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WorksheetsOB Midterm
Total questions: 122
Worksheet time: 2hrs 5mins
When measuring the BPD, if orbits are seen, which way should the sonographer move the transducer?
superior
inferior
lateral
medial
Which of the following represents the second trimester?
weeks 1-12
weeks 12-26
weeks 27-40
Which of the following represents the first trimester?
weeks 1-12
weeks 12-26
weeks 27-40
Which of the following represents the third trimester?
weeks 1-12
weeks 12-26
weeks 27-40
What is the first sonographic finding of a pregnancy?
yolk sac
gestational sac
amnion
embryo
The gestational sac is typically seen by how many weeks?
3 weeks
4 weeks
5 weeks
6 weeks
The yolk sac is typically identified by how many weeks?
4 weeks
5.5 weeks
6 weeks
6.5 weeks
The yolk sac should be seen when the gestational sac exceeds _____mm in diameter
3mm
5mm
7mm
8mm
A ____ ____describes a small, spherical structure with an anechoic center within the gestational sac
(a)
Which of the following are characteristics of an abnormal yolk sac?
echogenic
anechoic
abnormally small
abnormally large
solid
The __________ ______ sign represents a small, hypoechoic area that appears in the fundus; may be seen before the gestational sac is identified
(a)
Which of the following is formed from the follicle after ovulation?
paraovarian cyst
theca lutein cyst
corpus luteum cyst
follicular cyst
A corpus luteum cyst remains intact until approximately what week of pregnancy?
12 weeks
14 weeks
16 weeks
18 weeks
An amniotic membrane is seen at what gestational week?
3 weeks
4.5 weeks
5.5 weeks
6 weeks
When sonographers use the term gestational age, they mean:
weeks or days since conception
weeks or days since fertilization
weeks or days since implantation
weeks or days since the first day of the last menstrual period
weeks or days since the last day of the last menstrual period
Up to 10 weeks' gestation (menstrual) age, the mean diameter of the normal gestational sac should grow approximately:
0.5mm per day
1.0mm per day
2.0mm per day
3.0mm per day
4.0mm per day
A successful pregnancy outcome is associated with a yolk sac that:
occupies more than 30% of gestational sac volume
measures less than 2mm in diameter at 8-10 weeks
has irregular echogenic borders
measures greater than 6mm in diameter
has a round shape
Which sonographic finding is associated with an abnormal pregnancy?
spherical gestational sac within the uteurs
embryo with a calcified yolk sac
oval gestational sac within the uterus
double sac sign within an intrauterine gestational sac
An incomplete abortion is defined as:
spontaneous abortion with retained products of conception
subchorionic hemorrhage
ectopic pregnancy without bleeding
anembryonic abortion
heterotopic pregnancy
When does the trilaminar embryonic disc form?
during organogenesis
during implantation
during gastrulation
during transit through the fallopian tube
The primitive hindbrain can be seen as a cystic structure within the embryonic head. What is the name of this structure?
prosencephalon
diencephalon
rhombencephalon
mesencephalon
What is a heterotopic pregnancy?
a cervical ectopic pregnancy
an abdominal ectopic pregnancy
a fertility-assisted pregnancy
coexisting intrauterine and ectopic pregnancies
a twin ectopic pregnancy
In a ruptured ectopic pregnancy, which section of the fallopian tube is potentially the most life-threatening?
ampulla
interstitial
fimbrial
isthmic
Which statement about ectopic pregnancies is NOT true?
the ovary is the second most common site for ectopic pregnancy
the increased incidence of ectopic pregnancies is mostly attributable to sexually transmitted diseases
if a patient has had a previous ectopic pregnancy, she is at increased risk for a current ectopic pregnancy
the most common clinical symptom is pain
A patient presents with a positive pregnancy test, bleeding, and cramping. The sonogram reveals an intrauterine gestational sac containing an echogenic structure but no heartbeat. Measurement of the structure shows it to be 11mm in length. The most likely diagnosis is:
anembryonic pregnancy
placenta previa
early pregnancy failure
missed abortion
Normal embryonic midgut herniation occurs at approximately:
6 menstrual weeks
8 menstrual weeks
10 menstrual weeks
12 menstrual weeks
Physiologic herniation of fetal intestine outside the fetal abdomen is usually not seen after which gestational age?
6-8 weeks
8-10 weeks
10-12 weeks
12-14 weeks
To differentiate an early intrauterine pregnancy from a pseudogestational sac, it helps to visualize the:
yolk sac
decidualized endometrium
chorionic villi
corpus luteum cyst
Because of spinal segmentation, crown-rump length measurements begin to lose accuracy after how many gestational weeks?
3
5
7
9
11
What is the significance of measuring the nuchal translucency?
it is a good indicator of gestational age
it is an indicator of possible neural tube defects
it is a good indicator of possible chromosomal abnormalities
it is a good indicator of possible placenta abruption
Normally, nuchal translucency does not exceed:
1.5mm
2.0mm
2.5mm
3.5mm
Your patient is 10 weeks by good menstrual dates but presents with pregnancy induced hypertension. You should suspect:
an embryonic pregnancy
hydatidiform mole
threatened abortion
ectopic pregnancy
Of the following methods of calculating an estimated date of confinement (EDC), which is the most reliable?
yolk sac measurement
fundal height of uterus
sac measurement
crown rump length
All of the following are associated with trophoblastic disease EXCEPT:
pregnancy induced hypertension
theca lutein cysts
hyperemesis gravidarium
normal fetus
In a fetal heart, what is the name for the normal communication between the right and left atria?
atrial orfice
atrial septal defect
foramen ovale
ventricular septal defect
Second trimester obstetric ultrasound examinations are better than first trimester sonograms in determining?
gestational age of fetus
fetal anatomy
fetal life
fetal position
Normally, the anatomic structure closest to the spine in a four-chamber view of the fetal heart is the:
left ventricle
left atrium
right ventricle
right atrium
apex
When you have demonstrated the fetal stomach transversely at the level of the portal vein, you are at the appropriate level for the:
fetal kidneys
three-vessel cord
cord insertion
thoracic circumference
abdominal circumference
Sonographically, fetal gender cannot be anatomically differentiated until what gestational age?
10 weeks
13 weeks
16 weeks
20 weeks
Thoracic circumference is measured in the:
true transverse view at the level of fetal four-chamber heart
true longitudinal view at the level of fetal four-chamber heart
true transverse view just below the fetal diaphragm and at the level of fetal heart motion
The normal fetus heart occupies:
one-fourth of the chest cavity and points toward the right side of the fetus
one-third of the chest cavity and points toward the right side of the fetus
one-third of the chest cavity and points toward the left side of the fetus
one-half of the chest cavity and points toward the left side of the fetus
Which of the following landmarks should be visualized when measuring both biparietal diameter (BPD) and head circumference (HC)?
cavum septi pellucidi
cerebellum
orbits
lateral ventricle
The lateral ventricle of the fetal brain normally measures:
1cm in the largest dimension longitudinally
1mm in the largest dimension longitudinally
1mm in the largest dimension transversely
1cm in the largest dimension transversely
In a longitudinal scan of the fetal spine, what does the candy-cane shaped vessel to the left of the spine represent?
inferior vena cava
descending aorta
ascending aorta
aortic arch
Which of the following provides important prognostic information about fetal renal function?
amniotic fluid volume at 11 menstrual weeks
amniotic fluid volume at 15 menstrual weeks
amniotic fluid volume at term
shape of the fetal kidneys
The fluid-filled structure located between the cerebellum and the occipital bone in the posterior fossa is known as the:
third ventricle
fourth ventricle
cisterna magna
choroid plexus
Fetal heart position would be considered normal at an angle:
25 degrees to the left of midline
45 degrees to the left of midline
25 degrees to the right of midline
45 degrees to the right of midline
The fetal bladder should fill and then empty again approximately every:
5-10 minutes
10-15 minutes
20-30 minutes
30-60 minutes
If you were observing the fetal forearm in the anatomic position, which of the following statements about the ulna would be TRUE?
the ulna is longer than the radius proximally
the ulna is positioned lateral to the radius
the ulna and radius end at the same level distally
A and B
Which lab test(s) would be performed to evaluate for the presence of a neural tube defect or Down syndrome?
Quad screen
MSAFP
CVS
Amniocentesis
all of the above
While scanning an obstetric patient, you obtain a midline sagittal view of the lower uterine segment. If the cord is between the presenting part and the internal os, this is called:
complete previa
partial previa
vasa previa
cord presentation
Which ultrasound modality should sonographers use to prove fetal life on a frozen image?
A-mode
B-mode
M-mode
3D
The maternal side of the developing placenta is referred to as the:
decidua parietalis
decidua basalis
decidua chorion
decidua capsularis
What term refers to an accessory placental lobe?
Battledore
circumvallate
membrancea
succenturiate
A placenta that has two equally sized lobes connected by vessels is called a:
bipartite placenta
membranous placenta
circumvallate placenta
lobar placenta
A placenta previa can be ruled out if the placental edge is at least how far from the internal cervical os?
0.5cm
1cm
2cm
3cm
In which cord anomaly is the number of vessels reduced from three to two?
cord prolapse
umbilical vein thrombosis
cord stricture
single umbilical vein
single umbilical artery
Invasion and perforation of the uterine wall by placental villi is called:
placenta accreta
placenta percreta
placental increta
placental abruption
Which of the following is TRUE about placental abruption?
it usually presents as pain and bleeding
it is more common in patients with oligohydramnios
it is rarely accompanied by bleeding
it most commonly occurs idiopathically
What is the name for a placenta in which a loose chorionic membrane folds back upon itself and encircles the fetal surface?
annular
bipartite
circumvallate
succenturiate
A ring-shaped placenta that attaches circumferentially to the myometrium is called:
annular
bipartite
circumvallate
succenturiate
All of the following are functions of the placenta EXCEPT:
providing for diffusion of fetal wastes
providing for an exchange of gases
producing alpha-fetoprotein
serving as a source of nutrients
Alpha fetoprotein is produced by the fetal...
lungs
kidneys
spleen
liver
One can rule out placenta accreta by observing:
placental texture
cord insertion
retroplacental space
B and C
When the placenta invades the myometrium and penetrates the serosa it is called:
placental accreta
placental increta
placenta percreta
placental abruption
A cord that appears to be abnormally thickened in an otherwise normal-appearing pregnancy is most likely the result of:
cord edema
excessive Wharton's jelly
resistance of blood flow to the fetus
macrosomia
A placenta measuring 7cm in the greatest AP dimension may be associated with all of the following EXCEPT:
hydrops
triploidy
diabetes mellitus
infection
hypertension
All of the following conditions may be associated with a short umbilical cord EXCEPT:
multiple gestations
polyhydramnios
placental abruption
oligohydramnios
The thickness of the second trimester placenta should not measure more than:
2cm
3cm
4cm
5cm
6cm
The best method and time for estimating gestational age is:
femur length at 30 weeks
gestational sac measurement at 5 weeks
abdominal circumference at 20 weeks
crown rump length at 10 weeks
You are measuring abdominal circumference. You choose to do so at the level of the:
portal sinus
cord insertion site
fetal stomach
fetal kidneys
The cephalic index is calculated to determine:
fetal weight
head shape
lung maturity
gestational age
The cerebellum is visualized during an attempt to measure the BPD. In which direction, in relation to the fetus, does the transducer need to be moved in order to obtain a proper BPD?
proximal
lateral
cephalad
caudal
Given an occipitofrontal diameter (OFD) of 70mm and a biparietal diameter (BPD) of 43mm, calculate the cephalic index (CI).
50%
61%
75%
80%
86%
A cephalic index of 61% suggests:
anencephaly
ventriculomegaly
dolichocephaly
brachycephaly
holoprosencephaly
The biparietal diameter and head circumference measurements are best taken at which level of the fetal brain?
cerebellum
lateral ventricles
thalami
cavum septum pellucidi
cisterna magna
Which of the following statements about the fetal head circumference is TRUE?
it is considered less reliable than the biparietal diameter measurement as a gauge of gestational age
it is taken at the level of the lateral ventricles
it is measured from outer edge to outer edge
it is considered more reliable than the biparietal diameter measurement as a gauge of gestational age
C and D
MSD measurements are accurate when:
only a gestational sac is seen transabdominally
only a gestational sac is seen transvaginally
only a gestational sac and a yolk sac are seen
MSD is greater than 15mm
Which formula is used to calculate the cephalic index?
(BPD + OFD) x 1.57
(BPD + OFD) x 3.14
(BPD + OFD) x 1.62
(OFD/BPD) x 100
(BPD/OFD) x 100
The obstetric patient who presents with hypertension, swelling, and proteinuria is said to have:
eclampsia
pre-eclampsia
gestational diabetes
hyperemesis gravidarum
A and B
A molar pregnancy that is considered invasive but does not metastasize is called:
partial mole
pseudo mole
choriocarcinoma
chorioadenoma destruens
hydatidiform mole
Which of the following best describes the function of the nonstress test?
it calculates fetal heart and respiratory movements
it calculates fetal heart rate during fetal rest periods
it calculates fetal heart rate according to uterine contractions
it calculates fetal heart rate according to fetal activity
If a patient's AFP level is low, one should check for:
abdominal wall defects
trisomy 21
skeletal dysplasia
neural tube defects
A molar pregnancy associated with a viable fetus is called a:
coexistent mole and live fetus
choriocarcinoma
partial mole
hydatidiform mole
chorioadenoma desturens
A fetus that weighs 4200 grams at term is said to be:
small for gestational age
post-term
macrosomic
diabetic
The basic AIUM guidelines for obstetric scanning require us to take four fetal measurements. Which of the following is NOT one of those measurements?
head circumference
ventricular diameter
biparietal diameter
femur length
abdominal circumference
In the third trimester, symmetric intrauterine growth restriction (IUGR) may be associated with which of the following Doppler findings?
low resistance umbilical artery
low resistance renal artery
low resistance middle cerebral artery
nonpulsatile umbilical vein
Which of the following anomalies is associated specifically with maternal diabetes mellitus?
Turner syndrome
Potter sequence
Osteogenesis imperfecta
Caudal regression syndrome
Of the following conditions, which is NOT associated with a thick, edematous placenta?
chronic primary hypertension
nonimmune hydrops
maternal diabetes
TORCH infections
All of the following parameters are evaluated in the fetal biophysical profile EXCEPT:
fetal body movement
fetal eye movement
fetal breathing
amniotic fluid
fetal tone
What is the quantitative method of determining whether the amniotic fluid level is normal?
subjective method
qualitative evaluation
eyeballing
amniocentesis
amniotic fluid index
Amniotic fluid is produced by the:
fetal liver
fetal gut
placenta
fetal kidneys
Which of the following would NOT be considered a function of amniotic fluid?
it provides a means of protection
it allows for normal lung development
it provides nourishment
it regulates body heat
Of the following amniotic fluid indices, which would be considered polyhydramnios?
3cm
9cm
14cm
24cm
all of the above
Which of the following is LEAST likely to be associated with polyhydramnios?
twins
intrauterine growth restriction
neural tube defect
dwarfism
Green-tinged particles floating in amniotic fluid most likely are:
shed skin
vernix
shed hair
meconium
At what gestational age is nuchal fold thickness usually measured?
10-14 weeks
15-20 weeks
22-24 weeks
25-28 weeks
Measurement of the nuchal fold thickness is taken at the level of the:
cerebellum
thalami
third ventricle
falx
Which of the following is NOT associated with a decreased MSAFP?
hydatidiform mole
underestimated of gestational age
closed neural tube defect
Down syndrome
Which of the following is NOT associated with an elevated MSAFP?
maternal renal abnormalities
hydatidiform mole
fetal demise
multiple gestation
A triple marker screening (triple test) measures:
human chorionic gonadotrophin (hCG), unconjugated estriol (uE3), and alpha-fetoprotein levels
acetylcholinesterase (ACHE), unconjugated estriol (uE3), and alpha-fetoprotein levels
acetylcholinesterase (ACHE), estrogen, and alpha-fetoprotein levels
human chorionic gonadotrophin (hCG), follicle-stimulating hormone (FSH), and alpha-fetoprotein levels
For best results, the optimal gestational age for karyotyping by amniocentesis is:
11-14 weeks
15-20 weeks
21-23 weeks
24-26 weeks
Which of the following statements about Down syndrome is FALSE?
amniocentesis or CVS is sometimes unnecessary for prenatal diagnosis
there is an increased incidence with increased maternal age
it is characterized by enlarged nuchal thickness in some cases
it is characterized by an abnormal quad screen
decreased MSAFP is symptomatic of Down syndrome
At what gestational age are chorionic villus sampling (CVS) procedures commonly performed?
5-7 weeks
7-9 weeks
10-14 weeks
15-16 weeks
Nuchal fold thickness is measured to assess for the presence of:
chromosomal abnormalities
microcephaly
spina bifida
neural tube defects
The most common cause of fetal demise in the first trimester is:
intrauterine infections
maternal uterine anomalies
maternal diabetes mellitus
autosomal chromosomal abnormalities
unknown
The following condition is an indication for immediate delivery, for without it there is the risk of intrauterine demise:
placental abruption
uterine infection
incompetent cervix
vasa previa
Which of these findings would NOT lead you to suspect fetal demise?
decreased fundal height
negative fetal heart tones in office
increased fundal height
lack of fetal motion
What is the most common congenital cardiac anomaly in children?
Tetralogy of Fallot
ventricular septal defect
atrial septal defect
aortic coarctation
Which of the following cardiac anomalies can be easily detected in the four-chamber heart view?
ventricular hypoplasia
transposition of the great vessels
coarctation of the aorta
persistent truncus arteriosus
Maternal serum alpha-fetoprotein (MSAFP) will be elevated with all of the following EXCEPT:
omphalocele
anencephaly
multiple gestation
trophoblastic disease
spina bifida
Which of the following is TRUE about macrosomia?
it is frequently associated with gestational diabetes
the fetal head and abdomen are enlarged
the fetal body is smaller than the abdomen
A and B
A and C
What potential trisomy 21 marker may be measured in the first trimester with or without a nuchal translucency measurement?
head circumference
liver length
middle phalanx of the fifth digit
foot length
nasal bone
Which of these congenital cardiac abnormalities is NOT diagnosed with the four-chamber view?
hypoplastic left ventricle
single ventricle
transposition of the great vessels
ventricular septal defect
AV block
Sonographic findings of a thickened nuchal fold, hypoplasia of the middle phalanx of the fifth digit, and shortened femurs are most likely associated with:
Trisomy 21
Trisomy 18
Trisomy 13
Turner's syndrome
Of the following choices, which is considered the most common solid mass associated with pregnancy?
chorioangioma
endometrioma
leiomyoma
ovarian fibroma
All of these Doppler ultrasound findings in the uterine arteries are associated with a growth-restricted pregnancy EXCEPT:
reversal of end-diastolic flow
increase of end-diastolic flow on serial surveillance
decrease of end-diastolic flow on serial surveillance
no end-diastolic flow
Spectral Doppler waveforms obtained in the mid second trimester from arteries supplying trophoblastic tissue will demonstrate:
high amplitude, low-resistance flow
high amplitude, high-resistance flow
low amplitude, low-resistance flow
low amplitude, high-resistance flow
What is the name of a finding associated with trophoblastic disease or ovarian hyperstimulation?
polycystic ovaries
theca-lutein cysts
heterotopic pregnancy
endometrioma
Your patient presents at 14 weeks post LMP large for gestational age and bleeding. Heart tones cannot be heard. You suspect:
fetal demise
complete hydatidiform mole
placenta previa
premature rupture of membranes
placental abruption
All of the following might cause a patient to present large for gestational age EXCEPT:
multiple gestation
polyhydramnios
uterine fibroids
fetal demise
adnexal masses
Of the following choices, the most common cystic mass associated with pregnancy is a:
paraovarian cyst
theca-lutein cyst
corpus luteum cyst
follicular cyst
