Question Bank – 1st Trimester OB

What is the best way to rule out an ectopic pregnancy on POCUS?

A woman comes in with cramping, bleeding, and being 4 weeks late on her period. Which of the following can you diagnose on POCUS?  Check all that apply.

True or False: In order to get basic competency in first trimester OB POCUS, the provider should perform 200 proctored scans before scanning on their own. 

Which of the following are steps in the 1st trimester evaluation of a patient with vaginal bleeding and a positive pregnancy.   Check all that apply. 

Which embryonic structure/feature is the first to appear in the early 1 st trimester?

You perform an ultrasound and see a gestational sac with a fetal pole within it. You’d like to calculate the gestational age. What do you measure to most accurately calculate the gestational age?

True or False.  The FEEDS mnemonic is used to help differentiate between a normal
gestational sac (GS) and a pseudosac caused by an ectopic pregnancy.

True or False. The absence of an ectopic pregnancy on ultrasound is sufficient to rule out the presence of an ectopic pregnancy.

What is the best way to evaluate for a twin gestation?

Which of the following is a useful troubleshooting technique to better visualize the pelvic organs with a transabdominal ultrasound approach?

What are some troubleshooting tips for seeing better pelvic views when using the intracavitary probe?  Mark all that apply.  

You are seeing a young woman with abdominal cramping and heavy bleeding.   Your chaperone is not available, and the intracavitary probe is broken and in the shop.   Should you still perform a point of care transabdominal ultrasound? 

You have a woman in your clinic with pelvic pain and risk factors for an ectopic pregnancy, including a history of a previous ectopic pregnancy and currently with an IUD.  Her pregnancy test is positive.  You see a fluid collection in the uterus without a yolk sac or fetal pole.  The sac is fundal, elliptical in shape, eccentric to the midline, with an echogenic stripe around the collection of fluid that measures 10 mm.  She is meeting all FEEDS criteria for a normal gestational sac. What would you do at this point? 

You just finished a point of care ultrasound for a woman with cramping and spotting and found that she has a single, normal appearing 7 week intrauterine pregnancy (IUP) with fetal heart tones in the normal range. Do you tell her that everything will be fine and not to worry about a thing? 

A 24 year old female presents with light vaginal bleeding and pelvic cramping. What does her bedside sonography show?

A 26 year old female presents to clinic with a report of a positive home pregnancy test. She is unsure of her last menstrual period. The following bedside ultrasound is performed. What can you tell her?

The clip is collected with what kind of ultrasound probe? What kind of disinfection procedures are required for it as per AIUM guidelines?

42 year old female at 6 weeks 0/7 days gestation with history of in vitro fertilization pregnancy presents with vaginal bleeding and pelvic cramping. Vital signs are stable. Quant HCG is 18,000. What is the most likely diagnosis?

42 year old female at 6 weeks 0/7 days gestation with history of in vitro fertilization pregnancy presents with vaginal bleeding and pelvic cramping. Vital signs are stable. Quant HCG is 18,000. What is the most likely diagnosis?

This transvaginal ultrasound shows evidence of which of the following: (Check all that apply)

The patient for whom this clip was taken is at a:

29 year old female presents to clinic with a report of a positive home pregnancy test. She is unsure of her last menstrual period. The following bedside ultrasound is performed. What can you tell her?

The most appropriate way to document a fetal heart rate in the patient for whom this clip was taken would be: (Check all that apply)

38 year old presents to your office, 8 weeks pregnant by home pregnancy test and last menstrual period. She had a day of bleeding and cramping yesterday with passage of some clots and tissue. The following bedside ultrasound is obtained. Which of the following are true? (Check all that apply)

32 year old female presents with light vaginal bleeding and pelvic cramping. Bedside sonography shows the following. Which of the following is true? (Check all that apply)

Which of the following is true of this patient with first trimester vaginal bleeding?

This fetal heart rate is measured using M-Mode. How many cardiac cycles is this machine set to use to measure the fetal heart rate?

In trying to determine the presence of an intrauterine pregnancy, the following image is obtained in a patient with first trimester vaginal bleeding. Which of the following is true?

Which of the FEEDS criteria does this fluid collection fulfill?

You obtain a saggital view of the uterus just prior to IUD insertion. What position is this uterus in?

You obtain a sagittal view of the uterus just prior to IUD insertion. What position is this uterus in?

Which of the following is true of this patient with first trimester vaginal bleeding?

You obtain this transvaginal image of the uterus. What position is it in?

The mean sac diameter is measured to be 28 mm, and no intrauterine yolk sac or fetal pole is seen. Which of the following is true?