Chapter 15: Gynecologic Sonography Overview Flashcards
the area located posterior to the broad ligaments, adjacent to uterus, which contains the ovaries and fallopian tubes
adnexa
A protein produced by the fetal yolk sac, fetal gastrointestinal tract, and the fetal liver; may also be produced by some malignant tumors
alpha-fetoprotein
birth defect in which the external genitalia appear recognizably neither male nor female
ambiguous genitalia
the absence of menstruation
amenorrhea
a collection of abdominal fluid within the peritoneal cavity
ascites
a tumor marker in the blood that can indicate certain types of cancers such as cancer of the ovary, endometrium, breast, gastrointestinal tract, and lungs; stands for cancer antigen 125
CA-125
a diagnostic modality that utilizes ionizing radiation to produce images of the human body in cross-sectional and reconstructed 3D formats
computed tomography
difficult or painful menstruation
dysmennorhea
painful sexual intercourse
dyspareunia
painful or difficult urination
dysuria
the sonographic appearance of a structure
echotexture
a pregnancy located outside of the endometrial cavity of the uterus
ectopic pregnancy
a means of looking inside the human body by utilizing an endoscope
endoscopy
the distinct layering of fluids within a cyst or cystic structure that is caused by the presence of at least two different fluid compositions
fluid-fluid level
a catheter placed into the urinary bladder via the urethra that is used to drain urine; it can also be clamped and used to temporarily distend the bladder for pelvic sonography
Foley catheter
a laboratory value that indicates the amount of red blood cells in the blood
hematocrit
excessive hair growth in women in areas where hair growth is normally negligable
hirsutism
a hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males
human chorionic gonadotropin
the dilation of the renal collecting system resulting from the obstruction of flow of urine from the kidney(s) to the bladder; also referred to as pelvocaliectasis, peliecaliectasis, or pyelecalectasis
hydronephrosis
decreased or scant menstrual flow; regular timed menses but light flow
hypomennorhea
inability to control urination
incontinence
inability to conceive a child after 1 year of unprotected intercourse
infertility
a common form of birth control in which a small device is placed within the endometrium to prevent pregnancy; also referred to as an intrauterine contraceptive device
intrauterine device
an enzyme found within the blood that may be used to monitor renal function; may also be used as a tumor marker for some ovarian tumors
lactate dehydrogenase
an elevated white blood cell count
leukocytosis
a diagnostic modality that utilizes electromagnetic radiation to produce images of the human body in cross-sectional and reconstructed 3D formats
MRI
ascites and pleural effusion in the presence of some benign ovarian tumors
Meigs syndrome
excessive or prolonged bleeding between periods
menometroorrhagia
abnormally heavy and prolonged menstruation
menorrhagia
irregular menstrual bleeding between periods; intermenstrual bleeding
metrorrhagia
having multiple chambers or compartments
multiloculated
growth or masses attached to the wall of a structure; most likely a cyst
mural nodules
a mass of tissue that contains abnormal cells; also called a tumor
neoplasm
a diagnostic imaging modality that utilizes the administration of radionuclides into the human body for an analysis of the function of organs, or for the treatment of various abnormalities
nuclear medicine
an abnormality that results from the ovary twisting on its mesenteric connection, consequently cutting off blood supply to the ovary
ovarian torsion
an infection of the female genital tract that may involve the ovaries, uterus, and/or fallopian tubes
pelvic inflammatory diseaes
kidney located within the pelvis
pelvic kidney
the abnormal accumulation of fluid in the pleural space
pleural effusion
a syndrome characterized by anovulatory cycles, infertility, hirsutism, amenorrhea, and obesity; may also be referred to as Stein-Leventhal syndrome
polycystic ovary syndrome
an intraperitoneal extension of mucin-secreting cells that results from the rupture of a malignant mucinous ovarian tumor or, possibly, a malignant tumor of the appendix
pseudomyxoma peritonei
a diagnostic imaging modality that uses ionizing radiation for imaging bones, organs, and some soft-tissue structures
radiography
separations; structures that divides something into different sections
septations
sonographic sign obtained during an endovaginal sonogram when gentle probe pressure is used to assess whether the anterior rectum and sigmoid colon glides freely across the posterior aspect of the uterus, cervix, and vaginal wall
sliding sign
an anechoic round mass that has smooth walls and demonstrates through transmission (acoustic enhancement)
simple cyst
a sonographic procedure that utilizes saline installation into the endometrial cavity and fallopian tubes to evaluate for internal abnormalities; also referred to as saline infusion sonohysterography
sonohysterogram
a breast cancer drug that inhibits the effects of estrogen in the breast
tamoxifen
sonogram that requires the transducer to be placed against the labia; often used for imaging of the cervix
translabial sonogram
a chromosomal aberration where one sex chromosome is absent; may also be referred to as monosomy x
Turner syndrome
having one chamber of compartment
unilocular
changes within the female that are caused by increased androgens; may lead to deepening of the voice and hirsutism
virilization
an inherited bleeding disorder that is characterized by low levels of a specific clotting protein in the blood referred to as von Willebrand factor, results in excessive bleeding and specifically vaginal bleeding in women
von Willebrand disease
without echoes
anechoic
having both cystic and solid components
complex
structure that produces echoes
echogenic
of differing composition
heterogenous
of uniform composition
homogenous
having many echoes
hyperechoic
having few echoes
hypoechoic
having the same echogenicity
isoechoic
Normal oral body temperature
98.6
Normal adult pulse
60-100 bpm
Normal adult blood pressure
120/8-
normal adult respiration
12-20 breaths per minute
If the sterility of an object is questionable, it is _____
not sterile
A sterile field ends at the level of the _____
tabletop
The _____ of a sterile gown is considered not sterile.
cuff
If one sterile person must pass another, they much pass _____
back to back
coughing, sneezing, or excessive talking over a sterile field leads to ______
contamination
caused by a large acoustic interface and subsequent production of false echoes
reverberation
produced by a strong specular reflector and results in a copy of the anatomy being placed deeper than the correct location
mirror image
caused by attenuation of the sound beam
shadowing
artifact that appears as a solid streak or a chain of parallel bands radiating away from a structure
ring-down artifact
caused by air or bowel gas
dirty shadowing
produced when the sound beam is barely attenuated through a fluid or a fluid-filled structure, May occassionaly by referred to as through transmission
acoustic enhancemen
could be caused by low-gain, low-frequency, high wall filter, or too high velocity scale
absent Doppler signal
Which of the following is an inherited bleeding disorder that is caused by low levels of a specific clotting protein in the blood?
a. Stein-Leventhal disease
b. Fitz-Hugh-Curtis disease
c. Meigs disease
d. von Willebrand disease
d
What is the term for elevated white blood cell count?
leukocytosis
What is another name for the anterior cul-de-sac?
vesicouterine pouch
Which of the following is also referred to as the space of Retzius?
a. paracolic gutters
b. retropubic space
c. anterior cul-de-sac
d. posterior cul-de-sac
b
Which of the following would be the least likely indication for a pelvic sonogram?
a. diarrhea
b. palpable pelvic mass
c. amenorrhea
d. screening for malignancy
a
Which of the following would least likely be associated with a palpable pelvic mass?
a. ovarian hyperstimulation syndrome
b. leiomyoma
c. ovarian cyst
d. endometrial hypoplasia
d
Which of the following is defined as painful or difficult urination?
a. dyspareiunia
b. nocturia
c. dyspnea
d. dysuria
d
A linear structure coursing through an anechoic cyst separating it into two separate cavities may be referred to as a:
septation
Which of the following would least likely indicate the presence of a complex cyst?
a. septation
b. mural nodule
c. acoustic enhancement
d. internal debris
c
Which of the following is a protein produced by the fetal yolk sac, fetal gastrointestinal tract, fetal liver, and by some malignant tumors?
a. lactate dehydrogenase
b. Ca-125
c. alpha-fetoprotein
d. human chorionic gonadotropin
c
What term describes the echogenicity of a simple ovarian cyst?
anechoic
The “S” in STAR criteria stands for:
Smooth walls
Which of the following is defined as pain during intercourse?
a. dysuria
b. dysmennorhea
c. dyspareunia
d. hirsutism
c
Which of the following is defined as excessive hair growth in women in areas where hair growth is normally negligable?
a. dyspareunia
b. hirsutism
c. Meigs syndrome
d. polycystic ovarian syndrome
b
Which of the following laboratory tests may be used as a tumor marker for an ovarian dysgerminoma?
a. lactate dehydrogenase
b. alpha-fetoprotein
c. CA-125
d. Tamoxifen
a
All of the following are associated with acute pelvic pain except:
a. pelvic inflammatory disease
b. ruptured ovarian hemorrhagic cyst
c. perforated IUD
d. Asherman syndrome
d
Which of the following is best defined as intermenstrual bleeding?
a. dysmennorhea
b. menorrhagia
c. menometrohagia
d. metrorrhagia
d
Having the same echogenicity means:
isoechoic
Which of the following would typically not be associated with amennorhea?
a. Asherman syndrome
b. polycystic ovarian syndrome
c. pregnancy
d. adenomyosis
d
Which of the following is best defined as difficult or painful menstruation?
a. dysmennorhea
b. dyspareunia
c. dysuria
d. menorrhagia
a
What term relates to the number of pregnancies a patient has had?
Gravida
Which of the following definitions best describes the term adnexa?
a. the area posterior to the uterus, between the uterus and the rectum
b. the area located posterior to the broad ligaments and adjacent to the uterus
c. the area anterior to the uterus, between the uterus and the urinary bladder
d. the area lateral to the iliac crest and posterior to the pubic symphysis
b
All of the following statements are true of endovaginal imaging except:
a. endovaginal imaging requires a full bladder
b. endovaginal imaging leads to reduced waiting time for the patient and quicker medical management
c. endovaginal imaging offers improved resolution of the endometrium, uterus, and ovaries, especially in the obese patient
d. enodvaginal imaging is contraindicated for pediatric patients and for those with an intact hymen
a
What laboratory value would be most useful to evaluate in a patient with suspected internal hemorrhage?
hematocrit
What abnormality results from the ovary twisting on its mesenteric connection?
ovarian torsion
Which of the following most often leads to an elevation of CA-125?
a. ovarian carcinoma
b. Fitz-Hugh-Curtis syndrome
c. ovarian torsion
d. Ovarian hyperstimulation syndrome
a
When does the CDC recommend that alcohol-based hand rub be combined with handwashing?
when your hands are visibly soiled
The best way to communicate with a patient who speaks a language other than your own is to use:
a trained medical interpreter
What artifact would be seen posterior to a tooth within a cystic teratoma?
shadowing
Which of the following is best described as an artifact that is produced by a strong reflector and results in a copy of the anatomy being placed deeper than the correct location?
a. reverberation
b. mirror image
c. acoustic shadowing
d. comet tail
b
Which of the following statements is not true concerning transabdominal pelvic imaging?
a. transabdominal imaging of the pelvis provides a global view of the entire pelvis
b. transabdominal imaging lacks the detail of endovaginal imaging
c. obese patients and patients with a retroverted or retroflexed uterus present a unique challenge to the transabdominal technique
d. Transabdominal imaging is contraindicated for pediatric patients
d
Malignant ovarian tumors may leak mucinous material, and this condition is known as:
pseudomyxoma peritonei
All of the following are proper techniques for providing patient care for patients during a pelvic sonogram except:
a. all transducers and their cords should be cleaned before performing a pelvic sonogram
b. endovaginal transducers should be cleaned with a high-level disinfectant
c. a probe cover should be placed on the transducer for transabdominal imaging to prevent the spread of infection
d. a sterile jelly should be used as a lubricant for endovaginal imaging
c
The breast cancer drug that inhibits the effects of estrogen in the breast is:
tamoxifenW
Which of the following statements would be considered an acceptable disadvantage of endovaginal imaging?
a. endovaginal imaging has a limited field of view
b. the resolution of endovaginal imaging is reduced compared to transabdominal imaging
c. endovaginal imaging is more time consuming than transabdominal imaging
d. endovaginal imaging can be performed only by female sonographers
a
What artifact could be noted emanating from air or gas within the endometrium in a patient with endometritis?
ring-down
What Doppler artifact occurs when the Doppler sampling rate is not high enough to display the Doppler shift frequency?
aliasing
Which of the following would be least likely to cause abdominal distention?
a. ascites
b. multiple leiomyoma
c. ovarian hyperstimulation syndrome
d. polycystic ovarian syndrome
d
All of the following are common indications for a pelvic sonogram except:
a. evaluation of congenital anomalies
b. evaluation of pelvic anatomy immediately following a motor vehicle accident
c. localization of an IUD
d. postmenopausal bleeding
b
Precocious puberty is best defined as:
pubertal development before the age of 8
Amennorhea is defined as:
lack of menstrual flow
occurs when the Doppler sampling rate is not high enough to accurately display the Doppler frequency shift
aliasing
caused by inappropriately high Doppler settings
Doppler noise
caused by sound beam striking a vessel at a 90 degree angle, producing an area void of color
flow directional abnormalities
occurs behind strong, granular, and irregular surfaces like crystals, calculi, or calcifications
twinkle artifact
between pubic bone and urinary bladder
retropubic space
also referred to as space of Retzius
retropubic space
extend alongside ascending and descending colon on both sides of abdomen
paracolic gutters
between the urinary bladder and rectum in males
posterior cul-de-sace
also referred to as rectovesical pouch
posterior cul-de-sac
between the uterus and rectum in females
posterior cul-de-sac
also referred to as pouch of Douglas
posterior cul-de-sac
between the urinary bladder and the uterus
anterior cul-de-sac
also called the vesicouterine pouch
anterior cul-de-sac
STAR critieria
smooth walls or borders
through transmission
anechoic
round in shape
provides a global view of the pelvis
transabdominal
number of pregnancies
gravida
number of pregnancies carried to term
para
Detected for rare ovarian tumors, developing gestation
HcG
lab value that should be evaluated in cases of suspected ectopic pregnancy
hematocrit
Low hematocrit indicates:
bleeding
elevated white blood cell count
leukocytosisk
Patients who has some form of “itis”, or possibly even as abscess, have an abnormal _______
white blood cell count
Most common cause of nosocomial infection
urinary tract infection
apply to blood, non intact skin, mucous membranes, contaminated equipment, and all other body fluids except sweat
standard precautions
Most effective means of protecting spread of infection
proper handwashing and hand cleaning
practices used to render an object or area free of pathogenic microorganisms
medical asepsis
Invasive procedures commonly performed in sonography department include
sonohysterogram
organ biopsies
mass biopsies
abscess drainages
allows for easy storage and comparison between sonographic findings and straightforward correlation between other image modality findings
PACS
The higher the frequency, the ____ the penetration abilities, the ____ the resolution
lower
better
Transabdominal transducers employ frequencies lower than __ MHz
6
Transvaginal transducers typically employ frequencies ___ MHz or greater
7.5
used for imaging very superficial structures
standoff pad
ability to accurately obtain volumetric measurements of structures
3D imaging
______ is much more common in adolescence
ovarian torsion
Adnexal or ovarian torsion is associated with:
large ovarian or adnexal cyst or mass
excessive mobility of adnexal structures
condition in which newborn’s external genitalia are recognizably neither male nor female
ambiguous genitalia
most common disorder of sex development
Turner syndrome
also referred to as monosomy X
Turner syndrome
gonadal dysfunction
short stature
webbing of skin on neck
Turner syndrome
kidney located within the pelvic
pelvic kidney
fluid that can collect in the pelvis
ascites
pelvic ascites can be associated with:
ovarian tumors
ectopic pregnancies
cirrhosis
portal hypertension
pelvic ascites, pleural effusion, and a benign ovarian mass
Meigs syndrome
malignant ovarian tumors that leak mucinous material
pseudomyxoma peritnei
A simple cyst should have _____, demonstrate ______, be completely _____, and be _____ in shape.
smooth walls
through transmission
anechoic
round
An advantage of ______ imaging, is that it offers improved resolution of the endometrium, uterus, and ovaries, especially in the obese patient.
endovaginal
The number of pregnancies is _____, whereas ____ is the number of pregnancies that a patient carried to term.
gravida
para
A decrease in _____ indicates bleeding.
hematocrit
Which of the following would be associated with hirsutism?
a. polycystic ovary syndrome
b. meigs syndrome
c. adenomyosis
d. adenomyomatosis
a
Which of the following would be caused by a large acoustic interface and subsequent product of false echoes?
a. posterior shadowing
b. acoustic enhancement
c. mirror image
d. reverberation
d
Which of the following would be best defined as abnormally heavy menstrual flow?
a. menometrorrhagia
b. menorrhagia
c. metrorrhagia
d. hypomennorhea
b
Which of the following would be best defined as regularly timed menses but light flow?
a. menometrorrhagia
b. mennorhagia
c. metrorrhagia
d. hypomennorhea
d
All of the following would be relevant laboratory tests to evaluate before performing a routine pelvic sonogram except:
a. human chorionic gonadotropin
b. hematocrit
c. white blood cell count
d. lipase
d
Which of the following could be described as an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes?
a. pseudomyxoma peritnei
b. pelvic inflammatory disease
c. polycystic ovarian disease
d. ovarian torsion
b
Which of the following diagnostic tests is used to evaluate emitted radiation from the patient to asses the function of organs?
a. MRI
b. Nuclear medicine
c. radiography
d. CT
b
Endovaginal transducers may be disinfected by submerging in a(n) ____-based solution
glutaraldehyde
Leukocytosis would most likely be associated with:
a. multiple degenerating fibroids
b. ovarian teratoma
c. adenomyosis
d. pelvic inflammatory disease
d
