Ch.43,44,45 Flashcards
- The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following?
a. Early pregnancy
b. Leiomyoma
c. Ruptured nabothian cyst
d. Ruptured follicular cyst
ANS: B Clinical signs of uterine leiomyoma include irregular bleeding, menorrhagia, an enlarged uterus, pelvic pain, and bladder symptoms.
- Which one of the following is the most common site for a leiomyoma to occur? a. Submucosal b. Subserosal c. Pedunculated d. Intramural
ANS: D An intramural (confined to the myometrium) is the most common site of a leiomyoma.
- Complications in delivery may occur with pregnancy if a fibroid is located in or near which one of the following structures? a. Near the fundus b. Pedunculated off the fundus c. Near the cervix d. Near the ovary
ANS: C a fibroid locates in the lower uterine segment or cervix may interfere with a normal vaginal delivery
- Hydrometra appears sonographically as a(n) _____
a. Sonolucent tubular structure in the adnexa
b. Echogenic thickening of the endometrium
c. Sonolucent fluid collection in the uterine canal
d. Sonolucent fluid collection in the uterus, cervix, and vagina
ANS: C Fluid accumulation in the uterus is termed hydrometra
- A benign invasion of endometrial tissue into the myometrium is known as which one of the following conditions? a. Endometriosis b. Pelvic inflammatory disease (PID) c. Adenomyosis d. Endomyosarcoma
ANS: C Adenomyosis is a benign disease, commonly diffuse, with global infiltration of the endometrium
- Which one of the following conditions is described as a hyperplastic protrusion of the epithelium of the cervix that may be broad based or pedunculated? a. Cervical stenosis b. Pyometrium c. Cervical polyps d. Cervical obstruction
ANS: C a cervical polyp is a benign condition arising from the hyper plastic protrusion of the epithelium of the cervix
- Which one of the following sonographic characteristics is the most common finding in endometrial carcinoma?
a. Abnormal thinning of the endometrial cavity, usually with irregular bleeding in postmenopausal women
b. Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women
c. Irregular bleeding
d. Heavy bleeding with a thickening of the myometrium
ANS: B In endometrial carcinoma, the most common sonographic finding is an abnormally thickened endometrium. The most common clinical symptom is irregular uterine bleeding.
- A small percentage of leiomyomas is located in which one of the following structures? a. Body b. Fundus c. Myometrium d. Cervix
ANS: D A small percentage of leiomyomas is located in the cervix.
- Which one of the following is most likely the result of an acquired condition with obstruction of the cervical canal? a. Leiomyoma b. Cervical c. Cervical stenosis
d. Adenomyosis
ANS: C an acquired condition with obstruction of the cervical canal is most likely a result of cervical stenosis at the internal or external os. This condition may be a result of radiation therapy, previous come biopsy, postmenopausal cervical atrophy, chronic infection, or cervical carcinoma
- The size and shape of the normal uterus are related to all of the following except: a. Family history b. Age c. Hormonal status d. Parity
ANS: A The size and shape of the normal uterus are related to age, hormonal status, and parity.
- Which one of the following locations of a fibroid will most likely cause heavy irregular uterine bleeding? a. Subserosal b. Submucosal c. Intramural d. Pedunculated
ANS: B A submucosal fibroid displaces or distorts the endometrial canal with subsequent irregular or heavy uterine bleeding.
- The most common cause of uterine calcification is which one of the following? a. Adenomyosis b. Endometriosis c. Arcuate artery calcification d. Myomas
ANS: D myomas are the most common cause of uterine calcifications. A less common cause is arcuate artery calcification, visualized in the periphery of the uterus
- On ultrasound, the characteristic appearance of a degenerating leiomyoma is _____ a. Homogeneous b. Heterogeneous c. Isoechoic d. Anechoic
ANS: B Degenerating leiomyomas demonstrate cystic degeneration and appear complex or heterogeneous
- Which one of the following statements about adenomyosis is false? a. Elevated progesterone levels may promote the growth of myometrial islands of endometrium b. Adenomyosis can be managed with hormone therapy. c. Adenomyosis may cause abnormal uterine bleeding. d. Adenomyosis may cause pelvic pain during menstruation.
ANS: A Elevated estrogen levels may also promote the growth of myometrial islands of endometrial tissue.
- Uterine arteriovenous malformation (AVM): a. Involves the endometrium b. Can be managed with dilation and curettage (D&C) c. Involves the myometrium d. Is always acquired
ANS: C uterine AVM usually involves the myometrium, but rarely the endometrium. The condition is typically acquired but may be congenital. A D&C could lead to catastrophic hemorrhaging
- The endometrium should be measured from ____ layer to ____ layer. a. Hypoechoic; hypoechoic b. Hyperechoic; hyperechoic c. Hyperechoic; hypoechoic d. Hypoechoic; hyperechoic
ANS: B The functionalis layers (hyperechoic layers) are only included in the measurement. The hypoechoic basalis layer is not included in the endometrial measurement.
- Endometrial hyperplasia develops from which one of the following? a. Unopposed estrogen stimulation b. Unopposed progesterone stimulation c. Follicular-stimulating hormone d. Endometrial polyp
ANS: A Endometrial hyperplasia develops from unopposed estrogen stimulation.
- A 3-day postpartum woman complains of intense pelvic pain. Sonographically, the uterus appears hypoechoic with an irregular endometrium. This condition most likely represents which one of the following? a. Adenomyosis b. Degenerating submucosal leiomyoma c. Endometritis d. Endometrial hyperplasia
ANS: C A clinical sign of endometritis is intense pelvic pain. It occurs most often in association with PID, postpartum, or instrument invasion.
- In postmenopausal patients, an endometrial thickness of less than _____ millimeters (mm) reliably excludes an endometrial abnormality. a. 4 b. 5 c. 8 d. 10
ANS: B In postmenopausal patients, an endometrial thickness of less than 5 reliably excludes an endometrial abnormality
- Only ___% of women with postmenopausal bleeding have endometrial carcinoma . a. 10 b. 25 c. 50 d. 75
ANS: A Although postmenopausal bleeding is the most common clinical sign of endometrial carcinoma , only 10 % of women with postmenopausal bleeding have endometrial carcinoma.
21, Patients on tamoxifen therapy have an increased risk of which one of the following reactions? a. Endometrial hyperplasia b. Endometrial polyp c. Endometrial carcinoma d. All of the above reactions
ANS: D An increased risk of endometrial carcinoma, hyperplasia, and polyp has been reported in patients on tamoxifen therapy.
- A 28-year-old woman reports left lower quadrant pain. Her last menstrual period was 2 weeks earlier. Sonographically, the uterine body displays a highly echogenic structure in the endometrial cavity. This appearance most likely represents which one of the following conditions? a. Endometritis b. Calcified submucosal fibroid c. Intrauterine contraceptive device (IUD) d. Calcified arcuate arteries
ANS: C Sonographically, an IUD appears as a highly echogenic structure in the endometrium of the uterine body.
- Irregular, acyclic bleeding is defined as which one of the following? a. Menorrhagia b. Metrorrhea c. Dysmenorrhea d. Amenorrhea
ANS: B Metrorrhea is defined as irregular, acyclic bleeding.
- In which of the following structures might a Gartner’s duct cyst be found? a. Fallopian tube b. Ovary c. Cervix d. Vagina
ANS: D The Gartner’s duct cyst is the most common cystic lesion of the vagina.
- In a patient after an hysterectomy, the normal vaginal cuff should not exceed ____ centimeters (cm).
a. 1
b. 2
c. 3
d. 4
ANS: B The upper normal limit of a vaginal cuff in a patient after an hysterectomy is 2.1 cm.
- An infection that involves the fallopian tube and the ovary is called which one of the following conditions?
a. Pelvic inflammatory disease
b. Tubo-ovarian abscess (TOA)
c. Pyosalpinx
d. Salpingitis
b. Tubo-ovarian abscess (TOA)
- Risk factors in pelvic inflammatory disease (PID) include all of the following except:
a. early sexual contact.
b. single sexual partner.
c. sexually transmitted disease.
d. intrauterine contraceptive device.
b. single sexual partner.
- Which one of the following statements about PID is false?
a. PID is almost always a bilateral collection of pus and fluid.
b. Patients may experience pelvic pain and have a history of infertility.
c. PID includes vaginal discharge with bleeding.
d. PID confers a decreased risk of ectopic pregnancy.
d. PID confers a decreased risk of ectopic pregnancy.
- Which one of the following statements about the fallopian tube is false?
a. The normal lumen is not usually visualized.
b. Detection is easier if fluid or pus is in the tube.
c. The tube is best seen transabdominally.
d. Ascites is helpful to outline the tube.
c. The tube is best seen transabdominally
- Which one of the following is an infection in the fallopian tube?
a. Parametritis
b. Oophoritis
c. Hydrosalpinx
d. Salpingitis
d. Salpingitis
- Early in the disease, the clinical presentation of both PID and endometriosis may mimic which one of the following?
a. Para-ovarian cyst
b. Subserosal fibroid
c. Functional bowel disease
d. Adenomyosis
c. Functional bowel disease
- PID is an inclusive term that refers to all of the following pelvic infections except:
a. oophoritis.
b. endometriosis.
c. parametritis.
d. myometritis.
b. endometriosis
- Which one of the following is the most common cause of PID?
a. Intrauterine devices
b. Sexually transmitted diseases
c. Postsurgical complications
d. Endometritis
b. Sexually transmitted diseases
- Fusion of the inflamed dilated tube and ovary is called which one of the following?
a. A tubo-ovarian abscess
b. Pyosalpinx
c. Pelvic inflammatory disease
d. Tubo-ovarian complex
d. Tubo-ovarian complex
- Which one of the following is an infection within the uterine serosa and broad ligaments?
a. PID
b. Parametritis
c. Myometritis
d. Peri-ovarian inflammation
b. Parametritis
- Clinical symptoms of PID may include which one of the following?
a. Fever
b. Dull pelvic aching
c. No symptoms
d. Fever and dull pelvic aching
d. Fever and dull pelvic aching
- The differential considerations of a solid-appearing adnexal mass include all of the following except:
a. endometrioma.
b. hemorrhagic cyst.
c. hydrosalpinx.
d. pedunculated uterine fibroid.
c. hydrosalpinx
- The differential considerations of PID may include all of the following except:
a. dermoid.
b. endometriosis.
c. serous cystadenoma.
d. ovarian neoplasm
c. serous cystadenoma.
- Sonographic findings of PID include all of the following except:
a. Endometritis.
b. Endometriosis.
c. Peri-ovarian inflammation.
d. Salpingitis.
b. Endometriosis.
- Enlarged ovaries with multiple cysts and indistinct margins describes which of the following conditions?
a. Peri-ovarian inflammation
b. Tubo-ovarian complex
c. Para-ovarian inflammation
d. Oophoritis
a. Peri-ovarian inflammation
- Sexually transmitted PID is spread via which one of the following?
a. Bloodstream
b. Mucosa
c. Serosa
d. Fallopian tubes
b. Mucosa
- A complex adnexal mass most likely represents which one of the following?
a. Salpingitis
b. Hydrosalpinx
c. Oophoritis
d. Pyosalpinx
d. Pyosalpinx
- Perihepatic inflammation ascending from a pelvic infection is called ____________ syndrome.
a. Stein-Leventhal
b. Fritz-Hugh-Curtis
c. Turner’s
d. de Quervain’s
b. Fritz-Hugh-Curtis
- An asymptomatic 32-year-old woman is diagnosed with a left adnexal mass on physical examination. A history of PID has been
reported. Transabdominal and transvaginal images demonstrate an anechoic tubular structure in the left lower quadrant. This
finding most likely represents which one of the following?
a. Iliac vessels
b. Hydrosalpinx
c. Theca-lutein cysts
d. Ectopic pregnancy
b. Hydrosalpinx
- A 24-year-old woman has a fever, vaginal discharge, and intense pelvic pain. Transabdominal and transvaginal images
demonstrate a complex multiloculated irregular mass in the pouch of Douglas. This clinical presentation most likely represents
which one of the following?
a. Ovarian torsion
b. A tubo-ovarian abscess
c. Degenerating pedunculated fibroid
d. Endometrioma
b. A tubo-ovarian abscess
- A 25-year-old woman complains of painful menstrual cycles and infertility. Transabdominal and transvaginal images demonstrate
a hypoechoic well-defined adnexal mass. Normal ovaries are seen bilaterally. This sonographic appearance most likely represents
which one of the following?
a. A tubo-ovarian abscess
b. Para-ovarian cyst
c. Endometrioma
d. Hemorrhagic corpus luteum cyst
c. Endometrioma
- Which one of the following statements about diffuse endometriosis is false?
a. It is the most common form of endometriosis.
b. Endometriosis is easily diagnosed by sonography.
c. Endometriosis leads to the disorganization of pelvic anatomy.
d. Its appearance is similar to PID.
b. Endometriosis is easily diagnosed by sonography.
- Inflammation of the serous membrane lining the abdominal cavity and covering the viscera is which one of the following?
a. Periangitis
b. Omentitis
c. Peritonitis
d. Retroperitonitis
c. Peritonitis
- A pelvic abscess will likely appear as which one of the following?
a. Complex cul-de-sac mass that distorts the pelvic anatomy
b. Hypoechoic adnexal mass with a separate normal ovary
c. Complex ovarian mass with anechoic cul-de-sac fluid
d. Hypoechoic cul-de-sac mass
a. Complex cul-de-sac mass that distorts the pelvic anatomy
- Which one of the following statements about interventional pelvic sonography is true?
a. Is not a valuable diagnostic tool
b. Lacks a safe biopsy route
c. Decreases patient care
d. Decreases patient cost
d. Decreases patient cost
- Theca-lutein cysts are associated with high levels of which of the following hormones?
a. Estrogen
b. Progesterone
c. Luteinizing hormone
d. Human chorionic gondotropin (HCG)
d. HCG
**2. A hypo echoic mass adjacent to the ovary is most likely which of the following masses?
a. Teratoma
b. Endometrioma
c. Paraovarian cyst
d. Mucinous cystadenoma
b. Endometrioma
- A tumor that may mimic gas or feces in the pelvis is which of the following masses?
a. Leiomyoma
b. Lipoma
c. Granulosa
d. Dermoid
d. Dermoid
- The demoid tumor is typically associated with which one of the following ultrasound signs?
a. Sandwich
b. Silhouette
c. Tip of the iceberg
d. Mickey Mouse
c. Tip of the iceberg
- Which one of the following cysts occurs when a dominant follicle does not succeed in ovulating but remains active although immature?
a. Nabothian
b. Corpus luteum
c. Follicular
d. Paraovarian
c. Follicular
- The most common adnexal mass found during early pregnancy is which one of the following cysts? a. Corpus luteal b. Theca-lutein c. Follicular d. Paraovarian
a. Corpus luteal
- A mucinous cystadenoma is all of the following except:
a. Large cystic mass with multilocular cystic spaces
b. Unilateral
c. Most common cystic tumor
d. Thick with irregular walls and septations
d. Thick with irregular walls and septations
- Mucinous cystadenocarcinoma most frequently occurs in women over the age of___ years
a. 20
b. 30
C. 40
d. 50
С. 40
- Which one of the following pelvic organs is more commonly involved with metastatic disease?
a. Uterus
b. Ovaries
c. Bladder
d. Fallopian tubes
b. Ovaries
- The normal ovary exhibits which one of the following characteristic appearances?
a. Heterogeneous echotexture
b. Homogeneous echotexture
c. Central hypoechoic medulla
d. Both a heterogeneous echotexture and a central hypoechoic medulla
b. Homogeneous echotexture
- Simple ovarian cysts in postmenopausal women are not likely malignant when measuring less than centimeters (cm)
a. 3
b. 4
c. 5
d. 6
c. 5
- Sonographic criteria for a simple ovarian cyst include all of the following except: a. Anechoic appearance b. Smooth walls c. Posterior shadowing d. Acoustic enhancement
c. Posterior Shadowing
- An ovary is generally considered abnormal if its volume is ____ the size of the contralateral ovary
a. One half
b. Twice
c. Three times
d. One quarter
b. Twice
- Which one of the following statements about polycystic ovarian syndrome (PCOS) is false? a. PCOS includes amenorrhea. b. PCOS includes early pregnancy loss. c. PCOS occurs in the middle-to-late 30s. d. PCOS includes hirsutism.
c. PCOS occurs in the middle-to-late 30s.
- In PCOS, the ovaries have which one of the following shapes?
a. Rounded
b. Irregular
c. Elongated
d. Smooth
a. Rounded
- Paraovarian cysts arise from which one of the following structures?
a. Fallopian tube
b. Round ligament
c. Peritoneum
d. Broad ligament
d. Broad ligament
- A specific diagnosis of a paraovarian cyst is possible only by:
a. Intervening surgically
b. Demonstrating an ipsilateral ovary separate from the cyst
c. Demonstrating thin deformable walls
d. Demonstrating a lack of peripheral blood flow
b. Demonstrating an ipsilateral ovary separate from the cyst
- the Ovarian carcinoma is classified into four stages. Stage ll is limited to which one of following?
a. Pelvis
b. One ovary
c. Broad ligament
d. Two ovaries
a. Pelvis
- The most common benign tumor of the ovary is which one of the following mas ses?
a. Serous cystadenoma
b. Endometrioma
c. Dermoid
d. Mucinous cystadenoma
c. Dermoid
- Which one of the following masses is a rare but benign ovarian neoplasm most often seen in postmenopausal women?
a. Fibroma
b. Thecoma
c. Granulosa
d. Dysgerminoma
b. Thecoma
- Functioning endometrial tissue is present outside of the uterus in which one of the following common conditions?
a. Adenomyosis
b. Endometriosis
c. Endometritis
d. Hemorrhagic cyst
b. Endometeriosis
- Th e partial or complete rotation of the ovarian pedicle on its axis is defined as which one of the following?
a. Hemorrhagic cyst
b. Endometrioma
c. Paraovarian cyst
d. Ovarian torsion
d. Ovarian torsion
- Which one of the following statements about ovarian torsion is false?
a. Ovarian torsion is usually associated with a mass.
b. Torsion frequently involves the ovary and the fallopian tube.
c. The ovary appears enlarged.
d. The left ovary is three times more likely to develop torsion than the right.
d. The left ovary is three times more likely to develop torsion than the right.
- Which one of the following pelvic organs is more involved with metastatic disease?
a. Uterus
b. Fallopian tube
c. Ovary
d. Bladder
c. Ovary
- Which if the following endocrine disorders is associated with chronic anovulation?
a. Polycystic ovarian syndrome
b. Endometriosis
c. Ovarian hyperstimulation syndrome
d. Theca-luetien cysts
a. Polycystic ovarian syndrome
