic finding?
placental abruption
197
