Obstetric and Gynecologic Sonography
Exam Answer Key
Course Introduction
Obstetric and Gynecologic Sonography is a specialized course focusing on the application of ultrasound imaging techniques in the assessment and management of female reproductive health and pregnancy. The course provides comprehensive coverage of sonographic anatomy and physiology, principles of ultrasound physics, and image acquisition. Students will learn to perform and interpret sonographic examinations for obstetric patients across all trimesters, including fetal growth assessment, identification of congenital anomalies, and evaluation of high-risk pregnancies. Additionally, the course covers gynecologic imaging for the assessment of pelvic organs, detection of pathologies such as fibroids and ovarian cysts, and infertility evaluations. Emphasis is placed on patient care, safety, and professional standards in the clinical practice of obstetric and gynecologic sonography.
Recommended Textbook
Sonography Introduction to Normal Structure and Function 3rd Edition by Reva Arnez Curry
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Chapter 1: Before and After the Ultrasound Examination
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Sample Questions
Q1) Fever and chills ´ 3 days ____
Answer: CH
"Fever and chills ´ 3 days" describes clinical symptoms (clinical history).
Q2) The sonographer should always provide the interpretive report. _____
A)True
B)False
Answer: False
Q3) Laboratory values are part of the patient's clinical history. ____
A)True
B)False
Answer: True
Q4) An assessment/treatment plan is listed on the ultrasound request form.____
A)True
B)False
Answer: False
Q5) The ultrasound request form indicates whether the examination is a regularly scheduled exam or a "stat" exam. ____
A)True
B)False
Answer: True
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Chapter 2: Ultrasound Instrumentation: Knobology, Imaging Processing, and Storage
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Sample Questions
Q1) The trace function
A) places cursors for distance measurement.
B) erases cursors, outlines, and measurement results.
C) places cursors for distance and transverse measurements.
D) outlines circumference measurements.
Answer: D
Q2) The body pattern control
A) displays the body pattern to indicate patient positioning.
B) adjusts automatically when the patient is turned to another position.
C) allows pulsed wave and M-mode images to overlie the body pattern.
D) adjusts the detail for images.
Answer: A
Q3) Explain why it is important to learn the knobology of the ultrasound system.
Answer: The sonographer's knowledge of knobology allows for optimum manipulation of system controls to produce images of diagnostic quality. Sonographers must master the ultrasound system controls to produce these optimum images and to retrieve diagnostic information from the ultrasound examination.
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Page 4
Chapter 3: General Patient Care
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Sample Questions
Q1) What action conveys a sense of genuine interest in the patient?
A) Making small talk
B) Adjusting the tone and expression of your voice
C) Obtaining a medical history
D) Discussing your opinion of the ultrasound findings
Answer: B
Q2) A sterile field is created by ________________________________. To maintain a sterile field, _________________________.
Answer: placing prepackaged sterile drapes around the cleaned site; all items that enter the sterile field must be sterile.
A sterile field is created by placing prepackaged sterile drapes around the cleaned site. To maintain a sterile field, all items that enter the field must be sterile.
Q3) During an ultrasound examination, it is acceptable for a sonographer to
A) show the patient any abnormal findings.
B) discuss his or her opinion of the ultrasound findings.
C) provide a diagnosis.
D) briefly point out one or more structures.
Answer: D
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Chapter 4: First Scanning Experience
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Sample Questions
Q1) Coronal planes divide the body into unequal ________ and ________ sections.
Q2) The term through transmission is synonymous with A) sound attenuation.
B) posterior enhancement.
C) acoustic shadowing.
D) infiltrative process.
Q3) Long axis measurements are taken in either the sagittal or coronal scanning plane.
A)True
B)False
Q4) With regard to composition, a mass is classified as ______, ______, or ______.
Q5) When an organ is described as hypoechoic to another organ, this means that A) one organ is brighter relative to the other.
B) one organ is less echogenic relative to the other.
C) one organ is visualized inferior to the other.
D) one organ is visualized posterior to the other.
Q6) With regard to echo texture characteristics, a disease can be described as _________ or __________.
Q7) Normal muscle echo texture appears _______ with ______ echogenicity.
Page 6
Q8) Transverse planes divide the body into unequal ______ and _________ sections.
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Chapter 5: Interdependent Body Systems
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Sample Questions
Q1) Tendons connect bones to bones. ____
A)True
B)False
Q2) Which organ allows free mixing of oxygenated and deoxygenated blood within the sinusoids?
A) Liver
B) Kidneys
C) Pancreas
D) Spleen
Q3) The nervous system uses long-term coordination of responses to stimuli to help maintain homeostasis. ____
A)True
B)False
Q4) Homeostasis is defined as _____________________________________________________.
Q5) The hypothalamus directly communicates with the pituitary gland. ____
A)True
B)False
Q6) The paired lungs enclose the branching bronchial tree and alveoli. ____
A)True
B)False
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Chapter 6: Anatomy Layering and Sectional Anatomy
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Q1) In gross anatomy, the splenic vein is oriented ________ and courses _________ to the body of the pancreas.
A) vertically, medial
B) horizontally, posterior
C) vertically oblique, posterior
D) horizontal oblique, anterior
Q2) The lesser sac
A) extends from the diaphragm to the pelvis and covers the width of the abdomen.
B) is a diverticulum of the greater sac located posterior to the stomach.
C) is a double layer of peritoneum that extends from the stomach to adjacent abdominal organs.
D) attaches to the anterior surface of the transverse colon.
Q3) In gross anatomy, the abdominal aorta is located ___________ to the left kidney. A) medial
B) lateral
C) inferior
D) anterior
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Chapter 7: Embryology
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Sample Questions
Q1) The ductus venosus shunts blood from the umbilical vein to the IVC. ____
A)True
B)False
Q2) Ventral and dorsal diverticula of the primitive hindgut rotate to form the pancreas.
A)True
B)False
Q3) Neural development continues postnatally. ____
A)True
B)False
Q4) About 50% of ectopic thyroids are lingual in nature. ____
A)True
B)False
Q5) After birth, the umbilical vein becomes the ligamentum venosum, and the ductus venosus becomes the ligamentum teres. ____
A)True
B)False
Q6) Most organogenesis takes place during the fetal stage. ____
A)True
B)False
Page 9
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Chapter 8: The Abdominal Aorta
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Sample Questions
Q1) The common hepatic artery branches into the A) celiac and gastroduodenal arteries.
B) celiac and splenic arteries.
C) gastroduodenal and proper hepatic arteries.
D) proper hepatic and celiac arteries.
Q2) The aorta becomes the abdominal aorta
A) when it leaves the left ventricular outflow tract.
B) when it follows a candy cane-shaped loop down into the thoracic cavity.
C) before it reaches the aortic hiatus on the diaphragm.
D) after it reaches the aortic hiatus on the diaphragm.
Q3) The superior mesenteric artery (SMA) can be seen with reasonable consistency on ultrasound. ____
A)True
B)False
Q4) The celiac artery (CA) can be seen with reasonable consistency on ultrasound.
A)True
B)False
Q5) Splenic artery ____
Q6) Splenic vein ____
Page 10
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Chapter 9: The Inferior Vena Cava
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Sample Questions
Q1) The left hepatic vein is easily seen on ultrasound. ____
A)True
B)False
Q2) Aorta ____
Q3) The left common iliac vein is easily seen on ultrasound. ____
A)True
B)False
Q4) Body of the liver ____
Q5) Intestines ____
Q6) In a sagittal scanning plane, the right renal artery can be seen as a(n)
A) longitudinal, curvilinear structure anterior to the axial IVC.
B) straight structure posterior to the AO.
C) round, short axis structure posterior to the longitudinal IVC.
D) oval structure anterior to the longitudinal IVC.
Q7) The right renal vein is easily seen on ultrasound. ____
A)True B)False
Q8) The hepatic veins are anechoic. ____
A)True
B)False
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Chapter 10: The Portal Venous System
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Sample Questions
Q1) Superior mesenteric vein walls ____
Q2) The bifurcation of the right portal vein is best seen in a sagittal scanning plane.
A)True
B)False
Q3) The medial branch of the left portal vein is easier to visualize than the lateral branch.
A)True
B)False
Q4) Tributaries of the portal vein include which vessels?
A) Right and left gastric veins and pancreaticoduodenal veins
B) Splenic and superior and inferior mesenteric veins
C) Gastroepiploic and right and left gastric veins
D) All of the above
Q5) In a transverse scanning plane, the main portal vein initially appears in an axial section as an oval, anechoic structure. ____
A)True B)False
Q6) Portal venous walls ____
Q7) Superior mesenteric vein lumen ____
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Chapter 11: Abdominal Vasculature
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Sample Questions
Q1) High resistance Doppler spectral waveforms recorded throughout the renal medulla and cortex suggest
A) proximal renal artery stenosis.
B) flow-limiting disease in the distal renal artery.
C) intrinsic medical renal disease.
D) the presence of accessory renal arteries.
Q2) Blood flow in the right, middle, and left hepatic veins is characterized by
A) four phases of flow: two away from the heart and two toward the heart.
B) three phases of flow: two toward the heart and a phase of systolic flow reversal.
C) three phases of flow: one toward the heart and then two away from the heart.
D) four phases of flow: two toward the heart followed by two away from the heart.
Q3) Which is NOT a tributary of the inferior vena cava?
A) Hepatic vein
B) Portal vein
C) Renal vein
D) Right suprarenal vein
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Chapter 12: The Liver
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Sample Questions
Q1) The portal system supplies _____ of the total blood flow to the liver.
A) 25%
B) 30%
C) 50%
D) 75%
Q2) The main lobar fissure represents a
A) marker identifying the falciform ligament.
B) boundary between the right and left lobes.
C) division between the medial and lateral portions of the left lobe.
D) landmark fissure of the caudate lobe.
Q3) Cholesterol ______
Q4) Tumor invasion of the portal vein may be observed in association with cancerous lesions of the liver or with metastases. Color Doppler scanning demonstrates tumor vascularity within the portal vein lesion by the presentation of: high resistance venous signals.
A) low resistance venous signals
B) low resistance arterial signals
C) high resistance venous signals
D) high resistance arterial signals.
Q5) Glycogenesis ______
14
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Chapter 13: The Biliary System
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Sample Questions
Q1) The gastroduodenal artery is a branch of the A) celiac artery.
B) proper hepatic artery.
C) splenic artery.
D) common hepatic artery.
Q2) Length of the right and left hepatic ducts ____
Q3) The cystic duct is routinely seen on ultrasound. ____
A)True
B)False
Q4) The relationship of the gallbladder and the right kidney can be stated as:
A) The right kidney is anterior to the gallbladder.
B) The right kidney is superior to the gallbladder.
C) The right kidney is posterior to the gallbladder.
D) The right kidney is inferior to the gallbladder.
Q5) Length of the common hepatic duct ____
Q6) The gallbladder remains stationary despite changes in the patient's position. ____
A)True
B)False
Q7) Diameter of the cystic duct ____
Page 15
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Chapter 14: The Pancreas
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Sample Questions
Q1) Hormones that stimulate the formation of pancreatic juice are triggered by chyme.
A)True
B)False
Q2) The length of the pancreas is
A) 3 to 5 cm.
B) 8 to 10 cm.
C) 12 to 18 cm.
D) 15 to 20 cm.
Q3) The gastroduodenal artery divides into
A) lateral and medial superior pancreaticoduodenal branches.
B) proper and common hepatic arteries.
C) anterior and posterior superior pancreaticoduodenal branches.
D) anterior and posterior portasplenic arteries.
Q4) Sonographically, the pancreas appears isoechoic to the liver. ____
A)True
B)False
Q5) The contour of the pancreas cannot be observed on ultrasound. ____
A)True
B)False
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Chapter 15: The Urinary System
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Sample Questions
Q1) The structures anterior to the left kidney are the:
Q2) The medullary pyramids are separated from each other by bands of cortical tissue called ____________ .
Q3) The adrenal gland is easily visualized sonographically in adults. ____
A)True
B)False
Q4) The structures posterior to the kidneys are the:
Q5) List the structures contained in the renal pelvis.
Q6) The base of the medullary pyramid comes in contact with the ________.
Q7) The apex of the medullary pyramid sits within a __________.
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Chapter 16: The Spleen
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Sample Questions
Q1) At the hilum, the splenic artery branches into
A) two to four lobular arteries.
B) four to six lobular arteries.
C) two to four lobar arteries.
D) four to six lobar arteries.
Q2) The spleen lies in the epigastrium. ____
A)True
B)False
Q3) The normal splenic index is approximately
A) 51 to 153 cm3.
B) 155 to 450 cm3.
C) 450 to 750 cm3.
D) 107 to 314 cm3.
Q4) Left renal cortex ____
Q5) The splenic artery arises from the A) superior mesenteric artery.
B) common hepatic artery.
C) celiac artery.
D) proper hepatic artery.
Q6) Splenic artery lumen ____
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Chapter 17: The Gastrointestinal System
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Sample Questions
Q1) Which of the following is NOT a part of the small bowel ?
A) Duodenum
B) Ileum
C) Cecum
D) Jejunum
Q2) The ascending colon is anterolateral to the
A) tail of the pancreas.
B) neck of the gallbladder.
C) left iliac crest.
D) lower pole of the right kidney.
Q3) The lesser curvature of the stomach marks the _____ border of the organ.
A) right
B) left
C) anterior
D) posterior
Q4) The juncture of the greater and lesser curvatures of the stomach occurs at the A) cardiac orifice.
B) esophageal orifice.
C) entrance of the esophagus into the stomach.
D) all of the above
Page 19
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Chapter 18: The Prostate Gland and Seminal Vesicles
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Sample Questions
Q1) The prostate weighs about
A) 5g
B) 10g
C) 20g
D) 40g
Q2) The periurethral tissues can easily be differentiated from the anterior fibromuscular stroma. ______
A)True
B)False
Q3) Only alkaline fluid is produced by the seminal vesicles. ____
A)True
B)False
Q4) In a scan of the prostate and seminal vesicles, the prostate appears
A) hypoechoic to the seminal vesicles.
B) isoechoic to the seminal vesicles.
C) hyperechoic to the seminal vesicles.
D) anechoic to the seminal vesicles.
Q5) Alkaline, viscous fructose is produced by the prostate gland. ____
A)True
B)False
20
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Chapter 19: The Female Pelvis
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Sample Questions
Q1) Which of the following produces the hormones estrogen and progesterone in females?
A) Anterior pituitary gland
B) Ovarian medulla
C) Ovarian follicles
D) Uterine endometrium
Q2) The arteries in the uterus that penetrate the myometrium are the A) spiral arteries.
B) arcuate arteries.
C) straight arteries.
D) radial arteries.
Q3) The congenital malformation recognized sonographically by the presence of two endometrial canals is known as a ________________.
Q4) Anechoic areas seen between the outer and intermediate layers of the myometrium represent A) spiral arteries.
B) arcuate vessels.
C) areas of placental abruption.
D) the "sonographic halo."
Q5) The _______ ligaments are not true ligaments and provide minimal support.
Page 21
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Chapter 20: First Trimester Obstetrics 0 to 12 Weeks
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Sample Questions
Q1) 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.
Q2) The chorionic frondosum eventually becomes the:
A) amniotic cavity.
B) chorionic cavity.
C) yolk sac.
D) placenta.
Q3) 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.
Q4) 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
Page 22
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Chapter 21: Second and Third Trimester Obstetrics 13 to 42
Weeks
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Q1) Head circumference (HC) is best obtained through (a) ___________ plane(s) of section perpendicular to the ________________.
A) single; thalami, cavum septum pellucidum, and tentorium
B) multiple; thalami, cavum septum pellucidum, and tentorium
C) single; thalami, third ventricle, cavum septum pellucidum, and tentorium
D) multiple; thalami, third ventricle, cavum septum pellucidum, and tentorium
Q2) Collapsed, the fetal colon typically
A) appears hyperechoic compared with adjacent structures.
B) presents with anechoic, thick walls and a hyperechoic lumen.
C) appears hypoechoic compared with adjacent structures.
D) indicates a gastrointestinal abnormality.
Q3) Some experts believe that __________________ in the 2nd trimester can be used as an accurate predictor of an abnormal fetal outcome.
Q4) The fetal adrenal glands appear _______________ to the liver, spleen, and renal cortex.
A) hyperechoic
B) hypoechoic
C) anechoic
D) anterolateral
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Chapter 22: High-Risk Obstetric Sonography
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Q1) If division occurs in the embryonic disk more than 13 days after fertilization, the result is
A) the demise of one twin.
B) a dichorionic-monoamniotic gestation.
C) conjoined twins.
D) a dichorionic-diamniotic gestation.
Q2) If twin fetuses are of opposite gender, they are always
A) monochorionic and monoamniotic.
B) monochorionic and diamniotic.
C) dichorionic and monoamniotic.
D) dichorionic and diamniotic.
Q3) In a twin gestation, division of the zygote before day 4 postfertilization results in a A) monochorionic-monoamniotic gestation.
B) monochorionic-diamniotic gestation.
C) dichorionic-monoamniotic gestation.
D) dichorionic-diamniotic gestation.
Q4) Twin gestations result from fertilization of either _______ or a _______.
Q5) When certain defects are found during a pregnancy, high concentrations of _____________________ are found in amniotic fluid samples.
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Chapter 23: The Thyroid and Parathyroid Glands
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Q1) The average weight of the thyroid gland is approximately
A) 25g.
B) 40g.
C) 15g.
D) 10g.
Q2) The high resolution sonography recommended for evaluation of parathyroid adenomas is
A) 3.5 to 5 MHz.
B) 5 MHz only.
C) 4.5 MHz.
D) 7.5 to 15 MHz.
Q3) The major neurovascular bundle is located posterolateral to the thyroid gland and consists of the common carotid artery, internal jugular vein, and vagus nerve. ____
A)True
B)False
Q4) Patients with secondary hyperparathyroidism develop hypercalcemia. ____
A)True
B)False
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Chapter 24: Breast Sonography
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Q1) Prolactin
A) aids breast development.
B) stimulates breast secretory system after childbirth.
C) acts on breast during pregnancy to prepare for nursing.
D) stimulates the release of milk during nursing.
Q2) The breast has the largest amount of fatty tissue during the reproductive years.
A)True
B)False
Q3) Lobules are subunits of lobes. ____
A)True
B)False
Q4) Estrogen
A) aids in breast development.
B) stimulates the breast's secretory system after childbirth.
C) acts on the breast during pregnancy to prepare for nursing.
D) stimulates the release of milk during nursing.
Q5) The glandular layer of the breast atrophies after menopause. ____
A)True
B)False
26
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Chapter 25: Penile and Scrotal Ultrasound
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Q1) Convoluted seminiferous tubules connect to straight tubules, which empty into the
A) mediastinum testis.
B) tunica albuginea.
C) spermatogenesis.
D) rete testis.
Q2) The testes are classified as
A) endocrine and seminal glands.
B) exocrine and seminal glands.
C) exocrine and endocrine glands.
D) none of the above.
Q3) What is the echogenicity of the septum penis?
A) Low level echoes
B) Medium level echoes
C) High echogenicity
D) It cannot be identified on ultrasound.
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Chapter 26: The Neonatal Brain
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Q1) The lateral ventricles communicate with the third ventricle through the A) interventricular foramina of Monro.
B) aqueduct of Sylvius.
C) aperture of Magendie.
D) aperture of Luschka.
Q2) What is the echogenicity of the corpus callosum?
A) Anechoic
B) Hypoechoic
C) Echogenic
D) Moderately echogenic
Q3) What is the echogenicity of the fourth and third ventricles?
A) Moderately echogenic
B) Anechoic
C) Hypoechoic
D) Low level echoes
Q4) What is the echogenicity of the sylvian fissure?
A) Echogenic
B) Moderately echogenic
C) Low level echoes
D) Hypoechoic
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Chapter 27: Pediatric Echocardiography
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Q1) In fetal development, if the bulboventricular looping is to the right, the result is dextrocardia. ____
A)True
B)False
Q2) In the normal infant heart, blood from the right atrium travels
A) across the foramen ovale into the left atrium, through the mitral valve and into the left ventricle.
B) through the tricuspid valve into the right ventricle, then continues to and through the pulmonary valve crossing into the pulmonary artery to the lungs.
C) across the foramen ovale into the left atrium, through the pulmonary veins to the lungs.
D) through the tricuspid valve into the right ventricle, across the aortic valve into the aorta.
Q3) The heart functions to
A) distribute medications throughout the body.
B) move antibodies and white blood cells to areas of infection.
C) dispose of waste products.
D) all of the above.
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Chapter 28: Adult Echocardiography
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Q1) Blood with a high oxygen content entering the heart comes from the pulmonary veins. ____
A)True
B)False
Q2) Suspected aortic root dissection may be diagnosed with confidence with A) TTE.
B) a chest radiograph.
C) a fast CT scan.
D) TEE.
Q3) Blood with a low oxygen content entering the heart comes from the coronary arteries. ____
A)True
B)False
Q4) Atrioventricular valves are not the same as semilunar valves. ____
A)True
B)False
Q5) The SA node is the "pacemaker" of the heart. ____
A)True
B)False
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Chapter 29: Vascular Technology
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Sample Questions
Q1) The transcranial approach is commonly chosen for interrogation of the ophthalmic artery. ____
A)True
B)False
Q2) The Doppler spectral waveform from the normal common carotid artery is characterized by all of the following except
A) rapid systolic deceleration.
B) systolic window.
C) spectral broadening.
D) constant forward diastolic flow.
Q3) Intracranial arteries are identified during a noninvasive vascular examination based on all the following factors except A) pulsatility.
B) peak systolic velocity.
C) depth.
D) flow direction.
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Chapter 30: Three-Dimensional Ultrasound
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Sample Questions
Q1) For a multiplanar format, data must be achieved from the A) original acquisition plane.
B) three orthogonal planes.
C) fourth acquisition plane.
D) none of the above
Q2) Three-dimensional ultrasound consists of which three steps?
A) Measurements, volume data set, and minimum mode
B) Measurements, flat screen image, and algorithms
C) Volume acquisition, measurements, and 3D rendering
D) Volume acquisition, multiplanar display, and 3D rendering
Q3) The SonoVCAD and SonoAVC are volumetric advances that can identify the A) nongravid uterus and early pregnancy.
B) fetal heart outflow tract and ovarian follicles.
C) neonatal brain in three orthogonal views.
D) adult and pediatric urinary system.
Q4) Four-dimensional imaging can be done only with A) existing ultrasound systems with a 3D option.
B) 3D systems that use electromagnetic positioning sensors.
C) dedicated 3D transducers.
D) offline systems that attach to the ultrasound transducer.
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Chapter 31: Interventional and Intraoperative Ultrasound
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Q1) The term percutaneous means
A) to pour over or through, especially the passage of a fluid through the vessels of a specific organ.
B) to sample.
C) to perform through the skin.
D) to suture.
Q2) Ultrasound-guided biopsies assist needle placement for A) fluid sampling.
B) small organ or stone extraction.
C) amniocentesis.
D) tissue sampling.
Q3) A percutaneous cholangiogram is an ultrasound-guided procedure for A) bile drainage.
B) evaluation of the gallbladder.
C) gallbladder biopsy.
D) evaluation of the liver.
Q4) __________ are caused by bubbles between the transducer tip and the sterile sheath covering separated by a coupling agent.
Q5) Intraoperative ultrasound is not limited by __________, __________, or __________.
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