DMS 221 All Test Questions

which one of the following abnormalities refers to a fetus with a significantly narrow diameter of the chest?

• bronchopulmonary sequestration

• asphyxiating thoracic dystrophy

• congenital bronchia atresia

• lymphangiectasia

asphyxiating thoracic dystrophy

ch 61

the most important determinant for fetal viability is which one following?

• pulmonary hypoplasia

• bronchopulmonary sequestration

• pulmonary development

• bronchial atresia

pulmonary development

ch 61

sonographic evaluation of the normal fetal thorax should include all of the following except:

• size

• shape

• chest circumference/abdominal circumference ratio

• symmetry

chest circumference/abdominal circumference ratio

ch 61

which one of the following statements about fetal breathing is false?

• fetal breathing is most prominent in the second & third trimesters

• the mature fetus spends one third of its time breathing

• breathing is present if the fetal chest or abdomen makes seesaw movements for 20 seconds

• breathing is absent if no fetal activity is noted during a 2-minute period

breathing is absent if no fetal activity is noted during a 2-minute period

ch 61

the average cardiac axis is ____ degrees

• 23

• 30

• 45

• 50

45

ch 61

common abnormalities associated with pulmonary hypoplasia include all of the following except:

• renal agenesis

• premature rupture of membranes (PROM)

• macrosomia

• posterior urethral valve syndrome

macrosomia

ch 61

sonographic findings in cystic adenomatoid malformation include all of the following except:**

• cystic adenomatoid malformation may occur below diaphragm

• cystic adenomatoid malformation may be an echogenic mass in type II cystic adenomatoid malformation

• cystic adenomatoid malformation may be a large cyst in type I cystic adenomatoid malformation

• cystic adenomatoid malformation is associated with polyhydramnios

ch 61

diaphragmatic hernias may occur anteriorly and medially in the diaphragm through the foramen of ____

• luschka

• bochdalek

• morgagni

• monro

morgagni

ch 61

which one of the following lung cysts detected prenatally is the most common?

• cystic adenomatoid malformation

• bronchogenic cyst

• pleural effusion

• lymphangiectasia

bronchogenic cyst

ch 61

the severity of pulmonary hypoplasia depends on which one of the following?

• when it occurs during pregnancy

• fetal breathing movements

• amniotic fluid volume

• systolic/diastolic ration of the umbilical artery

when it occurs during pregnancy

ch 61

the supernumerary lobe of the lung is called which one of the following?

• pulmonary hypoplasia

• succenturiate lobe

• anomalous lobe

• pulmonary sequestration

pulmonary sequestration

ch 61

normal sonographic appearances of the fetal chest include all of the following except:

• ribs form the lateral margin of the chest

• clavicles form the upper margin of the chest

• lungs serve as the medial borders for the heart

• thoracic cavity is symmetric and bell shaped

lungs serve as the medial borders for the heart

ch 61

the normal fetal lungs appear on ultrasound as which one of the following?

• heterogeneous with moderate echogenicity

• homogeneous and hyperechoic

• homogeneous and hypoechoic

• homogeneous with moderate echogenicity

homogeneous with moderate echogenicity

ch 61

which of the following statements about the fetal thorax is false?

• the majority of the heart is positioned in the midline and left chest

• the apex of the heart should be directed toward the spleen

• the central portion of the thorax is occupied by the heart

• the base of the heart lies horizontal to the heart

the central portion of the thorax is occupied by the heart

ch 61

when fetal pleural effusion is encountered, a careful search of the ____ should be attempted.

• urinary bladder, lung

• diaphragm, lung, cardiac

• long bones, cardiac, lung

• facial profile, lung, diaphragm

diaphragm, lung, cardiac

ch 61

sonographic findings in sequestration include all of the following except:

• sequestration appears as an echogenic mass that resembles lung tissue

• sequestration is seen with normal intra-thoracic anatomy

• sequestration commonly occurs below the diaphragm

• sequestration is associated with hydrops

sequestration commonly occurs below the diaphragm

ch 61

congenital bronchial atresia is found most commonly in the ____ lobe

• left lower

• left upper

• right lower

• right upper

left upper

ch 61

the most common type of diaphragmatic defect occurs:

• posteriorly and laterally

• posteriorly and medially

• anteriorly and laterally

• anteriorly and medially

posteriorly and laterally

ch 61

herniation through the foramen of bochdalek is usually found on which one of the following portions of the diaphragm?

• anterior

• right

• medial

• left

left

ch 61

abnormalities within the thoracic cavity include all of the following except:

• pleural effusion

• pulmonary sequestration

• brachial cleft cyst

• cystic adenomatoid malformation

brachial cleft cyst

ch 61

which one of the following does not describe sonographic features of a right-sided diaphragmatic hernia?

• the liver is seen in the chest

• a collapsed bowel may be present

• the stomach lies superior to the diaphragm

• the heart is deviated far to the left

the stomach lies superior to the diaphragm

ch 61

the mortality rate at birth for the 25 week fetus with a diaphragmatic hernia, pulmonary hypoplasia, and hypoplastic left heart is ____

• low

• mild

• moderate

• high

high

ch 61

the presence of a pleural effusion may cause which of the following to occur?

• enlargement of the heart

• enhancement of the diaphragm

• a shift of mediastinal structures

• a bronchogenic cyst

a shift of mediastinal structures

ch 61

what heart structure contains a natural opening to allow blood to shunt from the right side of the heart to the left side of the heart in the fetus?

• foramen ovale

• interatrial septum

• interventricular septum

• ductus arteriosus

foramen ovale

ch 61

what is the shunt in the fetal circulation that allows blood to bypass the fetal lungs after passing through the right ventricle?

• ductus arteriosus

• ductus venosus

• ductus teres

• foramen ovale

ductus arteriosus

ch 61

what sonographic feature definitively identifies transposition of the great vessels?

• outflow tracts that are parallel to each other

• outflow tracts that crisscross each other

• overriding aorta

• presence of a VSD

outflow tracts that are parallel to each other

ch 61

sonographic features of narrowing of the aortic arch, enlargement of the right ventricle, and enlargement of the pulmonary artery are characteristics of what heart defect?

• coarctation of the aorta

• tetralogy of fallot

• ebstein anomaly

• transposition of the great arteries

coarctation of the aorta

ch 61

a fetus is demonstrated to have a mass in the lung that has both cystic and solid components. Pleural effusion is also present. What disorder is indicated? 

• cystic adenomatoid malformation

• pulmonary sequestration

• pulmonary hypoplasia

• rhabdomyoma

cystic adenomatoid malformation

ch 61

an echogenic focus is demonstrated in the left ventricle of the fetal heart. What is this most likely associated with?

• trisomy 21

• trisomy 18

• trisomy 13

• turner syndrome

trisomy 21

ch 61

which condition is most commonly associated with a fetal TC/AC ratio of less than .77?

• thoracic hypoplasia

• fetal hepatosplenomegaly

• risk of macrosomia

• fetal growth restriction

thoracic hypoplasia

ch 61

which structure forms the inferior border of the thoracic cavity?

• diaphragm

• pulmonary leaflets

• apex of the heart

• atria of the heart

diaphragm

ch 61

the arrow in the following image is pointing to what? 

• foramen ovale

• ductus arteriosus

• mitral valve

• tricuspid valve

foramen ovale

ch 61

the following image demonstrates heart views in what order? (look at images top to bottom)**

• 3 vessel trachea view, RVOT, LVOT, 4 chamber

• LVOT, RVOT, 3 vessel view, 3V trachea view

• four chamber, RVOT, # V view, LVOT

• RVOT, 4 chamber, LVOT, 3v trachea view

3 vessel trachea view, RVOT, LVOT, 4 chamber

ch 61

How does blood get from the placenta to the fetal heart?

• Umbilical vein > Ductus venosus > IVC > Right ventricle

• Umbilical artery > Common iliac artery > Inferior vena cava (IVC)

• Umbilical artery > Ductus venosus > Left portal vein > IVC > Right ventricle

• Umbilical vein > Ductus arteriosus > IVC > Right ventricle

Umbilical vein > Ductus venosus > IVC > Right ventricle

ch 61

Which type of Congenital Cystic Adenomatoid Malformation (CCAM) is characterized by bulky, non-cystic lesions appearing as echo-dense masses of the entire lung lobe?

• type III

• type II

• type 1

• type IV

type III

ch 61

What type of Congenital Cystic Adenomatoid Malformation consists of multiple small cysts less than 1cm in diameter? 

• type II

• type IV

• type III

• type IV

type II

ch 61

which one of the following neural tube defects is characterized by a lack of development of the cerebral and cerebellar hemispheres and cranial vault and is an abnormality that is incompatible with life?

• acrania

• cephalocele

• dandy-Walker malformation

• anencephaly

anencephaly

ch 60

which one of the following central nervous anomalies demonstrates splaying of the cerebellar hemispheres on ultrasound?

• hydranencephaly

• cephalocele

• vein of galen malformation

• dandy-walker malformation

dandy-walker malformation

ch 60

a condition in which a complete or partial absence of the cranial bones is demonstrated is which one of the following?

• cebocephaly

• acrania

• holoprosencephaly

• hydranencephaly

acrania

ch 60

anomalies associated with anencephaly include all of the following except:

• cleft lip

• holoprosencephaly

• polyhydramnios

• spina bifida

holoprosencephaly

ch 60

which one of the following is the most severe form of holoprosencephaly and is characterized by a single common ventricle and malformed brain?

• alobar

• cephalocele

• anencephaly

• acrania

alobar

ch 60

Which one of the following anomalies may be characterized by the presence of colpocephaly?

• agenesis of the corpus callosum

• arnold-chiari malformation

• dandy-walker malformation

• holoprosencephaly

agenesis of the corpus callosum

ch 60

the absence of the cavum septi pellucidi is a distinguishing characteristic of which one of the following fetal anomalies?

• craniostenosis

• schizencephaly

• dandy-walker malformation

• agenesis of the corpus callosum

agenesis of the corpus callosum

ch 60

which one of the following defects is associated with meckel-gruber syndrome?

• anencephaly

• arachnoid cyst

• encephalocele

• hydranencephaly

encephalocele

ch 60

facial anomalies in holoprosencephaly may represent all of the following except:

• hypotelorism

• cyclopia

• hypertelorism

• flattened nose with a single nostril

hypertelorism

ch 60

which of the following signs are characteristic of the arnold-chiari malformation?

• banana- and lemon-shaped

• strawberry- and banana-shaped

• lemon- and strawberry-shaped

• cloverleaf- and banana-shaped

banana- and lemon-shaped

ch 60

which one of the following anomalies is characterized by the presence of a posterior fossa cyst and a splaying of the cerebellar hemispheres?

• agenesis of the corpus callosum

• arachnoid cyst

• dandy-walker malformation

• encephalocele

dandy-walker malformation

ch 60

which one of the following abnormalities is described as the congenital absence of the cerebral hemispheres resulting from an occlusion of the internal carotid arteries?

• hydranencephaly

• hydrocephalus

• agenesis of the corpus callosum

• holoprosencephaly

hydranencephaly

ch 60

the absence of the cavum septi pellucidi is a distinguishing characteristic of which one of the following fetal anomalies?

• craniostenosis

• schizencephaly

• dandy-walker malformation

• agenesis of the corpus callosum

agenesis of the corpus callosum

ch 60

an open spinal defect characterized by a protrusion of meninges and spinal cord through the defect, usually within a meningeal sac, is called which one of the following?

• meningocele

• spina bifida occulta

• meningomyelocele

• arnold-chiari syndrome

meningomyelocele

ch 60

conditions commonly associated with fetal hydrocephalus include all of the following except:

• choroid plexus cyst

• dandy-walker malformation

• meningomyelocele

• agenesis of the corpus callosum

choroid plexus cyst

ch 60

ventriculomegaly coupled with an enlargement of the fetal head is called which one of the following?

• hydrocephalus

• hydranencephaly

• hydronephrosis

• dandy-walker malformation

hydrocephalus

ch 60

which one of the following abnormalities is the most common open neural tube defect?

• anencephaly

• acrania

• encephalocele

• cephalocele

anencephaly

ch 60

which one of the following fetal head anomalies is characterized by the presence of a single primitive ventricle?

• arachnoid cyst

• dandy-walker malformation

• holoprosencephaly

• schizencephaly

holoprosencephaly

ch 60

a vein of Galen malformation is which one of the following abnormalities?

• an aneurysm of the Galen vein

• a rare arteriovenous malformation

• a sporadic event

• all of the above

all of the above

ch 60

a form of holoprosencephaly characterized by a common ventricle, hypotelorism, and a nose with a single nostril is which one of the following?

• lissencephaly

• cebocephaly

• ethmocephaly

• porencephaly

cebocephaly

ch 60

which one of the following statements about anencephaly is incorrect?

• the incidence of anencephaly varies with geographic location

• anencephaly is a lethal disorder

• presents as a cyst within the brain parenchyma

• anencephaly is caused by the failure of closure of the neural tube at the cranial end

presents as a cyst within the brain parenchyma

ch 60

which one of the following statements about microcephaly is incorrect?

• microcephaly is an abnormally large head

• the prognosis for fetuses with microcephaly is always poor

• microcephaly affects the head circumference

• microcephaly may manifest later in pregnancy

microcephaly is an abnormally large head

ch 60

the differential considerations of anencephaly include all of the following except:

• arachnoid cyst

• microcephaly

• acrania

• cephalocele

arachnoid cyst

ch 60

which one of the following terms is used to describe the herniation of the meninges and brain through a calvarium defect?

• dandy-walker malformation

• encephalocele

• cranial meningocele

• cebocephaly

encephalocele

ch 60

differential considerations of dandy-walker malformation should include which one of the following?

• ventriculomegaly

• arachnoid cyst

• cystic hygroma

• nuchal edema

arachnoid cyst

ch 60

ventriculomegaly is defined as lateral ventricular enlargement measuring greater than ____ millimeters (mm).

• 5

• 7

• 10

• 12

10

ch 60

the cisterna magna should not exceed ___ mm.

• 10

• 8

• 6

• 12

10

ch 60

the band of tissue that allows communication between the right and left cerebral hemispheres is known as the:

• corpus callosum

• falx cerebri

• CSP

• cerebellum

corpus callosum

ch 60

what chromosomal aberration is most often associated with holoprosencephaly?

• trisomy 13

• trisomy 18

• trisomy 21

• turner's syndrome

trisomy 13

ch 60

what is the most common cause of hydrocephalus in utero?

• aqueductal stenosis

• holoprosencephaly

• brain tumor

• cerebral hemorrhage

aqueductal stenosis

ch 60

what artery in the brain is abnormally affected with agenesis of the corpus collosum?

• pericallosal artery

• middle cerebral artery

• anterior cerebral artery

• posterior cerebral artery

pericallosal artery

ch 60

what is the cerebral disorder characterized by the absence of gyri and sulci on the surface of the fetal brain?

• lissencephaly

• porencephaly

• hydraencephaly

• schizencephaly

lissencephaly

ch 60

which fetal brain structure is affected by dandy-walker malformation?

• cerebellum

• cisterna magna

• choroid plexus

• CSP

cerebellum

ch 60

what cerebral abnormality presents with clefts in the fetal brain tissue, which are filled with cerebrospinal fluid and connected to the arachnoid space?

• schizencephaly

• holoprosencephaly

• porencephaly

• lissencephaly

schizencephaly

ch 60

what condition is defined by the absence of one or all of the cranial sutures?

• craniosynostosis

• lissencephaly

• schizencephaly

• toxoplasmosis

craniosynostosis

ch 60

what is a distinguishing feature of an arachnoid cyst in the brain?

• it does not communicate with the lateral ventricles

• it is typically filled with CSF

• it communicates with the fourth ventricle

• it presents as a hypoechoic mass with posterior shadowing

it does not communicate with the lateral ventricles

ch 60

what condition may be indicated if a large rhombencephalon is seen after 11 weeks?

• dandy-walker malformation

• meckel-gruber syndrome

• arachnoid cyst

• ventriculomegaly

dandy-walker malformation

ch 60

what syndrome is associated with occipital encephalocele?

• meckel-gruber syndrome

• beckwith-widemann syndrome

• zellweger syndrome

• russell-stover syndrome

meckel-gruber syndrome

ch 60

the following image shows which sign?

• dangling choroid plexus

• lemon

• strawberry

• banana

dangling choroid plexus

ch 60

the arrowhead is pointing to what?

• cerebellar vermis

• cerebellar hemispheres

• cisterna magna

• csp

cerebellar vermis

ch 60

the rupture of the amnion that leads to entrapment or entanglement of the fetal parts by the "sticky" chorion is called which one of the following?

• beckwith-wiedemann syndrome

• amniotic band syndrome

• pentalogy of cantrell

• gastroschisis

amniotic band syndrome

ch 62/63

a defect in the lower abdominal wall and anterior wall of the urinary bladder is which one of the following?

• bladder exstrophy

• amniotic band syndrome

• umbilical hernia

• ectopic bladder

bladder exstrophy

ch 62/63

an anomaly with large cranial defects, facial cleft, large body-wall defects, and limb abnormalities is called which one of the following?

• pentalogy of cantrell

• beckwith-wiedemann syndrome

• dandy-walker malformation

• limb-body wall complex

limb-body wall complex

ch 62/63

evaluation of the fetal abdominal wall that demonstrates evisceration of the bowel to the right of the umbilical cord is most representative of which one of the following?

• gastroschisis

• omphalocele

• limb-body wall defect

• umbilical hernia

gastroschisis

ch 62/63

if omphalocele and scoliosis are found in the fetus, which one of the following conditions should be considered?

• pentalogy of cantrell

• skeletal dysplasia

• limb-body wall complex

• amniotic band syndrome

limb-body wall complex

ch 62/63

if a low omphalocele is found in the fetus, other anomalies may include all of the following except:

• bladder or cloacal exstrophy

• anal atresia

• esophageal atresia

• spina bifida

esophageal atresia

ch 62/63

beckwith-wiedemann syndrome includes all of the following except:

• organomegaly

• macroglossia

• omphalocele

• gastroschisis

gastroschisis

ch 62/63

a gastroschisis is a consequence of atrophy of which one of the following vessels?

• right umbilical vein

• left umbilical vein

• right umbilical artery

• left umbilical artery

right umbilical vein

ch 62/63

bladder exstrophy is characterized by a defect in the lower abdominal wall and anterior wall of the urinary bladder. This abnormality may be accompanied by all of the following except:

• omphalocele

• inguinal hernia

• gastroschisis

• undescended testes

gastroschisis

ch 62/63

a critical part of the process of closing the abdominal wall is which one of the following?

• herniation of the midgut

• embryonic folding

• shortening of the neural tube

• expansion of the amniotic cavity

embryonic folding

ch 62/63

the normal embryologic herniation of the bowel permits which one of the following?

• expansion of the thorax

• development of the intra-abdominal organs

• development of the umbilical cord

• development of the diaphragm

development of the intra-abdominal organs

ch 62/63

which one of the following statements about an omphalocele is correct?

• the herniation is covered by a membrane that consists of amnion and chorion

• an omphalocele that contains only bowel has a higher risk for chromosomal abnormalities

• the maternal serum alpha-fetoprotein (MSAFP) level will be significantly elevated

• an omphalocele is a periumbilical defect located to the right of the umbilicus

an omphalocele that contains only bowel has a higher risk for chromosomal abnormalities

ch 62/63

a 19-week fetus with elevated MSAFP shows herniated, free-floating bowel loops, which most likely represent a(n) ____.

• omphalocele

• umbilical hernia

• gastroschisis

• jejunoileal atresia

gastroschisis

ch 62/63

the five defects of pentalogy of cantrell include which of the following?

• omphalocele, ectopic lung, proximal sternum defect, diaphragmatic hernia, and anterior pericardium

• gastroschisis, ectopic heart, proximal sternum defect, diaphragmatic hernia, and anterior pericardium

• omphalocele, ectopic heart, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium

• gastroschisis, ectopic lung, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium

omphalocele, ectopic heart, distal sternum defect, diaphragmatic hernia, and diaphragmatic pericardium

ch 62/63

which one of the following statements about a gastroschisis is false?

• gastroschisis is found more frequently in males

• gastroschisis is located next to the normal cord insertion

• MSAFP levels are significantly elevated

• small bowel is not always found in the herniation

small bowel is not always found in the herniation

ch 62/63

the prognosis for an infant with an uncomplicated gastroschisis is which one of the following?

• excellent

• moderate

• poor

• extremely poor

excellent

ch 62/63

the most dramatic finding in ectopia cordis is which one of the following?

• cleft lip and palate

• umbilical vein separate from the umbilical arteries

• heart outside of the thoracic cavity

• omphalocele

heart outside of the thoracic cavity

ch 62/63

a high or superumbilical omphalocele is usually the primary finding in which one of the following conditions?

• limb-body wall complex

• beckwith-wiedemann syndrome

• meckel-gruber syndrome

• pentalogy of cantrell

pentalogy of cantrell

ch 62/63

limb-body wall defects are more common:

• on the right side than the left side

• on the left side than the right side

• in females

• anteriorly than posteriorly

on the left side than the right side

ch 62/63

the herniation of an omphalocele is covered by a membrane that consists of the ____ and ____.

• amnion; chorion

• amnion; peritoneum

• chorion; wharton's jelly

• amnion; wharton's jelly

amnion; peritoneum

ch 62/63

the umbilical vein drains all of the following except the:

• placenta

• body stalk

• yolk sac

• evolving abdominal wall

yolk sac

ch 62/63

the hepatic bud enlarges and the right umbilical vein atrophies during the ____ gestational week.

• sixth

• seventh

• eighth

• ninth

seventh

ch 62/63

which of the following types of anterior abdominal wall defects are the most common?

• gastroschisis, inguinal hernia, and ectopia cordis

• omphalocele, inguinal hernia, and umbilical hernia

• gastroschisis, umbilical hernia, and omphalocele

• omphalocele, gastroschisis, and limb-body wall complex

gastroschisis, umbilical hernia, and omphalocele

ch 62/63

all of the following are clinical or sonographic findings consistent with LBWC except:

• ventral wall defects

• decreased MSAFP

• marked scoliosis

• shortened umbilical cord

decreased MSAFP

ch 62/63