Deck 20: First Trimester Obstetrics 0 to 12 Weeks

Question 1

The embryonic gut herniates

A) into the small bowel.
B) at 5 to 6 weeks GA.
C) into the base of the umbilical cord.
D) into the amnion.

Answer 1

C
The embryonic gut herniates into the base of the umbilical cord and returns to the fetal abdomen by the gestational week 12.

Question 2

Progesterone is produced by the

A) uterus.
B) pituitary gland.
C) corpus luteum.
D) none of the above

Answer 2

C
The corpus luteum produces progesterone and a small amount of estrogen to prepare the uterus for implantation.

Question 3

Human chorionic gonadotropin (hCG) is secreted by the developing:

A) ovary.
B) oviduct.
C) zygote.
D) placenta.

Answer 3

D
HCG is secreted by the developing placenta to communicate to the rest of the body that a gestation is present.

Question 4

The amniotic fluid volume (AFV) normally is reduced by

A) fetal regurgitation.
B) maternal urination.
C) fetal swallowing.
D) fetal urination.

Question 5

A sonographic marker of the chorionic cavity is

A) echogenic.
B) anechoic.
C) hyperechoic.
D) triple line.

Question 6

The embryo is sonographically visible with transvaginal scanning

A) as early as 3 to 4 weeks of gestational age (GA).
B) when it retreats from the amnion.
C) at 5 to 6 weeks GA.
D) after obliteration of the chorionic cavity.

Question 7

Lacunae are structures in the

A) ovary.
B) fetal brain.
C) amnion.
D) placenta.

Question 8

The embryo's sonographic appearance is

A) echogenic.
B) anechoic.
C) heterogeneous.
D) complex.

Question 9

On a short axis view, the umbilical cord presents as

A) a single large, round, anechoic vessel flanked by two small, round, anechoic vessels encircled by thick, bright walls.
B) a single small, round, anechoic vessel interposed between two large, round, hypoechoic vessels.
C) two linear, anechoic vessels with bright walls that join the fetal portal vein and a single linear, anechoic vessel with hyperechoic walls that joins the urinary bladder.
D) a single large, anechoic vessel flanked by two linear, anechoic vessels.

Question 10

What is the first structure identified within the gestational sac?

A) Amniotic membrane
B) Yolk sac
C) Double bleb sign
D) Synechia

Question 11

The term gestational sac describes the

A) endometrial cavity.
B) pseudo sac.
C) yolk sac.
D) chorionic cavity.

Question 12

The most accurate method of dating gestation is the

A) sac size.
B) crown-rump length (CRL).
C) biparietal diameter.
D) femur length.

Question 13

Which is NOT a common indication for a 1st trimester ultrasound examination?

A) Vaginal bleeding
B) Size bigger than dates
C) Size smaller than dates
D) Lack of sensation of fetal movement

Question 14

The embryonic primative heart starts to beat at the beginning of which gestational week?

A) week 4
B) week 6
C) week 8
D) week 10

Question 15

Separation of chorion and amnion membranes at 14 weeks is

A) within normal limits.
B) a sign of twins.
C) due to a large yolk sac.
D) a sign of fetal death.

Question 16

Myometrial contractions are distinguished from a myoma by their:

A) outward bulge
B) echogenicity
C) inward bulge
D) location

Question 17

The secondary yolk sac can

A) be bigger than the embryo.
B) be cystic in appearance.
C) be visualized before the embryo.
D) all of the above

Question 18

The secondary yolk sac is

A) outside both the chorion and the amnion.
B) inside both the chorion and the amnion.
C) outside the amnion but inside the chorion.
D) outside the chorion but inside the amnion.

Question 19

The chorionic frondosum eventually becomes the:

A) amniotic cavity.
B) chorionic cavity.
C) yolk sac.
D) placenta.

Question 20

An anechoic area identified sonographically in the embryonic skull at 8 weeks is

A) abnormal.
B) the vitelline duct.
C) the hindbrain.
D) the midbrain.

Question 21

The double sac sign

A) describes the early blastocyst.
B) distinguishes a pseudo sac from a gestational sac.
C) is eventually obliterated by the amniotic cavity.
D) describes the sonographic appearance of the trilaminar embryonic disk.

Question 22

What is the corpus luteum?

A) The outermost tissues of the developing embryo
B) The part of early development that surrounds the amniotic cavity
C) The trophoblast layer of the blastocyst
D) What remains of the ovarian follicle after ovulation

Question 23

The double bleb sign

A) describes the early blastocyst.
B) is the sonographic appearance of the embryo disk lying between the secondary yolk sac and developing amniotic cavity.
C) distinguishes a pseudo sac from a gestational sac.
D) is eventually obliterated by the amniotic cavity.

Question 24

Membranes formed from scarring or adhesions secondary to surgery or infection are called

A) succenturiate.
B) uterine synechia.
C) amniotic bands.
D) amnion-chorionic separation.

Question 25

The corpus luteum

A) may become enlarged and cystic.
B) is an abnormality.
C) contains the yolk sac.
D) is eventually obliterated by the amniotic cavity.

Question 26

The gestational age in days is calculated by

A) dividing the mean sac diameter by 30.
B) dividing the largest sac dimension by 30.
C) volume measurement of the gestational sac.
D) adding 30 to the mean sac diameter.

Question 27

The chorionic villi

A) may become enlarged and cystic.
B) contain the yolk sac.
C) are eventually obliterated by the amniotic cavity.
D) are fingerlike projections of the trophoblast layer that extend into the deciduate endometrium.

Question 28

The fluid-filled ________ cavity appears slightly hyperechoic to the anechoic ______ cavity because of low-level echoes produced by protein and albumin.

A) blastocyst, amniotic
B) amniotic, chorionic
C) blastocyst, chorionic
D) chorionic, amniotic

Question 29

Gestational age determined by the size of the gestational sac uses

A) two right angle measurements in a longitudinal section.
B) the mean sac diameter (MSD).
C) addition of the number 30 to the sac depth.
D) addition of the number 30 to the CRL.