Special Section

Spotters /e
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☛ ECGs
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☛ Chest X-rays
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☛ Ultrasounds
 820 Spotters
PHOTON 20

ECGs

First Degree Heart Block

Explanation:
Due to delay somewhere in the conduction pathway, the PR interval gets prolonged in first degree heart block. It may be a sign of
coronary artery disease, acute rheumatic carditis, digoxin activity or electrolyte disturbances.

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Second Degree Heart Block (Wenckebach or Mobitz Type 1)
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Explanation:
PR interval gets lengthened progressively and then failure of conduction of an atrial beat occurs. Next conducted beat has a shorter PR
interval than the preceding conducted beat.

Second Degree Heart Block (Mobitz Type 2)

Explanation:
Most beats are conducted with a constant PR interval. One P wave is not followed by a QRS complex as there is atrial depolarization
without a subsequent ventricular depolarization.
 Spotters 821

Third Degree Heart Block

SPOTTERS
Explanation:
In this, there is no relationship between P waves and QRS complexes. QRS complexes are abnormally shaped because of abnormal
spread of depolarization from a ventricular focus.

Sinus Rhythm with Right Bundle Branch Block

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Explanation:
In this, there is normal PR interval. In lead V1, there is an RSR1 pattern and deep, wide S waves in lead V6 leading to wide QRS complexes.
ST segments and T waves are normal.
 822 Spotters

Sinus Rhythm with Left Bundle Branch Block

PHOTON 20

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Explanation:
There is normal PR interval and wide QRS complexes. M pattern in the QRS complexes is best seen in leads I, VL, V5 and V6. Inverted
T waves are seen in leads I, II and VL. ,3
20
Atrial Tachycardia
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Explanation:
After 3 sinus beats, atrial tachycardia develops at a rate of 150/min. In the preceding beats, P waves are seen to be superimposed on T
waves and there is no change of shape of QRS complexes. They are same as those of sinus beats.

Atrial Flutter with AV Block

Explanation:
The P wave are seen at a rate of more than 250/min, which gives a “sawtooth” appearance. There are extra P waves per QRS complex (4
in this ECG). Ventricular activation is however, perfectly regular.
 Spotters 823

Ventricular Tachycardia

SPOTTERS
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Explanation:

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In this, there are no P waves. The QRS complexes are regular and their rate increases to 200/min. Abnormally broad QRS complexes are
seen with no identifiable T waves.
20
Atrial Fibrillation
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Explanation:
There is only an irregular line and no P wave is present in this condition. QRS complexes are narrow and of normal shape as the
ventricular conduction occur through the normal route. T waves are normal.
 824 Spotters

Wolff-Parkinson-White Syndrome
PHOTON 20

Explanation:
In this, the PR interval is short and the QRS complex shows an early slurred upstroke called “delta wave”. Wide QRS complex develops
due to delta wave.

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Pulmonary Embolism ,3
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Explanation:
In this, we find peaked P waves in lead II, persistent S wave in lead V6, inversion of T wave in leads V1 to V4 and tall R waves in lead V1.
 Spotters 825

Left Ventricular Hypertrophy

SPOTTERS
Explanation:
In this, we can see a tall R wave (>25 mm) in leads V5 or V6 and a deep S wave in lead V1 or V2. Inverted T waves in leads I, VL and
V5-V6 are also seen.

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Anterior Non-ST Segment Elevation Myocardial Infarction
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Explanation:
A patient presented with Chest-pain, with ECG shown and Elevated enzymes. QRS complexes are normal. However, inverted T waves
in leads V3 and V4 are seen along with biphasic T waves in leads V2 and V3.
 826 Spotters

ST Segment Depression in Unstable Angina

PHOTON 20

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Explanation:
QRS complexes are normal in this condition and even the T waves are normal. ST segments are depressed horizontally in leads V3 and
V5. ,3
ST Segment Elevation in Acute Anterior ST Segment Myocardial Infarction
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Explanation:
QRS complexes and T waves are normal in this. ST segments are elevated in leads V1 to V5.
 Spotters 827

Hypertrophic Cardiomyopathy

SPOTTERS
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Explanation:

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In this, deep T wave inversion in leads I, II, VL and V3 to V6 is found and the inversion is maximal in lead V4. In Hypertrophic
cardiomyopathy, LVH is also present.
20

ECG Analysis
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Most Recent Question

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R1. Interpret the below ECG Photograph. [AIIMS November 2016]

Ans.
R1. a

a. 2:1 heart block

b. Complete heart block
c. Wenkebach phenomenon
d. Sinus rhythm
 828 Spotters

Topic-wise Questions
PHOTON 20

1. Hyperkalemia ECG changes (Photograph) do not 4. 

DOC for Congenital disorder (ECG shown in
include  [Recent Question 2013] Photograph) is  [Recent Question 2012]

a. Propranolol b. Labetalol
c. Metoprolol d. Phentolamine
a. Prolonged PR interval
b. Wider QRS
c. Inverted T waves 5. DOC for Termination of Disorder shown in ECG
d. ST segment depression/ elevation
Photograph is  [Recent Question 2014]

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2. S2 shown in the Photograph is due to
 [Recent Question 2014]
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a. Verapamil b. Esmolol
c. Adenosine d. Alprostadil
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6. 
DOC for Cardiac condition as shown in the
Photograph is
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Ans.
1. c a. Atrial contraction
2. d b. Right ventricular filling a. Verapamil b. Lidocaine
3. a c. Inthrushing of blood c. Esmolol d. Digoxin
4. d. Closure of Aortic valve
None
5. c 7. 
DOC for Acute Condition as shown in the
6. b Photograph is
7. c
3. 
A patient develops Condition (Arrow) intra-
operatively. DOC is

a. Propanolol b. Adrenaline a. PTU b. Propranolol

c. Hyoscine d. Neostigmine c. Calcium gluconate d. Alkaline diuresis
 Spotters 829

8. A 76 year old male came to emergency department

SPOTTERS
10. Identify the ECG given  [AIIMS November 2015]
with complaints of retrosternal pain for 6 hours.
The following is the ECG of the same patient.
The appropriate next line of management of this
patient is  [AIIMS May 2016]

a. Sinus rhythm
b. PSVT
c. Atrial fibrillation
d. Ventricular fibrillation

11. Identify the ECG given [AIIMS November 2015]

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a. IV abciximab
b. IV thrombolysis


c.
d.
Primary percutaneous intervention
Low molecular weight heparin
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9. 
A 52 year old diabetic patient complaints of a. Sinus rhythm
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palpitations. His ECG is as below. The first line of b. PSVT

management is  c. Torsades de pointes Ans.
[AIIMS May 2016; AIIMS November 2015] d. Ventricular fibrillatio
8. c
9. d
10. c
11. c
12. c
12. 
Diagnose the Underlying Medical disorder by
ECG change in Photograph

a. Primary PCI
b. Cardioversion a. Ventricular tachycardia
c. IV amiodarone b. Ventricular fibrillation
d. Adenosine c. First degree AV block
d. Hyperkalemia
 830 Spotters
PHOTON 20

13. 
Diagnose the Underlying Medical disorder by 16. 
Diagnose the Underlying Medical disorder by
ECG change in Photograph ECG change in Photograph

a. Hypokalemia
b. Hyperkalemia
c. Hypercalcemia a. Sinus arrhythmia b. Atrial flutter
d. Hypocalcemia c. Atrial fibrillation d. AV block

14. 
Diagnose the Underlying Medical disorder by 17. 
Diagnose the Underlying Medical disorder by
ECG change in Photograph ECG change in Photograph

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a. Sinus arrhythmia
b. Atrial flutter
c. Atrial fibrillation
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a. Hypokalemia
b. Hyperkalemia d. AV block
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c. Hypercalcemia
d. Hypocalcemia
Ans.
13. d
14. b
15. c 15. 
Diagnose the Underlying Medical disorder by 18. Identify the ECG type shown in the Photograph
16. c ECG change in Photograph
17. b
18. b

a. P-mitrale
b. Sinus tachycardia
a. Left atrial enlargement c. Atrial ectopics
b. Left ventricular hypertrophy d. PSVT
c. Right atrial enlargement
d. Right ventricular hypertrophy
 Spotters 831

SPOTTERS
19. Identify the ECG type shown in the Photograph 22. Wider duration of ECG wave form (Red line) in
Photograph occur if [Recent Question 2013]

a. P-mitrale
b. Atrial flutter a. > 0.06 seconds b. > 0.08 seconds
c. Atrial ectopics c. > 0.10 seconds d. > 0.12 seconds
d. PSVT
23. Wave (Arrow) shown in Photograph is character-
istic of  [Recent Question 2014]

20. Condition shown in Photograph is NOT found in

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[Recent Question 2013]

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a. Hypocalcemia b. Hyponatremia
c. Hypomagnesemia d. Hypokalemia
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a. Hypocalcemia
24. ECG changes and Tachycardia are seen maximum
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b. Hyponatremia
c. Hypokalemia with which Antidepressant drug?
d. Hypomagnesemia
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Ans.
19. d
20. b
21. Best line of Management of Condition shown in 21. c
Photograph is [Recent Question 2014] 22. d
23. d
a. Amitriptyline b. Fluoxetine 24. a
c. Trazodone d. Doxepin 25. a

25. 
Prolongation of Segment shown in ECG
Photograph occur due to

a. IABP
b. Vasopressors
c. Reperfusion therapy a. Thioridazine b. Haloperidol
d. Thrombolysis c. Chlorpromazine d. Clozapine
 832 Spotters

Answers & Explanations of ECG Analysis

PHOTON 20

R1. Ans. (a)  2:1 heart block Topic-wise Answers

[Ref. Interpreting the Electrocardiogram by Fleming, 1/e p85]
1. Ans. (c)  Inverted T waves
BRADYCARDIAS
•• Sinus bradycardia: Normal rhythm with HR <60
•• First degree heart block: Only prolongation of the PR
interval
[Ref. A.K. Jain, 6/e Vol 1 p306]
ECG CHANGES WITH CHANGE IN IONIC COMPOSITION
•• Hyperkalemia (Photograph): Prolonged & abnormal QRS
complex, Tall tented T waves
•• Hypokalemia: Increase PR interval, ST segment depression,
T-wave inversion, Prominent U wave
•• Hypercalcemia: Calcium rigor (heart relaxes less in diastole,
finally stops in systole)
•• Hypocalcemia: Prolonged ST segment, QT interval also
increases

2. Ans. (d)  Closure of Aortic valve

[Ref. AK Jain, 6/e p287-288]

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HEART SOUNDS (PHOTOGRAPH)

•• Second degree heart block:

,3 •• HS1: AV valve closure (Onset of Ventricular diastole) 0.1-
0.17 seconds
•• HS2: Semilunar valve closure (Onset of Ventricular systole)
Mobitz I (Wenkebach): Progressive prolongation of PR
20
ƒƒ
0.1-0.14 seconds
interval followed by one missed beat. (non-conducted ‘P’ •• HS3: Vibrations in cardiac walls (Rapid filling in Ventricular
wave) diastole) 0.1 second
•• HS4: Vibrations during Atrial systole (Last Rapid filling in
on

Ventricular diastole)

3. Ans. (a)  Propanolol

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[Ref. Tripathi, 7/e p145]

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•• During intraoperative tachycardia (Photograph),

ƒƒ Mobitz II: Normal PR interval with one missed beat in Propranolol decreases heart rate,force of contraction
between. (non-conducted ‘p’ wave) prolongs systole by retarding conduction so that synergy of
contraction of ventricular fibres is disturbed
•• Total coronary flow is reduced by blockade of dilator
receptors

4. Ans.  NONE (Magnesium is DOC)

[Ref. Tripathi, 7/e p533, 144]
•• Complete heart block:
CONGENITAL TORSADES DE POINTES (PHOTOGRAPH)
ƒƒ All the SA node impulses are block and there is escape
•• A life threatening polymorphic ventricular tachycardaia
rhythm regularly from below the level of the block associated with rapid asynchronous complexes and long
ƒƒ No relation between the P wave and QRS complexes (AV Q-T interval
dissociation) •• Treatment of choice: Magnesium
ƒƒ Also P-P interval and RR intervals are constant •• Prophylaxis: Beta blockers are indicated
ƒƒ Propranolol is most extensively used followed by Esmolol

Topper’s edge..................................................
•• Drug of choice for acquired torsades de pointes: Intravenous
magnesium
 Spotters
5. Ans. (c)  Adenosine
[Ref. Tripathi, 7/e p519]
•• Adenosine is Class 5 anti arrythmatic
•• Leads to hyper polarization of AV node by opening up the
potassium channels
•• Drug of choice for PSVT (Photograph)
•• Short acting; t½ is 10 seconds
•• Theophylline inhibits and dipyrimadole upregulates.
•• Other class V agents: Magnesium & Digoxin
6. Ans. (b)  Lidocaine
[Ref. Katzung, 13/e p238]
•• Lidocaine is the agent of choice for termination of
ventricular tachycardia and prevention of ventricular
fibrillation (Photograph) after cardioversion in the setting
of acute ischemia
•• Lidocaine has a half-life of 1-2 hours
7. Ans. (c)  Calcium gluconate
[Ref. Acute Kidney Problems by Jörres, 1/e p135]
•• Calcium gluconate (10 ml of 10% solution intravenous)
is the preferred immediate treatment in hyperkalemia
20
(Photograph)
8. Ans. (c)  Primary percutaneous intervention
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[Ref. Clinical Cardiology: Current Practice Guidelines, Updated 1/e
p270]
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SYNOPSIS FOR MANAGEMENT OF ACUTE MI (ECG IN
PHOTOGRAPH)
Ph
•• Patients facing a transport time <30 minutes should be
transferred for primary PCI
•• Thrombolytic-eligible patients who present <2 to 3 hours
from onset of symptoms and have >30 minutes transport
time should receive thrombolytic therapy
•• Patients presenting >2 to 3 hours after the onset of chest
pain and have a transport time of 60 minutes or less should
be promptly transported for primary PCI
•• If the anticipated transport time is >60 minutes, patients can
be treated with either thrombolytic therapy or primary PCI
•• In the given question, we have only the details of the
duration of the symptoms, which is 6 hours. (>2–3 hour
scale)
•• Transportation time < 60 min—Primary PCI
•• Transportation time > 60 minutes—thrombolysis or
primary PCI
9. Ans. (d)  Adenosine
•• ECG shows narrow complex tachycardia most probably
SVT (ECG in Photograph)
•• Next line of management is IV adenosine
833
SPOTTERS
Topper’s edge..................................................
APPROACH TO NARROW COMPLEX TACHYCARDIA (QRS <120 mS)
•• If irregular: AF, MAT
•• If regular look for visible p waves
ƒƒ No p waves: AVNRT
ƒƒ P waves visible: Atrial rate > ventricular rate – Atrial flutter
ƒƒ P waves visible: Atrial rate < ventricular rate look for RP
interval
  Short: AVNRT ,AVRT
  Long: Atrial tachycardia ,atypical AVNRT
10. Ans. (c)  Atrial fibrillation
[Ref. The ECG Manual by Gertsch, 1/e p223]
ATRIAL FIBRILLATION ECG (PHOTOGRAPH)
•• Occurs when multiple electrical impulses occur within the
atria
•• This chaotic electrical activity results in a chaotic wave form
between the QRS complexes
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•• P waves are absent: They are replaced by lower case “f ”
waves
•• No P waves means there is no PR interval measurement
,3
11. Ans. (c)  Torsades de pointes
[Ref. Emergency Cardiovascular Care and CPR by Field, 1/e p329]
TORSADES DE POINTES (TDP) (ECG IN PHOTOGRAPH)
•• A specific form of polymorphic ventricular tachycardia
occurring in the context of QT prolongation
•• It has a characteristic morphology in which the QRS
complexes “twist” around the isoelectric line
•• For TdP to be diagnosed, the patient has to have evidence of
both PVT and QT prolongation
•• Torsades de pointes may be responsive to magnesium and
to the combination of pacing and beta-blockers, whereas
polymorphic VT of other causes generally is not
12. Ans. (c)  First degree AV block
[Ref. CMDT 2016, p398; Harrison’s, 18/e p1872]
•• AV block is categorized as first-degree (PR interval greater
than 0.21 second with a atria impulses conducted)
•• The PR interval of the surface ECG is measured from the
onset of atrial depolarization (P wave) to the beginning of
ventricular depolarization (QRS complex)
•• Normally, this interval should be between 120 and 200
msec in the adult population. First-degree AV block is
considered “marked” when the PR interval exceeds 300
msec (Photograph)
13. Ans. (d)  Hypocalcemia
[Ref. Harrisons, 18/e p1838]
•• Hypocalcemia typically prolongs the QT interval (ST
portion) (Photograph), whereas hypercalcemia shortens it
•• Digitalis effect: Digitalis glycosides also shorten the QT
interval, often with a characteristic scooping of the ST–T-
wave complex
 834 Spotters
14. Ans. (b)  Hyperkalemia
PHOTON 20
[Ref. Harrisons, 18/e p1838]
HYPERKALEMIA
•• Begins with narrowing and peaking / tenting of tall T waves
(Photograph)
•• Further elevation of extracellular K + leads to AV
conduction disturbances, diminution in P-wave amplitude,
and widening of the QRS interval
•• Severe hyperkalemia causes sine wave pattern followed by
asystole
15. Ans. (c)  Right atrial enlargement
[Ref. Harrison’s, 19/e p1453]
•• Diagnosis of underlying medical condition shown in ECG is
right atrial enlargement
•• Right atrial overload (acute or chronic) may lead to an
increase in P-wave amplitude (≥2.5 mm), sometimes
referred to as “P-pulmonale (Photograph)
•• Left atrial overload typically produces a biphasic P wave
in V1 with a broad negative component or a broad (≥120
ms), often notched P wave in one or more limb leads. This
pattern, previously referred to as “P-mitrale
20
16. Ans. (c)  Atrial fibrillation
[Ref. Harrison’s, 19/e p1485]
on
ATRIAL FIBRILLATION
•• Disorganized, rapid, and irregular atrial activation with loss
of atrial contraction and with an irregular ventricular rate
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that is determined by AV nodal conduction
•• Varying R-R interval (Photograph), Normal QRST
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complex, atrial rate- 300-600/min, ventricular rate 100-160/
min
17. Ans. (b)  Atrial flutter
[Ref. CMDT 2016, p393]
ATRIAL FLUTTER (PHOTOGRAPH)
•• Usually regular heart rhythm
•• Often tachycardic (100–150 beats/min)
•• Often associated with palpitations (acute onset) or fatigue
(chronic)
•• ”Sawtooth”pattern of atrial activity in leads II, III, and AVF
•• Normal QRST complex, F-waves replacing P-waves
•• Often seen in conjunction with structural heart disease or
chronic obstructive pulmonary disease (COPD)
18. Ans. (b)  Sinus tachycardia
[Ref. CMDT 2016, p382]
SINUS TACHYCARDIA (PHOTOGRAPH)
•• Defined as a heart rate faster than 100 beats/min that is
caused by rapid impulse formation from the sinoatrial node
•• Sinus P-wave exceeding QRST with Rate >100/ min
19. Ans. (d)  PSVT
[Ref. Perioperative Medicine by Newman, 1/e p222]
•• MC SVT is Paroxysmal SVT (PSVT) with AV node reentry
•• It occurs in 60% of patients with SVT
•• Rate 160-200/min, Regular QRS complexes, P-wave hidden
in QRST complex
20. Ans. (b)  Hyponatremia
[Ref. CMDT 2016, p395]
•• Torsades de pointes (Photograph), a form of ventricular
tachycardia in which QRS morphology twists around the
base line, may occur in the setting of severe hypokalemia,
hypomagnesemia, or after administration a drug that
prolongs the QT-interval
21. Ans. (c)  Reperfusion therapy
[Ref. Internal Medicine by Singh, 2/e p900]
•• Management of Acute Myocardial Infarction: Best treatment
strategy is to prevent the development of cardiogenic shock
/e
with aggressive reperfusion therapy
•• Tall and peaked T waves (hyperacute T waves) in at least
,3 two contiguous leads provide an early sign of myocardial
infarction that may precede ST segment elevation
(Photograph)
22. Ans. (d)  > 0.12 seconds
[Ref. Respiratory Care by Wyka, 2/e p532]
•• If the QRS complex (Photograph) is wide (0.12 second), the
block is distal to the bundle of His
23. Ans. (d)  Hypokalemia
[Ref. Harrisons, 18/e p1834,1838]
•• An abnormal increase in U-wave (Photograph) amplitude
is most commonly due to drugs like dofetilide, amiodarone,
sotalol, quinidine, procainamide, disopyramide or due to
hypokalemia
•• Hypokalemia prolongs ventricular repolarization, often
with prominent U waves
24. Ans. (a)  Amitriptyline
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e p1368]
•• CVS adverse effects of Amitriptyline (Tryptomer) are
postural hypotension, dizziness, hypertension, sinus
tachycardia, premature atrial or ventricular beats, anti
arrhythmic effect, myocardial depression, pedal edema,
ST-segment depression, T-wave flattened or inverted, QRS-
prolongation
25. Ans. (a)  Thioridazine
[Ref. Kaplan & Sadock, 11/e p274]
•• Thioridazine has been associated with QTc interval in a
dose related manner
•• Prolongation of the QTc interval (Photograph) has been
associated with Torsade’s de pointes arrhythmias.
 Spotters 835

SPOTTERS
Chest X-rays

Lobar Pneumonia Asbestos Plaques

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Explanation: Explanation:
The chest x-ray shows right upper lobe pneumonia. We can The chest x-ray shows multiple calcified asbestos plaques on
observe how the inferior margin of the consolidation is quite inner chest wall.
on

straight.
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Pleural Effusion Bronchiectasis

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Explanation: Explanation:
The chest x-ray shows right pleural effusion. The fluid has The chest x-ray shows the localized bronchiectatic area in
encased the majority of the lung and increased whiteness can the right lower lobe. Typical ring shadows giving a “bunch of
be seen around the apex of the lung. grapes” appearance (a) can be seen in the lower lobe.
 836 Spotters

Pulmonary Fibrosis Chronic Obstructive Pulmonary Disease

PHOTON 20

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Explanation: Explanation:
The chest x-ray shows pulmonary fibrosis. A fine meshwork
can be seen over the lungs which is worse at base of the lung.
,3 The chest x-ray shows chronic obstructive pulmonary disease.
The lungs appear larger in volume. The right upper zone and
20
many areas of left lung appear abnormally black because of
emphysema.
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Tuberculosis Pneumothorax
Ph

Explanation:
The chest x-ray shows tuberculosis findings in the lungs.
Typical military shadowing and soft shadowing in left apex is
seen, which confirms tuberculosis.
Explanation:
 he chest x-ray shows left sided pneumothorax with partial
T
collapse of the left lung. The outer lung field is black.
 Spotters 837

Atrial Septal Defect Descending Thoracic Aortic Aneurysm

SPOTTERS
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Explanation: Explanation:
The chest x-ray shows typical atrial septal defect appearance.
The heart is enlarged and the apex appears rounded. The right
atrium can be seen highly prominent (a) and dilatation of
,3 The chest x-ray shows aneurysm in descending thoracic
aorta. The mediastinum is widened to the left with increased
convexity around aortic arch.
20
pulmonary arteries (b) is visible due to increased blood flow
to the lungs.
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Pericardial Effusion Hiatus Hernia

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Explanation: Explanation:
The chest x-ray shows pericardial effusion. The shadow of the The chest x-ray shows hiatus hernia as a curved white line
heart is enlarged and is globular in shape. lying behind the heart.
 838 Spotters
PHOTON 20

Ultrasounds

Gestational Sac at 5 Weeks Gestational Sac at 9 Weeks

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20
Explanation: Explanation:
USG shows gestational sac (in red circle) at 5 weeks of gestation USG shows the view of gestational sac at 9 weeks of pregnancy,
in the sagittal midline view of the uterus. The gestational sac in which embryo (red arrow), yolk sac (blue arrow) and
appears as a fluid collection with 2 echogenic rings around it. amnion (pink circle) can be seen. The fluid within the amnion
on

This is called double sac sign. is amniotic fluid and outside the amnion is chorionic fluid.
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Yolk Sac at 6 Weeks Placenta (At Late First Trimester)

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Explanation:
USG shows yolk sac (in red circle) within the gestational sac at
6 weeks of gestation. Explanation:
USG shows well-formed placenta (red arrow) in the late first
trimester of pregnancy.
 Spotters 839

Umbilical Cord Placenta Previa

SPOTTERS
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Explanation:
USG shows insertion of umbilical cord (red arrow) into the
placenta (blue arrow).
,3
Explanation:
USG shows complete placenta previa in the sagittal view of
lower uterus in which the placenta (red arrow) can be seen
20
completely covering the cervix (blue arrow).
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Placenta (At Second Trimester) Placental Abruption

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Explanation:
USG shows well-formed placenta (marked red) in the second
trimester which appears as a homogenously echogenic
structure on anterior aspect of gestational sac. Explanation:
USG shows placental abruption with a hematoma (marked
red) between the placenta (blue arrow) and the uterine wall.
 840 Spotters

2 Gestational Sac at 5 Weeks Complete Hydatidiform Mole

PHOTON 20

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Explanation:

Explanation: USG shows complete hydatidiform mole (marked red) which

USG shows 2 gestational sacs (red arrows) in a 5 weeks

pregnancy confirming twins.
,3 is seen as a mass filled with multiple cystic spaces.
20

Normal Ovary Ectopic Pregnancy

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Explanation:
USG shows a corneal ectopic pregnancy which is a rare
condition and happens only in females with bicornuate or
septate uterus. The gestational sac shows a live embryo (red
arrow) corresponding to 6 weeks of pregnancy.
Explanation:
USG shows the normal ovary (marked red) of a woman of
reproductive age. Several small follicles (blue arrow) are easily
identifiable.
Ph
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