OB Midterm Flashcards
The caudal regression syndrome is found most commonly in patients with:
Diabetes
The development of conjoined twins occurs when the division of the egg occurs after ________ days after conception.
13
Twins that arise from two separately fertilized ova are known as:
Dizygotic
Secondary to pregnancy-induced hypertension, a coma and seizures in the patient during the 2nd and 3rd trimesters represents what?
Eclampsia
Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb into the uterus is:
Fetus papyraceous
What complication of pregnancy is characterized by increasing hypertension, proteinuria, and edema?
Preeclampsia
What term describes a group of conditions in which hydrops is present in the fetus, but is not a result of fetomaternal blood group incompatibility?
Nonimmune hydrops (NIH)
Hypertensive pregnancies may be associated with which one of the following abnormalities?
a. Macrosomia
b. Small placentas
c. Large placentas
d. Caudal regression syndrome
b. Small placentas
What sonographic finding(s) confirms the presence of a diamniotic pregnancy?
Membrane that separates the fetuses
What is defined as the appearance of overlapping skull bones?
Spalding’s sign
Sonographic findings of fetal hydrops in an isoimmunized pregnancy include all of the following except:
a. Pleural effusion
b. Polyhydramnios
c. Thinning placenta
d. Pericardial effusion
c. Thinning placenta
Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate ranging between _______ and _______ beats per minute (bpm).
200; 240
Maternal obesity has been associated with an increase incidence of what abnormality?
Neural tube defects
What is caudal regression syndrome described as?
Lack of the development of the caudal spine and cord
Skeletal and central nervous system congenital anomalies in infants of diabetic mothers include all of the following except:
a. Macrocephaly
b. Neural tube defects
c. Anencephaly
d. Caudal regression syndrome
a. Macrocephaly
Premature labor is defined as the onset of labor before _______ weeks’ gestation.
37
Monochorionic twin pregnancy, during which one fetus develops without a heart or upper body is:
Acardia anomaly
What happens in twin-to-twin transfusion syndrome?
The arterial blood of one twin is pumped into the venous system of the other twin.
Poly-Oli sequence is also known as:
Stuck twin syndrome
Stuck twin syndrome is usually observed between _______ and _______ weeks’ gestation.
16; 26
A diamniotic and dichorionic twin pregnancy demonstrates:
Two amniotic sacs and two placentas
What is demonstrated if the division of one fertilized egg occurs 4 to 8 days after fertilization?
One chorion and two amnions
In twin-to-twin transfusion syndrom, which one of the following statements is true?
a. Both twins are at risk of dying
b. An arteriovenous shunting within the placenta is demonstrated
c. The recipient twin may demonstrate polyhydramnios
d. All of the above statements are true
d. All of the above statements are true
Predictors of discordance in the growth of twins include all of the following exept:
a. Difference in estimated fetal weight greater than 20%
b. Difference in biparietal diameter of 10 mm or greater
c. Difference in abdominal circumference of 20 mm or greater
d. Difference in femur length of 5 mm or greater
b. Difference in biparietal diameter of 10 mm or greater
What is the most frequent cause of nonimmune hydrops?
Cardiovascular legions
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 hrs
c. The results are available within 1 week
d. Early results allow more options for parents
b. The results are available within 48 hours.
What is cordocentesis commonly used for?
Guidance for transfusions to treat fetal isoimmunization
Amniocentesis may be used for all of the following except:
a. Analysis of fetal chromosomes
b. Prediction of Rh immunization
c. Documentation of lung maturity
d. Prediction of cardiac abnormalities
d. Prediction of cardiac abnormalities
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 AFP level
b. Multiple gestations
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. Reduced movement
AFP is found in all of the following fetal structures except:
a. Spine
b. Liver and gastrointestinal tract
c. Brain
d. Kidneys
c. Brain
High levels of AFP indicate all of the following except:
a. Anencephaly
b. Down Syndrome
c. Open spina bifida
d. Gastroschisis
b. Down Syndrome
The quadruple screen evaluates all of the following markers except:
a. AFP
b. hCG
c. Unconjugated estriol
d. Fetal lung maturity
d. Fetal lung maturity
What is the term meaning an abnormality in the number of chromosomes?
Aneuploidy
Anencephaly is an example of which one of the following conditions?
a. Aneuploidy
b. X-linked disorder
c. Multifactorial
d. Mosaicism
c. Multifactorial
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
b. Nuchal translucency
The following sonographic findings of increased nuchal thickening, shortened femurs, cardiac anomalies, and pyelectasis may be found in which one of the following?
a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome
c. Trisomy 21
The sonographic findings of strawberry shaped head, choroid plexus cysts, facial abnormalities, and rocker bottom feet may be found in which one of the following?
a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome
b. Trisomy 18
Holoprosencephaly and proboscis are most likely to be found in a fetus with:
a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome
a. Trisomy 13
A larger cystic hygroma, hydrops, and coarctation of the aorta may be seen in a fetus with:
Turner syndrome
Pregnancy-associated plasma protein A (PAPP-A) levels:
Increase throughout pregnancy
What is AFP produced by in early gestation?
Yolk sac
A common reason for an elevated level of maternal serum AFP (MSAFP) is:
Incorrect dates
One of the most common aneuploid conditions is which one of the following?
a. Trimsomy 13
b. Trisomy 18
c. Trisomy 21
d. Turner syndrome
c. Trisomy 21
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 position of the placenta
a. Away from the maternal midline
MSAFP levels increase with advancing gestational age and peak at _______ weeks’ gestation.
15 to 18
Free beta-hCG can be assessed in maternal serum in the first trimester to evaluate for increased risk of:
Down syndrome
After amniocentesis, the sonographer should demonstrate and document which one of the following?
a. Amniotic fluid level
b. Cervical length
c. Placenta location
d. Fetal cardiac activity
d. Fetal cardiac activity
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
d. Premature rupture of membranes
Low MSAFP levels have been found in which one of the following?
a. Fetus older than expected
b. Anencephaly
c. Fetus younger than expected
d. Omphalocele
c. Fetus younger than expected
The fetal membranes are comprised of all of the following except:
a. Chorion
b. Amnion
c. Blastocyst
d. Yolk sac
c. Blastocyst
The chorionic plate is related to which one of the following?
a. Maternal surface of the fetus
b. Fetal surface of the placenta
c. Allantois of the yolk stalk
d. Cotyledons and intervillous spaces
b. Fetal surface of the placenta
The decidual reaction that changes in the endometrium opposite the site of implantation is:
Decidua vera
The major functioning unit(s) of the placenta is (are) which of the following?
a. Chorionic villi
b. Yolk sac
c. Amnion
d. Cotyledons
a. Chorionic villi
The placenta performs all of the following functions except:
a. Protection
b. Absorption
c. Nutrition
d. Respiration
b. Absorption
The velamentous placenta refers to a(n):
Membranous insertion of the cord
Fusion of the amnion and chorion usually occurs by _______ weeks’ gestation.
16
The function of hCG is to perform:
Maintain the corpus luteum in early pregnancy
A marginal or an eccentric insertion of the umbilical cord into the placenta is:
Battledore placenta
The primary cause of placentomegaly is which one of the following abnormalities?
a. IUGR
b. Battledore placenta
c. Maternal diabetes
d. Intrauterine infection
c. Maternal diabetes
The most common site of fibrin deposition is which one of the following?
a. Along the subchorionic area
b. Along the retroplacental area
c. Within the chorioangioma
d. Within the hydatidiform mole
a. Along the subchorionic area
Complications of placenta previa include all of the following except:
a. Premature delivery
b. Maternal hemorrhage
c. Postpartum hemorrhage
d. Succenturiate placenta
d. Succenturiate placenta
Penetration of the chorionic villi through the uterus is known as placenta _______.
Percreta
The presence of one or more accessory lobes connected to the body of the placenta by blood vessels is a ________ placenta.
Succenturiate
Which one of the following statements about a placental abruption is false?
a. Bleeding in the decidua basalis occurs with separation
b. Placental abruption may be a retroplacental or marginal abruption
c. The bleed may lead to a chorioanioma
d. Preterm labor may result
c. The bleed may lead to a chorangioma
An example of a low-pressure bleed is which one of the following?
a. Marginal abruption
b. Retroplacental abruption
c. Decompression of the uterus
d. Trauma to the uterus
a. Marginal abruption
The maternal side of the placenta is the decidua ________.
Basalis
The chorion around the gestational sack on the opposite side of implantation is chorion ________.
Laeve
A marginal placenta previa demonstates:
The placenta touches but does not cross the internal cervical os.
Which one of the following might demonstrate a small placenta?
a. Maternal anemia
b. Rh sensitivity
c. Maternal diabetes
d. Aneuploidy
d. Aneuploidy
Which one of the following occurs when the intramembranous vessels course along the internal cervical os?
a. Placenta previa
b. Battledore placenta
c. Vasa previa
d. Velamentous placenta
c. Vasa previa
The growth of the chorionic villi superficially into the myometrium describes:
Placenta accreta
The attachment of the placental membranes to the fetal surface of the placenta describes:
Circummarginate placenta
A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appearance most likely represents a:
Chorioangioma
Which one of the following umbilical cord entanglements in the fetus is the most common?
a. Nuchal cord
b. True knot
c. False knot
d. Hematoma
a. Nuchal cord
What occurs when the cord inserts into the membranes before it enters the placenta?
Velamentous insertion
Cord prolapse problems can be produced during all of the following obstetric procedures except:
a. Velamentous cord insertion
b. Artificial rupture of membranes
c. Disengaging the head
d. Version and extraction
a. Velamentous cord insertion
Which one of the following problems may lead to inadequate fetal descent?
a. Long cord
b. Twisted cord
c. Short cord
d. Ruptured cord
c. Short cord
What does the ductus venosus turn into after birth?
Ligamentum venosum
Thrombosis of the umbilical vessels is most common in which one of the following?
a. Right umbilical artery
b. Left umbilical artery
c. Umbilical vein
d. Hypogastric arteries
c. Umbilical vein
What is the presence of umbilical vessels crossing the internal os of the cervix called?
Vasa previa
The umbilical cord is formed by the fusion of:
Yolk stalk and allantoic ducts
In the first trimester, the length of the umbilical cord is approximately the same size as:
Crown-rump length
A cystic mass in the umbilical cord is usually which one of the following?
a. Allantoic in origin
b. An omphalocele
c. A false knot of the cord
d. A true knot of the cord
a. Allantoic in origin
Velamentous umbilical cord insertion is associated with all of the following except:
a. Preterm labor
b. Abnormal fetal heart rate
c. Low Apgar scores
d. Macrosomia
d. Macrosomia
Which one of the following statements about a single umbilical artery is false?
a. The incidence of IUGR is increased
b. The right umbilical artery is absent more than the left umbilical artery
c. An increase in prenatal mortality is present
d. The incidence of chromosomal abnormalities is increased
b. The right umbilical artery is absent more often than the left umbilical artery
A dilated intrabdominal, extrahepatic portion of the umbilical vein is called:
Varix of the umbilical vein
Conditions predisposing a fetus to cord prolapse include all of the following except:
a. Velamentous cord
b. Premature rupture of membranes
c. Polyhydramnios
d. Normal fetal presentation
d. Normal fetal presentation
Which of the following statements about the umbilical cord is false?
a. The chorion covers the cord & blends with the fetal skin at the umbilicus
b. The umbilical vein carries oxygenated blood to the fetus
c. One umbilical vein and 2 umbilical arteries make up the umbilical cord
d. The umbilical cord is the essential link from the mother to the fetus
a. The chorion covers the cord and blends with the fetal skin at the umbilicus
A right paraumbilical defect involving all layers of the abdominal wall is called:
Gastroschisis
Coiling of the umbilical cord:
a. Is abnormal
b. Is not related to fetal activity
c. Has a higher incidence of fetal anomalies when the cord is twisted toward the right
d. Is insignificant
c. Has a higher incidence of fetal anomalies when the cord is twisted toward the right
False knots of the umbilical cord:
a. Are associated with short cord length
b. Occur when the blood vessels are longer than the cord
c. Are loops of cord slipped over the fetal head
d. Are umbilical hernias
Occur when the blood vessels are longer than the cord
A hypoplastic umbilical artery is defined as a three-vessel cord when the artery-to-artery difference is greater than _______.
50%
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:
Amniotic bands
What is produced by the umbilical cord and membranes, the fetal lung, skin and kidney?
Amniotic fluid
What structure is formed early in gestation and surrounds the embryo?
Amniotic cavity
During what weeks of gestation does the fetal production of urine and the ability to swallow begin?
8 to 11
The amount of amniotic fluid is regulated by all of the following except:
a. Production of the fluid
b. Removal of the fluid by swallowing
c. Fluid exchange within the heart
d. Membranes of the cord
c. Fluid exchange within the heart
Which of the following statements about the amniotic fluid volume (AFV) is false?
a. The amniotic fluid increases in the early 2nd trimester by 25 ml
b. The amniotic fluid increases in the 3rd trimester by 50 ml
c. The amniotic fluid increases in the late 2nd trimester by 50 ml
d. The amniotic fluid in the 3rd trimester doesn’t change significantly
b. The amniotic fluid increases in the 3rd trimester by 50 ml
Signs of polyhydramnios include all of the following sonographic demonstrations except:
a. Appearance of free-floating fetus within the amniotic cavity
b. Accentuated fetal anatomy as increased amniotic fluid improves image resolution
c. AFI greater than 20 centimeters
d. AFI greater than 15 cm
d. AFI greater than 15 cm
Maternal conditions associated with polyhydramnios include all of the following except:
a. Diabetes mellitus
b. Fetal macrosomia
c. Tetralogy of Fallot
d. Rh immunization
c. Tetraology of Fallot
Oligohydramnios is associated with all of the following except:
a. Renal agenesis
b. Gastrointestinal disorders
c. Premature rupture of the intrauterine membranes
d. Postdate pregnancy
b. Gastrointestinal disorders
Syndactylism is most likely the result of:
Amniotic bands
What are amniotic sheets believed to be caused by?
Synechiae
What method is used for visual assessment of the AFV?
Subjective assessment of fluid
Early in gestation, what is the major source of amniotic fluid produced by?
Amniotic membranes
Twin pregnancies have a _______ median AFI than a singleton pregnancy.
Slightly lower
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
c. Developing fetal swallowing
Amniotic fluid may appear generous during _______ weeks’ gestation.
20 to 30
What technique is both valid and reproducible in assessing the AFV?
AFI
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
d. Infantile polycystic kidney disease
Persistent oligohydramnios in the 2nd trimester, regardless of the cause carries a(n):
Poor prognosis
Scars within the uterus, secondary to previous gynecologic surgery, are called:
Synechiae
The amniotic fluid generally appears anechoic on ultrasound. Occasionally, however, mobile particle are observed that are most likely:
Vernix caseosa
Using the maximum vertical depth method of assessing the, 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
d. Between 2 and 8 cm is considered normal
Polyhydramnios is defined as an AFV greater than _______ ml.
2000
The AFI may be approximated by multiplying the largest pocket of amniotic fluid by _______.
Three
Nonanomalous conditions causing oligohydramnios include ll of the following except:
a. Dysplastic kidney
b. PROM
c. IUGR
d. Postdate pregnancy
a. Dysplastic kidney
