Chapter 15: Pelvic Inflammatory Disease and Endometriosis

Question 1

presence of endometrial glands and tissue found in the uterine wall

Answer 1

adenomyosis

Question 2

painful menstruation

Answer 2

dysmennorhea

Question 3

painful intercourse

Answer 3

dyspareunia

Question 4

implants of endometrial tissue outside the uterus

Answer 4

endometriosis

Question 5

blood-filled cyst located on the ovary, which is the result of endometriosis

Answer 5

endometrioma

Question 6

Bacterial infection of the endometrium with potential extension into the surrounding (parametrial) tissues

Answer 6

endometritis

Question 7

Rare complication of PID resulting in the development of liver adhesions owing to the inflammatory exudates

Answer 7

Fitz-Hugh-Curtis syndrome

Question 8

myometrial inflammation

Answer 8

myometritis

Question 9

infection of the ovaries

Answer 9

oophoritis

Question 10

infection of the connective tissue surrounding the uterus

Answer 10

parametritis

Question 11

infection of the female reproductive tract

Answer 11

pelvic inflammatory disease (PID)

Question 12

pus within the fallopian tube

Answer 12

pyosalpinx

Question 13

infection of the fallopian tube

Answer 13

salpingitis

Question 14

infection found in the late stages of PID resulting in the inability to differentiate between tubal and ovarian structures

Answer 14

tubo-ovarian abscess (TOA)

Question 15

infection of the peritoneum

Answer 15

peritonitis

Question 16

Pelvic inflammatory disease is:

Answer 16

infection of the female genital tract causing diffuse inflammation

Question 17

One incident of PID can increase the risk of tubal factor infertility and ectopic pregnancy:

Answer 17

six times

Question 18

Bacterial vaginosis (BV) is the most common infection of the _____ in reproductive-age women.

Answer 18

lower genital tract

Question 19

Early sonographic findings of pelvic inflammatory disease are:

Answer 19

often nonspecific

Question 20

A normal fallopian tube:

Answer 20

is not visualized with ultrasound

Question 21

Fitz-Hugh-Curtis syndrome is caused by peritonitis and includes what organ?

Answer 21

liver

Question 22

Acute PID sonographic findings are all except:
a. edematous fallopian tube wall, large amount of pelvic free fluid
b. enlarged ovaries
c. purulent exudate escaping the tube
d. sharp uterine borders

Answer 22

d

Question 23

When seen in cross-section, a hydrosalpinx may exhibit is

Answer 23

the “beads on a string” sign

Question 24

Define tubo-ovarian complex:

Answer 24

refers to the affected ovary and tube that are adheret to one another, but their individual architecture is still identifiable on ultrasound

Question 25

Chronic progression of endometriosis can lead to all but the following: a, severe cyclic pain b. infertility c. simple cysts d. endometrial invasion of organs

Answer 25

c

Question 26

Endometriosis is known to affect:

Answer 26

reproductive-age females

Question 27

Endometriosis _____ transforms into malignancy.

Answer 27

rarely

Question 28

Introduction of an IUD may elevate the risk for PID following insertion for:

Answer 28

up to 3 weeks

Question 29

Endometriomas appear sonographically thick-walled, spherical masses, and frequently (95% of the time) displaying:

Answer 29

low-level internal echoes ("ground-glass" appearance)

Question 30

Hydrosalpinx develops when:

Answer 30

fluid accumulates within a scarred, obstructed fallopian tube

Question 31

Sonographic findings for adenomyosis are all except: a. an asymmetrically enlarged uterus b. heterogeneous myometrial echotexture c. peripheral uterine calcific deposits d. myometrial cysts

Answer 31

c

Question 32

Endometriomas image as:

Answer 32

anechoic

Question 33

Choose the correct statement regarding pelvic inflammatory disease. a. Early stages demonstrate a variable appearance and an enlarged uterus with indistinct margins b. salpingitis displaying thin walled tubes with pyosalpinx c. normal ovarian dimensions with ill-defined tissue planes d. No pelvic free fluid will be seen

Answer 33

a

Question 34

The most effective treatment for patients suffering from severe endometriosis who do not respond to conservative surgical management and medical therapies is:

Answer 34

oophorectomy and hormonal medical management

Question 35

Endometriosis can implant in all areas except the: a. ovary b. groin c. posterior cul-de-sac d. pelvic lymph nodes

Answer 35

d

Question 36

The most likely area for PID to develop is ______, also known as ______.

Answer 36

oviducts or fallopian tubes salpingitis

Question 37

The three major sequelae of PID are ______, ______, and ______.

Answer 37

chronic pelvic pain ectopic pregnancy infertility

Question 38

A fallopian tube affected with PID demonstrates a _____ sign when imaged in cross-section.

Answer 38

cogwheel

Question 39

Clinical findings that include right-sided pleuritic pain and right-sided upper quadrant pain and tenderness on palpitation related to PID is called ______.

Answer 39

Fitz-Hugh-Curtis Syndrome

Question 40

PID of the uterine myometrial endometrial junction appears ______, and the endometrium may be thickened and heterogeneous and contain ______ within the cavity.

Answer 40

Blurred Fluid

Question 41

Escape of purulent exudate beyond the fallopian tube results in ______ complex.

Answer 41

Turbo-Ovarian

Question 42

The presence of endometrial glands and tissues in the uterine wall is ______.

Answer 42

Endometriosis

Question 43

Endometriosis nodules may vary from _____ echoic to ____ echoic in appearance and may be either ______ in the case of recent hemorrhage or ______ secondary to fibrosis.

Answer 43

Hypo Hyper Cystic Nodular

Question 44

Focal ovarian endometriosis appears on ultrasound examination as cystic structures called ______.

Answer 44

Endometriomas

Question 45

Endometriosis can be focal or _____.

Answer 45

Diffuse

Question 46

The sonographic appearance of adenymyosis lacks a discrete ______ within the myometrium.

Answer 46

Junctional zone

Question 47

Adenomyosis is generally treated _____.

Answer 47

Surgically

Question 48

_______ may be difficult to differentiate from an ovarian cyst or small cystadenoma.

Answer 48

Endometrioma

Question 49

______ is infection of the ovary (ies).

Answer 49

Oophoritis

Question 50

A round mass like calcific structure with edge shadowing and peripheral vascularization is a ______.

Answer 50

Leiomyomata

Question 51

An endometrioma associated with urinary bladder causes _____ symptoms.

Answer 51

Dysuria

Question 52

A highly sensitive and specific imaging method for diagnosing adenomyosis is _______.

Answer 52

Endovaginal ultrasound

Question 53

An elevated white blood count, vaginal secretions, elevated erythrocyte sedimentation rate, and C-reactive protein is an indication of _______.

Answer 53

Pelvic inflammatory disease

Question 54

If color Doppler flow is visualized within an endometrioma, ______ must be suspected.

Answer 54

Malignancy

Question 55

Adenomyosis usually affects the ______ portion of the uterus.

Answer 55

Myometrial