Myultrasoundtutor quizzes (Part 1) Flashcards by Ysabella Hartnett

What 2 bony boundaries are most posterior and inferior and form the back wall of the pelvis?

1) Sacrum
2) Coccyx

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What structure are the innominate bones?

bones of the hips

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Name the 3 bones that form the innominate

1) ilium
2) ischium
3) pubic symphysis

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The imaginary line from the symphysis to sacral prominence is called?

Linea Terminalis

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Where is the true pelvis located?

deep and below the linea terminalis

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The bladder, small bowel, ascending and descending colon, rectum, uterus, ovaries, fallopian tubes, internal iliacs, and 5 muscles make up:

a) true pelvis
b) deep pelvis

a) true pelvis

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Name the 5 true pelvic muscles

1) levator ani
2) coccygeus
3) obturator internus
4) piriformis
5) iliopsoas

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Name the 2 muscles that make up the pelvic diaphragm

1) levator ani
2) coccygeus

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This muscle is hammock shaped and gives support to the pelvic organs

Pelvic diaphragm

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This muscle is identified scanning transverse inferiorly at the level of the vagina posterior to the bladder, vagina, and rectum

Pelvic diaphragm

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Name the 3 muscles located in the adnexa

1) obturator internus
2) piriformis
3) iliopsoas

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What adnexa muscle is located lateral to the bladder?

Obturator internus

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What adnexa muscle is located posterolateral?

piriformis

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What adnexa muscle is located anterolateral?

Iliopsoas release

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What muscles appear as ovoid hypoechoic structures that elongate in sagittal and are adjacent or lateral to the bladder, ovaries, and uterus?

Adnexa “OPI” muscles

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What ligament is only ever visualized when there is pelvic ascites?

Broad ligament

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Name the uterine ligament that is a double fold of peritoneum that is on the lateral sides of the uterus to the wall so the pelvis that support the pelvic organs

Broad ligament

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Name the uterine ligament that is between the folds of the broad ligament and supports the fundus of the uterus

Round ligament

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Name the uterine ligament that contains the vasculature of the pelvis

Cardinal ligament

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What is another name for the retropubic space?

Space of Retzius

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This space is located anterior to the bladder

Retropubic space

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This space is located in the lower quadrants of the abdomen and are lateral spaces to the uterus

Adnexa

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What is another name for the anterior cul de sac?

Vesicouterine pouch

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What space is located between the bladder and uterus and is anterior to the uterus

Anterior cul de sac

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What is another name for the posterior cul de sac?

Rectouterine pouch or pouch of Douglas

Name the space that is located between the uterus and rectum

Posterior cul de sac

What is another name for the internal iliac artery

hypogastric artery

The uterine arteries are branches of what artery?

Internal iliac artery

What artery is a ?periphery of the myometrium?

Arcuate arteries

What arteries are located deeper into the myometrium?

Radial arteries

Name the 2 arteries that are layers of the endometrium

1) straight 2) spiral

The ovarian arteries originate from what?

The aorta

What is another name for the ovarian arteries?

Gonadal arteries

The uterine veins return or drain into ?

Internal iliac veins

The right ovarian vein drains into?

IVC

the left ovarian vein drains into?

Left renal vein

This vein is the longest pelvic muscle

Left ovarian vein

Name the organ that is located anterior to the rectum, posterior to the bladder, and bound laterally by the broad ligament

Uterus

This part of the uterus is the most superior and widest

Fundus

What part of the uterus is the body and is the largest area

Corpus

The _____ is called the lower uterine segment in pregnancy

Isthmus

The ________ ______ opens into the vaginal canal and is surrounded by vaginal fornix

External os

Name the 3 layers of the uterus

1) serosa 2) myometrium 3) endometrium

What is another for the serosa layer of the uterus?

Perimetrium

This layer of the uterus is outermost /organ fasica

Serosa

What layer of the uterus is the mucosal layer that consists of 2 layers

Endometrium

The endometrium consists of 2 layers the basal and functional. Which layer is shed during menses?

Functional

This type of uterus the body tilts forward 90 degree angle with the cervix a) anteversion b) anteflexion c) retroflexion d) retroversion

a) anteversion

This type of uterus the body folds forward and comes in contact with the cervix a) anteversion b) anteflexion c) retroflexion d) retroversion

b) anteflexion

This type of uterus the body tilts back and comes in contact with the back of the cervix a) anteversion b) anteflexion c) retroflexion d) retroversion

c) retroflexion

This type of uterus the body tilts back without a bend a) anteversion b) anteflexion c) retroflexion d) retroversion

d) retroversion

What muscle group can be visualized lateral to the urinary bladder? a) obturator internus b) obturator externus c) psoas major d) pelvic diaphgram

a) obturator internus

What structure replaces the Graffian follicle? a) cumulus oophorus b) corpus albicans c) corpus luteum d) ovarian medulla

c) corpus luteum

Where is the most likely location for fluid to collect post-ovulatory? a) retropubic space b) endometrial cavity c) anterior cul de sac d) rectouterine pouch

d) rectouterine pouch

The ovaries are: a) endocrine glands b) exocrine glands

a) endocrine glands

The ______ ligament supports the ovary from the lateral side of the uterus to the ovary

ovarian

The ______ ligament supports the ovaries from the lateral pelvic side walls

Suspensory

The ovaries produce what 2 hormones?

1) estrogen 2) progesterone

The ovaries are stimulated by?

1) FSH 2) LH

How do you calculate ovarian volume?

L x W x H x 0.523

What section of the fallopian tube traverses the uterine cornu? a) isthmus b) interstitial c) ampulla d) cilia

b) interstitial

What marks the most inferior part of the cervix? a) internal os b) vagina c) external os d) isthmus

c) external os

Where does the uterine blood supply originate? a) internal iliac vein b) hypogastric artery c) aorta d) uterus

b) hypogastric artery -blood supply is referring to the artery. The uterine artery originates or arises from the internal iliac artery

Fertilization is most likely to occur where? a) ampulla b) infundibulum c) endometrial cavity d) uterine cornu

a) ampulla

What best describes the neonatal uterus? a) cervix is approx twice the size of the corpus b) fundus is twice the size of the uterine body c) uterine fundus is same size as the cervix d) entire uterus is small and tubular in shape

a) cervix is approx twice the size of the corpus

What muscle group is most likely to be identified while imaging inferiorly at the level of the vagina? a) iliopsoas b) psoas major c) rectus abdominis d) coccygeus

d) coccygeus

What is the superficial layer of the endometrium? a) functional layer b) serosal layer c) perimetrium d) basal layer

a) functional layer

The gonadal arteries orginate from what vessel? a) common iliac arteries b) internal iliacc arteries c) aorta d) uterine arteries

c) aorta

What muscles would be most likely mistaken as ovaries or adnexal masses? a) obturator internus b) gemellus c) levator ani d) psoas major

a) obturator internus

The uterus is bounded anteriorly by what structure? a) rectum b) bladder c) space of Retzius d) round ligament

b) bladder

What hormone is responsible for ovulation? a) Estrogen b) gonadotropin releasing hormone c) luteinizing hormone d) follicle stimulating hormone

c) luteinizing hormone

A 28 year old patient typically has a 26 day menstrual cycle. What ovarian phase would she be at day 14 of her current cycle? a) follicular b) periovulatory c) luteal d) secretory

c) luteal

What best describes the effects of the release of progesterone? a) endometrial shedding b) thickens the functional layer c) maintains the thickness of the endometrium d) thickening of the basal layer

c) maintains the thickness of the endometrium

What dimension is the upper limit of normal for the reproductive age endometrium? a) 16 mm b) 8 mm c) 4 mm d) 22 mm

a) 16 mm

What would be the expected endometrial appearance during the luteal phase? a) trilaminar b) thin and echogenic c) thick and echogenic d) thick and hypoechoic

c) thick and echogenic

What is responsible for releasing estrogen? a) follicles b) corpus albicans c) pituitary gland d) corpus luteum

a) follicles

What event in the menstrual cycle occurs due to the drop in progesterone? a) corpus luteal regression b) endometrial thickening c) ovulation d) endometrial shedding

d) endometrial shedding

What best describes the late proliferative endometrium? a) hypoechoic basal and echogenic functional layer b) echogenic basal and functional layer c) echogenic basal and hypoechoic functional layer d) hypoechoic basal and functional layer

c) echogenic basal and hypoechoic functional layer

The maximum measurement of the endometrium immediately following menses should measure no more than? a) 4 mm b) 10 mm c) 6 mm d) 18 mm

a) 4 mm Immediately following menses is the thinnest at 4 mm. Early proliferative up to 6 mm. Late proliferative up to 10 mm and secretory up to 16 mm

What stimulates follicular development? a) FSH b) estrogen c) LH d) HCG

a) FSH

What hormones is endometrial tissue responsive to? a) estrogen and progesterone b) LH and progesterone c) FSH and estrogen d) FSH and LH

a) estrogen and progesterone The endometrium is stimulated by estrogen and progesterone. Estrogen thickens and progesterone maintains

What is the function of estrogen? a) endometrial shedding b) stimulates ovulation c) maturation of the follicle d) endometrial thickening

d) endometrial thickening

What hormone stimulates rupture of the graafian follicle? a) follicle stimulating hormone b) progesterone c) estrogen d) luteinizing hormone

d) luteinizing hormone The ovaries respond to FSH and LH. FSH develops and matures the follicle. LH ruptures it

During what phase does the endometrium appear thick and echogenic? a) proliferative b) secretory c) follicular d) periovulatory

b) secretory

What endometrial appearance would correlate with the periovulatory phase? a) multi layered b) thin and echogenic c) anechoic d) thick and echogenic

a) multi layered

When approximately would a peak in estrogen occur? a) day 1 b) day 7 c) day 14 d) day 28

c) day 14

What term describes a patient that no longer experiences a menstrual cycle? a) arrhagia b) oligomenorrhea c) amenorrhea d) menomenorrhea

c) amenorrhea

What is the Mullerian malformation that occurs most frequently? a) bicornuate uterus b) septate uterus c) arcuate uterus d) uterus didelphys

b) septate uterus

What is the most likely sonographic appearance of a 14 year old with vaginal atresia? a) hematometra b) meatocolpos c) hydrocolpos d) hematosalpinx

a) hematometra

of pregnancies is called?

Gravida

of pregnancies carried to term is called?

Para

_______ ________ is a person who has not reached menarche by age 15

Delayed menses

_______ ________ is when a person experiences puberty changes by the age of 8

Precocious puberty

The prefix "a" means

without/non

The prefix "dys" means

abnormal/painful

The prefix "sub" means

under

The prefix "hemato" means

Blood

The prefix "meno" means

Heavy

The prefix "metro" means

irregular

The suffix "menorrhea" means

menses

The suffix "rrhagia" means

Bleeding

The suffix "pareunia" means

Intercourse

The suffix "plasia" means

Growth

the suffix "oma" means

Mass

The suffix "colpos" means

Vagina

The suffix "metra" means

Uterus

"Middle pain" pain in middle of cycle near ovulation is called

Mittelschmertz

Failure to have a menses by the age of 16 or never reached menarche is called?

Primary amenorrhea

When a menses stops this is called?

Secondary amenorrhea

During the 70s what drug was given to women to treat threatened miscarriages?

DES

What is the most commonly shaped uterus that is associated with DES?

T shaped

What uterus is normal contour, with a slight indentation of the fundal endometrium that mimics a normal uterus?

Arcuate

What is another name for a bicornuate uterus?

Bicornis Unicollis

What type of uterus has 1 endometrial cavity that divides into 2 at the fundus is "Y" shaped and the uterine fundas has concave contour

Bicornuate

What type of uterus has a normal uterine contour with 2 separate endometrial cavities?

Subseptate

What is the most common congenital uterine anomaly?

Septate

What type of uterus has 2 completely separate endometrial cavities and the uterine contour is concave at the fundus

Septate

What type of uterus has a complete lack of fusion. 2 vaginas, cervices, and uteri?

Didelphys

What type of uterus has a lack of formation of one duct and has a single horn?

Unicornuate

What is the most common cause of a congenital malformation of the vagina?

Imperforate hymen

When there is vaginal atresia what will be distended?

The uterus and cervix

A absent or closed vagina is called?

Vaginal atresia

Hydrometra and hematometra are 2 examples of what?

Vaginal atresia

_______ _______= a closed hymen

Imperforate hymen

Hydrocolpos, hydrometracolpos, and hematometracolpos are examples of what?

Imperforate hymen

Which of the following is caused by lack of formation of one of the Mullerian ducts? a) uterine agenesis b) uterus didelphys c) unicornuate uterus d) bicornuate uterus

c) unicornuate uterus -Lack of formation means one duct never was there in the first place. So just a smaller uterus with one cornu will be there

When encountering a congenital uterine malformation, what also should be evaluated for congenital anomalies? a) ovaries b) posterior cul-de-sac c) left ovarian vein d) kidneys

d) kidneys

What is the most likely finding associated with a patient presenting with pelvic pain and primary ameorrhea? a) hydrometra b) hematometra c) hydrocolpos d) hematometracolpos

d) hematometracolpos -The most common diagnosis in a patient with this clinical history is imperforate hymen. q

Hydrocolpos is usually secondary to what? a) cervical stenosis b) vaginal atresia c) endometrial cancer d) imperforate hymen

d) imperforate hymen -Hydrocolpos= fluid in the vaginal canal. This must be caused by imperforate hymen. Vaginal atresia would have a closed vaginal canal

What part of the cycle corresponds with Mittelschmerz? a) menstruation b) regression of corpus luteum c) ovulation d) start of endometrial thickening

c) ovulation

What term best describes painful menstruation? a) dyspareunia b) dysmenorrhea c) hypermenorrhea d) metrorrhagia

b) dysmenorrhea

What is the definition of infertility ? a) unsuccessful conception after 6 months of unprotected intercourse b) unsuccessful conception after 3 months of unprotected intercourse c) unsuccessful conception after 2 years of unprotected intercourse d) unsuccessful conception after 1 year of unprotected intercourse

d) unsuccessful conception after 1 year of unprotected intercourse

What does metrorrhagia mean?

Irregular bleeding

What does menorrhagia mean?

Heavy bleeding

What does hypermenorrhea mean?

Increased menstrual flow

what does oligomenorrhea mean?

A greater than 35 day cycle

What does polymenorrhea mean?

Less than 21 day cycle

What term describes a benign cyst of the vaginal canal? a) gartner duct cyst b) nabothian cyst c) fornix cyst d) adenomyosal cyst d)

a) gartner duct cyst

A 32 year old patient is presenting with urinary frequency and pelvic pressure. What diagnosis is most likely? a) leiomyosarcoma b) adenomyosis c) cervical carcinoma d) leiomyomatous uterus

d) leiomyomatous uterus

A patient is referred for an ultrasound to confirm IUD placement. What description best describes a normal finding? a) hyperechoic reflection within the isthums b) hypoechoic with shadowing throughout the endometrium c) reverberation artifact within the cavity extending to fundus d) hyperechoic with reverberation within the fundus only

c) reverberation artifact within the cavity extending to fundus

What is the most common benign mass of the cervix? a) gartner duct cyst b) leiomyoma c) nabothian cyst d) cervical adenoma

c) nabothian cyst

Which artifact is most likely seen with an IUD? a) reverberation b) mirror image c) edge shadowing d) posterior enhancement

a) reverberation

Whats the most common gynecological malignancy under the age of 50? a) leiomyosarcoma b) ovarian cystadenocarcinoma c) cervical carcinoma d) endometrial carcinoma

c) cervical carcinoma

Small myometrial cystic areas, thickening of the myometrium, abnormal bleeding, and dysmenorrhea all describe what condition? a) adenomyosis b) endometrial carcinoma c) endometriosis d) endometrial hyperplasia

a) adenomyosis

What clinical history best corresponds to a diagnosis of adenomyosis? a) infertility b) secondary amenorrhea c) acute pelvic pain d) dsymenorrhea

d) dsymenorrhea

Posterior thickening of the myometrium is most often related to what? a) fibroids b) congential malformations c) adenomyosis d) cervical cancer

c) adenomyosis

Focal mass like adenomyosis is called?

Adenomyoma

Dysmenorrhea, menometrorrhagia, pelvic pain, dyspareunia and being multiparous what clinical signs of what uterine pathology?

Adenomyosis

What is the most common benign gyn tumor?

Leiomyoma

What uterine tumor is a benign smooth muscle tumor and is the leading cause of hysterectomy and gyn surgery?

Leiomyoma

What uterine tumor is stimulated by estrogen?

Leiomyoma

Clinically this uterine tumor causes abnormal bleeding, pelvic distention, pressure, infertility and urinary frequency

Leiomyoma

Sonographically this uterine tumor appears as a hypoechoic mass with poor thru transmission with a bulky enlarged uterus

Leiomyoma

What fibroid is the most common? a) intramural b) subserosal c) submucosal d) pedunculated

a) intramural

This fibroid is located within the muscle wall of the uterus and makes the whole uterus bulky but does not change the countour a) intramural b) subserosal c) submucosal d) pedunculated

a) intramural

What fibroid grows under the serosal layer and distorts the outer contour? a) intramural b) subserosal c) submucosal d) pedunculated

b) subserosal

What fibroid is adjacent to the endo and distorts the contour of the endo? a) intramural b) subserosal c) submucosal d) pedunculated

c) submucosal

What fibroid is a type of subserosal myoma that grows out and attaches by a stalk? a) intramural b) subserosal c) submucosal d) pedunculated

d) pedunculated

This type of fibroid is malignant and will cause a rapid increase in growth most commonly found in perimenopausel and postmenopausel women

Leiomyosarcoma

What is the most common female malignancy under the age of 50?

Cerival carcinoma

What presents as heterogenous, enlarged cervix or a focal mass within the cervix?

Cervical carcinoma

Thickening of the endometrium is called what?

Endometrial hyperplasia

What results from unopposed estrogen stimulation?

Endometrial hyperplasia

Clinically what is the result of post menopausel bleeding, abnormal bleeding, history of PCOS, HRT or Tamoxifen treatment?

Endometrial hyperplasia

What is the most likely diagnosis in a post-menopausel patient with a thickened endometrium?

Endometrial hyperplasia

Sonographically this appears as an abnormally thickened endometrium that is heterogenous with cystic changes

Endometrial hyperplasia

If a postmenopausel women has no bleeding and is asymptomatic what is the upper limit of normal for the endometrium?

< 8mm

If a post menopausel women is bleeding and is asymptomatic what is the upper limit of normal for the endometrium?

< 5 mm

In a reproductive aged patient what is the upper limits of normal for the endometrium if they are in the early proliferative stage?

4-6 mm

In a reproductive aged patient what is the upper limits of normal for the endometrium if they are in the late proliferative stage?

6-10 mm

In a reproductive aged patient what is the upper limits of normal for the endometrium if they are in the secretory phase?

<16 mm

What is the most common GYN malignancy?

Endometrial carcinoma

Clinically what is seen in postmenopausel bleeding, abnormal uterine bleeding, and elevated CA-125?

Endometrial carcinoma

Sonographically this appears as abnormal thickening of the endometrium/heterogenous with cystic changes, an enlarged/heterogenous uterus, polypoidal mass within the endo with increased vascularity, and low resistance flow

Endometrial carcinoma

What is the most likely reason for abnormal bleeding/ thick endo in a reproductive age patient? (unless with a diagnosis of PCOS)

Endometrial polyps

Saline infused sonohysterography is best to visualize?

Endometrial polyps

What are small nodules of hyperplastic endometrial tissue that are most likely seen as focal or diffuse thickening of the endometrium?

Endometrial polyps

Thinning of the endometrium in postmenopausel patients is called?

Endometrial atrophy

What is the most common cause of post menopausel bleeding?

Endometrial atrophy

What is the most likely finding and diagnosis in a post menopausel bleeding patient with no other history

Endometrial atrophy

This appears as a thin endometrium < 4 mm and possible intracavity fluid

Endometrial atrophy

Adhesions or synechiae within the uterine cavity as a result of scar formation after a surgery or D&C is called?

Asherman syndrome

Clinically this is the cause of amenorrhea, hypomenorrhea, a history of miscarriages, or surgery

Asherman syndrome

Songraphically this appears as a thin endometrium with echogenic regions/scarring

Asherman syndrome

Which is most likely associated with cystic changes of the endometrium? a) hormone replacement therapy b) adenomyosis c) tamoxifen treatment d) intrauterine device

c) tamoxifen treatment

What is the most likely diagnosis in a 70 year old patient with vaginal bleeding? a) endometrial atrophy b) endometrial carcinoma c) hyperplastic polyp d) uterine fibroid

a) endometrial atrophy

A 12 mm irregular, heterogenous endometrium is documented in a patient with post-menopausel bleeding. What information would aid in the differentiation of hyperplasia vs carcinoma? a) B-mode appearance b) previous tamoxifen therapy c) duration of bleeding d) CA-125 value

d) CA-125 value

What is the typical effect of tamoxifen on the endometrium? a) myometrial cystic changes b) cystic changes in a thinned endometrium c) endometrial cavity fluid d) thickened endometrium with cystic changes

d) thickened endometrium with cystic changes

What is the most likely sonographic appearance of the endometrium in a patient complaining of post menopausal bleeding? a) endometrium measuring < 4mm b) thickened and cystic endometrium c) focal echogenic thickening d) endometrial synechiae

a) endometrium measuring < 4mm

Hormone replacement therapy is related to what typical endometrial appearance? a) focal thickening of the endometrium b) thickened, echogenic endometrium c) cyclic changes of the endometrium d) cystic changes with endometrial thickening

c) cyclic changes of the endometrium

A 24 year old patient with a history of PCOS presents with abnormal bleeding. What is the most likely diagnosis? a) Ruptured ovarian cyst b) endometrial polyps c) endometrial hyperplasia d) asherman syndrome

c) endometrial hyperplasia - The patient history of PCOS predisposes her to endometrial hyperplasia due to chronic anovulation and increased estrogen levels

What is the normal maximum dimension of the endometrium in the reproductive age group? a) 22 mm b) 16 mm c) 6 mm d) 8 mm

b) 16 mm

An elevation in which hormone will increase the likelihood of the patient developing endometrial carcinoma? a) estrogen b) FSH c) hCG d) progesterone

a) estrogen

What is the normal maximum dimension of the endometrium in a patient experiencing post menopausal bleeding? a) 4mm b) 14 mm c) 8 mm d) 5 mm

d) 5 mm

What is the most likely cause of endometrial thickening in the reproductive age patient? a) endometrial hyperplasia b) endometrial carcinoma c) asherman syndrome d) endometrial polyp

d) endometrial polyp

What is the most common cause of infertility?

PCOS

Clinically this pathology is related to Stein-Leventhal syndrome

PCOS

Sonographically this pathology has bilateral enlarged ovaries with multiple small follicles along the periphery "string of pearls" and is secondary to endometrial hyperplasia

PCOS

Ectopic endometrial tissue outside the uterus into the adnexa is most likely?

Endometriosis

Where is the most common location for endometriosis to develop?

Ovaries

What are 2 other names for blood-filled cysts?

1) endometriomas 2) chocolate cysts

dysmenorrhea, dyspareunia, chronic pelvic pain, painful bowel movements, infertility, nulliparity that are in reproductive age patients are clinical signs of?

Endometriosis

Sonographically this pathology appears as a cystic mass with low level echoes, anechoic, or complex with posterior enhancement

Endometriosis

What is the common adnexal mass?

Follicular cyst

What is the most common adnexal mass in pregnancy?

Corpus luteal cyst

_______ ________ ________ is caused by hCG found in fertility treatments

Ovarian hyperstimulation syndrome

Sonographically this pathology presents as bilaterally enlarged multiloculated ovarian cysts "grape clusters" with no normal ovarian parenchyma

Theca Lutein cysts

This type of cyst is found only with elevated levels of hCG >100,000

Theca Lutein cysts

What is the most common benign ovarian tumor?

Dermoid cyst

What is another name for a cystic teratoma

Dermoid cyst

What is the most common complication of a dermoid cyst?

Ovarian torsion

What is the most common solid benign tumor?

Fibroma

A fibroma is most like associated with what syndrome?

Meigs syndrome

Ascites, pleural effusion and in the presence of a benign ovarian tumor is associated with what syndrome?

Meigs

Sonographically what looks like a solid hypoechoic mass with poor thru transmission?

Fibroma

What tumor is a transitional cell tumor that is small, solid, and unilateral with calcifications

Brenner tumor

Fribromas and Brenner tumors do not produce what? a) estrogen b) progesterone

a) estrogen

What mass is associated with hirsutism and menstrual disturbances? a) polycystic ovaries b) granulosa cell tumor c) sertoli-Leydig tumor d) dysgerminoma

c) sertoli-Leydig tumor

What abnormality can be found in the presence of ascites and pleural effusion? a) dermoid b) fibroma c) krukenberg tumor d) ovarian torsion

b) fibroma

During a pelvic sonogram, a 1.8 cm cyst adjacent to the ovary is documented. What is the etiology of the cyst? a) follicular cyst b) corpus luteum c) cystadenoma d) paraovarian cyst

d) paraovarian cyst

Name the 2 types of cystadenomas

1) serous 2) mucinous

Which cystadenoma are benign large and typically bilateral with septations? a) serous b) mucinous

a) serous

Which cystadenoma is typically larger and usually unilateral with the presence of septations and internal debris? a) serous b) mucinous

b) mucinous

What is most common ovarian malignancy?

Serous cystadenocarcinoma

Intraperitoneal extensions of mucin-secreting cells that appear similar to complex ascites is termed?

pseudomyxoma peritonei

Clinically this malignancy presents as weight loss, pelvic pressure/swelling, abnormal bleeding, GI symptoms, elevated CA-125, acute abdomen pain associated with torsion or rupture

Cystadenocarcinoma

Sonographically what malignancy appears as a cystic mass with thick septations and papillary projections with internal vascularity

Cystadenocarcinoma

Name the 2 estrogen producing ovarian tumors

1) thecoma 2) granulosa cell tumor

What is the most common estrogenic tumor?

Granulosa cell tumor

What ovarian tumor is most often seen in postmenopausal patients with post menopausal bleeding?

Thecoma

Metastasis from the GI tract that presents with bilateral ovarian masses and ascites is most likely?

Krukenburg tumor

What is another name for Sertoli-Leydig cell tumor?

Androblastoma

What sex cord stromal tumor is most commonly found in women < 30 years old and may be benign or malignant?

Sertoli-Leydig cell tumor

What is the most common malignant germ cell tumor?

Dysgerminoma

What tumor is related to elevated hCG levels in a nongravid female?

Dysgerminoma

This tumor is most often found in young patients <30 years of age and may be found in pregnancy with the tumor maker of serum lactate deyhydrogenase

Dysgerminoma

What is another name for yolk sac tumor?

Endodermal sinus tumor

What is the second most common malignant germ cell tumor?

Yolk sac tumor

This tumor is characterized by growth and presents in females less than 20 years old and has elevated AFP in the nongravid female

Yolk sac tumor

Ovarian torsion is most common on which side? a) right side b) left side

a) right side

What doppler settings should be set to identify ovarian torsion?

Low scale/PRF and low wall filter

Songraphically what pathology presents as a enlarged ovary with diminished or lack of blood flow?

Ovarian torsion

What mass is related to estrogen production? a) dysgerminoma b) endometrioma c) sertoli-Leydig cell tumor d) granulosa cell tumor

d) granulosa cell tumor

What usually occurs secondary to PCOS? a) endometrial hyperplasia b) endometriosis c) ovarian torsion d) theca lutein cysts

a) endometrial hyperplasia

Which of the following could possibly be related to post menopausal bleeding? a) teratoma b) endometrioma c) fibroma d) thecoma

d) thecoma

What adnexal abnormality is associated with gastric cancer? a) Krukenberg tumor b) pseudomyxoma peritonei c) Meigs syndrome d) brenner tumor

a) Krukenberg tumor

Which of the following is most likely to be associated with Meigs syndrome? a) mucinous cystadenocarcinoma b) thecoma c) krukenberg tumor d) fibroma

d) fibroma

Pseudomyxoma peritonei is associated with which of the following masses? a) androblastoma b) endometrioma c) serous cystadenocarcinoma d) mucinous cystadenocarcinoma

d) mucinous cystadenocarcinoma

What ovarian mass is related to elevated levels of hCG in the non-pregnant female? a) dysgerminoma b) seminoma c) yolk sac tumor d) sertoli-leydig tumor

a) dysgerminoma -dysgerminoma is associated with hCG in a nongravid female -Yolk sac tumor is associated with AFP in a non-gravid female

A large adnexal cyst with thick septations and papillary projections is documented. This finding most likely corresponds with what diagnosis? a) serous cystadenoma b) serous cystadenocarcinoma c) mucinous cystadenoma d) mucinous cystadenocarcinoma

b) serous cystadenocarcinoma - Thick septations and papillary projections are findings suggestive of malignancy. Serous cystadenocarcinoma is the best choice because it is the most common

What would be most likely be related to infertility? a) chocolate cyst b) krukenberg tumor c) adenomyosis d) theca lutein cyst

a) chocolate cyst - Causes for infertility are either functional (PCOS) or conditions that damage the ovaries, tubes, or endometrium such as endometriosis, PID, or polyps

What sonographic feature would be most consistent with acute PID? a) anechoic tubular structure within the adenexa b) heterogenous myometrium with posterior thickening c) bilateral complex masses with increased peripheral vascularity d) enlarged ovary with diminished or absent doppler signals

c) bilateral complex masses with increased peripheral vascularity

What doppler arterial signal is normally expected in the non-gravid uterus? a) triphasic and pulsatile b) monophasic and high resistance c) low velocity and low resistance d) high velocity and low resistance

b) monophasic and high resistance

What clinical finding is most likely associated with chronic PID? a) leukocytosis b) hypomenorrhea c) post-menopausel bleeding d) dysmenorrhea

b) hypomenorrhea

What finding is most likely to be documented in an afebrile 30 year old female with acute right lower quadrant pain? a) absent doppler signals in an enlarged ovary b) hyperemia in an enlarged ovary c) turbulent flow within the myometrium d) low resistance signals within the adnexa

a) absent doppler signals in an enlarged ovary

What is the most common initial clinical presentation of acute PID? a) menorrhagia b) acute pelvic pain c) leukocytosis d) vaginitis

d) vaginits

How can endometriosis be differentiated from endometrial hyperplasia? a) clinical symptoms b) color doppler patterns c) uterine enlargement d) patient age

a) clinical symptoms -these 2 may be similar sonographically. Endometritis is only found in the presence of acute PID which means the patient will have symptoms of infection

When evaluating an infertility patient, what signs would be indicative of chronic PID? a) tubo-ovarian complex b) hyperemia along salpinx wall c) complex ovarian cyst d) ovarian mass with septations

a) tubo-ovarian complex

What is a sonographic finding consistent with acute PID? a) hydrosalpinx b) pyosalpinx c) free fluid in the cul-de-sac d) complex ovarian cyst

b) pyosalpinx -sonographic finding specifically found in the presence of acute PID are: endometriosis and pyosalpinx. Hydrosalpinx and TOA can be seen with acute, but can be seen with chronic as well

What is the most common cause of pelvic inflammatory disease? a) cesarean section b) abortion c) urinary tract infection d) chlamydia

d) chlamydia

What sonographic finding is consistent in a patient presenting with acute pelvic pain, leukocytosis, and fever? a) enlarged avascular ovary b) vaginitis c) endometritis d) hemorrhagic ovarian cyst

c) endometritis - The symptoms indicate infection. The only sonographic finding listed that goes with active infection is endometritis

What diagnosis is consistent with pelvic pain, irregular menses, and pelvic adhesions? a) acute PID b) pseduomyxoma peritonei c) chronic PID d) adenomyosis

c) chronic PID

When would be the most accurate time to perform doppler analysis of the ovaries? a) periovulatory phase b) luteal phase c) secretory phase d) early proliferative phase

d) early proliferative phase

What is a sonographic finding consistent with chronic PID? a) comet tail artifact in endometrium b) hyperemia of the salpinges c) pyosalpinx d) hydrosalpinx

d) hydrosalpinx Chronic PID is not an active infection, it is the damage done by previous infection. A patient may have hydrosalpinx or TOA chronically after PID

Doppler analysis in the ovaries in the periovulatory and luteal phases commonly demonstrates what characteristics? a) high resistive index b) low resistance flow c) decreased end diastolic flow d) decreased peak systolic velocity

b) low resistance flow - These phases require the greatest volume of flow for the ovary. The normal flow pattern during this time would be low resistance with an increased end diastolic and low pulsatility

What feature best corresponds to adenomyosis? a) bulky, heterogenous myometrium with cystic spaces b) hypoechoic mass with posterior shadowing c) abnormal endometrial thickening d) multiple echogenic regions within the myometrium

a) bulky, heterogenous myometrium with cystic spaces

What is the most common bengign ovarian solid tumor? a) dysgerminoma b) brenner tumor c) dermoid d) fibroma

d) fibroma

What blood test can reveal the probability of malignancy in the presence of an abnormally thickened endometrium? a) AFP b) hCG c) lactate dehydorgenase d) CA-125

d) CA-125

What complication is most often associated with a fibroma? a) Ovarian hyperstimulation syndrome b) Meigs syndrome c) Stein leventhal syndrome d) ashermans syndrome

b) Meigs syndrome

What is the most common congenital uterine abnormality? a) bicornus unicollis b) imperforate hymen c) nabothian cyst d) septate uterus

d) septate uterus

Which of the following conditions is most likely to demonstrate a reverberation artifact? a) pyosalpinx b) endometritis c) adenomyosis d) hematometra

b) endometritis

What would cause an elevation in the serum AFP in a non-gravid patient? a) yolk sac tumor b) dermoid c) theca lutein cysts d) cystadenocarcinoma

a) yolk sac tumor

What is the most likely diagnosis in a patient with clinical findings of dysmenorrhea, hypermenorrhea, and muliparity? a) adenomyosis b) Ashermans syndrome c) Endometriosis d) polycystic ovarian disease

a) adenomyosis

What condition is most likely to be a factor in infertility? a) paraovarian cyst b) dermoid c) adenomyosis d) chronic PID

d) chronic PID

What is Ashermans syndrome? a) hyperstimulation of ovarian follicles b) scarring of the uterine cavity c) infertility, hirsutism, and amenorrhea d) metastasis to the ovaries

b) scarring of the uterine cavity

Which scenario would lead to further investigation with sonohysterography with saline infusion? a) endometrial hyperplasia b) subserosal myoma c) adenomyosis d) endometrial synechiae

d) endometrial synechiae

What vessel supplies a layer of the endometrium? a) spiral artery b) radial artery c) basal artery d) arcuate artery

a) spiral artery

Which pelvic vessel is most likely to become abnormal? a) left ovarian vein b) right uterine vein c) left uterine vein d) right ovarian vein

a) left ovarian vein

What endometrial measurement is abnormal in the post-menopausel patient? a) 8 mm b) 6 mm c) 9 mm d) 5 mm

c) 9 mm -non-bleeding <8 mm -bleeding <5 mm

Fluid in the posterior cul-de-sac in the reproductive age patient is most likely the result of what event? a) Ovulation b) Ovarian torsion c) Menstruation d) Regression of the corpus luteum

a) Ovulation

Which fibroid distorts the peripheral contour? a) intramural b) subserosal c) intracavity d) submucosal

b) subserosal

What abnormality is most likely to result in first trimester miscarriages? a) adenomyosis b) endometriosis c) cystic teratoma d) ashermans syndrome

d) ashermans syndrome

what is the significance of pyometra? a) pus within the vaginal canal b) pus within the endometrial cavity c) pus within the fallopian tube d) pus within the myometrium

b) pus within the endometrial cavity

What muscle group forms the pelvic floor and provides support to the pelvic organs? a) piriformis b) levator ani c) psoas major d) obturator externus

b) levator animation

What hormone is responsible for the maturation and preparation of the Graffian follicle for ovulation? a) follicle stimulating hormone b) gonadrotropin-releasing hormone c) estrogen d) luteinizing hormone

a) follicle stimulating hormone

A patient presents to the ER with acute pelvic pain and negative hCG. which of the following is the most likely differential diagnosis? a) PCOS b) ovarian torsion c) fibroma d) hydrosalpinx

b) ovarian torsion

What hormone is responsible for the appearance of the secretory endometrium? a) estrogen b) progesterone c) luteinizing hormone d) hCG

b) progesterone

Approximately what day would the trilaminar appearance be imaged in a patient with a 26 day cycle? a) 18 b) 26 c) 14 d) 12

d) 12

What characteristics are most suggestive of ovarian malignancy? a) calcifications with posterior shadowing b) thick septations and papillary projections c) septations and internal debris d) low resistance doppler patterns

b) thick septations and papillary projections

Myultrasoundtutor quizzes (Part 1) Flashcards

Gynecology (290 cards)