Chapter 43 - Pathologies of Uterus

Question 1

1. 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

Answer 1

B

Question 2

2. Which one of the following is the most common site for a leiomyoma to occur? a. Submucosal b. Subserosal c. Pedunculated d. Intramural

Answer 2

D

Question 3

3. 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

Answer 3

C

Question 4

4. 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

Answer 4

C

Question 5

5. 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

Answer 5

C

Question 6

6. 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

Answer 6

C

Question 7

7. 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

Answer 7

B

Question 8

8. A small percentage of leiomyomas is located in which one of the following structures? a. Body b. Fundus c. Myometrium d. Cervix

Answer 8

D

Question 9

9. 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

Answer 9

C

Question 10

10. 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

Answer 10

A

Question 11

11. 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

Answer 11

B

Question 12

12. The most common cause of uterine calcification is which one of the following? a. Adenomyosis b. Endometriosis c. Arcuate artery calcification d. Myomas

Answer 12

D

Question 13

13. On ultrasound, the characteristic appearance of a degenerating leiomyoma is _____ a. Homogeneous b. Heterogeneous c. Isoechoic d. Anechoic

Answer 13

B

Question 14

14. 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.

Answer 14

A

Question 15

15. 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

Answer 15

C

Question 16

16. The endometrium should be measured from ____ layer to ____ layer. a. Hypoechoic; hypoechoic b. Hyperechoic; hyperechoic c. Hyperechoic; hypoechoic d. Hypoechoic; hyperechoic

Answer 16

B

Question 17

17. Endometrial hyperplasia develops from which one of the following? a. Unopposed estrogen stimulation b. Unopposed progesterone stimulation c. Follicular-stimulating hormone d. Endometrial polyp

Answer 17

A

Question 18

18. A 3-d ay 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

Answer 18

C

Question 19

19. In postmenopausal patients, an endometrial thickness of less than _____ millimeters (mm) reliably excludes an endometrial abnormality. a. 4 b. 5 c. 8 d. 10

Answer 19

B

Question 20

20. Only ___% of women with postmenopausal bleeding have endometrial carcinoma . a. 10 b. 25 c. 50 d. 75

Answer 20

A

Question 21

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

Answer 21

D

Question 22

22. 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

Answer 22

C

Question 23

23. Irregular, acyclic bleeding is defined as which one of the following? a. Menorrhagia b. Metrorrhea c. Dysmenorrhea d. Amenorrhea

Answer 23

B

Question 24

24. In which of the following structures might a Gartner’s duct cyst be found? a. Fallopian tube b. Ovary c. Cervix d. Vagina

Answer 24

D

Question 25

25. In a patient after an hysterectomy, the normal vaginal cuff should not exceed ____ centimeters (cm). a. b. 2 c. d. 4

Answer 25

B