OB II Final Exam

What procedure is done earliest in a pregnancy?

Chorionic Villus Sampling (Early Gestation - 10-12 wks for women at high risk of abnormal birth)

In second trimester, the normal heart rate ranges between

120 and 160 bpm

A structure commonly visualized anterior to the great vessels and superior vena cava is the

thymus gland (anterior to the great vessels and SVC with high frequency imaging)

The lateral fissure, or sylvian fissure, separates the

frontal and temporal lobes

Type ____ classification of osteogensis imperfecta is considered the most severe?

Type II

Which of the following about achondroplasia is incorrect?

1. Advanced maternal age is a risk factor.

2. Patients with heterozygous achondroplasia have a poor survival rate.

3. Achondroplasia is most commonly the result of a spontaneous mutation.

4. achondroplasia results from decreased endochondral bone formation.

2. Patients with heterozygous achondroplasis have a poor survival rate. (Incorrect because heterozygous has a good survival rate)

Which one of the following anomalies is assoicated with the Amish community?

Ellis-van Creveld syndrome

A lethal skeletal dysplasia characterized by short ribs, short limbs and polydactyly is which one of the following?

Short-rib polydactyly

The testes are not visible within the scrotal sack until approximately ____ weeks of gestation

24

Sonographic findings in Prune Belly syndrome include all the following except

1. Oligohydramnios

2. Dilated prostatic urethra

3. fetal ascites

4. renal agenesis

4. renal agenesis

Renal agenesis, oligohydramnios, pulmonary hypoplasia, abnormal facies, And malform hands and feet may be found in what condition?

Potter Syndrome

Most common characteristics of multicystic dysplastic kidney disease?

Multiple non communicating cysts of variable size

A fetus with dilated of echogenic bowels should be evaluated for all of the following except

1. Cystic fibrosis

2. meconium peritonitis

3. duodenal atresia

4. bowel obstruction

3. duodenal atresia

Coexisting anomalies of fetuses with esophageal atresia include all the following except

1. vertebral defects

2. renal anomalies

3. cardiac defects

4. ascites

4. Ascites

A high or superumbilical omphalocele is usually the primary finding of what condition?

Pentalogy of Cantrell

The presence of plural effusion may cause what to occur?

A shift of mediastinal structures

Conditions commonly associated with fetal hydrocephalus include all the following except

1. Choroid plexus cyst

2. Dandy-Walker malformation

3. meningomyelocele

4. Agenesis of the corpus callosum

1. Choroid plexus cyst

Which one of the following statements about anencephaly is incorrect?

1. The incidence of anencephaly varies with geographic location.

2. Anencephaly is a lethal disorder.

3. Presents as a cyst within the brain parenchyma

4. Anencephaly is caused by the failure of closure of the neural tube at the cranial end.

3. Presents as a cyst within the brain parenchyma

What is produced by the umbilical cord and membranes and the fetal lungs skin and kidneys?

Amniotic fluid

Syndactylism (think fused fingers or toes) is most likely the result of which condition

Amniotic bands

The fetal production of urine and the ability to swallow began during which of the following weeks of gestation?

8 to 11 weeks

What is the most common neck mass?

Cystic hygroma colli (lymphatic obstruction)

Facial anomalies in holoprosencephaly may represent all of the following except

1. hypotelorism

2. cyclopia

3. hypertelorism

4. flattened nose with a single nostril

hypertelorism

Congenital bronchial atresia is found most commonly in the _____ lobe

left upper

A 19-week fetus with elevated MSAFP shows herniated, free-floating bowel loops, which mostly likely represents a(n) _____

Gastroschisis

What is the most dramatic finding in ectopia cordis?

Heart outside of the thoracic cavity

The sonographic criteria for choledochal cyst include all of the following except

1. Close proximity of the cyst to the neck of the gallbladder

2. Decreased size of a cyst in the gallbladder on serial examinations

3. Ovoid right upper-quadrant cyst with an entering bile duct

4. Absence of peristalsis within the cyst

2. Decreased size of a cyst in the gallbladder on serial examinations

The derivatives of the hindgut include all of the follow except:

1. descending colon

2. sigmoid colon

3. cecum

4. urethra

3. cecum

What describes total situs inversus?

Heart on the right, the liver is on the left, and the spleen is on the right (heart & abdominal organs are completely reversed)

A fetus with partial situs inversus demonstrates which of the following abnormalities?

Only heart OR abdominal organs are reversed - stomach on the right, and the heart is on the left

Protrusion of the posterior wall of the urinary bladder, which contains the trigone of the bladder and the ureteric orifices, is called _____?

Exstrophy of the bladder

The kidneys initally lie in what position?

very close together in the pelvis

Sonographic findings in complete renal agenesis include all of the following except

1. oligohydramnios

2. absence of urine in the fetal bladder

3. dilated fetal bladder

4. small thorax

3. dilated fetal bladder

Which condition is caused by cartilage abnormalities that result in abnormal bone formation and hypomineralization?

Achondrogenesis

Sonographic findings of severe micromelia, decreased or absent ossification of the spine, macrocephaly and micrognathia describe what condition?

Achondrogenesis

The lateral ventricles communicate with the third ventricle through the _____

interventricular foramina of monro

What is the echogenicty of the sylvian fissure?

Echogenic

How much of the thoracic area should the heart occupy?

1/3

With increasing gestational age, what percentage larger can the right ventricle normally be compared to the left ventricle?

20%

If twin fetuses are of opposite gender, they are always

dichorionic and diamniotic

True or False: The aorta normally arises from the right ventricle

False (arises from the left ventricle)

Fetal intravascular transfusion is recommended in fetuses with

Severe Hydrops 

The main pulmonary artery is connected to the descending aorta by the 

Ductus arteriosus 

What can be given to the neonate after birth to allow the ductus arteriosus to remain patent until surgery can be performed

Prostaglandin E (Alprostadil)

The transverse fissure separates the

Cerebrum from the Cerebellum 

The majority of talipes (clubfoot) is 

Idiopathic

Webbing across the joint and multiple contractures are sonographic findings of what abnormality?

Lethal multiple pterygium syndrome 

Sonographic features of a small thorax, rhizomelia, renal dysplasia and polydactyly area associated with what condition?

Jeune syndrome (ATD)

A rare condition characterized by phocomelia and facial anomalies is what syndrome?

Roberts syndrome 

The normal AP diameter of the renal pelvis at 20 weeks gestation should not exceed

4 mm 

Sonographic findings in the posterior urethral valve obstruction include all of the following except

1. Hydronephrosis

2. Hydroureter

3. Bladder Dilatation

4. Thinning of the bladder wall

4. Thinning of the bladder wall

The permanent kidneys arise from the 

metanephros (develops in the 5th gestational week)

The bladder wall thickness in a fetus is normally 

2 mm or less

Haustral folds can be found within which structure?

colon 

The most common type of diaphragmatic defect occurs

posteriorly and laterally 

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

1. Esophageal atresia

2. Bladder or cloacal exstrophy

3. A n a l atresia

4. Spina bifida

1. Esophageal atresia

Ventriculomegaly is defined as lateral ventricular enlargement measuring greater than

10 mm

Hypotelorism (think eyes too close together) or proboscis (think tube-like nasal growth) suggests what abnormality?

Holoprosencephaly

Evaluation of the nasal triad should include all of the following except 

1. nostril symmetry

2. nostril length

3. nasal septum integrity

4. continuity of the upper lip

2. nostril length

What is the suspected cause of the amniotic sheets 

Synechiae

Amniotic fluid may appear generous during 

20 - 30 weeks of gestation 

Which one of the following statements about a fetal goiter is incorrect? 

1. fetal goiter appears symmetric

2. fetal goiter appears heterogeneous

3. mass arises from the anterior neck

4. fetal goiter is associated with maternal thyroid disease

2. fetal goiter appears heterogeneous

A form of holoprosencephaly characterized by a common ventricle, hypotelorism, and a nose with a single nostril is what? 

Cebocephaly

Which central nervous anomalies demonstrates splaying of the cerebellar hemispheres on ultrasound? 

Dandy-walker malformation

What is the most common lung cysts detected prenatally? 

Bronchogenic cyst

What are the 3 most common types of anterior abdominal wall defects? 

Gastrochisis, umbilical hernia, and omphalocele

VACTERL is a group on anomalies associated with what form of atresia?

Anorectal atresia

A transposition of the liver and stomach, an absence of the gallbladder, multiple spleens, and a disruption of the IVC describes which condition? 

Polysplenia (more than one spleen)

What is the most likely cause of bilateral hydronephrosis in the fetus?

Bladder outlet obstruction 

The “hamburger” sign refers to: 

Labia

Fusion of the lower extremities is associated with what condition? 

Sirenomelia 

What is the echogenicity of the quadrigeminal plate cistern? 

Echogenic 

The structures of the brain stem are:

The pons, midbrain, and medulla oblongata

The central fissure separates the: 

Parietal and frontal lobes 

What is the echogenicity of the lateral ventricle? 

Anechoic

Where does the beam isonate first in the basal four-chamber view of the heart? 

Base

What controls the opening between the right atrium and ventricle? 

Tricuspid valve

Normal arrangement of the abdominal and thoracic organs is referred to as:

Situs solitus

What biophysical profile score for gross movement would a fetus receive for two separate body movements in a 30 minute examination?

0

True or False: Twin gestations only result from fertilization of single ovum.

False

When evaluating the ascending aorta superior to the LVOT view, what is the first branch coming off the aortic arch?

brachiocephalic artery

At the entrance of the liver, the umbilical vein branches into what?

ductus venosus

True or False: The diameter of the main pulmonary artery, before it gives off branches, should equal to or slightly larger than the diameter of the ascending aorta

True

What term describes a shortening of the proximal portion of the extremity?

Rhizomelia

All of the following findings are observed in hydronephrosis except:

1. anteroposterior (AP) renal pelvic diameter is greater than 5 to 10 mm

2. rim of renal parenchyma is preserved

3. calyceal distention is seen with central pelvis communication

4. renal enlargement is found

4. renal enlargement is found

What is the most reliable criterion for diagnosing dilated bowel?

Bowel diameter

In a transverse image, evidence of the “double bubble” sign in a fetus with trisomy 21 represents what condition?

Duodenal atresia

What is the remnant of the proximal yolk stalk

Meckel diverticulum

Which one of the following statements about the fetal liver is incorrect?

1. The fetal liver is large compared with other intraabdominal organs

2. The hepatic veins and fissures are formed by the end of the first trimester

3. The right lobe is larger than the left lobe in utero

4. The liver occupies most of the upper abdomen

3. The right lobe is larger than the left lobe in utero

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

1. Expansion of the thorax

2. Development of the intra-abdominal organs

3. Developmental of the umbilical cord

4. Development of the diaphragm

2. Development of the intra-abdominal organs

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

high

Which one of the following statements about the fetal face is false?

1. The fetal profile is well imaged with transvaginal sonography beginning late in the first trimester to early in the second trimester.

2. The modified coronal view is best to image a cleft lip and palate

3. The maxilla and orbits are well imaged in a true sagittal plane

4. The longitudinal view demonstrates the nasal bones, soft tissue, and mandible

3. The maxilla and orbits are well imaged in a true sagittal plane

What term describes a small chin?

Micrognathia

Oligohydramnios is associated with all of the following except:

1. renal agenesis

2. gastrointestinal disorders

3. premature rupture of the intrauterine membranes (PROM)

4. postdate pregnancy

2. gastrointestinal disorders