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ARDMS OBSTETRICS /ARDMS OB/GYN ACTUAL
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What is the most accurate sonographic measurement during the first trimester? - CORRECT ANSWER>>CRL (Crown Rump Length) Why is the CRL no longer considered accurate after the 12th week of gestation? - CORRECT ANSWER>>Because of the flexion and extension of the active fetus. What is the first and most widely accepted means of measuring the fetal head and estimating fetal age? - CORRECT ANSWER>>BPD (Biparietal Diameter)
What level should the BPD be measured at? - CORRECT ANSWER>>At the level of the thalamus and the cave septum pellucidum How should the calipers be placed to measure the BPD? - CORRECT ANSWER>>Outer edge to inner edge (Leading edge) What is another valuable measurement of the fetal head to asses gestational age?
- CORRECT ANSWER>>Head circumference What is the cephalic index formula? - CORRECT ANSWER>>BPD/OFDx
- Biparietal diameter
- Occipitofrontal diameter What is the normal cephalic index? - CORRECT ANSWER>>75% to 85%
What measurement is more useful as a growth parameter than predicting gestational age? - CORRECT ANSWER>>Abdominal circumference (AC) What level should the abdominal circumference be measured? - CORRECT ANSWER>>In the tv plane at the level of the umbilical vein as it joins the left portal vein within the liver What is the first trimester risk sonographic examination also called? - CORRECT ANSWER>>The nuchal translucency examination What does the nuchal translucency examination measure? - CORRECT ANSWER>>1. Measurement of the nuchal translucency
2. CRL (Crown-Rump Length)
3. Visualization of the fetal nasal bone What does the standard obstetric sonography examination evaluate? - CORRECT ANSWER>>1. Gestational age by fetal biometry 2. Fetal number 3. Placental position 4. Cardiac activity 5. AFI (Amniotic Fluid Index) 6. Fetal anatomic survey Define gravidity - CORRECT ANSWER>>The number of pregnancies Define parity - CORRECT ANSWER>>A numeric system that describes all possible pregnancies
How long is the second trimester? - CORRECT ANSWER>>From 14 weeks to 26 weeks and 6 days. How long is the third trimester? - CORRECT ANSWER>>Begins at 27 weeks gestation until term. What is Nagele's rule? - CORRECT ANSWER>>EDD (Estimated Due Date) = 3 months from LMP + 7 days What fetal biometry is used in the estimate in fetal weight? - CORRECT ANSWER>>AC (Abdominal Circumference) What is conceptual age also known as? - CORRECT ANSWER>>Embryonic age
What is conceptual age? - CORRECT ANSWER>>With conception as the first day of pregnancy What is gestational age? - CORRECT ANSWER>>Considers the first day of the last menstrual period as the beginning of gestation What is gestational age also known as? - CORRECT ANSWER>>Menstrual age What is the conceptus called during the implantation process? - CORRECT ANSWER>>A zygote What is the zygote called from the implantation to 10 weeks? - CORRECT ANSWER>>An embryo
What does the anechoic center is the first trimester represent? - CORRECT ANSWER>>Chorionic cavity What does the echogenic rim surrounding the chorionic cavity represent in the first trimester ultrasound? - CORRECT ANSWER>>Desidual reaction What is the first structure seen in the intragestational sac? - CORRECT ANSWER>>The secondary yolk sac What are the functions of the secondary yolk sac? - CORRECT ANSWER>>1. Provision of nutrients to the embryo
2. Hematopoiesis (the formation of blood or of blood cells) 3. Development of the embryonic endoderm
What should a talk sac NOT exceed? - CORRECT ANSWER>>6mm *Enlarged yolk sacs may have threatening outcomes True or False The number of yolk sacs are not consistent with the number of amnion membranes - CORRECT ANSWER>>False It is very consistent with the number amnion membranes When is the yolk sac reabsorbed and never seen again? - CORRECT ANSWER>>12 weeks Define chorioamniotic fusion - CORRECT ANSWER>>Fusion of the membranes When does chorioamniotic fusion occur? - CORRECT ANSWER>> 14 - 1 5 weeks
What does the rhombencephalon divide into?
- CORRECT ANSWER>>- Metencephalon (Cephalic portion) - Myelencephalon (Caudal portion) What appears in the 4-5 week of gestation? - CORRECT ANSWER>>The gestational sac What appears in the 5th week of gestation? - CORRECT ANSWER>>Yolk sac What is seen in the 5.5-6 weeks of gestation? - CORRECT ANSWER>>Fetal heartbeat What is two structures are seen sonographically in the 7.5 weeks of gestation?
CORRECT ANSWER>>-Spine
When are the upper limbs seen sonographically? - CORRECT ANSWER>> 8 weeks When are the the body movements and midline falx seen? - CORRECT ANSWER>>9 weeks What is seen sonographically in the 9.5 week of gestation? - CORRECT ANSWER>>- Midgut herniation
- Choroid plexus
- Hindbrain What forms the fourth ventricle and part of the aqueduct of Sylvius? - CORRECT ANSWER>>The enclosing of the rhomboid fossa by the medulla, medullar oblongata, and the cerebellum.
How to calculate the menstrual age - CORRECT ANSWER>>MSD (mm) + 30 = Menstrual age (days) Menstrual age (days) / 7 = Menstrual age (weeks) What is the marker for the beginning of CRL measurements? - CORRECT ANSWER>>The embryonic heart motion The CRL is considered accurate until what week? - CORRECT ANSWER>>12th week Why is the CRL not considered accurate after 12 weeks? - CORRECT ANSWER>>Because at this time the fetus begins to "curl" into the fetal position, making the measurement of length more difficult.
What measurements are used after 13 weeks (second trimester) for pregnancy dating? - CORRECT ANSWER>>1. BPD (Biparietal Diameter)
- FL (Femur Length) What combined test is the standard for first trimester risk assessment? - CORRECT ANSWER>>1. Maternal age 2. The nuchal translucency measurement 3. Biochemistry analyses for hCG and PAPP-A What is the small pocket of fluid along the back of the fetus? - CORRECT ANSWER>>Nuchal translucency What sonographic appearance is associated with trisomy 21 in the first trimester? - CORRECT ANSWER>>Absence of the fetal nasal bone
- One yolk sac
- One amniotic membrane
- Two embryos within a single amniotic cavity What may an early sign of twin-to-twin transfusion? - CORRECT ANSWER>>Differences in the NT measurements Define threatened abortion - CORRECT ANSWER>>Pregnancies of fewer than 20 weeks with a: - Heartbeat
- Viable embryo
- Vaginal Bleeding What is the diagnosis of a threatened abortion? - CORRECT ANSWER>>It is made when the cervix is long and closed in a patient with vaginal bleeding Define embryonic demise - CORRECT ANSWER>>The term is used when there is clear evidence of a nonviable embryo What is another term for blighted ovum? - CORRECT ANSWER>>Anembryonic pregnancy Define a blighted ovum - CORRECT ANSWER>>A gestational sac in which the embryo fails to develop or stops developing at such an early stage that it is imperceptible by ultrasound.
