Preguntas de Gineco Obstetricia
Preguntas de Gineco Obstetricia
DAVIES
Ob/Gyn Sonography Review
Test yourself before the ARDMS tests you! Ob/Gyn Sonography Review illuminates the
facts and principles on which you will be tested, hones your test-taking skills, and reveals
your strengths and weaknesses by exam topic. Based precisely on the ob/gyn specialty
exam outline published by ARDMS, this review contains 520 registry-like questions
together with answers, clear explanations, and quick references for further study. More
than 100 image-based cases prepare you to tackle the images on the exam. Coverage
includes obstetrics (first through third trimesters, placenta, assessment of gestational age,
and complications), gynecology (normal pelvic anatomy, physiology, pediatric,
infertility/endocrinology, postmenopausal, pelvic and extrapelvic pathology), patient care,
patient preparation, and technique—all in the same proportion as the exam itself. Ob/Gyn
Sonography Review is very effective in combination Ob/Gyn Sonography: An Illustrated
Review and Ob/Gyn CD-ROM Mock Exam. Why are our mock exams so popular and
effective? Because they contain the same kinds of thought-provoking questions you will
find on the exam! 12 hours’ CME credit. Davies catalog #11032.
The New CD-ROM Mock Exams from Davies are the most effective and
featuresome CDs available. Interactive, fun, and packed with regularly updated peer-reviewed
content for SPI, Abdomen, Vascular, Ob/Gyn, Breast, and Fetal Echo. Work in Test Mode or Study &
Learn Mode and easily customize your Test and Study sessions to focus on specific exam topics.
Hundreds of continuously variable questions and images in registry format.
Clear, simple explanations and current references. Expert tutorials on key concepts. Additional
explanatory images. Test timer keeps you on track. Instant results analysis scores and
guides you topic by topic. Automatically review missed questions with one click. Available
CME credit. A snap to use. Order toll-free 1-877-792-0005 or download from our website.
2014
Peter W. Callen, MD
UCSF School of Medicine
San Francisco, California
Editor in Chief
Ob/Gyn Sonography Review iii
v
All rights reserved. No part of this work may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, electronic or mechanical, including photocopying,
scanning, and recording, without prior written permission from the publisher.
Gill, Kathryn A.
OB/GYN sonography review : a review for the ARDMS obstetrics & gynecology exam,
2002-2003 / Kathryn A. Gill, Misty H. Sliman, Peter W. Callen.
p. ; cm.
Includes bibliographical references.
ISBN 0-941022-53-6
Ultrasonics in obstetrics—Examinations, questions, etc. I. Sliman, Misty H. II. Callen, Peter
W. III. Title.
[DNLM: 1. obstetrics—Examination Questions. 2. Genital Diseases,
Female—ultrasonography—Examination questions. 3. Pregnancy
Complications—ultrasonography—Examination Questions. WQ 18.2 G475o 2003]
RG527.5.U48G55 2003
618.2’07543’076—dc21
2002041681
Ob/Gyn Sonography Review iv
Preface
T
HIS MOCK EXAM is a question/answer/reference review of ob/gyn sonography for
those RDMS candidates who plan to take the ARDMS Obstetrics and Gynecology
specialty examination. It is designed as an adjunct to your regular study and as a
method to help you determine your strengths and weaknesses so that you can study more
effectively. Ob/Gyn Sonography Review covers everything on the current ARDMS exam
content outline and in fact follows that outline, which you will find in Part VI of this
book.
Ob/Gyn Sonography Review effectively simulates content and experience of the exam.
Current ARDMS standards call for approximately 170 multiple-choice questions to be
answered during a three-hour period. That is, you will have an average time of 1 minute
to answer each question. A passing score is between 65% and 75%, depending on the
difficulty of the particular exam. Timing your practice sessions according to the number
of questions you need to finish will help you prepare for the pressure experienced by
RDMS candidates taking this exam. It also helps to ensure that your score accurately
reflects your strengths and weaknesses so that you study more efficiently and with greater
purpose in the limited time you can devote to preparation. Because the content of this
Ob/Gyn Sonography Review v
Q&A review is formatted and weighted according to the registry’s outline of topics and
subtopics, you can readily identify those areas on which you should concentrate.
We include below and strongly recommend that you read Taking and Passing Your
Exam, by Don Ridgway, RVT, who offers useful tips and practical strategies for taking
and passing the ARDMS examinations.
Finally, you have not only our best wishes for success, but also our admiration for taking
this big and important step in your career.
Kathy Gill
Kathryn A. Gill, MS, RT, RDMS
Daphne, Alabama
Ob/Gyn Sonography Review vi
Study. And then study some more. Knowing your stuff is the most important factor in
your success. Start early, set a regular study schedule, and stick to it. Make your schedule
specific so you know exactly what to study on a particular day. Write it down. Establish
realistic goals so that you don’t build a mountain you can’t climb.
As to what you study, don’t just read aimlessly. Focus your efforts on what you need to
know. Rely on a core group of dependable references, referring to others as necessary to
firm up your understanding of specific topics. Let the ARDMS exam outlines guide you.
And use different but complementary study methods—texts, flashcards, and mock
exams—to exercise those neural pathways.
Ease down on studying the week before. Wind down, reduce stress, build confidence,
and rest up. Don’t cram! And no studying the night before. You had your chance. Watch
a movie, relax, go to bed early, and sleep well.
Organize your things the night before. Lay out comfortable clothes (including a
sweater or sweatshirt in case the testing center is cold), pencils, your ARDMS test-
admission papers, car and house keys, glasses, prescriptions, directions to the test center,
and any other personal items you might need. Be prepared!
Eat lightly. You do not want to fall asleep during the exam. Go easy on the coffee or tea
so your bladder doesn’t distract you halfway through the exam.
Arrive early. Plan to arrive at the test center early, especially if you haven’t been there
before. Take directions, including the telephone number of the testing center in case you
have to make contact en route. You don’t need a wrong-offramp adventure.
Be confident. As you wait for the exam to begin, smile, lift both hands, wave them
toward yourself, and say, “Bring it on.”
∗
Don Ridgway is the author of Introduction to Vascular Scanning: A Guide for the Complete Beginner and
editor of Vascular Technology Review 2003. Don teaches and practices at Grossmont College and Hospital
in El Cajon, California.
Ob/Gyn Sonography Review vii
Read each question twice before answering. Guess how easy it is to get one word
wrong and misunderstand the whole question.
Try to answer the question before looking at the choices. Formulating an answer
before peeking at the possibilities minimizes the distractibility of the incorrect answer
choices, which in the test-making business are called—guess what!—distractors.
Knock off the easy ones first. First answer the questions you feel good about. Then go
back for the more difficult items. Next, attack the really tough ones. Taking notes on long
or tricky questions often can jog your memory or put the question in new light. For
questions you just cannot answer with certainty, eliminate the obviously wrong answer
choices and then guess.
Guessing. Passing the exam depends on the number of correct answers you make.
Because unanswered questions are counted as incorrect, it makes sense to guess when all
else fails. The ARDMS itself advises that “it is to the candidate’s advantage to answer all
possible questions.” Guessing alone improves your chances of scoring a point from 0 (for
an unanswered question) to 20% (for randomly picking one of five possible answers).
Eliminating answer choices you know or suspect are wrong further improves your odds
of success. By using your knowledge and skill to eliminate three of the five answer
choices before guessing, for example, you increase your odds of scoring a point to 50%.
Don’t second-guess. The common wisdom is that your first answer is more likely than
revised answers to be correct. Actual studies indicate that when you return to a question
and change the answer, you’ll probably be wrong. Change an answer only if you’re quite
sure you should.
Pace yourself; watch the time. Work methodically and quickly to answer those you
know, and make your best guesses at the gnarly ones. Leave no question unanswered.
Don’t despair 50 minutes into the exam. At some point you may feel that things just
aren’t going well. Take 10 seconds to breathe deeply—in for a count of five, out for a
count of five. Relax. Recall that you need only about three out of four correct answers to
pass. If you’ve prepared reasonably well, a passing score is attainable even if you feel
sweat running down your back.
Ob/Gyn Sonography Review viii
Some candidates express concern about taking the registry exam on computer. Most folks
find this to be pretty easy; some find it off-putting, at least in prospect. But the computer-
ized exams are quite convenient: You can take the exam at your convenience (a far cry
from the days of one exam per year), you know whether or not you passed before you
leave the testing center (compare that to waiting weeks and even months, as used to be
the case), and you can reschedule the exam after 90 days if you happen not to pass the
first time (rather than waiting another six months to a year). Another good point: The
illustrations are said to be clearer on computer than in the booklets at a Scantron-type
exam.
Taking the test by computer is not complicated. The center even gives you a tutorial to be
sure you know what you need to do. You sit in a carrel with a computer and answer the
multiple-choice questions by pointing and clicking with a mouse. There is a clock on the
display letting you know how much time is left. Use it to pace yourself. Scratch paper is
available; make liberal use of it.
You can mark questions to return for answering later. A display shows which questions
have not been answered so you can return to them. When you have finished, you click on
“DONE,” and you find out immediately whether you passed.
It’s nothing to be afraid of. The principles are the same as those for any exam. Be
methodical and keep breathing.
Summary . . .
Contents
Preface
Taking and Passing Your Exam
PART I Obstetrics 1
FIRST TRIMESTER 1
Gestational sac
Yolk sac
Embryo
Ovaries
Cul-de-sac
Pregnancy failure
Ectopic pregnancy
Cranial
Spine
Heart Thorax
Abdomen
Extremities
Fetal position
Other
PLACENTA 29
Development
Position
Anatomy
Membranes
Umbilical cord
Abruption
Previa
Masses & lesions
Maturity/grading
Doppler
Physiology
Accreta
Biparietal diameter
Femur length
Abdominal circumference
Head circumference
Transcerebellar measurements
Binocular measurements
Cephalic indices
Fetal lung maturity
Other
COMPLICATIONS 40
AMNIOTIC FLUID 51
Assessment
Polyhydramnios
Oligohydramnios
Fetal pulmonic maturity studies
GENETIC STUDIES 52
FETAL DEMISE 54
FETAL ABNORMALITIES 58
Cranial
Facial
Neck
Neural tube
Abdominal wall
Thoracic
COEXISTING DISORDERS 78
Leiomyoma
Cystic
Trophoblastic disease
Solid/mixed
Myometrial contraction
Other
Ob/Gyn Sonography Review xii
PART II Gynecology 82
NORMAL PELVIC ANATOMY 82
Uterus
Ovaries
Fallopian tubes
Supporting structures
Cul-de-sac
Vasculature
Doppler flow
Gynecology-related studies
PHYSIOLOGY 96
Menstrual cycle
Pregnancy tests
Human chorionic gonadotropin
Fertilization
PEDIATRIC 103
Precocious puberty
Hematometra/hematocolpos
Sexual ambiguity
Other
INFERTILITY/ENDOCRINOLOGY 105
Contraception
Causes
Medications and treatment
Ovulation induction (follicular monitoring)
Assisted reproductive technology (GIFT, IVF, ZIFT)
POSTMENOPAUSAL 109
Anatomy
Physiology
Therapy
Pathology
Ascites
Liver metastasis
Hydronephrosis
Other
Review charts
Explain examinations
Supine hypotensive syndrome
Bioeffects
Infectious disease control
Scanning techniques
Artifacts
Physical principles
Obstetrics
Gynecology
Patient Care Preparation/Technique
PART I
Obstetrics
First Trimester
Second/Third Trimester (Normal Anatomy)
Placenta
Assessment of Gestational Age
Complications
Amniotic Fluid
Genetic Studies
Fetal Demise
Fetal Abnormalities
Coexisting Disorders
1. The pelvic mass most commonly seen during a normal first trimester pregnancy is:
A. Leiomyoma
B. Cystic teratoma
C. Corpus luteal cyst
D. Theca lutein cysts
E. Cystadenoma
2. The primitive hindbrain can be seen as a cystic structure within the embryonic head.
It is called the:
A. Diencephalons
B. Rhombencephalon
C. Prosencephalon
Ob/Gyn Sonography Review 2
D. Mesencephalon
E. Encephalocele
4. Up to 10 weeks gestational age, the mean diameter of the normal gestational sac
should grow:
A. 0.5 mm/day
B. 1 mm/day
C. 2 mm/day
D. 3 mm/day
E. 4 mm/day
5. Physiologic herniation of fetal intestine outside the fetal abdomen should not be
seen after gestational age:
A. 6 weeks
B. 8 weeks
C. 10 weeks
D. 12 weeks
E. 14 weeks
10. Your patient is 10 weeks by good menstrual dates but presents with pregnancy-
induced hypertension. You suspect:
A. Threatened abortion
B. Hydatidiform mole
C. Normal pregnancy
D. Ectopic pregnancy
E. Blighted ovum
11. Your patient has a positive pregnancy test and presents with bleeding and cramping.
Of the following sonographic findings, which one would make you suspect an
inevitable abortion?
A. Low implantation
B. Irregular sac shape
C. Poor decidual reaction
D. Double yolk sac
E. Dilated cervix
C. 4 mm
D. 5 mm
E. 6 mm
15. Which of these drugs may be used to treat an early unruptured ectopic pregnancy in
order to preserve fertility?
A. Thalidomide
B. Methotrexate
C. Diethylstilbestrol (DES)
D. Pergonal
E. Danazol
C. Anteflexed
D. Retroflexed
E. Unidentifiable
18. A patient presents with a positive pregnancy test and bright red spotting. By dates
she is 8–9 weeks. What does this transverse image demonstrate?
A. An anembryonic pregnancy
B. Subchorionic hemorrhage
C. Placental abruption
D. Normal amnion
E. Second gestational sac
D. Yolk sac
E. Umbilical cord
21. Your patient relates a history of amenorrhea for 7 weeks. Her home pregnancy test
was negative, but her serum beta-hCG exceeds 4000. What does this image
demonstrate?
A. Normal empty uterus with periovulatory endometrium
B. Normal early intrauterine pregnancy
C. Fluid contained within the endometrial cavity
D. Pseudocyesis with an endometrial cyst
E. Degenerating submucosal fibroid
22. In a ruptured ectopic pregnancy, which section of the fallopian tube is potentially
the most life-threatening?
A. Interstitial
B. Ampulla
C. Isthmus
D. Fimbria
E. Ligamentous
23. The double bleb sign refers to the sonographic presentation of:
A. The amnion and chorion
B. Two intrauterine gestational sacs
C. The amnion and yolk sac
D. A heterotopic pregnancy
E. A bicornuate uterus
24. This patient is 10 weeks by good menstrual dates, but her doctor feels that she is
small for gestational age and he cannot hear any fetal heart tones. He orders a
sonogram to confirm viability. An M-mode was not included. Referring to the
image on the following page, what do you suspect?