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Genitourinary > Female Genital Tract > Flashcards

Female Genital Tract Flashcards

1
Q

Used to stage and follow up pelvic malignancies to supplement US by providing additional characterization of lesion

A

MR and CT

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2
Q

Has the potential to aid in the discrimination between benign peritoneal metastases and tumor recurrence

A

Diffusion weigted MR

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3
Q

In sonohysterography, what is used as a contrast agent

A

Isotonic saline

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4
Q

Emerging MDCT technique that offers the potential of high-resolution images depicting both the internal and external surfaces of the uterus and fallopian tubes

A

Virtual HSG

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5
Q

Pear-shaped organ located between the bladder and rectum

A

Uterus

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6
Q

Anterior and posterior surfaces of the uterus are covered by peritoneum, the folds of which extend laterally to the pelvic sidewalls forming the

A

Broad ligament

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7
Q

A “bare area” of extraperitoneal space is present between the ______ which is an important area for the direct spread of tumor from one organ to the other

A

Lower uterus and bladder

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8
Q

Uterus, cervix and upper one-third of vagina are derived from

A

Mullerian ducts

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9
Q

Lower two-thirds of vagina arise from the

A

Urogenital sinus

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10
Q

Refers to connective tissue adjacent to the vagina

A

Parametrium

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11
Q

Parametrium allows passage of

A

Uterine vessels and lymphatics

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12
Q

Well outlined when fluid is present in the pelvic peritoneal cavity

A

Broad ligament

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13
Q

Part of uterus that extends cephalad from the origin of the fallopian tubes

A

Fundus

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14
Q

A slight constriction that marks the location of the internal cervical Os

A

Isthmus

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15
Q

Length of cervix

A

3-4 cm

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16
Q

Ureters pass __ cm lateral to the supravaginal portion of cervix

A

2 cm

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17
Q

Ovarian size varies on

A

Woman’s age, hormonal status and stage of menstrual cycle

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18
Q

Adult ovary is oval with a maximal dimension of

A

5 x 3 x 2 cm

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19
Q

Abnormalities of ovarian size are best determined by calculating

A

Ovarian volume

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20
Q

Maximum ovarian volume is ____ cc before menarch, ____ cc mentruating women, ____ cc in postmenopausal women

A

9cc
22cc
6 cc

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21
Q

Typical location of ovaries

A

Lateral, superior or posterior to the uterine fundus or in cul-de-sac

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22
Q

Landmark for pelvic masses

A

Pelvic ureters

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23
Q

Ovaries are located ______ to the ureters, so an ovarian mass will displace the ureter posteriorly or posterolaterally

A

Anteriorly

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24
Q

Adenopathy will displace the ureters

A

Medially or anteromedially

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25
Q

Appearance of endometrium in T2WI

A

High signal intensity

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26
Q

The junctional zone of myometrium appears what on T2

A

Low signal intensity

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27
Q

Normal thickness of endometrium in women of menstrual age

A

14mm

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28
Q

Bulk of myometrium appears what in T2

A

Intermediate signal intensity

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29
Q

On T1, uterus is

A

Low in signal

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30
Q

Cervix is largely composed of collagenous tissues, which appears ____ in signal in both T1 and T2

A

Low in signal

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31
Q

Cervical carcinomas appearance on T1 and T2

A

Homogeneous high signal

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32
Q

In high resolution MR using surface or intravaginal coils shows two zones in the cervical fibromuscular stroma, a darker ______ zone contiguous with the uterine junctional zone and intermediate signal ______ zone

A

Inner

Outer

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33
Q

May be inserted for MR scanning to distend the vagina and optimize evaluation of vagina and cervix

A

Aqueous vaginal gel

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34
Q

Ovarian follicles of fertile woman appear _____ on T2

A

Bright

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35
Q

Follicles are _____ in signal on T1

A

Low or intermediate

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36
Q

Cortex of ovary in premenopausal women is ____ in signal than the medulla in T2

A

Darker

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37
Q

Imaging that is sensitive to physiological changes that affect the uterus and ovary during menstrual cycle

A

MR

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38
Q

Signal intensity of myometrium is highest during what menstrual stage

A

Late proliferative and early secretary phases

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39
Q

MR Signal intensity is lowest in what menstrual stage

A

Menstruation and early proliferative phase

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40
Q

Low intensity myometrial lesions such as leiomyomas and adenomyas are best demonstrated when the myometrium has the highest signal intensity in what phase

A

Mid-menstrual cycle

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41
Q

Ovaries are largest with a dominant follicle at what phase of menstrual cycle

A

Just prior to ovulation

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42
Q

Outline of uterus often appears _____ because of position

A

Lobulated or bulbous

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43
Q

Endocervical canal width

A

1 to 3 cm

44
Q

Normal fallopian tubes are ____ cm in length, extending from cornua or uterus

A

10 to 12 cm

45
Q

Lumen of fallopian tube is

A

Thread like (1-2 mm)

46
Q

The ampulla of fallopian tube has width of

A

5-10 mm

47
Q

most congenital anomalies of the female genital tract result from

A

arrested mullerian duct development

48
Q

this finding is found in 5-10% of patients with female genital tract anomalies

A

ipsilateral renal agenesis

49
Q

two uteri, two cervices and two vaginas

A

uterus didelphys

50
Q

two uterine horns, one or two cervices and one vagina

A

bicornuate uterus

51
Q

midline septum dividing uterus into two cavities

A

arcuate (septate) uterus

52
Q

most common uterine tumor affecting 50% of women of reproductive age

A

leiomyomas

53
Q

myomas that has scant fibrous tissue enhance

A

brightly

54
Q

myomas that has abundant fibrous tissue enhance

A

poorly

55
Q

most myomas are intramural? subserosal or submucosal?

A

intramural

56
Q

type of myoma that is prone to ulcerate resulting in severe menorrhagia

A

submucosal

57
Q

type of myoma that may be pedunculated and on long stalks

A

subserosal or submucosal

58
Q

imaging that provides best characterization of size, number and location of myomas

A

MRI

59
Q

appearance of myomas in MRI

A

low signal compared to myometrium on both T1 and T2, visualization is best on T2

60
Q

benign disease of the uterus characterized by the presence of ectopic endometrial glands and stroma within the myometrium eliciting surrounding myometrial hypertrophy

A

adenomyosis

61
Q

diffuse adenomyosis is characterized by regular or irregular thickening of the myometrium of ___mm

A

> 12 mm

62
Q

Difference in the borders of leiomyoma versus adenomyosis

A

Leiomyomas are well circumscribe, whereas adenomyosis are poorly defined with vague margination

63
Q

Retention cysts of the mucous-secreting glands of the cervical epithelium

A

Nabothian cysts

64
Q

Multicystic form of cervical adenocarcinoma

A

Adenoma malignum

65
Q

Differentiates adenoma malignum with nabothian cysts

A

Nabothian cysts has small size and sharp margins

66
Q

Size of physiologic ovarian follicle

A

<3cm

67
Q

Normal physiologic ovarian structure that develops at the site of dominant follicle following ovulation

A

Corpus luteum

68
Q

Size of normal corpus luteum

A

Smaller than 3 cm

69
Q

Ovarian follicle that has diffusely thick wall and prominent peripheral blood flow

A

Corpus luteum

70
Q

presence of endometrial tissue in locations outside of the uterus

A

endometriosis

71
Q

hallmarks of this disease include numerous tiny implantations of endometrial tissue on peritoneal surfaces, development of endometriomas (endometrial cysts filled with hemorrhage and formation of adhesions between surrounding tissues

A

endometriosis

72
Q

most common sites of endometriosis

A

ovaries, cul-de-sac and peritoneal refelctions over the uterus, fallopian tubes, bladder and rectosigmoid colon

73
Q

cause of severe pelvic pain with tiny deposits of endometrium on peritoneal surfaces in recesses, pelvic organs and other extraperitoneal sites

A

deep pelvic endometriosis

74
Q

contain blood products of various ages reflecting recurrent episodes of bleeding corresponding to the menstrual cycle. they are characteristically multiple, bilateral and located in the cul-de-sac

A

endometriomas

75
Q

common associated finding in endometriomas

A

hydrosalpinx

76
Q

endometriosis may involve what areas

A

bowel, urinary tract or occur outside the pelvis and in surgical scars

77
Q

common adnexal mass that may occur as an isolated lesion or as a component of a complex adnexal mass

A

hydrosalpinx

78
Q

most common cause of hydrosalpinx

A

pelvic infection

79
Q

increasingly common and difficult to treat cause of chronic pelvic pain. adhesions from previous surgery or inflammatory process entrap the ovary within a fluid collection that extends into peritoneal recesses

A

peritoneal inclusion cyst

80
Q

most common germ cell neoplasm of the ovary. lesions contain ectoderm, mesoderm or endoderm resulting in a broad range of appearance

A

benign cystic teratoma

81
Q

mean patient at discovery of benign cystic teratoma is

A

30 years

82
Q

solid ovarian masses that are commonly associated with ascites which mimic ovarian cancers

A

fibrotic ovarian tumors

83
Q

fibrotic ovarian tumor tissue types

A

fibromas, thecomas, and fibrothecomas

84
Q

defined as association of ascites and pleural effusion with an ovarian fibroma

A

Meigs syndrome

85
Q

a gynecologic emergency resulting from twisting of the ovary, fallopian tube or most commonly both structures restricting blood supply

A

adnexal torsion

86
Q

key findings in adnexal torsion include

A

smooth-walled adnexal mass, which serves as a nidus for twisting. the torsed mass demonstrates concentric wall thickening. involved fallopian tube appears as an amorphous mass or as a tube with thickened walls. uterus is deviated toward the torsed adnexa

87
Q

most common histologic type of ovarian cancer

A

epithelial

88
Q

peak age of ovarian cancer

A

55 to 59 y.o

89
Q

serologic marker for ovarian cancer

A

CA 125

90
Q

evidence of ovarial malignancy

A

wall thickness greater than 3 mm, nodularity, vegetations, solid components, evidence of invasion of adjacent structures, ascites, contrast enhancement of peritoneym and adenopathy

91
Q

ovarian carcinoma spreads primarily by

A

peritoneal seeding wiuth small tumor nodules implanting on the peritoneum, mesentery, omentum and malignant ascites

92
Q

properly applied only to mucinous tumors metasttic to the ovary from a mucinous gastric carcinoma

A

Krukenberg tumor

93
Q

produces large bilateral solid ovarian masses that show minimal enhancement

A

ovarian lymphoma

94
Q

most common gynecologic malignancy

A

cervical cancer

95
Q

95% of cervical cancer are what histologic type

A

adenocarcinoma

96
Q

peak age of cervical cancer

A

45- 55 y.o

97
Q

second most common gynecologic malignancy in women aged 15 to 34 y.o

A

cervical cancer

98
Q

moder of cervical cancer spread

A

predominantly direct extension to involve the vagina, paracervical and parametrial tissues, bladder and rectum

99
Q

sign of pelvic side wall invasion from cervical ca include

A

tumor abutting or extending to within 3 mm of pelvic musculature

100
Q

most common invasive gynecologic malignancy

A

endometrial carcinoma

101
Q

peak age of endometrial cancer

A

55 to 62 years old

102
Q

key symptom of endometrial cancer

A

postmenopausal bleeding

103
Q

true or false: lymph node metastasis are unlikely in endometrial cancer if myometrial invasion is less than 50%

A

true

104
Q

most aggressive of uterine tumors

A

uterine sarcomas

105
Q

fallopian tube carcinoma histologic types

A

adenocarcinoma, endometroid carcinoma and transitional cell carcinoma

106
Q

most fallopian tube carcinoma arise in what part of the fallopian tube

A

ampulla

107
Q

most of the vaginal malignancies are of what histologic type

A

squamous cell carcinoma

Genitourinary (5 decks)

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