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Penny - OB CH > Chapter 21 - Pelvic Inflammatory Disease & infertility > Flashcards

Chapter 21 - Pelvic Inflammatory Disease & infertility Flashcards

1
Q

the buildup of fluid within the air sacs of alveoli within the lungs

A

acute respiratory distress syndrome

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2
Q

a hormone such a tester one that is responsible for a male characteristic

A

androgen

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3
Q

syndrome characterized by endometrial adhesions that typically occur as result of scar formation after some types of uterine surgery

A

ashermann syndrome

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4
Q

inflammation of the cervix

A

cervicitis

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5
Q

sexually transmitted disease that can lead to an infection of the genital tract in both sexes

A

chlaymidia

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6
Q

inflammation of the GB

A

cholecystitis

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7
Q

function ectopic endometrial tissue located outside of the uterus

A

endometritis

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8
Q

permanent form of birth control that uses small coils placed into the proximal isthmus segment of the FT

A

essure device

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9
Q

a perihepatic infection that results in liver capsule inflammation from the pelvic infections such as gonorrhea and chlamydia

A

Fitz-Hugh-Curtis-Syndrome

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10
Q

technique used for in vitro fertilization in which follicles are drained for oocyte retrieval

A

follicular aspiration

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11
Q

infertility treament in which oocytes and sperm are placed in the FT by means of laparoscopy

A

gamete intrafallopian tube transfer

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12
Q

a sexually transmitted disease that can lead to PID

A

gonnorrhea

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13
Q

peritoneal space located between liver and right kidney ; also referred to as Morrison pouch

A

hepatorenal space

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14
Q

coexisting ectopic & intrauterine pregnancies

A

heterotopic pregnancy

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15
Q

abnormal accumulation of fluid within the Fallopian tube

A

hydrosalpinx

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16
Q

excessive serum androgen levels ; produces male characteristics in females

A

hyperandrogegism

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17
Q

an increase in blood flood

A

hyperemic

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18
Q

fertility treatment that requires that a mature ovum be extracted from the ovary with fertilization taking place outside of the body

A

in vitro fertilization

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19
Q

an elevated white blood cells count

A

leukocytosis

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20
Q

when the endometrium does not develop appropriately in the luteal phase of the endometrial cycle as a result of reduced progesterone production

A

luteal phases deficiency

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21
Q

a small plastic T-shaped intrauterine device

A

Mirena

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22
Q

overweight to the point of causing significant health problems and increased mortality

A

obesity

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23
Q

infrequent or light menstrual periods

A

oligomenorrhea

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24
Q

scant or decreased urine output

A

oliguria

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25
Q

the removal of oocytes from ovarian follicles by aspiration

A

oocyte retrieval

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26
Q

a syndrome resulting from hyper stimulation of the ovaries by fertility drugs ; results in development of multiple enlarge follicular ovarian cysts

A

ovarian hyperstimulation syndrome

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27
Q

the stimulation of the ovaries by hormonal therapy in order to treat infertility

A

ovulation induction

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28
Q

intrauterine contraceptive device that utilizes copper in its composition to inhibit sperm transport or to prevent fertilization or transplantation

A

paraguard

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29
Q

infertility medicine used to stimulate the follicular development of the ovaries

A

pergonal

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30
Q

time directly after giving birth and extending to about 6 weeks

A

postpartum

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31
Q

synthetic progesterone secreted by some intrauterine devices to regulate menstrual flow

A

progestin

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32
Q

an inflammatory reaction that leads to the formation of pus

A

purulent

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33
Q

presence of pus within uterus

A

pyometra

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34
Q

presence of pus within the FT

A

pyosalpinx

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35
Q

artifact seen posterior to air or gas bubbles

A

ring down artifact

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36
Q

inflammation of FT

A

salpingitis

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37
Q

method of reducing with number of pregnancies in a multiple gestation whereby certain embryos or fetuses are terminated

A

selective reduction

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38
Q

an illness resulting from another disease, trauma, or injury

A

sequela

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39
Q

sonographic finding that is described as the presence of 10 fr more small cysts measuring 2 to 18 mm along the periphery of the ovary

A

“String of pearls” sign

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40
Q

functional ovarian cysts that are found in the presenceof elevated levels of HCG ; also referred to as theca luteal cyst

A

theca lutein cysts

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41
Q

the formation of clot within a blood vessel with the potential to travel to a distant site and cause occlusion

A

thromboembolism

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42
Q

a permanent form of female sterilization in which the FT are severed

A

tubal ligation

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43
Q

a pelvic abscess involving FT and OV that is often cause by pelvic inflammatory disease

A

tube-ovarian abscess

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44
Q

when adhesions develop within pelvis that leads to fusion of ovaries and dilated tubes as a result PID

A

tube-ovarian complex

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45
Q

the uterus, ovaries and FT

A

upper genital tract

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46
Q

a benign, smooth muscle tumor of the uterus ; may also be referred to as a fibroid or uterine myopia

A

uterine leiomyoma

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47
Q

inflammation of the vagina

A

vaginitis

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48
Q

infertility treatment where the zygote is placed into the FT

A

zygote intrafallopain transfer

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49
Q

An infection in the upper genital tract

A

PID

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50
Q

What is the origin of PID

A

ascension of an infection from the lower genital tract

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51
Q

Risk factor for PID

A

IUD

Post abortion

Post Childbirth

Douching

Mulitple Sexual Partners

Early Sexual Contact

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52
Q

After PID it manifests

A

TB
Association of Appdx
Ruptured colonic diverticulum
Pelvic surgery

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53
Q

Common causes of PID are

A

Chlamydia & Gonorrhea

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54
Q

PID is usually ___

A

Bilateral

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55
Q

Clinical findings of Acute PID

A

fever
chills
pelvic pain/tenderness
purulent vaginal discharge
vaginal bleeding/itchiness
dyspareunia
leukocytosis

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56
Q

Sonographic findings of acute PID

A

Thickened Irregular Endometrium

Ill defined uterine borders

Pyosalpinx

Hydrosalpinx

Cul de sac Fluid

Multicystic and solid complex andexal masses

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57
Q

Clinical findings of chronic PID

A

Continual Pelvic / Abd Pain

Infertility

Palpable Adnexal Mass

Irregular Menses

Purulent Vaginal Discharge

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58
Q

Sonographic findings of Chronic PID

A

Hydrosalpinx

Scars in Fallopian Tubes (Echogenic bands in tube)

Adhesions may obliterate distinct borders

Multicystic and solid complex adnexal masses

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59
Q

The most common initial clinical presentation in early stages of PID

A

Vaginitis

60
Q

Vaginitis can lead too

A

excesssive vaginal discharge & purulent foul smelling discharge

61
Q

The progression vaginitis into the cervix

A

Cervicitis

62
Q

Inflammation of the endometrium

A

endometritis

63
Q

Endometritis can occur after

A

Postpartum
D&C
IUD

64
Q

Clinical findings of Endometritis

A

HX of Abortion, Postpartum, D&C, PID, Surgery, and IUD

Pelvic Tenderness

Fever

Leukocytosis

65
Q

Snographic findings of endometritis

A

Thickened echogenic or irregular endometrium

Endometrial Fluid

Ring down artifact (Gas or air within the endometrium)

66
Q

Patients suffering from saplinigitis may present with

A

symptoms like cholecytisis

67
Q

Chlamydia or Gonorrhea can lead to what

A

perihepatic infections (development of adhesions located between the liver & diaphragm)

68
Q

Fitz Hugh Curtis syndrome

A

chlyamidia and gonorhhea can lead to this , liver capsules become inflamed, mimicking GB disease , elevated liver function tests

69
Q

PID is linked to

A

Ectopic pregnancy

70
Q

Clinical findings of Salpingitis

A

PID Findings
Pelvic Tenderness
Fever
Leukocytosis

71
Q

Sonographic findings of Salpingitis

A

distended Fallopian tube filled with echogenic material (pus) or anechoic fluid
-hyperemic flow within or around the affected FT
-nodular thickness wall of FT

72
Q

As PID progresses what happens

A

Reaches beyond the FT and involves the ovaries and peritoneum

73
Q

The progression of Tube Ovarian complex

A

Tubo Ovarian Abcess

74
Q

Both Tubo Ovarian Complex and Abcess Sonographic Findings

A

Thickened, Irregular Endometrium

Pyosalpinx / Hydrosalpinx

Culd de sac fluid

Multicystic and solid complex adnexal masses

75
Q

What are the Sonographic Findings for both Tubo Ovarian Abcess and Complex

A

Thickened, Irregular Endometrium

Pyosalpinx / Hydrosalpinx

Cul de sac fluid

Multicystic and solid complex adnexal masses

76
Q

With Tubo Ovarian Complex what is a sonographic findings that is different than with an abcess?

A

Ovaries and tubes recognized as distinct structures but the ovaries will not be seperated by pushing them with a vaginal probe

77
Q

PID is a common cause of

A

Infertility

78
Q

What are some causes of Female Infertility ?

A

Septate Uterus

Endometriosis

PCOS

Asherman Syndrome

Uterine Leiomyoma

Tubal Causes

79
Q

Uterine malformations often lead to what?

A

Repeated abortions

80
Q

How does implantation of ectopic endometrial tissue result?

A

From passing through the fallopian tubes during menstruation or may result from scarring from surgery after a c - section

81
Q

Ectopic endometrial tissue undergoes physiologic changes?

A

As a result of stimulation of the hormones of the menstrual cycle

82
Q

Hemorrhage of endometriosis tissue occurs resulting in what?

A

Focal areas of bloody tumors - endometriomas

Chocolate cysts

83
Q

Endometriosis is most commonly located where?

A

Ovaries

84
Q

Where can ednometriosis be located?

A

Within C- section scars, liver, lungs and extremities

85
Q

Endometrial age range

A

25 TO 35

86
Q

infertility results from development of pelvic adhesions that may alter normal anatomy - prevents ovum from being picked up

A

Infertility & Endometriosis

87
Q

The Clinical Findings of Endometriosis

A

Asymptomatic

Pelvic Pain

Infertility

Dysmenorrhea

Dyspareunia

Menorrhagia

Painful bowel movement

88
Q

Sonographic findings of endometriosis

A

Cystic mass with low level internal echos - hemorrhagic cyst

Anechoic or complex mostly cystic mass with posterior enhancement and may contain a fluid - fluid level

89
Q

Polycystic ovary syndrome is also known as what

A

Stein Levethal Syndrome

90
Q

Patients with Polycystic Ovarian Syndrome may suffer from chronic anovulation as a result from?

A

Hormonal imbalances

91
Q

PCOS is cited as the most common cause of

A

Androgen excess

92
Q

Diagnosis of PCOS includes what ?

A

Oligo or Annovulation

Blood work shows Hyperandrogenism

Sonographic Findings of PCOS

93
Q

For a diagnosis the ovaries should contain what ?

A

12 or more follicles that measure between 2 and 9 in diameter

94
Q

PCOS ovarian volume should not exceed

A

10 ml

95
Q

Hydrosalpinx occurs because

A

Obstruction of fimbriated end of the fallopian tube by adhesions

96
Q

The clinical findings of Sherman syndrome

A

HX of D&C, Trauma, Uterine Surgery
-recurrent pregnancy loss
-amenorrhea/hypomenorrhea

97
Q

What kind of fibroids can impede fertilization

A

Intracavity or submucosal

98
Q

What causes female infertility

A

-Uterine malormations
-Endometriosis
-PCOS
-Tubal
-Luteal Phase Deficiency
-Asherman Syndrome
-Uterine Leiomyoma

99
Q

Ovulation
Induction

A

Clomid
Personal

100
Q

Clomid is also known as

A

Clomiphene Citrate

101
Q

Women who are undergoing ovulation induction by means of hormone administration are at an increased risk for developing what?

A

Ovarian Hyperstimulation

102
Q

With OHS ovaries will often measure

A

5 to 12 cm

103
Q

with OHS what kind of cysts

A

Theca Lutein Cysts

104
Q

with OHS ovaries become so large

A

Ovarian torsion is possible

105
Q

OHS can initiate

A

Renal Failure, Thromboembolism, Acute Respiratory Distress Syndrome

106
Q

The clinical findings of OHS

A

Abdominal Distension

Oliguria

Ovarian Enlargement

Nausea

Vomiting

Fertility treatment

107
Q

What is the radiographic procedure used to evaluate the patency of the FT
A. sonohysterography
B. hysterosalpingography
C.Hysteroscopy
D. Hysterscopic fallopa

A

Hysterosalpingography

108
Q

The sonographic finding of a tubular, simple-appearing, anechoicstructure within the adnexa is most consistent with
A. Dyspareunia
B. Hematometra
C. Hydrosaplinx
D. Endometritis

A

Hydrosalpinx

109
Q

All of the following are considered risk factors for PID except
A. IUD
B Multiple sexual partners
C. Post childbirth
D. Uterine leiomyoma

A

Uterine leioymoma

110
Q

Which of the following would be the least likely clinical finding for a pt with endometriosis
A. pelvic pain
B. Dysmenorrhea
C. painful bowel movements
D. hyperandrogenism

A

D

111
Q

Which of the following is not a potential cause of PID Is
A. intrauterine contraception
B. postabortion
C. chlymadia
D. pyelonephritis

A

D

112
Q

a patient presents to the sonography department with a fever, chills, and vaginal discharge. sonographically, what findings would you most likely not encounter?
c. cul-de-sac fluid
b. uterine adhesions
c. dilated uterine tubes
d. ill-defined uterine border

A

B

113
Q

a 26-year old patient presents to the sonography department with a history of infertility and oligomenorrhea. sonographically, you discover that the ovaries are enlarged and contain multiple, small follicles along their periphery, with prominent echogenic stromal elements. what is the most likely diagnosis?
a. ovarian torsion
b. OHS
c. PID
d. PCOS

A

D

114
Q

the most common initial clinical presentation of PID is:
a. endometritis
b. tubo-ovarian abscess
c. vaginitis
d. pyosalpinx

A

C

115
Q

sonographic findings of the endometrium in a patient with a history of PID, fever, and elevated white blood cell count would include all of the following except:
a. ring-down artifact posterior to the endometrium
b. thin, hyperechoic endometrium
c. endometrial fluid
d. thickened, irregular endometrium

A

B

116
Q

What is another name for an endometrioma
A. dermoid
B. teratoma
C. chocolate cyst
D. string of pearl

A

C

117
Q

Fitz-Hugh-Curtis syndrome could be described as:
a. clinical findings of gallbladder disease as a result of PID
b. the presence of uterine fibroids and adenomyosis in the gravid uterus
c. coexisting intrauterine and exrauterine pregnancies
d. the presence of pyosalpinx, hydrosalpinx, and endometritis

A

A

118
Q

all of the following statements concerning PID are true except:
a. PID is typically a unilateral condition
b. PID can be caused by douching
c. PID can lead to a tubo-ovarian abscess
d. dyspareunia is a clinical finding in acute PID

A

A

119
Q

a patient presents to the sonography department with complaints of infertility and painful menstrual cycles. sonographically, you discover a cystic mass on the ovary consisting low-level echoes. based on the clinical and sonographic findings, what is the most likely diagnosis?
a. cystic teratoma
b. endometrioma
c. PID
d. OHS

A

B

120
Q

The development of adhesions between the liver and the diaphragm as a result of PID is termed
A. fitz hugh curtis syndrome
B. Dandy Walker syndrome
C. Stein leventhal syndrome
D. aSherman syndrome

A

A

121
Q

Assisted reproductive therapy can result in all of the following of except :
A. hetertopic pregnancy
B. multiple gestations
C. OHS
D. asherman syndrome

A

D

122
Q

Polycystic ovarian syndrome may also be referred to as:
A. Fitz-Hugh Curtis syndrome
B. plateau syndrome
C.stein leventhal syndrome
D. asherman syndrome

A

C

123
Q

PID can lead to all of the following except:
a. infertility
b. polycystic ovarian disease
c. ectopic pregnancy
d. scar formation in the fallopian tubes

A

B

124
Q

What term is used to describe painful intercourse?
A. dyspareunia
B. Dysuria
C. dysmenorrhea
D. dynsconception

A

A

125
Q

the presence of functional, ectopic endometrial tissue outside the uterus is termed:
A. adenomyosis
B. asherman syndrome
C. Fitz-Hugh Curtis syndrome
D. endometriosis

A

D

126
Q

all of the following are sonographic findings of a tubo-ovarian abscess except:
a. the presence of 10 or more small cysts along the periphery of the ovaries
b. dul-de-sac fluid
c. thickened, irregular endometrium
d. fusion of the pelvic organs as a conglomerated mass

A

A

127
Q

a patient presents to the sonography department with a history of Chlamydia and suspected PID. which of the following would be indicative of the typical sonographic findings of PID?
a. enlarged cervix, thin endometrium, and theca lutein cysts
b. atrophic uterus, free fluid, and small ovaries
c. bilateral, cystic enlargement of the ovaries with no detectable flow
d. thickened irregular endometrium, cul-de-sac fluid, and complex adenexal masses

A

D

128
Q

causes of female infertility include all of the following except:
a. previous intrauterine device use
b. polycystic ovary syndrome
c. Asherman syndrome
d. endometriosis

A

A. previous intrauterine device use

129
Q

Infertility is defined as
A. the inability to conceive a child after 2 years of unprotected intercourse
B. the inability to conceive a child after 5 years of unprotected intercourse
C. The inability conceive a child after 1 year of unprotected intercourse

A

A

130
Q

a 25-year old patient present to the sonography department complaining of pelvic pain, dyspareunia, and oligomenorrhea. an ovarian mass, thought to be a chocolate cyst, is noted during the examination. which of the following is consistent with the sonographic appearance of a chocolate cyst?
a. simple-appearing anechoic mass
b. echogenic mass with posterior shadowing
c. cystic mass with low-level level echoes
d. anechoic mass with posterior shadowing

A

C.

131
Q

amenorrhea, hirsutism, and obesity describe the clinical features of:
a. Fitz-Hugh-Curtis syndrome
b. Stein-Leventhal syndrome
c. Asherman syndrome
d. Endometriosis

A

B

132
Q

the sonographic evidence of a hyperemic fallopian tube is consistent with:
a. pyosalpinx
b. hydrosalpinx
c. endometritis
d. salpingitis

A

D

133
Q

the sonographic “string of pearls” sign is indicative of

A

polycystic ovary syndrome

134
Q

complex-appearing fluid within the fallopian tubes seen with PID is most likely:

a. pyosalpinx
b. pyometra
c. hydrosalpinx
d. hematometra

A

a

135
Q

sonographic findings of OHS include all of the following except:
a. cystic enlargement of the ovaries
b. ascites
c. pleural effusions
d. oliguria

A

oliguria

136
Q

he development of adhesions within the uterine cavity is termed

a. fitz-hugh-curtis syndrome
b. dandy-waler syndrome
c. stein-leventhal syndrome
d. asherman syndrome

A

Asherman syndrome

137
Q

OHS can cause multiple large follicles to develop on the ovaries termed

OHS can cause multiple large follicles to develop on the ovaries termed:

a. theca lutein cysts
b. chocolate cysts
c. corpus luteum cyst
d. dermoid cysts

A

Theca lutein cysts

138
Q

what is another name for adhesions within the endometrial cavity

what is another name for adhesions within the endometrial cavity?

a. endometritis
b. synechiae
c. septation
d. mural nodules

A

Synechiae

139
Q

a female patient presents to the sonography department with a clinical history of Clomid treatment. She is complaining of nausea, vomiting, and abdominal distention. What circumstance is most likely causing her clinical symptoms

a. stein-leventhal syndrome
b. pcos
c. fitz-hugh-curtis syndrome
d. OHS

A

OHS

140
Q

a 35 year old patient presents the the sonography department with a history of tubal ligation and positive pregnancy test. What condition should be highly suspected?

a. asherman syndrome
b. pcos
c. endometriosis
d. ectopic pregnancy

A

ectopic pregnancy

141
Q

patients with OHS are at increased risk for:
a. ovarian torsion
b. Chlamydia
c. gonorrhea
d. vaginitis

A

ovarian torsion

142
Q

which of the following would be described as functional cysts that are found in the presence levels of hcg

a. theca lutein cysts
b. chocolate cysts
c. corpus luteum cysts
d. endometrial cysts

A

theca lutein cysts

143
Q

The presence of pus within the uterus defines:
A. Pyosalpinx
B. Pyometra
C. Pyocolpos
D. Pyomyoma

A

Pyometra

144
Q

The occurrence of having both an intrauterine and extrauterine pregnancy at the same time describes

a. PID
b. ectopic pregnancy
c. heterotopic pregnancy
d. molar pregnancy

A

heterotopic pregnancy

145
Q

excessive hair growth in women in areas where hair growth is normally negligible would be see with:

a. ectopic pregnancy
b. fitz-hugh-curtis syndrome
c. asherman syndrome
d. stein-leventhal syndrome

A

Stein leventhal syndrome

146
Q

what form of permanent birth control would be seen sonographically as echogenic, linear structures within the lumen of both isthmic portions of the fallopian tubes?
a. Essure devices
b. ParaGards
c. Lippes loops
d. Mirenas

A

A

Penny - OB CH (18 decks)

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