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OBGYN Flashcards

1
Q

Choose the quantitative pregnancy test

a) thyroxin
b) progesterone
c) serum
d) urine

A

c) serum

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2
Q

Name the solid ball of developing cells which occur after fertilization

A

Morula

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3
Q

What hormone is secreted by both the syncytiotrophoblast and placenta

A

hCG

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4
Q

What process allows for spermatic penetration of the ovum

A

Acrosome disintegration

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5
Q

Where does implantation of the embryo occur

A

Endometrium

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6
Q

A patient presents as small for gestational age with a known LMP 10 weeks ago. The sonographic exam reveals a gestational sac equivalent to a 6 week gestation. Select the most likely differential

a) Incomplete abortion
b) Miscarriage
c) Blighted Ovum

A

c) Blighted ovum

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7
Q

Select the sonographic findings that increase suspicion of a choriocarcinoma

a) soft tissue mass filling the uterine cavity
b) normal fetus and placenta with a cystic vesicular portion
c) hyperechoic shadowing mass within the myometrium
d) mass invasion through the uterine myometrium to the serosa with hypoechoic liver lesions

A

d)

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8
Q

What describes an oocyte without maternal chromosomes resulting in proliferation of swollen chorionic villi and the absence of identifiable embryonic structures

A

Complete hydatidiform mole

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9
Q

What sonographic finding in the uterus is made up of bleeding from the decidulized endometrium

A

Pseudosac

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10
Q

What is the discriminatory cutoff for b-hCG

A

Above 1,500 to 2,500

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11
Q

What portion of the fallopian tube has the highest incidence of ectopic gestations

A

Ampullary

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12
Q

Which type of ectopic pregnancy implants on previous cearean scars

A

Intramural

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13
Q

What measurement from the frontal to the occipital bone is obtained at the level of the thalami

A

Occipito-frontal diameter (OFD)

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14
Q

Which cranial bones are the landmarks for measurement of the BPD

A

Parietal bones

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15
Q

What is the most common fetal ratio parameter

A

Head circumference/ abdominal circumference (HC/AC)

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16
Q

What portion of the humerus does the sonographer measure to obtain the length

A

Ossesous diaphysis

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17
Q

Choose the maternal factor that results in delayed placental maturation of a 5 cm placenta

a) Rh dieases
b) Gestational diabetes
c) Syphillis
d) Choriooangioma

A

b) Gestational diabetes

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18
Q

Decidual formation defect with abnormal placental attachment to the uterine wall describes

A

Placenta accreta

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19
Q

Which of the following describes the sonographic characteristic of excessive Wharton’s jelly

a) small mas adjacent to abdomen
b) irregular protrusion from the cord
c) cystic dilation up to 6 cm, usually located close to the fetus
d) variably echogenic, soft tissue mass with three vessels visible

A

d) variably echogenic, soft tissue mass with three vessels visible

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20
Q

What is the chromosomal cause for a thick placenta

A

Triploidy

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21
Q

What form of placenta previa lies within 2 cm of the internal cervical os

A

Low-lying placenta

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22
Q

Select the differential for an intraplacental lesion

a) Subchorionic hemorrhage
b) Circumvallate placenta
c) Fibrin deposition
d) Vasa previa

A

c) Fibrin deposition

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23
Q

At which Carnegie stage does the brain folding begin

A

Stage 9

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24
Q

What anatomy is imaged on an axial plane at the cerebellar level

A

Cisterna magna

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25
Q

Choose the sonographic characteristic of a cephalocele

a) nuchal ligament forming a midline segment
b) macrocephaly
c) complex paracranial mass
d) located in the anterior portion of the neck

A

c) complex paracranial mass

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26
Q

What term describes dilation of the renal calices

A

Caliectasis

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27
Q

What term describes the portion of the fetus that will deliver first

A

Fetal presentation

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28
Q

What is the maximum right renal volume for a 30 week fetus

A

12.0 cm3

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29
Q

Which malformation results in failure to identify pulmonary vascular communication with color doppler

a) pulmonary sequestration
b) bronchogenic cyst
c) hirschsprungs disease
d) meconium ileus

A

a) pulmonary sequestration

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30
Q

Identify the sonographic appearance of a Type 3 CCAM

a) unilateral, 4 cm cyst with multiple outpouchings
b) unilateral cysts replacing the lower lobe of one lung
c) solid echogenic mass within the lung
d) spherical homogeneous mass resulting in a midline shift

A

c) solid echogenic mass within the lung

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31
Q

The finding of subcutaneous edema, ascites, a large spleen and liver, and a thick placenta raises suspicion for what process

A

Fetal hydrops

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32
Q

Which of the following is part of Epstein’s anomaly

a) underdeveloped left ventricle
b) tricuspid stenosis
c) right ventricular hypoplasia
d) overriding aorta

A

b) tricuspid stenosis

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33
Q

What is an abnormal opening between the right and left atrium

A

Atrial septal defect

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34
Q

What anatomy is imaged on a 4 chamber view

A

Interventricular septum

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35
Q

What heart defect has an increase in right ventricular size, a small aorta, and reversed ductus arteriosus flow

A

Interrupted aortic arch

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36
Q

What dominant category does thanatophoric dysplasia fall into

A

Micromelia

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37
Q

What sonographic findings are seen with thanatophoric dysplasia

a) heart malformations, bone fractures, radial hypoplasia
b) polydactyly, macrocepahly, hypermineralization
c) bowed long bones, wide thorax, syndactyly, rhizomelia
d) narrow thorax, curved or bowed long bones, hypomineralization

A

d

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38
Q

What scanning angle avoids artificial limb shortening when performing biometry

A

Perpendicular

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39
Q

Choose the maternal indication for performance of a fetal doppler exam

a) hypertension
b) umbilical cord anomaly
c) history of chromosomal anomaly
d) intrauterine growth retardation

A

a) hypertenstion

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40
Q

What is the normal umbilical artery waveform

A

Low resistance

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41
Q

What fetal vessel is sampled above the umbilical sinus and has a normal triphasic flow pattern

A

Ductus venosus

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42
Q

Identify the vessel with flow fluctuations and pulsations in the distressed fetus

a) SVC
b) umbilical vein
c) uterine artery
d) ductus venosus

A

b) umbilical vein

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43
Q

What fetal testing method includes the nonstress test and amniotic fluid volume

A

Modified biophysical profile

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44
Q

What first sonographically observed biophysical change is seen with fetal hypoxia

A

Gross fetal body movements

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45
Q

What is the primary factor for increased multiple births

A

delayed childbearing

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46
Q

Select the maternal complication of a multiple pregnancy

a) preterm birth
b) hypertension
c) fetal death
d) Intrauterine growth restriction

A

b) hypertension

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47
Q

In a twin gestation with a placenta on the anterior wall and a second on the posterior wall, what would be the membrane configuration

A

Dichorionic/diamniotic

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48
Q

Fetal death and the retention of the fetus can result in what type of process

A

Fetal papyraceus

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49
Q

Identify the doppler parameter which confirms the presence of an acardiac twin

a) increased flow velocities in the MCA
b) decreased resistance in umbilical cord flow
c) lack of low in the umbilical artery
d) umbilical cord flow reversal

A

d) umbilical cord flow reversal

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50
Q

Which of the following is a sonographic finding for the donor twin in the TTS pregnancy

a) hypovolemic
b) polyhydramnios
c) macrsomia
d) hydrops

A

a) hypovolemic

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51
Q

What type of placentation occurs with the division of the monozygotic twinning at day 3

A

dichorionic/diamniotic

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52
Q

Which of the following is a perinatal pathology associated with IUGR

a) hypoglycemia
b) hypertenstion
c) diabetes
d) obesity

A

b) hypertension

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53
Q

Choose the fetal cause of IUGR

a) varicella zoster
b) palcental abruption
c) preterm birth
d) sibling with IUGR

A

a) varicella zoster

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54
Q

What is the doppler finding seen with asymmetric IUGR

A

Increased RI in aorta

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55
Q

What type of cell division results in an individual with 2 genotypes

A

Mosaicism

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56
Q

What term describes a mutation caused by multiple genes

A

Heterogenous disorder

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57
Q

Select the soft sonographic marker for trisomy 21

a) low set ears
b) choroid plexus cysts
c) microcephaly
d) cleft lip

A

b) choroid plexus cysts

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58
Q

How many chromosomes are found in a gamete

A

23

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59
Q

What is the chromosome makeup of a Turner syndrome fetus

A

45XO

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60
Q

What maternal bacterial infection raises the risk of fetal hydrops

A

Syphilis

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61
Q

Immune fetal hydrops include which of the following fetal findings

a) two vessel cord
b) pericardial fluid
c) decreased PI
d) microcephaly

A

b) pericardial fluid

62
Q

Which placental problem coexists with maternal preeclampsia

a) choriocarcinoma
b) lack of lakes
c) infarcts
d) decreased flow ratio

A

c) infarcts

63
Q

When does Rh isoimmunization occur

64
Q

Which of the following is a result of abnormal placental penetration into the myometrium

a) hemorrhage
b) chorioamnionitis
c) involution
d) atony

A

a) hemorrhage

65
Q

What is the software program used to measure volumes

66
Q

What term describes the display of parallel images

A

Tomographic

67
Q

What is the surface rendering control

A

Gradient light

68
Q

How is the uterus situated to the pelvis, bladder and rectum

A

Medially to the pelvis
Posterior to the bladder
Anterior to the rectum

69
Q

What 3 layers is the uterus composed of

A
  • peritoneum
  • myometrium
  • endometrium
70
Q

The out layer of the uterus is called

A

Peritoneum or the serosal layer

71
Q

The muscular portion of the uterus is called

A

Myometrium

72
Q

The inner layer of the uterus is called

A

Endometrium

73
Q

What is another name for the posterior cul-de-sac

A

Pouch of Douglas

74
Q

The peritoneum covers the posterior surface of the uterus and the anterior surface of the rectum which is called what potential space

A

Posterior cul-de-sac

75
Q

What is the echotexture of the myometrium

A

Homogenous

76
Q

This type of uterus tilts forward with a 90 degree angle to the posterior vaginal wall
-This is also the most common type of uterus

A

Anteverted

77
Q

This type of uterus the uterine corpus is flexed anteriorly on the cervix, forming a sharp angle at the cervix

A

Anteflexed

78
Q

This type of uterus tilts backward without a sharp angle between the corpus and cervix

A

Retroverted

79
Q

This type of uterus the uterine corpus is flexed posteriorly on the cervix, forming a sharp angle at the cervix

A

Retroflexed

80
Q

The uterine and ovarian arteries are branches of what artery

A

Internal iliac (hypogastric)

81
Q

In relationship to the uterus where are the ovaries located

A

Ovaries are located lateral in the ovarian fossa

82
Q

The ovarian fossa is bound laterally but what artery and vein

A

Iliac artery and vein

83
Q

What is the normal echo texture of the ovaries

A

Homogenous

84
Q

What part of the fallopian tube is the narrowest portion

85
Q

What part of the fallopian tube is the most lateral portion

A

Infundibulum

86
Q

The purpose of this structure is to aid in fertilization and to transport the ova from the ovary to the uterus

A

Fallopian tube

87
Q

On a sagittal view, this muscle appears as a paired long hypoechoic stripe with echogenic linear lines

A

Iliopsoas muscle

88
Q

What is the most common uterine tumor

89
Q

What is the most common cause of uterine enlargement in the nonpregnant female

90
Q

What is an invasion of endometrial tissue into the the myometrium > 2 mm

A

Adenomyosis

91
Q

What is an accumulation of blood within the vagina

A

Hematocolpos

92
Q

What is an accumulation of blood within the uterine cavity secondary to atrophy of the endocervical canal or cervical stenosis

A

Hematometra

93
Q

What type of ovarian mass tends to be smooth walled, well- defined, and anechoic with increased posterior acoustic enhancment

A

Benign cystic masses

94
Q

What are the 3 most common functional cysts of the ovaries

A
  • follicular
  • corpus luteal cysts
  • theca luteal
95
Q

The twisiting of an ovary and its vessels resulting in occlusion of its blood supply refers to

A

Ovarian torsion

96
Q

What hormone is normally produced by the placenta and present in the serum and urine of a pregnant woman

97
Q

What is any pregnancy outside the endometrial cavity called

A

Ectopic pregnancy

98
Q

Where do most ectopic pregnancies occur

A

Fallopian tube

99
Q

This describes blood or decidual cast in the uterine cavity mimicking a gestational sac

A

Pseduogestational sac

100
Q

What is a coexistent intrauterine pregnancy and ectopic pregnancy called

A

Heterotopic

101
Q

An adnexal ring like mass with increased color flow around its periphery aka ring of fire describes

A

Unruptured ectopic pregnancy

102
Q

This refers to the space between the back of the neck and the overlying fetal skin

A

Nuchal translucency

103
Q

A congenital lymphatic obstruction between the lymphatic and venous pathway resulting in lymphatic fluid accumulation in the lymphatic sac within the nuchal region describes

A

Cystic hygroma

104
Q

What is the most common and benign component of gestational trophoblastic disease that may be partial or complete

A

Hadatidiform mole

105
Q

This type of Hydatidiform mole the sono findings are an enlarged uterine cavity filled with complex echoes often resembling placental tissue with multiple cystic vesicles

106
Q

This is associated with a markedly increased beta hCG and may have bilateral theca lutein cysts

A

Hydatidiform mole

107
Q

The sono appearnace of this hydatidiform mole presents as an enlarged hydropic placenta with focal multicystic anechoic spaces replacing the normal homogenous appearance of placenta

108
Q

The sono appearance of swiss cheese, snowstorm, vesicular texture, and honey comb describes

A

Hydatidiform mole

109
Q

This describes a large >2 cm gestational sac without an embryo or yolk sac

A

Blighted ovum or anembryonic demise

110
Q

This describes an embryo without fetal heart rate motion retained in the uterus before 20 weeks.

A

Missed abortion

111
Q

This describes a fetus that weighs more than 4,000 g and is often a manifestation of insulin dependent diabetes mellitus

A

Macrosomia

112
Q

This is defined by ultrasound as weight <10th percentile

A

Intrauterine growth restriction (IUGR)

113
Q

Which of the folllowing indicates a patient who had a twin pregnancy

a) G2 P2 A2 T0
b) G4 P4 A0 T4
c) G1 P0 A0 T0
d) G3 P3 A2 T2

114
Q

An 18 year old presents to the department with complaints of intermittent left lower quadrant pain. Though she has not missed any periods, her clinician ran a pregnancy test came up positive. The sonographic exam revealed a solid mass with calcifications and multiple small cysts in the left side apart from the uterus. What is the most likely cause for these findings

a) endometriod
b) Granulosa theca cell tumor
c) Clear cell carcinoma
d) immature teratoma

A

d) immature teratoma

115
Q

Choose the least common malignant ovarian cancer

a) androblastoma
b) krukenberg tumor
c) arrhenoblastoma
d) choriocarcinoma

A

a) androblastoma

116
Q

Which of the following is a tumor marker for colon, stomach, breast, or ovarian carcinomas

a) CEA
b) BRCA1/BRCA2
c) AFP
d) CA 125

117
Q

How does the fallopian tube image in a patient with stage 2 pelvic inflammatory diease

a) hypoechoic with a cogwheel appearance
b) normal ovary
c) decreased doppler flow to a tubal structure
d) thin wall tubular structure

A

a) hypoechoic with a cog wheel appearance

118
Q

a discrete adnexal mass with peripheral doppler flow is a sonographic sign of

A

Endometriosis

119
Q

Cervical motion tenderness is a clinical presentation of

A

Pelvic inflammatory disease

120
Q

What phase overlaps the menstrual phase

A

Proliferative phase

121
Q

What is the primary sex hormone produced by the ovarian follicles

122
Q

How long after fertilization does an embryo transfer occur

123
Q

Which of the following is a uterine anatomic cause of infertility

a) ovarian hyperandrogenism
b) endometrial polyp
c) endometriosis
d) hydrosalpinx

A

b) endometrial polyp

124
Q

This term describes the estimation of the quality and quantity of a womans remaining follicles

A

Ovarian reserve

125
Q

What is the precursor to the penis and clitoris

A

Genital tubercle

126
Q

The preembryonic phase occurs during which portion of the gestation

127
Q

A pregnancy in one uterus with a decidual reaction in a second uterus describes what congenital malformation

A

Didelphic uterus

128
Q

Which of the following is a Class 2 mullerian duct anomaly

a) unicornuate uterus
b) bicornuate uterus
c) DES uterus
d) hypoplasia of the vagina

A

a) unicornuate uterus

129
Q

What is the hormone that GnRH stimulates the pituitary gland to secrete

130
Q

What hormone resumes with a decrease in estrogen and a positive feedback loop

131
Q

What hormone is secreted from the anterior lobe of the pituitary gland

132
Q

Which of the following secretes progesterone

a) graafian follicle
b) corpus luteum
c) theca interna
d) theca externa

A

b) corpus luteum

133
Q

What is the transitional portion of the uterus

134
Q

In the normal bladder, echogenic urine indicates which technical error

A

High overall gain

135
Q

What is the imaginary line that separates the true and false pelvis

A

Linea terminalis

136
Q

Select the organ fold in the false pelvis

a) rectum
b) ovaries
c) ileum
d) bladder

137
Q

What vessel drains directly into the left renal vein

A

Left ovarian vein

138
Q

This doppler measurement takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak

A

Pourcelot resistive index

139
Q

Where does the uterine artery anastomoses with the ovarian artery

A

At the uterine cornua

140
Q

What term defines the physiologic process of growing new vessels

A

Angiogneisis

141
Q

Select the karytype seen with a partial mole

a) 46 XY
b) 46 XX
c) 44 OX
d) 69 XXX

142
Q

What dominant category does thanatophoric dysplasia fall into

A

Micromelia

143
Q

What scanning angle avoids artificial limb shortening when performing biometry

A

Perpendicular

144
Q

Describe the normal umbilical artery waveform

A

Low resistance

145
Q

What fetal vessel is sampled above the umbilical sinus and has a normal triphasic flow pattern

A

Ductus venosus

146
Q

What is the optimal angle of insonation to obtain a doppler tracing of the fetal MCA

A

34 degrees

147
Q

What fetal testing method includes the nonstress test and amniotic fluid volume

A

Modified BPP

148
Q

What is the first sonographically observed biophysical change seen with fetal hypoxia

A

Gross fetal body movements

149
Q

What is the primary factor for increased multiple births

A

Delayed child bearing

150
Q

Select the maternal complication of a multiple pregnancy

a) preterm birth
b) hypertension
c) fetal death
d) intrauterine growth restriction

A

b) hypertension

151
Q

Fetal death and the retention of the fetus can result in what type of process

A

Fetal papyraceus

152
Q

Choose the fetal cause of IUGR

a) varicella zoster
b) placental abruption
c) preterm birth
d) silbing with IUGR

A

a) varicella zoster

OBGYN board review (1 decks)

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