Obstetric and Gynaecological Imaging (Advanced Ultrasound, Fetal Anomalies) MCQs

Radiology · 22 free questions with answers & explanations.

1. At 20-week anomaly scan, the fetus has a lemon-shaped skull, banana-shaped cerebellum (obliterated cisterna magna), and bilateral ventriculomegaly. The spine shows a posterior defect at L4 level. The most likely diagnosis and associated open neural tube defect are:
2. In a pregnancy at 24 weeks, Doppler examination shows absent end-diastolic flow (AEDF) in the umbilical artery. This finding is associated with:
3. Transvaginal ultrasound in a woman with suspected placenta praevia at 28 weeks shows placenta covering the internal os. The cervical length measured by TV-USG is 22 mm. The management is:
4. MRI pelvis in a woman with suspected placenta accreta spectrum reveals loss of the normal dark myometrial line behind the placenta, placental bulge into the myometrium, and bridging vessels crossing the placenta-myometrium interface. The specific accreta subtype MOST likely is:
5. During a 20-week anomaly scan, ultrasound shows bilateral choroid plexus cysts (CPCs), clenched fists with overlapping fingers, and a 'strawberry-shaped' calvarium. Which chromosomal abnormality is most strongly associated with this triad?
6. A 30-week obstetric ultrasound shows severe oligohydramnios (AFI 2 cm), absent kidneys in the renal fossa, bilateral adrenal hyperplasia appearing to fill the renal fossa, and absent bladder filling. What is this condition?
7. A 34-year-old woman with a previous uterine scar presents at 32 weeks. Ultrasound shows absence of the retroplacental myometrial layer, placental lacunae, and loss of the bladder wall-uterine interface. Doppler reveals turbulent flow within lacunae. What is the correct diagnosis and recommended management?
8. Ultrasound of a 38-year-old woman with postmenopausal bleeding shows endometrial thickness of 14 mm on transvaginal scan (TVS). At what endometrial thickness cut-off in a postmenopausal woman is endometrial biopsy recommended, according to current guidelines?
9. A 20-week anomaly scan shows the fetal cerebellum displaced posteriorly with an S-shaped or banana sign, and the frontal bones show inward scalloping (lemon sign). These signs are most characteristic of:
10. On first-trimester ultrasound at 13 weeks, a fetal nuchal translucency (NT) of 4.5 mm is measured. What is the most appropriate next step?
11. Ultrasound in a twin pregnancy at 18 weeks shows both fetuses in a single chorionic sac (monochorionic) with discordant amniotic fluid (one polyhydramnios, one oligohydramnios) and a stuck twin. What condition does this describe?
12. On transvaginal ultrasound, a 30-year-old woman with dysmenorrhoea shows a uterus with a junctional zone thickness >12 mm and a honeycomb pattern with irregular myometrial heterogeneity. What is the most likely diagnosis?
13. Doppler ultrasound of the umbilical artery at 32 weeks shows absent end-diastolic flow (AEDF). Which of the following statements regarding this finding is correct?
14. A 38-year-old woman presents with painless haematuria. CT urography shows a 3 cm filling defect in the left renal pelvis on the excretory phase. The filling defect is irregular, non-calcified, and does not shift with position change. Overlying parenchyma is normal. What is the most likely diagnosis?
15. Antenatal ultrasound at 20 weeks gestation reveals bilateral moderate pyelectasis (renal pelvis AP diameter 7 mm each), echogenic foci in the cardiac ventricles, and a short femur. These sonographic markers are used to calculate which risk assessment?
16. A 32-year-old woman with a history of previous caesarean section presents at 28 weeks with painless antepartum haemorrhage. Ultrasound confirms placenta praevia. Colour Doppler shows multiple intraplacental lacunae with turbulent flow and loss of the normal retroplacental hypoechoic zone. What is the most likely diagnosis and what additional MRI finding would confirm the most severe form?
17. A 50-year-old man presents with a painless scrotal swelling. Ultrasound shows a 2 cm well-defined hypoechoic intratesticular nodule with internal vascularity on colour Doppler. Serum AFP and beta-hCG are normal; LDH is mildly elevated. What is the most likely diagnosis and how should it be managed?
18. A 45-year-old woman presents with flank pain and microscopic haematuria. Unenhanced CT KUB shows a 6 mm calculus in the left ureter at the level of the pelvic brim with upstream hydronephrosis. The calculus measures 800 Hounsfield Units (HU). Which type of calculus does this density suggest, and does it favour lithotripsy?
19. A 20-week antenatal ultrasound shows a fetus with ventriculomegaly (atrial width 14 mm), absent corpus callosum, and small posterior fossa. The cisterna magna is not visualised. These findings are MOST consistent with:
20. On obstetric ultrasound at 28 weeks, the placenta is noted to be low-lying with the placenta extending over the internal os. Colour Doppler shows multiple vascular lacunae within the placenta and loss of the hypoechoic retroplacental zone. These findings raise concern for:
21. A 16-week fetal ultrasound shows a posterior fossa cyst, absence of normal cerebellar vermis, and splaying of cerebellar hemispheres. The posterior fossa is markedly enlarged. This triad is MOST consistent with:
22. Transvaginal ultrasound in a 45-year-old woman shows a complex adnexal mass: unilocular cyst 9 cm, a solid 2 cm papillary projection, no ascites, and bilateral involvement. Using the IOTA (International Ovarian Tumour Analysis) simple rules, features suggesting malignancy include: