ACOG quiz Verified Exam Questions and Answers Latest update
2026/2027
Question:
Most lethal finding in achondroplasia in infant
Answer:
The most ominous complication of achondroplasia in infancy is pulmonary hypoplasia, which is
indicated by a small chest- to- abdominal circumference ratio (<0.6). The ratio can be measured
prenatally, and it is a strong predictor of perinatal lethality.
Question:
Risk factors for anencephaly
Answer:
Possible teratogens associated with NTDs include: folic acid deficiency, heat (e.g., due to fever or use
of hot tubs or saunas), irradiation, alcohol abuse, aminopterin, valproic acid (spina bifida rather than
anencephaly), and maternal obesity
Question:
What is the banana sign?
Answer:
banana sign (Figure 4) is due to distortion in shape of the cerebellum. It is typically associated with
obliteration of the cisterna magna and is due to the Arnold-Chiari malformation (downward herniation
of the brain stem in infants with spina bifida).
Question:
What is lemon sign indicative of?
Answer:
Spina bifida; The lemon sign (Figure 1) is present in approximately 90% of fetuses at less than 24
weeks' gestation. After that point in gestation, the skull is more rigid, and the scalloping of the frontal
area is not as obvious.
Question:
Choriod plexus cyst, ventriculoseptal defect, omphalocele, and "rocker bottom" feet
Answer:
Trisomy 18
,Question:
Parvo B19, erythema infectious, most common fetal congenital effect?
Answer:
hydrops
Question:
Associated with echogenic bowel - diseases?
Answer:
Four major conditions/abnormalities have been associated with echogenic bowel: cystic fibrosis,
congenital cytomegalovirus (CMV) infection, Down's syndrome, and aspiration of blood.
Question:
BV pregnancy treatment
Answer:
oral metronidazole (250 mg three times daily for 7 days).
Question:
Pentalogy of Cantrel?
Answer:
This fetus has the Pentalogy of Cantrell, which is a rare congenital syndrome that has abnormalities in
the following anatomic sites: lower sternum, anterior diaphragm, diaphragmatic pericardium, anterior
supraumbilical abdominal wall, and heart. The most common cardiac anomaly is ectopia cordis, as
illustrated in the photograph, where the cardiac silhouette is outside of the thoracic cavity adjacent to
the hypoplastic lungs and liver.
Question:
WHEN DOES splitting of the twins occur?
Answer:
Division at day 1 to 3 results in diamniotic, dichorionic placentation. Division at day 4 to 8 results in
diamniotic, monochorionic placentation. Finally, division at day 9 to 12 results in monoamniotic,
monochorionic placentation. C
, Question:
Causes of hydrops
Answer:
Other causes of hydrops fetalis include tachyarrhythmias, chromosomal abnormalities, lysosomal
storage disorders, and alphathalassemia. Infectious diseases that can also cause hydrops fetalis include
Parvovirus B19, syphilis, cytomegalovirus, and toxoplasmosis. In patients with fetal hydrops, MCA
doppler studies are invaluable in confirming the diagnosis of fetal anemia. When the peak systolic
velocity in the MCA exceeds 1.5 multiples of median (MoM), the fetus almost certainly has
moderately severe anemia. Cordocentesis should then be performed to directly assess the fetal
hematocrit and perform an intrauterine transfusion.
Question:
Van see woude syndrome
Answer:
van der Woude syndrome, which is characterized by cleft lip or cleft palate, or both, in association
with pit-like depressions on the lower lip. Van der Woude syndrome is caused by mutations in the
IRF6 gene, which is a transcription factor that affects development and maturation of facial tissue.
This syndrome is inherited in an autosomal dominant pattern. Individuals with van der Woude
syndrome may have an increased risk of delayed language development and learning disabilities in the
future, as well as mild cognitive problems.
Question:
Rocker bottom feet, micrognathia, IUGR, microcephaly, low set ears, omphalocele, VSD/ASD
Answer:
Trisomy 18
Question:
S/e of protease inhibitors
Answer:
lipodystrophy (redistribution of fat to the back of the neck and away from the cheeks; elevated insulin
elects, glucose, LDL, TG, and cholesterol
Question:
What is the threshold to start vaginal progesterone?
Answer:
<20 mm cx
2026/2027
Question:
Most lethal finding in achondroplasia in infant
Answer:
The most ominous complication of achondroplasia in infancy is pulmonary hypoplasia, which is
indicated by a small chest- to- abdominal circumference ratio (<0.6). The ratio can be measured
prenatally, and it is a strong predictor of perinatal lethality.
Question:
Risk factors for anencephaly
Answer:
Possible teratogens associated with NTDs include: folic acid deficiency, heat (e.g., due to fever or use
of hot tubs or saunas), irradiation, alcohol abuse, aminopterin, valproic acid (spina bifida rather than
anencephaly), and maternal obesity
Question:
What is the banana sign?
Answer:
banana sign (Figure 4) is due to distortion in shape of the cerebellum. It is typically associated with
obliteration of the cisterna magna and is due to the Arnold-Chiari malformation (downward herniation
of the brain stem in infants with spina bifida).
Question:
What is lemon sign indicative of?
Answer:
Spina bifida; The lemon sign (Figure 1) is present in approximately 90% of fetuses at less than 24
weeks' gestation. After that point in gestation, the skull is more rigid, and the scalloping of the frontal
area is not as obvious.
Question:
Choriod plexus cyst, ventriculoseptal defect, omphalocele, and "rocker bottom" feet
Answer:
Trisomy 18
,Question:
Parvo B19, erythema infectious, most common fetal congenital effect?
Answer:
hydrops
Question:
Associated with echogenic bowel - diseases?
Answer:
Four major conditions/abnormalities have been associated with echogenic bowel: cystic fibrosis,
congenital cytomegalovirus (CMV) infection, Down's syndrome, and aspiration of blood.
Question:
BV pregnancy treatment
Answer:
oral metronidazole (250 mg three times daily for 7 days).
Question:
Pentalogy of Cantrel?
Answer:
This fetus has the Pentalogy of Cantrell, which is a rare congenital syndrome that has abnormalities in
the following anatomic sites: lower sternum, anterior diaphragm, diaphragmatic pericardium, anterior
supraumbilical abdominal wall, and heart. The most common cardiac anomaly is ectopia cordis, as
illustrated in the photograph, where the cardiac silhouette is outside of the thoracic cavity adjacent to
the hypoplastic lungs and liver.
Question:
WHEN DOES splitting of the twins occur?
Answer:
Division at day 1 to 3 results in diamniotic, dichorionic placentation. Division at day 4 to 8 results in
diamniotic, monochorionic placentation. Finally, division at day 9 to 12 results in monoamniotic,
monochorionic placentation. C
, Question:
Causes of hydrops
Answer:
Other causes of hydrops fetalis include tachyarrhythmias, chromosomal abnormalities, lysosomal
storage disorders, and alphathalassemia. Infectious diseases that can also cause hydrops fetalis include
Parvovirus B19, syphilis, cytomegalovirus, and toxoplasmosis. In patients with fetal hydrops, MCA
doppler studies are invaluable in confirming the diagnosis of fetal anemia. When the peak systolic
velocity in the MCA exceeds 1.5 multiples of median (MoM), the fetus almost certainly has
moderately severe anemia. Cordocentesis should then be performed to directly assess the fetal
hematocrit and perform an intrauterine transfusion.
Question:
Van see woude syndrome
Answer:
van der Woude syndrome, which is characterized by cleft lip or cleft palate, or both, in association
with pit-like depressions on the lower lip. Van der Woude syndrome is caused by mutations in the
IRF6 gene, which is a transcription factor that affects development and maturation of facial tissue.
This syndrome is inherited in an autosomal dominant pattern. Individuals with van der Woude
syndrome may have an increased risk of delayed language development and learning disabilities in the
future, as well as mild cognitive problems.
Question:
Rocker bottom feet, micrognathia, IUGR, microcephaly, low set ears, omphalocele, VSD/ASD
Answer:
Trisomy 18
Question:
S/e of protease inhibitors
Answer:
lipodystrophy (redistribution of fat to the back of the neck and away from the cheeks; elevated insulin
elects, glucose, LDL, TG, and cholesterol
Question:
What is the threshold to start vaginal progesterone?
Answer:
<20 mm cx
