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OB > OB/GYN Registry review > Flashcards

OB/GYN Registry review Flashcards

1
Q

–Placenta Accreta

A

invasion of the chorionic tissue through the endometrium and attaches to the myometrium

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2
Q

Placenta Increta

A

Chorionic tissue invades the myometrium

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3
Q

Placenta Percreta

A

Chorionic tissue extends through the uterine wall to the bladder and adjacent pelvic structures

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4
Q

Sign of fetal distress identified by ultrasound late in pregnancy

A

Meconium, fetal waste that accumulates in the bowel in the 3rd trimester

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5
Q

The autosomal recessive genetic disorder that is associated with meconium ileus and fetal bowel obstruction is

A

Cystic Fibrosis

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6
Q

___________________ would be consistent with increase in the AP renal pelvic diameter between the second and third trimesters.

A

Ureterocele, vesicoureteral reflux, UPJ obstruction, UVJ obstruction and MCKD

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7
Q

Streak gonads and infertility are associated with what fetal syndrome

A

Turner

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8
Q

Syndactyly refers to :

A

webbing between the digits

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9
Q

Clinodactyly refers to:

A

arching of the 4th and 5th digits toward the thumb

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10
Q

Underdevelopment of the left heart structures

A

Hypoplastic left heart syndrome

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11
Q

Highly vascular, benign mass of the placenta that is associated with polyhydramnios

A

Chorioangioma

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12
Q

____________________ is seen in about 90% of fetuses in a partial molar pregnancy

A

triploidy

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13
Q

__________________ is common with Potter syndrome due to the _________________ caused by ___________________________

A

Pulmonary hypoplasia, oligohydramnios, renal agenesis

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14
Q

The majority of encephaloceles are located in the _______________region of the cranium

A

occipital

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15
Q

Maternal alcoholism is most associated with

A

IUGR
microcephaly
hypotelorism
cardiac defects

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16
Q

Which type of osteogenesis imperfecta has the poorest prognosis?

A

type II

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17
Q

A Foramen of Bochdalek hernia involves:

A

Hernia on the left side of the fetus

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18
Q

Foreshortened distal limbs

A

mesomelia

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19
Q

Foreshortened hand and foot bones

A

acromelia

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20
Q

Foreshortening of the entire limb

A

micromelia

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21
Q

Foreshortening of the proximal limbs

A

rhizomelia

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22
Q

Bilaterally enlarged echogenic fetal kidneys with a normal bladder is most suggestive of :

A

autosomal dominant polycystic disease

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23
Q

What causes potter facies?

A

renal agenesis. Potter facies are facial anomalies caused by low fluid.

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24
Q

During which week of the menstrual cycle is best to evaluate a patient with normal cycles and a possible ovarian cyst.

A

Week one when endometrium is thinnest and no dominant follicles on the ovary

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25
Q

Which view is best for demonstrating the posterior and lateral ossification centers of the vertebra?

A

Transverse

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26
Q

Number and stage of embryos to be transferred during a sonography guided embryo transfer must be documented on:

A

the signed informed consent form

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27
Q

What is coelocentesis?

A

Sample of coelomic fluid from around the amniotic sac. Can be performed as early as 6 weeks.

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28
Q

How do you measure endometrial thickness when fluid is not present in the endometrium?

A

Measure from the outer edge of functionalis layer to the outer edge of the opposing funtionalis layer

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29
Q

Femur/foot ratio is useful in diagnosis of

A

skeletal dysplasia. Normal = 0.99 plus or minus 0.06
abnormal < 0.87

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30
Q

To improve imaging of a fetus of an obese mother :

A

Place the patient in a modified sims position

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31
Q

How do you document the presence of a marginal cord insertion

A

measure the distance from the placental cord insertion to the edge of the placenta

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32
Q

A femur length > 2 SD below the expected gestational age indicates the strong possibility of:

A

skeletal dysplasia

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33
Q

Infection, uterine perforation, hematometra, and thermal injury to adjacent structures are all potential complications of:

A

endometrial ablation

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34
Q

Primary purpose of performing serial doppler evaluations of the umbilical artery

A

To assess for signs of placental insufficiency

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35
Q

When evaluating a patient for the antral follicle count, the transvaginal exam should be performed:

A

between day 2 and 4 of the menstrual cycle

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36
Q

Best way to evaluate agenesis of the corpus callosum

A

transverse axial view of the fetal head with the beam perpendicular to the parietal bones

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37
Q

Cardiotocography is used to document findings in a:

A

contraction stress test

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38
Q

Fetal lung volumetry performed with 3D sonography should be used to help diagnose:

A

skeletal dysplasia

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39
Q

___________________ would benefit from a sonohysterogram

A

suspected focal endometrial hyperplasia

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40
Q

Standard BPD accurately provides an estimated gestation age before _______________ weeks gestation

A

20

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41
Q

metrorrhagia

A

intermittent vaginal bleeding between cycles

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42
Q

Best way to evaluate for atrioventricular septal defect

A

transverse view of the fetal chest at the level of the four chamber heart. commonly associated with trisomy 21

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43
Q

Best technique to evaluate the cisterna magna

A

axial view of the posterior fossa with an AP measurement of the posterior fossa

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44
Q

Most helpful view for detecting facial defects associated with skeletal dysplasia

A

midsagittal

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45
Q

Formula for estimated age of pregnancy with gestational sac measurement

A

GSDmm + 30 days
Example: 30+30+39 = 99/3 = 33 mm mean sac diameter
33+30 = 63 days or 9 weeks

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46
Q

Sonoelastography would be helpful in the evaluation of

A

fibroids and polyps

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47
Q

Which view of the heart is preferred to evaluate possible muscular VSD

A

4 chamber view

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48
Q

During BPP to assign 2 points for fetal breathing you must observe

A

30 seconds of fetal breathing

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49
Q

Gross movement during BPP

A

3 within 30 minutes

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50
Q

Muscle tone movement during BPP

A

1 tone movement within 30 min

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51
Q

AFI during BPP

A

> 5.0 cm

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52
Q

Estrogen therapy cause an increased risk of:

A

thrombosis

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53
Q

Most important plane used to evaluate a fetus with suspected limb body wall complex

A

Coronal view. Limb body wall is commonly associated with severe scoliosis. The excessive lateral curvature of the spine is best seen in the coronal view

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54
Q

Which procedure has the highest risk of fetal demise?

A

Periumbilical blood sampling

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55
Q

What is the philtrum?

A

Vertical groove in the upper lip located between the base of the nose and the border of the upper lip.

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56
Q

Accuracy of biometric measurements for predicting gestational age in the third trimester is within:

A

21 days

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57
Q

Normal left and right ventricular outflow tract views can rule out : (4 chamber heart view)

A

Ebsteins anomaly

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58
Q

If the heart and stomach are visible on the same transverse view:

A

a diaphragmatic hernia is present

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59
Q

Premenopausal women are more susceptible to _______________ formation while postmenopausal women are more susceptible to___________________ formation.

A

mucinous cystadenoma
mucinous cystadenocarcinoma

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60
Q

___________ hormone stimulates the formation of the cervical mucous plug found with pregnancy

A

Progesterone

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61
Q

The corpus luteal cyst secretes:

A

progesterone

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62
Q

A trident hand is commonly seen with which skeletal abnormality

A

heterozygous achondroplasia

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63
Q

Cervix longer than body

A

prepubertal

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64
Q

body fundus of uterus longer than cervix

A

Nulliparous

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65
Q

ratio of uterus and cervix remain the same

A

postmenopausal

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66
Q

1:1 ratio of cervix and body/fundus of uterus

A

premenopausal

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67
Q

cervix and corpus of equal length

A

premenopausal nulliparous

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68
Q

Which hormone causes the endometrium to thicken during the proliferative phase

A

Estrogen

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69
Q

What muscles originate from the sacrum and connect to the greater trochanters to form the posterior wall of the pelvis

A

piriformis

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70
Q

The corpus in a multiparous uterus is usually at least __________ the cervix

A

2 times the length

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71
Q

Dominant ovarian follicle grows at a rate of ___________ prior to ovulation

A

2-3 mm per day

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72
Q

Early proliferative phase, day 5-9 the endometrium is:

A

thin line

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73
Q

Late proliferative phase day 10-14 the endometrium is

A

thicker and trilaminar

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74
Q

Secretory phase day 15 - 28 the endometrium is:

A

thick and hyperechoic

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75
Q

Ligaments that provide support for the ovary

A

mesovarium, infundibulopelvic and ovarian

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75
Q

Which hormone stimulates the cervix to produce mucous just prior to ovulation

A

Estrogen

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76
Q

The isthmus connects what two segments of the fallopian tube?

A

Interstitial and ampulla

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77
Q

What is the following is responsible for stimulating the contraction of the fallopian tubes to propel the egg toward the uterine cavity?

A

Estrogen

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78
Q

The greater pelvis is also know as the

A

False pelvis and contains the bowel

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79
Q

What carries blood to the uterine arteries?

A

anterior branch of the internal iliac arteries

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80
Q

Ligament that connects the medial ovary t the lateral uterine wall

A

ovarian

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81
Q

Ligament that supports the ovary and fallopian tubes within the pelvis and attaches t the lateral pelvic wall

A

Suspensory

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82
Q

Muscles that form the lateral pelvic walls

A

Obturator Internus

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83
Q

The rectus abdominis is _________ to the ovary

A

anterior

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84
Q

The broad ligaments envelops the_____________________

A

fallopian tubes

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85
Q

Grand multiparity

A

woman who has delivered 5 or more infants who have achieved a gestational age of 24 weeks or more

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86
Q

Portion of the peritoneum connecting the anterior ovary to posterior broad ligament

A

Mesovarium

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87
Q

What uterine ligaments are composed of peritoneum

A

suspensory and broad ligaments

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88
Q

What muscle connects the coccyx and pubis bones and houses the openings for the urethra, vagina and rectum?

A

levator ani

89
Q

_________________ stimulates the endometrial proliferation in the secretory phase to prepare for implantation.

A

progesterone

90
Q

Postmenopausal endometrium with no symptoms and not taking hormones should not exceed

A

8mm

91
Q

Postmenopausal endometrium with bleeding should not exceed

A

5 mm

92
Q

Which layer of the uterine wall is composed of fibrous connective tissue?

A

perimetrium

93
Q

The internal iliac artery normally courses ___________ _____________ to the internal iliac vein

A

anterior lateral

94
Q

What is the term for the free margin of the broad ligament where vessels and the fallopian tube travels?

A

Mesosalpinx

95
Q

The ovary is normally found in the _______________ fossa

A

fossa of waldeyer

96
Q
A
97
Q

Absence of hands

A

Acheira

98
Q

Absence of feet

A

Apodia

99
Q

Destruction of red blood cells of the neonate by maternal immunoglobulin G antibodies

A

Erythroblastosis

100
Q

Placenta previa should not be diagnosed before

A

16 weeks

101
Q

midline facial clefting, ocular abnormalities, echogenic kidneys and microcephaly is most likely

A

Trisomy 13

102
Q

Taxoplasmosis infection is associated with

A

IUGR

103
Q

Ventriculomegaly and calcifications in the liver and brain are associated with

A

Cytomegalovirus

104
Q

HELLP Syndrome

A

Hemolysis of RBC’s, and elevated liver function test, low platelet count. Preeclampsia is associated with the HELLP Syndrome

105
Q

Laboratory findings in a mother with preeclampsia would demonstrate

A

Low platelet count and increased liver function test

106
Q

Most common chest mass identified in a fetus

A

Congenital Cystic Adenomatoid Malformation (CCAM)
Type I Macrocystic
Type II Medium cystic
Type III Microcystic (most common)

107
Q

Cleidocranial dysplasia

A

Autosomal dominant condition characterized by clavicular aplasia or hypoplasia

108
Q

What two blood vessels form the lateral border of the thymus gland?

A

right and left internal mammary arteries

109
Q

Treacher Collins Syndrome

A

Mandibulofacial Dysostosis. Autosomal dominant disorder that is associated with small mandible, micrognathia, holoprosencephaly and cleft palate

110
Q

Capomelic Dysplasia

A

A rare form of lethal short limbed dwarfism. Characterized by hypomineralizaiton of short bowed or curved limbs, most commonly the lower leg bones

111
Q

Fetal Frontomaxillary Facial (FMF) is measured in a fetus with

A

Trisomy 21 (much larger in these patients)
Spina Bifida (much smaller in these patients)

112
Q

Cranial ossification begins in the _________week and the full calvarium is usually visible by the ______________ week.

A

9th
12th
If calvarium is not identified by the 16th week, acrania should be suspected

113
Q

Polyhydraminos is associated with

A

holoprosencephaly
Congenital cystic adenomatoid malformation
cystic hygroma

114
Q

Oligohydramnios is commonly seen with

A

pulmonary hypoplasia

115
Q

Lethal skeletal dysplasia typically has a FL/AC ratio less than

A

0.16

116
Q

What will be demonstrated as hypoechoic areas within the placenta that display turbulent flow on color doppler?

A

placenta accreta

117
Q

Congenital Diaphragmatic Eventration

A

Developmental defect of the muscular portion of the diaphragm. Mimics the appearance of a hernia with abdomen contents appearing to be in the chest cavity.

118
Q

Craniosynostosis

A

premature ossification of one or more skull sutures causing abnormally shaped calvarium and abnormal facial features. Can present as clover leaf or strawberry skull

119
Q

Prune belly syndrome

A

triad of signs, non visualization of abdominal muscles, urinary tract abnormalities and undescended testes. Most commonly caused by posterior urethral valves

120
Q

Difference between porencephalic cyst and arachnoid cyst

A

porencephalic cyst are within the brain tissue and communicate with the ventricular system while arachnoid cyst form between the brain tissue and the calvarium

121
Q

Disorder of bony demineralization. Severe micromelia, poor ossification , multiple fractures. Low levels of alkaline phosphatase. Increased echogenicity of the falx cerebri

A

Hypophosphatasia

122
Q

Preeclampsia is associated with placental insufficiency and oligohydramnios. Oligohydramnios is diagnosed when the 4 quadrant AFI is below

A

5 cm

123
Q

IUGR identified in the second trimester is usually associated with

A

chromosomal abnormalities

124
Q

Most skeletal dysplasias are associated with

A

polyhydramnios

125
Q

Pierre Robin sequence includes

A

micrognathia, retrognathia and an isolated cleft palate

126
Q

Echogenic bowel, meconium peritonitis, meconium ileus, and absent gallbladder are most suggestive of:

A

Cystic Fribrosis

127
Q

Smooth brain tissue with absence of sulci and gyri indentations.

A

Lissencephaly. Best evaluated using MRI

128
Q

How to differentiate megacisterna magna from Dandy Walker malformation

A

a normal cerebellar vermis is usually seen with megacisterna magna but not with Dandy Walker

129
Q

Ellis Van Creveld syndrome

A

autosomal recessive disorder that is most common in the amish communities. Associated with mild to moderate mesomelia, short ribs, narrow thorax, ploydactyly and atrail septal defect

130
Q

Spina bifida cystica

A

cystic formation at eh defect in the spine. Cyst can contain meninges and or spinal cord tissues.

131
Q

Abnormally short neck with fixed posterior flexion is called

A

iniencephaly

132
Q

A cisterna magna that measures greater than 10 mm is a common finding with

A

cerebellar agenesis and dandy walker malformation

133
Q

Which skeletal dysplasia only affects one side of the body

A

CHILD Syndrome - Congenital Hemiddysplasia with Ichthyosiform Erythroderma and Limb defects on one side of the body

134
Q

What indicates abnormal fetal growth in twins

A

28% difference in EFW between fetuses

135
Q

Spina Bifida is associated with

A

polyhydraminos

136
Q

hypoplastic left heart is commonly associated with

A

double outlet right ventricle

137
Q

Autosomal recessive disorder

A

required two copies of an abnormal non sex chromosome to be present in order for the trait to develop

138
Q

Arthrogryposis

A

contraction and loss of movement in multiple joints. Bilateral talipes, deformed elbows, wrists, ankles, knees and hips

139
Q

Most common cerebral finding with cytomegalovirus

A

hyperechoic periventricular halo and septations within the occipital horns

140
Q

Potters syndrome is always

A

lethal to the fetus because of renal agenesis

141
Q

Mandible anomalies are associated wit increased risk of

A

acute neonatal respiratory distress

142
Q

failure of neurulation

A

failure to close. open neural tube

143
Q

Most common cause of pleural effusion in a fetus

A

chylothorax

144
Q

A dilated third ventricle, colpocephaly and the sunburst sign in the cerebral tissues are findings of

A

agenesis of the corpus callosum

145
Q

bulging forehead, increased cephalic index midface and orbital hypoplasia and polysyndactyly of the hands and feet are suggestive of

A

Apert syndrome

146
Q

What is caused by arteriovenous malformation in the placenta?

A

twin to twin transfusion

147
Q

Most severe for of spina bifida

A

Rachischisis

148
Q

Cullen sign

A

indicates ruptured ectopic

149
Q

Deuel sign

A

scalp edema

150
Q

spalding sign

A

suture overlap on skull

151
Q

Robert sign

A

air in circulatory system

152
Q

Choriocarcinoma of the ovary

A

aggressive malignancy most common in patients between 5 - 25 years of age. Elevated levels of bhCG. Can lead to positive pregnancy test.

153
Q

common cause of dysfunctional uterine bleeding

A

hormone replacement therapy

154
Q

Spotting between cycles and infertility are common symptoms of

A

endometrial polyps

155
Q

Fitz Hugh Curtis syndrom

A

PID that leads to inflammation of Glissons capsule, peritonitis and perihepatic adhesions

156
Q

metritis

A

inflammation of the uterus

157
Q

Csystic teratoma (dermoid cyst) most common in

A

premenopausal women

158
Q

Ovarian tumor most commonly in postmenopausal women

A

granulosa cell tumor(theca lutea cell tumor, thecoma, fibroma

159
Q

unicornuate uterus is commonly associated with

A

ipsilateral renal agenesis

160
Q

Asherman syndrome

A

adhesions of the endometrial lining due to uterine trauma. Common symptoms include amenorrhea, hypomenorrhea, recurrent miscarriage and infertility

161
Q

Ovarian mass with dot dash pattern is most likely

A

teratoma

162
Q

Benign unilocular cyst usually do not exceed a diameter of

A

5 cm

163
Q

Chorioadenoma destruens

A

invasive malignant molar pregnancy

164
Q

Arrhenoblastoma

A

Sertoli-Leydig cell tumor (androblastoma). Usually benign in premenopausal patients age 20-40. Increased testerone levels which can lead to masculinization (virilization)

165
Q

Tumor associated with precocious puberty

A

granular cell tumor

166
Q

Which tumor is composed of epithelial and stromal tissues of the ovary

A

cystadenofibroma

167
Q

Ovarian neoplasm composed of ectodermal tissue

A

cystic teratoma

168
Q

paraovarian cyst is also know as

A

morgagni or mesonephric cyst

169
Q

polycystic ovarian disease usually demonstrates multiple follicles:

A

< 10 mm along the periphery of the ovary

170
Q

Lithium exposure is related to

A

cardiac malformation of the fetal heart

171
Q

Leiomyosarcoma

A

Rare malignant tumor of the myometrium usually found in females in their mid 50’s.

172
Q

Most commonly occurring germ cell tumor of the ovary

A

benign cystic teratoma

173
Q

Cogwill sign

A

Acute salpingitis- thick walled acute infection with PID

174
Q

Peritoneal inclusion cyst commonly associated with

A

prior c-section

175
Q

Most primary malignancies of the ovary originate in

A

the epithelial stromal tissues

176
Q

Most common type of mullerian duct anomaly

A

septate uterus

177
Q

Normal endometrial thickness in the secretory phase is

A

9-18mm

178
Q

What is the first stage of PID that is identified sonographically

A

Endometritis

179
Q

Thecomas and Fibromas are generally

A

hypechoic with posterior shadowing

180
Q

Granulosa cell tumors and androblastomas are generally

A

complex with cystic components

181
Q

Uterine arcuatus is a failure of

A

dissolution anomaly

182
Q

Rokitansky nodule is another name for

A

dermoid plug ( cystic teratoma)

183
Q

Microtia

A

small ears

184
Q

Eagle Barrett Syndrom

A

Prune belly syndrome weakend abdominal wall musculature with significantly dilated bladder ureters and kidneys

185
Q

ectopia cordis, club foot and asymmetric cleft lip/palate

A

Amniotic band sequence

186
Q

Most common anomaly of the umbilical cord

A

single artery

187
Q

maternal history of hyperparathyroidism or hypothroidism has what effect on the fetus

A

fetal demise

188
Q

Characteristics of multicystic kidney disease

A

multiple noncommunicating cyst that do not connect to a dilated ureter

189
Q

If the LVOT and RVOT are parallel as they exit the fetal heart

A

complete transposition of the great vessels is demonstrated

190
Q

Truncus arteriosus

A

single large outflow tract with malalignment VSD

191
Q

The fetal cranial suture located between the parietal bone and occipital bone is the

A

lambdoidal suture

192
Q

A heart rate using M mode should be sonographically obtainable with endovaginal imaging when the crown rump length measures:

A

4 -5 mm

193
Q

Location of the ductus arterious is:

A

between the pulmonary artery and aortic arch

194
Q

Umbilical arteries carry

A

deoxygenated blood from the fetus back to the placenta

195
Q

What term refers to the number of eggs that are fertilized

A

Zygosity

196
Q

Dizogotic twinning always result in

A

dichorionic, diamniotic twins

197
Q

The uterus is considered a:

A

retroperitoneal organ

198
Q

Prepubertal uterus:

A

cervix is larger than the uterine fundus

199
Q

The ovaries are ___________ glands

A

endocrine

200
Q

Which hormone initiates the proliferation and thickening of the endometrium

A

Estrogen

201
Q

Which hormone encourages the induction of salt and water retention, and stimulates the contractile motions to occur within the uterine myometrium and the fallopian tubes

A

Estrogen

202
Q

Progesterone is produced by:

A

The corpus luteum

203
Q

What hormone is responsible for maintaining the thickness of the endometrium and inducing secretory activity

A

Progesterone

204
Q

Beta hCg maintains:

A

corpus luteum

205
Q

Opening between the atrial septum

A

Foramen ovale

206
Q

upper limit of normal for yolk sac

A

5.9 mm

207
Q

Intracranial clefting of cerebral hemispheres

A

schizencephaly

208
Q

Sonographic view that best demonstrates the presence of three vessel cord

A

axial view of cord

209
Q

Congenital condition most likely related to oligohydraminos

A

autosomal recessive polycystic kidney disease

210
Q

Deficiency related to acrainia

A

folate

211
Q

Most common malignant germ cell tumor

A

Dysgerminoma

212
Q

What hormone is responsible for stimulating the corpus luteum in early pregnancy

A

hCG`

213
Q

PW doppler of the MCA, an elevated end diastolic velocity is documented, what condition may this cause

A

hypoxia

214
Q

Gestational sac measuring 5 mm is _____________ weeks, 18mm is _____________ weeks

A

6.5 and 8 weeks

215
Q

In what space is the secondary yolk sac located?

A

Intraembryonic coelem

216
Q

What hormone stimulates proliferation of the functional endometrial layer

A

estrogen

217
Q

What biometry measurements are necessary to calculate cephalic index

A

BPD and OFD

218
Q

What scanning technique is best for color assessment of the presence of renal arteries

A

coronal

219
Q

To measure resistive index measure

A

peak systolic and end diastole

220
Q
A

OB (5 decks)

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