Tube/Adnexal Pathology

Question 1

This is infection within the myometrium of the uterus.

Answer 1

myometritis

Question 2

This is infection within the uterine serosa and broad ligament.

Answer 2

parametritis

Question 3

The normal fallopian tube is an undulating __ structure of approximately __ mm in width, running __from the uterus to lie within the cul-de-sac near the ovary.

Answer 3

echogenic, 8-10, posterolaterally

Question 4

The mucous membrane lining the cavity of the tube is how many layers thick?

Answer 4

one

Question 5

The mucous membrane lining the cavity of the tube is called…

Answer 5

the ciliar epithelium.

Question 6

T/F? Development abnormalities of the tube are rare.

Answer 6

true

Question 7

Three things that cause tube abnormalities…

Answer 7

1. pregnancy
2. infection
3. neoplasm

Question 8

This is a generic term referring to the inflammation/infection of the pelvic and adrenal structures with pus and fluid.

Answer 8

pelvic inflammatory disease (PID)

Question 9

PID is usually caused by __ which ascend through the cervix and endometrial cavity into the pelvis through the __.

Answer 9

STDs, mucosa

Question 10

T/F? PID inflammation may be diffuse but is generally localized.

Answer 10

FALSE, the opposite

Question 11

Long term consequences of PID include..

Answer 11

1. infertility
2. tubal scarring
3. ectopic pregnancy
4. chronic pelvic pain

Question 12

PID is usually __lateral.

Answer 12

bi-

Question 13

Unilateral PID is caused by __ of an adjacent inflammatory process.

Answer 13

direct extension

Question 14

Clinically, PID patients present with…

Answer 14

leukocytosis**

also pain, fever, dysparunia, vaginal bleeding &/or discharge, pelvic tenderness…

Question 15

Sonographically, PID is seen as…

Answer 15

a large complex mass with indistinct walls within one or both adnexa with flow

Question 16

Early in the disease, the clinical presentation of PID may mimic…

Answer 16

functional bowel disease (IBS)

Question 17

PID is treated with…

Answer 17

antibiotics and exploration & removal of the abscess

Question 18

This is a condition in which bacteria spread through the abdomen and cause inflammation of the tissue surrounding the liver.

Answer 18

Fitz-Hugh-Curtis syndrome

Question 19

This occurs in 15-30% of women with PID (but can also occur without PID and in men).

Answer 19

Fitz-Hugh-Curtis syndrome

Question 20

The best way to confirm Fitz-Hugh-Curtis syndrome is..

Answer 20

laparoscopy.

Question 21

How do physicians describe the liver adhesions in Fitz-Hugh-Curtis syndrome?

Answer 21

‘violin-string’ adhesions

Question 22

This is a collection of fluid within a scarred fallopian tube.

Answer 22

hydrosalpinx

Question 23

This is a collection of pus within a scarred fallopian tube with a wall thickness of greater than 5 mm.

Answer 23

pyosalpinx

Question 24

Pyosalpinx has a wall thickness greater than…

Answer 24

5 mm.

Question 25

Sonographically, hydro/pyosalpinx is seen as...

Answer 25

a tubular or elliptical cystic mass in the adnexa.

Question 26

This is the inflammatory process of a tube that incorporates the ovary.

Answer 26

tubo-ovarian abscess (TOA)

Question 27

Fusion of the inflamed dilated tube and ovary is called..

Answer 27

TOA complex.

Question 28

Sonographically, TOA is seen as...

Answer 28

a complex low-level echoes within the tube and ovary, complex fluid in the posterior cul-de-sac

Question 29

What's the 'beak' sign?

Answer 29

Compressed ovarian tissue forming a rim around an ovarian abscess

Question 30

T/F? Endometriosis implants may be small and undetectable or large and palpable.

Answer 30

true

Question 31

Endometriosis is more common in __ and women of __ socioeconomic status.

Answer 31

caucasians, higher

Question 32

Early in the disease, the clinical presentation of endometriosis may mimic...

Answer 32

functional bowel disease (IBS)

Question 33

This is a focal collection of ectopic or extravasated endometrial tissue

Answer 33

endometrioma

Question 34

Endometrioma is also known as...

Answer 34

chocolate cyst

Question 35

Tubal neoplasms are usually __ and __, and discovered incidentally.

Answer 35

small, asymptomatic

Question 36

The rarest cancer of the female reproductive system (and the most common of the fallopian tube) is...

Answer 36

adenocarcinoma

Question 37

If there is a fallopian tube malignancy, the chances it's a metastatic tumor is...

Answer 37

85%.

Question 38

Incidence and clinical symptoms of fallopian adenocarcinoma...

Answer 38

1. women 50+ years of age 2. low pariety 3. pain, discharge

Question 39

Sonographically, fallopian adenocarcinoma appears as...

Answer 39

an adnexal mass.

Question 40

Krukenberg tumors spread from what disease?

Answer 40

gastric carcincoma

Question 41

Sonographically, Krukenberg tumors are seen as...

Answer 41

bilateral adnexal or ovarian masses & ascites** | oval or lobulated margins, hypoechoic areas in the mass, posterior enhancement

Question 42

T/F? Patients with Krukenberg tumors always experience pain and bloating.

Answer 42

FALSE, not always

Question 43

Large pelvic masses may cause __, so evaluate the kidneys next.

Answer 43

urinary obstruction

Question 44

If a primary malignant process is suspected in the pelvis, one should also scan...

Answer 44

the liver, kidneys, pancreas and lymph nodes.

Question 45

Whenever you suspect pelvic ascites, you should always check...

Answer 45

Morrison's pouch.