Class 5

Question 1

What are some of the indications for an Ultrasound Examination of the female pelvic area?

Answer 1

• UTERINE ENLARGEMENT
• PELVIC PAIN
• IRREGULAR OR POST MENOPAUSAL BLEEDING
• PALPABLE PELVIC MASS
• AMENORRHEA OR DYSMENORRHEA
• INFERTILITY

Question 2

What is a Nabothian Cyst?

Answer 2

A cyst found on the cervix

Question 3

Benign Condition of the Cervix: What causes a Nabothian Cyst?

Answer 3

Forms in response to inflammation of endocervical gland

Question 4

True or False: Nabothian Cysts are common

Answer 4

True

Question 5

How big is a Nabothian Cyst?

Answer 5

3mm to 3cm

Question 6

What is the Ultrasound Appearance of a Nabothian Cyst?

Answer 6

Anechoic with enhanced sound transmission in cervix

Question 7

True or False: Cervical Polyps are NOT common in Multigravidas

Answer 7

False

Question 8

True or False: Cervical Polyps are common in patients in their 40’s and 50’s

Answer 8

True

Question 9

True or False: Cervical Polyps are Asymptomatic

Answer 9

True

Question 10

True or False: Cervical Polyps are a rare condition

Answer 10

False: Cervical Polyps are the most common benign cervical neoplasm

Question 11

Ultrasound Appearance of Cervical Polyps

Answer 11

Small echogenic areas in cervix

Question 12

What is the percentage of the time that Cervical Myomas (fibroids) occur?

Answer 12

3% to 8%

Question 13

True or false: Cervical Myoma (fibroid) may be asymptomatic

Answer 13

True

Question 14

Cervical Myoma (fibroid) may cause?

Answer 14

dyspareunia, dysuria, cervical obstruction, prolapse, bleeding, obstructed labor

Question 15

Treatment for Cervical Myoma (fibroid) may include?

Answer 15

Resection or hysterectomy if warranted

Question 16

Ultrasound Appearance of Cervical Myoma

Answer 16

Cervix may appear bulk or distorted

Question 17

Endometrial Polyps are most common in patients aging?

Answer 17

40-49 years old

Question 18

True or False: The Etiology of Endometrial Polyps is known

Answer 18

False: the Eitology is unknown

Question 19

Where are endometrial Polyps often found?

Answer 19

The Cornual region of the fundus

Question 20

True or False: Endometrial Polyps may be asymptomatic or Cause Bleeding

Answer 20

True

Question 21

Ultrasound Appearance of Endometrial Polyps

Answer 21

May appear on US as hyperechoic areas within endometrium

Question 22

What is Tamoxifen?

Answer 22

A non-steroidal anti-estrogen drug

Question 23

Who is given Tamoxifen?

Answer 23

Patients with Breastcancer

Question 24

Tamoxifen is associated with changes in where?

Answer 24

Endometrium

Question 25

True or False: Tamoxifen has no side-effects

Answer 25

False: Tamoxifen may lead to development of polyps, endometrial cancer, myoma growth

Question 26

What is Adenomyosis?

Answer 26

Endometrial glands and stroma grow into the myometrium

Question 27

Adenomyosis is more common in who and when?

Answer 27

Women over the age of 50 years old

Question 28

How is Adenomyosis diagnosed?

Answer 28

Surgically or with MRI

Question 29

In over 50% of cases Adenomyosis is associated with?

Answer 29

Leiomyoma

Question 30

US appearance of Adenomyosis

Answer 30

Enlarged Uterus of normal or decreased echogenicity

Question 31

What are Leiomyomas and what are other names for them?

Answer 31

AKA: leiomyomata, fibroid, myoma, fibromyoma Def: Benign muscle tumors

Question 32

Where are Leiomyomas commonly found?

Answer 32

Most common tumor of female pelvis

Question 33

Leiomyomas consist of?

Answer 33

Consist of lobulations of myometrial tissue which can distort the uterine contour and endometrial stripe

Question 34

Leiomyomas are found in _____% of women greater than ____ years old a. 20:20 b. 35:20 c. 20:35 d. 35:35

Answer 34

C. 20% : 35 years old

Question 35

Leiomyomas are found more in which population?

Answer 35

Afro-American Population

Question 36

Leiomyomas range from ___mm to ___cm in size? a. 1: 25 b. 20:20 c. 1:20 d. hecka:hella

Answer 36

C. 1mm : 20cm

Question 37

What are the signs and symptoms of Leiomyomas?

Answer 37

``` Pelvic pain Menorrhagia Asymptomatic Bladder or rectum pressure Infertility Spontaneous abortion ```

Question 38

How are Myoma classified?

Answer 38

``` CLASSIFIED IN RELATION TO POSITION TO UTERINE WALL INTRAMURAL (INTERSTITIAL) SUBSEROSAL SUBMUCOSAL PEDUNCULATED ```

Question 39

True or False: During Pregnancy fibroids may grow due to increase in progesterone

Answer 39

False: DURING PREGNANCY FIBROIDS MAY GROW DUE TO INCREASE IN ESTROGEN

Question 40

True or False: After menopause, fibroids tend to shrink due to decreased levels of estrogen

Answer 40

True

Question 41

What are some degenerative changes of Fibroids?

Answer 41

Cystic degeneration, calcification, and Hyaline degeneration

Question 42

True or False: Fibroids have subtle changes in echogenicity of myometrium

Answer 42

True

Question 43

True or False: Fibroids have ill-defined masses

Answer 43

False: they have well defined masses

Question 44

True or False: Fibroids have whorled appearances that are hypoechoic to anechoic

Answer 44

True

Question 45

``` Which of the following are not a sonographic appearance of Fibroids? A. Echogenic areas with distal shadowing B. Uterine lobulation C. Endometrial distortion D. Ill-defined masses E. Uterine enlargement ```

Answer 45

D. Fibroids do not have ill defined masses

Question 46

Pendunculated Fibroids may extend in which positions?

Answer 46

Anteriorly, Posteriorly, or Laterally

Question 47

What are some of the Differential Diagnoses of Penduculated Fibroids?

Answer 47

- Bicornuate uterus - Blind uterine horn - Ovarian mass - Hydatiform mole - Ectopic pregnancy