1. A 28-year-old woman presents for a routine prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a single umbilical artery. The most appropriate next step is:
A. Amniocentesis
B. Detailed fetal echocardiogram
C. Repeat ultrasound in 4 weeks
D. No further action required
2. A 32-year-old woman presents for a prenatal ultrasound at 18 weeks’ gestation. The ultrasound shows a cystic structure in the fetal chest. The most likely diagnosis is:
A. Congenital diaphragmatic hernia
B. Congenital pulmonary airway malformation
C. Esophageal duplication cyst
D. Bronchogenic cyst
3. A 25-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a large cystic structure in the fetal abdomen. The most likely diagnosis is:
A. Choledochal cyst
B. Duodenal atresia
C. Meconium peritonitis
D. Ovarian cyst
4. A 30-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a thickened nuchal fold and a heart defect. The most appropriate next step is:
A. Amniocentesis for karyotyping
B. Cordocentesis for rapid aneuploidy testing
C. Detailed fetal echocardiogram
D. No further action required
5. A 28-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a two-vessel umbilical cord. The most appropriate next step is:
A. Amniocentesis
B. Detailed fetal echocardiogram
C. Repeat ultrasound in 4 weeks
D. No further action required
6. A 34-year-old woman presents for a prenatal ultrasound at 32 weeks’ gestation. The ultrasound shows a single umbilical artery and an echogenic bowel. The most likely diagnosis is:
A. Cystic fibrosis
B. Cytomegalovirus infection
C. Duodenal atresia
D. Trisomy 21
7. A 30-year-old woman presents for a prenatal ultrasound at 36 weeks’ gestation. The ultrasound shows a cystic structure in the fetal brain. The most likely diagnosis is:
A. Arachnoid cyst
B. Choroid plexus cyst
C. Dandy-Walker malformation
D. Ventriculomegaly
8. A 28-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall. The most likely diagnosis is:
A. Gastroschisis
B. Omphalocele
C. Prune belly syndrome
D. Urachal cyst
9. A 32-year-old woman presents for a prenatal ultrasound at 30 weeks’ gestation. The ultrasound shows a cystic structure in the fetal neck. The most likely diagnosis is:
A. Bronchogenic cyst
B. Cervical teratoma
C. Lymphangioma
D. Thyroglossal duct cyst
10. A 26-year-old woman presents for a prenatal ultrasound at 18 weeks’ gestation. The ultrasound shows a fetal heart defect and a hyperechogenic focus in the fetal bowel. The most appropriate next step is:
A. Amniocentesis for karyotyping
B. Cordocentesis for rapid aneuploidy testing
C. Detailed fetal echocardiogram
D. No further action required
11. A 30-year-old woman presents for a prenatal ultrasound at 28 weeks’ gestation. The ultrasound shows a large cystic structure in the fetal abdomen and polyhydramnios. The most likely diagnosis is:
A. Choledochal cyst
B. Duodenal atresia
C. Meconium peritonitis
D. Ovarian cyst
12. A 28-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a thickened nuchal fold and a cystic structure in the fetal chest. The most appropriate next step is:
A. Amniocentesis for karyotyping
B. Cordocentesis for rapid aneuploidy testing
C. Detailed fetal echocardiogram
D. No further action required
13. A 34-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a cystic structure in the fetal brain and a heart defect. The most likely diagnosis is:
A. Arachnoid cyst and tetralogy of Fallot
B. Choroid plexus cyst and ventricular septal defect
C. Dandy-Walker malformation and coarctation of the aorta
D. Ventriculomegaly and hypoplastic left heart syndrome
14. A 32-year-old woman presents for a prenatal ultrasound at 26 weeks’ gestation. The ultrasound shows a fetal heart defect and a cystic structure in the fetal neck. The most likely diagnosis is:
A. Bronchogenic cyst and tetralogy of Fallot
B. Cervical teratoma and hypoplastic left heart syndrome
C. Lymphangioma and ventricular septal defect
D. Thyroglossal duct cyst and coarctation of the aorta
15. A 28-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall and a cystic structure in the fetal chest. The most likely diagnosis is:
A. Gastroschisis and congenital diaphragmatic hernia
B. Omphalocele and congenital pulmonary airway malformation
C. Prune belly syndrome and esophageal duplication cyst
D. Urachal cyst and bronchogenic cyst
16. A 30-year-old woman presents for a prenatal ultrasound at 34 weeks’ gestation. The ultrasound shows a single umbilical artery and oligohydramnios. The most appropriate next step is:
A. Amniocentesis
B. Biophysical profile
C. Detailed fetal echocardiogram
D. No further action required
17. A 26-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a fetal heart defect and a cystic structure in the fetal abdomen. The most likely diagnosis is:
A. Choledochal cyst and tetralogy of Fallot
B. Duodenal atresia and ventricular septal defect
C. Meconium peritonitis and hypoplastic left heart syndrome
D. Ovarian cyst and coarctation of the aorta
18. A 32-year-old woman presents for a prenatal ultrasound at 28 weeks’ gestation. The ultrasound shows a thickened nuchal fold and a cystic structure in the fetal neck. The most likely diagnosis is:
A. Bronchogenic cyst and trisomy 21
B. Cervical teratoma and trisomy 18
C. Lymphangioma and trisomy 13
D. Thyroglossal duct cyst and Turner syndrome
19. A 28-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall and a cystic structure in the fetal brain. The most likely diagnosis is:
A. Gastroschisis and arachnoid cyst
B. Omphalocele and choroid plexus cyst
C. Prune belly syndrome and Dandy-Walker malformation
D. Urachal cyst and ventriculomegaly
21. A 30-year-old woman presents for a prenatal ultrasound at 32 weeks’ gestation. The ultrasound shows a single umbilical artery and fetal growth restriction. The most appropriate next step is:
A. Amniocentesis
B. Biophysical profile
C. Cordocentesis
D. Detailed fetal echocardiogram
22. A 28-year-old woman presents for a prenatal ultrasound at 26 weeks’ gestation. The ultrasound shows a cystic structure in the fetal chest and polyhydramnios. The most likely diagnosis is:
A. Congenital diaphragmatic hernia
B. Congenital pulmonary airway malformation
C. Esophageal duplication cyst
D. Bronchogenic cyst
23. A 32-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a fetal heart defect and an echogenic bowel. The most likely diagnosis is:
A. Cystic fibrosis and tetralogy of Fallot
B. Cytomegalovirus infection and ventricular septal defect
C. Duodenal atresia and hypoplastic left heart syndrome
D. Trisomy 21 and coarctation of the aorta
24. A 26-year-old woman presents for a prenatal ultrasound at 18 weeks’ gestation. The ultrasound shows a thickened nuchal fold and an echogenic focus in the fetal heart. The most appropriate next step is:
A. Amniocentesis for karyotyping
B. Cordocentesis for rapid aneuploidy testing
C. Detailed fetal echocardiogram
D. No further action required
25. A 30-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a fetal heart defect and polyhydramnios. The most likely diagnosis is:
A. Esophageal atresia
B. Imperforate anus
C. Obstructive uropathy
D. Tracheoesophageal fistula
26. A 28-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a cystic structure in the fetal abdomen and an echogenic bowel. The most likely diagnosis is:
A. Choledochal cyst and cystic fibrosis
B. Duodenal atresia and cytomegalovirus infection
C. Meconium peritonitis and trisomy 21
D. Ovarian cyst and Beckwith-Wiedemann syndrome
27. A 34-year-old woman presents for a prenatal ultrasound at 30 weeks’ gestation. The ultrasound shows a single umbilical artery, an echogenic bowel, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis
B. Cytomegalovirus infection
C. Duodenal atresia
D. Trisomy 21
28. A 32-year-old woman presents for a prenatal ultrasound at 36 weeks’ gestation. The ultrasound shows a cystic structure in the fetal brain and ventriculomegaly. The most likely diagnosis is:
A. Arachnoid cyst
B. Choroid plexus cyst
C. Dandy-Walker malformation
D. Porencephalic cyst
29. A 28-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall and an echogenic bowel. The most likely diagnosis is:
A. Gastroschisis and cystic fibrosis
B. Omphalocele and cytomegalovirus infection
C. Prune belly syndrome and trisomy 21
D. Urachal cyst and Beckwith-Wiedemann syndrome
30. A 30-year-old woman presents for a prenatal ultrasound at 28 weeks’ gestation. The ultrasound shows a cystic structure in the fetal neck and polyhydramnios. The most likely diagnosis is:
A. Bronchogenic cyst
B. Cervical teratoma
C. Lymphangioma
D. Thyroglossal duct cyst
31. A 26-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a fetal heart defect, an echogenic bowel, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis and tetralogy of Fallot
B. Cytomegalovirus infection and ventricular septal defect
C. Duodenal atresia and hypoplastic left heart syndrome
D. Trisomy 21 and coarctation of the aorta
32. A 32-year-old woman presents for a prenatal ultrasound at 34 weeks’ gestation. The ultrasound shows a single umbilical artery, polyhydramnios, and fetal growth restriction. The most appropriate next step is:
A. Amniocentesis
B. Biophysical profile
C. Cordocentesis
D. Detailed fetal echocardiogram
33. A 28-year-old woman presents for a prenatal ultrasound at 26 weeks’ gestation. The ultrasound shows a cystic structure in the fetal chest and an echogenic bowel. The most likely diagnosis is:
A. Congenital diaphragmatic hernia and cystic fibrosis
B. Congenital pulmonary airway malformation and cytomegalovirus infection
C. Esophageal duplication cyst and trisomy 21
D. Bronchogenic cyst and Beckwith-Wiedemann syndrome
34. A 30-year-old woman presents for a prenatal ultrasound at 32 weeks’ gestation. The ultrasound shows a fetal heart defect, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Esophageal atresia
B. Imperforate anus
C. Obstructive uropathy
D. Tracheoesophageal fistula
35. A 34-year-old woman presents for a prenatal ultrasound at 28 weeks’ gestation. The ultrasound shows a cystic structure in the fetal abdomen, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Choledochal cyst
B. Duodenal atresia
C. Meconium peritonitis
D. Ovarian cyst
36. A 28-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall, an echogenic bowel, and fetal growth restriction. The most likely diagnosis is:
A. Gastroschisis and cystic fibrosis
B. Omphalocele and cytomegalovirus infection
C. Prune belly syndrome and trisomy 21
D. Urachal cyst and Beckwith-Wiedemann syndrome
37. A 32-year-old woman presents for a prenatal ultrasound at 30 weeks’ gestation. The ultrasound shows a cystic structure in the fetal neck, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Bronchogenic cyst
B. Cervical teratoma
C. Lymphangioma
D. Thyroglossal duct cyst
38. A 26-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a fetal heart defect, an echogenic bowel, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis and tetralogy of Fallot
B. Cytomegalovirus infection and ventricular septal defect
C. Duodenal atresia and hypoplastic left heart syndrome
D. Trisomy 21 and coarctation of the aorta
40. A 30-year-old woman presents for a prenatal ultrasound at 36 weeks’ gestation. The ultrasound shows a single umbilical artery, polyhydramnios, and fetal growth restriction. The most appropriate next step is:
A. Amniocentesis
B. Biophysical profile
C. Cordocentesis
D. Detailed fetal echocardiogram
41. A 28-year-old woman presents for a prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a cystic structure in the fetal brain, ventriculomegaly, and an echogenic bowel. The most likely diagnosis is:
A. Arachnoid cyst, hydrocephalus, and cystic fibrosis
B. Choroid plexus cyst, colpocephaly, and cytomegalovirus infection
C. Dandy-Walker malformation, hydranencephaly, and trisomy 21
D. Porencephalic cyst, holoprosencephaly, and Beckwith-Wiedemann syndrome
42. A 32-year-old woman presents for a prenatal ultrasound at 24 weeks’ gestation. The ultrasound shows a defect in the fetal abdominal wall, an echogenic bowel, and polyhydramnios. The most likely diagnosis is:
A. Gastroschisis, cystic fibrosis, and obstructive uropathy
B. Omphalocele, cytomegalovirus infection, and esophageal atresia
C. Prune belly syndrome, trisomy 21, and imperforate anus
D. Urachal cyst, Beckwith-Wiedemann syndrome, and tracheoesophageal fistula
43. A 26-year-old woman presents for a prenatal ultrasound at 32 weeks’ gestation. The ultrasound shows a cystic structure in the fetal neck, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Bronchogenic cyst, obstructive uropathy, and intrauterine growth restriction
B. Cervical teratoma, esophageal atresia, and small for gestational age
C. Lymphangioma, imperforate anus, and asymmetric growth restriction
D. Thyroglossal duct cyst, tracheoesophageal fistula, and placental insufficiency
44. A 30-year-old woman presents for a prenatal ultrasound at 28 weeks’ gestation. The ultrasound shows a fetal heart defect, echogenic bowel, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis, tetralogy of Fallot, obstructive uropathy, and intrauterine growth restriction
B. Cytomegalovirus infection, ventricular septal defect, esophageal atresia, and small for gestational age
C. Duodenal atresia, hypoplastic left heart syndrome, imperforate anus, and asymmetric growth restriction
D. Trisomy 21, coarctation of the aorta, tracheoesophageal fistula, and placental insufficiency
45. A 28-year-old woman presents for a prenatal ultrasound at 18 weeks’ gestation. The ultrasound shows a thickened nuchal fold, an echogenic focus in the fetal heart, and cystic hygroma. The most appropriate next step is:
A. Amniocentesis for karyotyping and microarray analysis
B. Chorionic villus sampling for rapid aneuploidy testing
C. Detailed fetal echocardiogram and fetal MRI
D. No further action required
46. A 34-year-old woman presents for a prenatal ultrasound at 22 weeks’ gestation. The ultrasound shows a cystic structure in the fetal abdomen, an echogenic bowel, and oligohydramnios. The most likely diagnosis is:
A. Choledochal cyst, cystic fibrosis, and placental insufficiency
B. Duodenal atresia, cytomegalovirus infection, and obstructive uropathy
C. Meconium peritonitis, trisomy 21, and renal agenesis
D. Ovarian cyst, Beckwith-Wiedemann syndrome, and premature rupture of membranes
47. A 32-year-old woman presents for a prenatal ultrasound at 30 weeks’ gestation. The ultrasound shows a single umbilical artery, an echogenic bowel, polyhydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis, obstructive uropathy, and intrauterine growth restriction
B. Cytomegalovirus infection, esophageal atresia, and small for gestational age
C. Duodenal atresia, imperforate anus, and asymmetric growth restriction
D. Trisomy 21, tracheoesophageal fistula, and placental insufficiency
48. A 30-year-old woman presents for a prenatal ultrasound at 26 weeks’ gestation. The ultrasound shows a fetal heart defect, a cystic structure in the fetal brain, and ventriculomegaly. The most likely diagnosis is:
A. Arachnoid cyst, tetralogy of Fallot, and hydrocephalus
B. Choroid plexus cyst, ventricular septal defect, and colpocephaly
C. Dandy-Walker malformation, hypoplastic left heart syndrome, and hydranencephaly
D. Porencephalic cyst, coarctation of the aorta, and holoprosencephaly
49. A 28-year-old woman presents for a prenatal ultrasound at 34 weeks’ gestation. The ultrasound shows a single umbilical artery, an echogenic bowel, oligohydramnios, and fetal growth restriction. The most likely diagnosis is:
A. Cystic fibrosis, obstructive uropathy, and intrauterine growth restriction
B. Cytomegalovirus infection, esophageal atresia, and small for gestational age
C. Duodenal atresia, imperforate anus, and asymmetric growth restriction
D. Trisomy 21, tracheoesophageal fistula, and placental insufficiency
50. A 32-year-old woman presents for a prenatal ultrasound at 38 weeks’ gestation. The ultrasound shows a single umbilical artery, polyhydramnios, fetal growth restriction, and doppler findings suggestive of fetal anemia. The most appropriate next step is:
A. Amniocentesis for karyotyping
B. Biophysical profile and non-stress test
C. Cordocentesis for fetal blood sampling
D. Induction of labor