Chapter 7: Congenital Anomalies of the Female Genital System

Question 1

Reconstructive surgery on the uterus for women with reproductive failure

Answer 1

metroplasty

Question 2

complete absence of the uterus

Answer 2

uterine aplasia

Question 3

a small opening, especially one of entrance into a hollow organ or canal, such as the fallopian tube

Answer 3

ostium

Question 4

accumulation of menstrual blood in the vagina resulting from a lower vaginal obstruction or imperforate hymen

Answer 4

hematocolpos

Question 5

usually congenital owing to failure of degeneration of central epithelial cells of the hymenal membrane. An imperforate hymen is visible upon examination as a translucent thin membrane just inferior to the urethral meatus that bulges with the Valsalva maneuver and completely covers the vagina; it must be surgically corrected

Answer 5

imperforate hymen

Question 6

mechanism by which the uterine septum regresses

Answer 6

apoptosis

Question 7

absence of one or both kidneys

Answer 7

renal agenesis

Question 8

accumulation of watery fluid in the uterine cavity

Answer 8

hydrometra

Question 9

characterized by congenital fusion of the cervical spine, a short neck, a low posterior hairline, and limited range of cervical spine motion. Associated with Mayer- Rokitansky- Kuster- Hauser syndrome

Answer 9

Klipper-Feil syndrome

Question 10

anomaly that results in one cervix and one uterine horn

Answer 10

uterus unicornis unicollis

Question 11

nonsteroidal drug administered between the late 1940s to early 1970s to pregnant women. This drug was first demonstrated as a transplacental carcinogen responsible for clear-cell vaginal carcinoma in girls born to mothers who took the drug during pregnancy to prevent miscarriage. Uterine malformations associated with this drug’s exposure include uterine hypoplasia and a T-shaped endometrium

Answer 11

diethylstilbestrol (DES)

Question 12

ring-like area of tissue that represents the opening to the vagina

Answer 12

hymen

Question 13

medical condition in which a pregnant woman’s cervix begins to dilate and efface before her pregnancy has reached term. This may cause miscarriage or preterm birth during the second and third trimesters.

Answer 13

cervical incompetence

Question 14

retention of blood in the uterine cavity

Answer 14

hematrometra

Question 15

mental or physical traits, anomalies, malformations, or diseases present at birth

Answer 15

congenital

Question 16

anomaly that results in two vaginas, two cervices, and two uteri

Answer 16

uterine didelphys

Question 17

uterus didelphys with obstructed unilateral vagina and associated ipsilateral renal and ureter agenesis

Answer 17

Wunderlich- Herlyn- Werner- syndrome

Question 18

accumulation of menstrual blood in the uterus and vagina caused by either an imperforate hymen or other obstruction

Answer 18

hematometrocolpos

Question 19

mildest fusion anomaly, resulting in a partial indentation of the uterine fundus with a normal endometrial cavity; considered a normal variant

Answer 19

uterus arcuate

Question 20

part of the vaginal plate of the urogenital sinus, which forms the lower 20% of the vagina

Answer 20

sinovaginal bulb

Question 21

paired embryonic tubes roughly parallel with the mesonephric ducts that empty into the urogenital sinus; in the female, the upper part of these ducts forms the fallopian tubes and the lower parts to fuse to form the uterus

Answer 21

paramesonephric (mullerian) ducts

Question 22

anomaly that results in one vagina, two cervices, and two uterine horns

Answer 22

uterus bicornis bicollic

Question 23

complete failure of resorption of the uterovaginal septum

Answer 23

septate uterus

Question 24

radiographic imaging of the uterus and fallopian tubes after injection of radiopaque material

Answer 24

hysterosalpingography

Question 25

anomaly that results in one vagina, one cervix, and two uterine horns

Answer 25

uterine bicornis unicollis

Question 26

partial failure of the medial septum to be reabsorbed

Answer 26

subseptate uterus

Question 27

congential anomalies of the vertebra/ anus/ cardiac/ trachea/ esophagus/ radius/ renal/ limb of unknown etiology

Answer 27

VATER/ VACTERL syndrome

Question 28

Complications from uterine and vaginal malformations do not occur from:

Answer 28

distal ductal regression

Question 29

Germ cells that migrate from the yolk sac to the gonadal region form the:

Answer 29

genital ridges becoming sex cords

Question 30

Apoptosis is related to:

Answer 30

regression of the uterine septum

Question 31

Sonography is useful in imaging _____, a combination of menstrual blood, fluid, and secretions in the distended vagina and uterus caused by imperforate hymen.

Answer 31

hematometerocolpos

Question 32

Arrested development of the bilateral mullerian ducts causes:

Answer 32

hypoplasia of both the uterus and vagina

Question 33

MRKH and MURCS are related to:

Answer 33

fetal renal and spinal anomalies

Question 34

The wolffian duct forms the sinovaginal bulbs which with the mullerian tubercle finally becomes:

Answer 34

lower one-fifth of the vagina

Question 35

Uterine agenesis is imaged best in the:

Answer 35

sagittal plane

Question 36

Defects of vertical vaginal fusion can result in the formation of a transverse vaginal septum, which can cause:

Answer 36

obstruction and hematocolopos

Question 37

Initially, a transverse vaginal septum requires all except: a. laparoscopy for endometriosis b. drainage of accumulated menstrual blood c. preservation of a perineal space of adequate size to function as a normal vagina d. septum excisiion

Answer 37

a

Question 38

The easiest vaginal anomaly to view sonographically is:

Answer 38

complete absence of the vagina

Question 39

Which imaging modality is extremely helpful if hematometrocolpos or hematometra distorts the reproductive organs causing limited imaging capability using ultrasound?

Answer 39

MRI

Question 40

Sonohysterography is also known as:

Answer 40

saline-infused sonography (SIS)

Question 41

Choose the most effective diagnostic method for determining uterus unicornis. a. 2D vaginal sonography b. HSG c. NM d. 2D abdominal sonography

Answer 41

b

Question 42

Bicornuate uterus is related to:

Answer 42

cervical incompetence

Question 43

Choose a definite method for distinguishing bicornuate uterus from septate anomalies. a. MRI, 3D endovaginal sonography b. MRI, HSG c. HSG, 3D sonography d. HSG, 3D transabdominal sonography

Answer 43

a

Question 44

Complete midline failure of mullerian duct fusion results in:

Answer 44

uterine didelphys

Question 45

The uterine septum consists of:

Answer 45

poorly vascularized fibromuscular tissue

Question 46

Uterus didelphys, more than any other mullerian anomaly, is associated with:

Answer 46

renal agenesis

Question 47

Anomalies of the fallopian tubes include:

Answer 47

luminal atresia, absent muscular layer, and absent ampulla

Question 48

Most congenital anomalies are diagnosed in the ______ or recurrent _______ loss populations.

Answer 48

infertility pregnancy

Question 49

It is extremely important to distinguish between a _______ and a septate uterus because the pregnancy outcomes and treatment techniques differ considerably.

Answer 49

bicornuate uterus

Question 50

DES-exposed women have uterine anomalies visualised with _____.

Answer 50

HSG

Question 51

3D multiplanar ______ sonography is valuable in imaging the hypoplastic uterus and T-shaped uterine cavity.

Answer 51

endovaginal

Question 52

Fallopian tube patency can be established with _____ or _____ using a contrast agent or saline.

Answer 52

HSG sonohysterography

Question 53

A double cervix (cervical duplication), in rare cases, develops with a complete ______ and _____ septa.

Answer 53

uterine vaginal

Question 54

Pelvic ultrasound can help to diagnose _______, menstrual blood, fluid, and secretions in the uterus and vagina.

Answer 54

hydrometrocolpos

Question 55

A ______ septum is not the same as the imperforate hymen

Answer 55

transverse

Question 56

The method used to create a vagina if vaginal agenesis is diagnosed is ______.

Answer 56

vaginoplasty

Question 57

A mild indentation ofo the superior portion of the endometrium is called an _____ uterus.

Answer 57

arcuate

Question 58

In the case of atretic or absent vagina, the _____ scanning approach is helpful.

Answer 58

sagittal

Question 59

Uterus _______ is the result of normal development of half of the uterus with no or rudimentary development of the rest/.

Answer 59

unicornis

Question 60

Sonographic _____ imaging of the unicornis uterus is sensitive, demonstrating myometrial and ______ structures, as well as cervical canal, uterine external contours, and cornual angles.

Answer 60

3D endometrial

Question 61

A bicornuate uterus _____ failed to fuse while a uterine didelyphis _____ failed to fuse.

Answer 61

partial complete

Question 62

A _____ duct cyst is a very common remnant of the distal mesonephric duct.

Answer 62

gartner

Question 63

Hematometra is retention of blood in the ______/

Answer 63

uterine cavity

Question 64

Narrowing of the uterine cavity by the septum is a condition suggesting poor _____ outcomes.

Answer 64

pregnancy

Question 65

HSG, ____, CT, and ______ help diagnose and monitor patients with congenital anomalies of the genital tract./

Answer 65

MRI sonography

Question 66

DES (diethylstilbestrol) is known to cause a ____ shaped uterine endometrium.

Answer 66

T

Question 67

Ectopic ovaries are known as _______ or accessory.

Answer 67

supernumerary