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Diagnostic Sonography Hagen--OB/GYN > Final Review > Flashcards

Final Review Flashcards

1
Q

Which one of the following statements about diffuse endometriosis is false?

A)Endometriosis is easily diagnosed by sonography
B) it is the most common form of endometriosis
C) it’s appearance is similar to PID
D) Endometriosis leads to disorganization of pelvic anatomy

A

Endometriosis is easily diagnosed by sonography

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2
Q

During in vitro fertilization the optimal placement of an embryo is within 2 cm of the Apex of…

A

Uterine fundus

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3
Q

The T-shaped uterus is a congenital anomaly caused by…

A

Exposure to DES

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4
Q

Infertility

A

Infertility in 40% of patients is attributed to men
Infertility is the inability to conceive within 12 months with regular coitus
Infertility 20% of patients is atributable to either the man or the woman or is unexplained

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5
Q

Mucinous cystadenoma is

A
  • The most common cystic tumor
  • Unilateral
  • Large cystic mass with multilocular cystic spaces
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6
Q

Tends to have a narrow base attachment to the endometrium with a vascular pedicle feeding it

A

Endometrial polyp

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7
Q

The most common malignancy of the ovary

A

Serous cystadenocarcinoma

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8
Q

A patient with an ovarian mass presents with an elevated serum AFP, what’s the most likely diagnosis

A

Yolk sac tumor

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9
Q

A tumor that mad mimic gas or feces in the pelvis is

A

Dermoid

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10
Q

A normal endometrial response associated with overstimulation is an increasing thickness between 2 to 3 mm and ____ mm

A

12-14

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11
Q

In the luteal phase the endometrial lining may be thinner than expected from an in adequate level of which hormone?

A

Progesterone

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12
Q

Para ovarian cyst’s arise from what structure

A

Broad ligament

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13
Q

The partial or complete rotation of the ovarian pedicle on its axis is…

A

Ovarian torsion

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14
Q

Inflammation of the fallopian tube

A

Salpingitis

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15
Q

Perihepatic inflammation ascending from a pelvic infection is called

A

Fritz-Hugh-Curtis syndrome

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16
Q

A dominant follicle grows at a rate of _____ to ____ mm per day

A

1-3 mm per day

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17
Q

What uterine anomaly is most frequently associated with a high incidence of infertility

A

Septate uterus

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18
Q

Used as a substitute for LH in o trigger ovulation

A

hCG

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19
Q

Bicornuate uterus is a congenital malformation that results from incomplete fusion of the

A

Mullerian ducts

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20
Q

The most common cause a fever and postpartum patients is

A

Endometritis

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21
Q

Mucinous cystadenocarcinoma most frequently occurs in women over the age of

A

40

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22
Q

A dermoid tumor typically contains tissues originating from

A

Endoderm, ectoderm, mesoderm

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23
Q

When does ovarian flow show the greatest resistance on PW Doppler

A

During menstruation

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24
Q

Endocrine disorder associated with chronic anovulation

A

Polycystic ovarian syndrome

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25
Q

The sonographic appearance of an ovarian dermoid tumor in which only the anterior elements of the mass can be seen, while the greater part of the mass is obscured by shadowing is consistent with

A

Tip of the iceberg

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26
Q

Demonstrates enlarged ovaries with multiple cysts, abdominal ascites and pleural effusion

A

Ovarian hyperstimulation

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27
Q

Infection within the uterine serosa and broad ligaments

A

Parametritis

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28
Q

The malignant ovarian mass that is associated with pseudomyxoma peritoneum is

A

Mucinous cystadenocarcinoma

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29
Q

An endometrioma most likely appears as a

A

Mostly cystic mass with low level echoes

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30
Q

Risk factors for PID

A

IUD
Post childbirth
Multiple sex partners

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31
Q

Ovarian mass that contains fat, sebum and teeth

A

Dermoid

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32
Q

A 55-year-old patient presents to the sonography department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic sonogram reveals a large multiloculated cystic mass with papillary projections

A

Serous cystadenocarcinoma

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33
Q

Theca lutein cysts are associated with high levels of which hormone

A

hCG

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34
Q

Hormone that can be correlated with follicle size to determine the likelihood of ovulation

A

Estradiol

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35
Q

Cyst that occurs when a dominant follicle does not succeed in ovulating but remains active although immature

A

Follicular cyst

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36
Q

A pelvic abscess will likely appear as

A

Complex cul-de-sac mass that distorts the pelvic anatomy

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37
Q

Patients with polycystic ovarian syndrome have the diagnostic triad of all of the following except

A

Dyspareunia

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38
Q

And ovary is generally considered abnormal and suggestive for malignancy if its volume is _____ the size of the contralateral ovary

A

Twice

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39
Q

Lack of progesterone production is known as

A

Luteal phase deficiency

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40
Q

Estrogen producing ovarian tumor

A

Thecoma

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41
Q

A specific diagnosis of a para ovarian cyst is possible only by

A

Demonstrating an ipsilateral ovary separate from the cyst

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42
Q

Ovarian induction therapy requires documentation of all follicles greater than ___ in both longitudinal and transverse plane

A

10mm

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43
Q

Adnexal pathology associated with Meigs syndrome

A

Ovarian fibroma

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44
Q

Stage two of ovarian carcinoma is limited to

A

Both ovaries

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45
Q

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

A

Heterotopic pregnancy

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46
Q

During which phase is the endometrial triple line sign visualized

A

Proliferative

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47
Q

Pelvic organ more commonly involved with metastatic disease

A

Ovaries

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48
Q

Producing more luteinizing hormone than follicle-stimulating hormone results in which condition

A

Polycystic ovarian syndrome

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49
Q

PID is an inclusive term that refers to

A

Oophoritis
Parametritis
Myometriris

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50
Q

In the early disease, the clinical presentation of both PID and endometriosis may mimic

A

Functional bowel disease

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51
Q

Inflammation of the serous membrane lining the abdominal cavity and covering the viscera is

A

Peritonitis

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52
Q

The malignant ovarian tumor with gastrointestinal origin is the

A

Krukenburg tumor

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53
Q

Granulosa cell tumor

A

May cause torsion
Comprised of cells resembling Graafian follicle
Estrogenic

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54
Q

The fallopian tubes are evaluated by a sonographic and saline examination to determine what characteristic

A

Patency

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55
Q

The patients who undergo assisted reproductive procedures have an increased risk factor for a ____ pregnancy

A

Heterotopic

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56
Q

Functioning endometrial tissue is present outside of the uterus in what condition

A

Endometriosis

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57
Q

A complex adnexal mass most likely represents

A

Pyosalpix

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58
Q

What ovarian mass is associated with virilization

A

Sertoli-Leydig cell tumor

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59
Q

On a baseline pelvic ultrasound, and ovarian cyst greater than ___ could interfere with ovarian stimulation and may represent a persistent follicle

A

15mm

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60
Q

Fusion of the inflamed dilated tube and ovary is called

A

Tubo-ovarian complex

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61
Q

When evaluating the patient who is in fertile, in addition to assessing structural anatomy, the sonographer should evaluate that

A

Endometrium

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62
Q

What tumor will most likely have a moth-eaten appearance on sonography

A

Metastatic tumor

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63
Q

Stein-Leventhal syndrome is characterized by

A

Obesity, hirsutism, and infertility

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64
Q

And asymptomatic 32 year old woman is diagnosed with a left adnexal mass on physical examination. A history of PID has been reported. Trans abdominal and transvaginal images demonstrate an anechoic tubular structure in the lower left quadrant

A

Hydrosalpinx

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65
Q

Sexually transmitted PID is spread via

A

Mucosa of the pelvic organs

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66
Q

What is the cause of irregular bleeding and a thickened endometrium in a patient with polycystic ovarian syndrome

A

Chronic elevation of estrogen

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67
Q

The most common cause of PID

A

Sexually transmitted diseases

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68
Q

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 what

A

Endometrioma

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69
Q

What is a method of fertilizing the human oocyte outside the body

A

In Vitro Fertilization

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70
Q

Patients with ovarian Hyperstimulation Syndrome are at increased risk for

A

Ovarian torsion

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71
Q

An infection that involves the fallopian tube and the ovary is called what

A

Tubo-ovarian abscess

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72
Q

Formula for ovarian volume

A

.523 x Length x Width x Height

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73
Q

What principle directs the sonographer to do no harm

A

Nonmaleficence

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74
Q

A malignant form of gestational trophoblastic disease is

A

Choriocarcinoma

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75
Q

Complications of placenta previa include

A

Postpartum hemorrhage, premature delivery, maternal hemorrhage

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76
Q

A patient presents for a sonogram. Upon examination, no intrauterine pregnancy can be seen. What are the differential diagnosis

A

Normal four week pregnancy, ectopic pregnancy, non-developing pregnancy

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77
Q

And embryonic heartbeat should be visible when the crown rump length measures

A

4mm

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78
Q

The feudal contribution of the placenta is the

A

Chorion frondosum

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79
Q

The cavity in which the fetus exits is called the

A

Amniotic

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80
Q

Using a transvaginal approach the first structure visualize within a gestational sack is

A

Secondary yolk sac

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81
Q

The interface between the decidua capsularis and the echogenic vascular decidua on the opposite wall of the endometrial cavity forms what

A

Double decidual sign

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82
Q

To calculate the mean sac diameter of a gestational sack what formula is used

A

(Length x Width X height)/3

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83
Q

A patient presents with a recent history of bright red vaginal bleeding.

A

Complete placenta previa

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84
Q

A marginal placenta previa demonstrates

A

The placenta touches but does not cross the internal cervical os

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85
Q

Maternal serum hCG levels in a normal intrauterine pregnancy at less than seven weeks should

A

Double every 48 hours

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86
Q

The double bleb sign refers to the song graphic presentation of

A

The amnion and adjacent yolk sac

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87
Q

An ovum without an embryo is known as

A

Anembryonic pregnancy

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88
Q

The primary cause of placentomegaly is

A

Maternal diabetes

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89
Q

The fusion of the chorion and amnion occurs between

A

14 and 15 weeks

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90
Q

Fetal anatomy may be adequately assessed after ____ weeks gestation

A

18 weeks

91
Q

_______ Is a focal discrete lesion caused by ischemic necrosis in the placenta

A

Placental infarct

92
Q

The trophoblastic cells produce

A

HCG

93
Q

The most accurate measurement of gestational age during the first trimester is

A

Crown rump length

94
Q

An ectopic pregnancy most commonly occurs in

A

Fallopian tube

95
Q

The placenta is considered too thick when it measures

A

Greater than 4 cm

96
Q

The velamentous placenta refers to

A

A membranous insertion of the cord

97
Q

Ultrasound is able to determine all of the following except

A

Exact date of delivery

98
Q

This structure was discovered during a routine obstetric exam for gestational dating. It most likely represents

A

Chorioangioma

99
Q

The beta hCG levels plateau and subsequently decline, whereas the gestational sack continues to grow, after _____ weeks

A

9-10

100
Q

Typically the yolk sac resorbs and is no longer visible sonographically by _____ weeks

A

12 weeks

101
Q

Implantation of the blastocyst into the uterine decidua is completed within ____ days after fertilization

A

12

102
Q

The presence of one or more accessory lobes connected to the body of the placenta by blood vessels is a _____ placenta

A

Succenturiate

103
Q

In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG level is

A

3000 mIU/ml

104
Q

The second trimester is between _______ gestational weeks

A

14-26

105
Q

Which grade refers to a placental appearance showing a uniform echogenicity with no calcifications and a smooth chorionic plate

A

Grade 0

106
Q

Fertilization typically occurs within ____ after ovulation

A

24 hours

107
Q

The attachment of the placental membranes to the fetal surface of the placenta describes

A

Circummarginate placenta

108
Q

The major functioning units of the placenta are

A

Chorionic villi

109
Q

What location of an ectopic pregnancy includes an increased risk of a massive hemorrhage with rupture that may lead to hysterectomy or even death

A

Near the uterine cornu

110
Q

The structure created by the union of sperm and egg

A

Zygote

111
Q

Severe blood loss may occur with placenta ____

A

Percreta

112
Q

Nuchal translucency must be measured between

A

11-13 weeks and 6 days

113
Q

The maternal side of the placenta is the decidua ____

A

Basalis

114
Q

Abnormality that might demonstrate a small placenta

A

Aneuploidy

115
Q

A placenta previa can be ruled out if the placental edges at least how far from the internal cervical os

A

2cm

116
Q

In early pregnancy, the gestational sack grows at a rate of

A

1 mm per day

117
Q

An anechoic or hypoechoic crescent-shaped area located between the gestational sac and the myometrium represents

A

Subchorionic hemorrhage

118
Q

A patient presents for a transvaginal ultrasound. She reports heavy vaginal bleeding and pelvic cramping. Her pregnancy test is positive. When performing her ultrasound, you discover an embryo measuring six weeks five days with a heart rate of 110 bpm. You also see a subchorionic hemorrhage. What is the correct diagnosis

A

Threatened abortion

119
Q

On transabdominal imaging, an over distended bladder may give a false impression of

A

Placenta previa

120
Q

Multiple tiny clusters of grape like echoes within the uterine cavity best describe what

A

Gestational trophoblastic disease

121
Q

In the first trimester, herniated bowel will return within the abdominal cavity by the ___ week

A

12th

122
Q

What would be most likely confused for a uterine Leiomyoma

A

Myometrial contraction

123
Q

An embryo with cardiac activity must be identified once the gestational sack measures ____

A

25 mm

124
Q

What increases the likelihood of developing placenta previa

A

Previous c section

125
Q

The serum level of beta hCG is _______ with gestational trophoblastic disease

A

Dramatically elevated

126
Q

The best sonographic correlation in the diagnosis of an ectopic pregnancy is the combination of free pelvic fluid and

A

Adnexal mass

127
Q

Compared with a normal intrauterine pregnancy, the ectopic pregnancy will have a

A

Lower hCG

128
Q

The most common pelvic mass seen in a first trimester pregnancy

A

Corpus luteum cyst

129
Q

A circumscribed complex mass protruding from the fetal surface of the placenta is demonstrated on ultrasound. This appears most likely represents

A

Chorioangioma

130
Q

With transvaginal ultrasound, an abnormal pregnancy is suspected when the yolk sac is not visualized with a minimum mean sac diameter of

A

12 mm

131
Q

What laboratory test is used to indicate pregnancy when the values are elevated

A

HCG

132
Q

The most common site of fibrin deposition is which of the following

A

Beneath the chorionic plate of the placenta

133
Q

The growth of the chorionic villi superficially on the myometrium describes

A

Placenta acreta

134
Q

A marginal insertion of the umbilical cord into the placenta is what

A

Battledore placenta

135
Q

From the time of implantation until the end of the 10th week menstrual age the conceptus is called

A

Embryo

136
Q

An embryo becomes a fetus after ____ weeks menstrual age

A

10 weeks

137
Q

Embryos with heart rate below _____ beats per minute generally have a poor prognosis

A

90

138
Q

An incomplete abortion is defined as

A

Spontaneous abortion with retained products of conception

139
Q

Fetal sonography with or without Doppler should be performed

A

With a valid medical reason

140
Q

What is the stage of the conceptus that implants within the decidualized endometrium

A

Blastocyst

141
Q

What is associated with an abnormal NT

A

Cardiac defects, trisomy 18, trisomy 21

142
Q

What ovarian pathology is associated with hydatidiform mole?

A

Theca-Lutein Cyst

143
Q

The diameter of the normal yolk sac should never exceed

A

6mm

144
Q

When the ovary is in the luteal phase, the endometrium is in the

A

Secretory

145
Q

The ovary receives its blood supply from what arteries

A

Uterine and ovarian arteries

146
Q

The hormone responsible for the final maturation of the follicle and for ovulation

A

LH

147
Q

What structure lies above the utero-ovarian ligament, round ligament, and tubo-ovarian vessels

A

Fallopian tube

148
Q

The most common cause of uterine calcification is

A

Myomas

149
Q

What portion of the fallopian tube is the most coiled

A

Ampulla

150
Q

Small vessels found along the periphery of the uterus

A

Arcuate vessels

151
Q

The release of an egg from the ruptured follicle is termed

A

Ovulation

152
Q

A mature follicle is known as a ______ follicle

A

Graafian

153
Q

Flexion refers to the axis of the uterine body relative to the

A

Cervix

154
Q

A small percentage of leiomyoma’s are located in what structure

A

Cervix

155
Q

What technique uses a catheter inserted into the endometrial cavity with the insertion of saline or contrast to fill the endometrial cavity to demonstrate abnormalities

A

Sonohysterography

156
Q

The thickness of the endometrium should be measured in what plane

A

Longitudinal

157
Q

On ultrasound, the characteristic appearance of a degenerating leiomyoma is

A

Heterogeneous

158
Q

Uterine arteriovenous malformation usually involves the

A

Myometrium

159
Q

The endometrium is at its greatest thickness and echogenicity with posterior enhancement in which corresponding ovarian phase

A

Luteal

160
Q

Which ligament contains uterine blood vessels and nerves

A

Broad

161
Q

Sonohysterography is usually performed on pre-menopausal women between days ____ of the menstrual cycle

A

6-10

162
Q

Arcuate artery calcifications may be observed in patients who are

A

Postmenopausal

163
Q

Fluid noted posterior to the uterus would most likely be located within the

A

Pouch of Douglas

164
Q

The ovaries are laterally supported by what ligaments

A

Suspensory, infundibulopelvic

165
Q

A 28 year old woman reports left lower quadrant pain. Her last menstrual period was two weeks earlier. Sonographically , the uterine body displays a highly echogenic linear structure in the endometrial cavity. This most likely represents

A

IUD

166
Q

Menarche may be defined as

A

The state after reaching puberty during which menses occur every 21 to 28 days

167
Q

A benign invasion of endometrial tissue into the myometrium is known as

A

Adenomyosis

168
Q

FSH is produced by

A

Anterior pituitary gland

169
Q

A patient presents to the sonography department with a history of uterine prolapse. what best describes this disorder

A

A condition that results from the weakening of the pelvic diaphragm muscles and allows for the displacement of the uterus often through the vagina

170
Q

In post menopausal patients who are not on hormone replacement therapy, an endometrial thickness of less than ___ millimeters is considered benign

A

5 mm

171
Q

Most common finding in endometrial carcinoma

A

Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women

172
Q

The left ovarian vein drains into

A

Left renal vein

173
Q

The most common benign tumor of the uterus

A

Leiomyoma

174
Q

The floor of the pelvis is formed by the

A

Levator ani muscles

175
Q

A 60 y/o patient presents to the emergency department with sudden onset of vaginal bleeding. The sonographic examination reveals and endometrium that measures 4 mm. There are no other significant findings. What is the most likely diagnosis

A

Endometrial atrophy

176
Q

Endometrial hyperplasia develops from

A

Unopossed estrogen stimulation

177
Q

The most common gynecologic malignancy in the United States

A

Endometrial

178
Q

The superficial layer of glands and stroma of the endometrium is called

A

Zona functionalis

179
Q

Limitations of trans labial scanning may be overcome by

A

Elevating the patients hips

180
Q

The curving forward of the fundus and body of the uterus on the cervix is called

A

Anteflexion

181
Q

Fibroid location that will most likely cause heavy irregular uterine bleeding

A

Submucosal

182
Q

Complications in delivery may occur with pregnancy if a fibroid is located in or near what structure

A

Near the cervix

183
Q

The pelvic recess between the anterior bladder wall and the pubic synthesis is

A

Space of Retzius

184
Q

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 represents

A

Leiomyoma

185
Q

Depending on the menstrual cycle, the inner lining of the uterine cavity that appears echogenic to hypoechoic on ultrasound is which structure

A

Endometrium

186
Q

Hydrometra appears sonographically as

A

Sonolucent fluid collection in the uterine canal

187
Q

What is the physiological status of pre-puberty called

A

Premenarche

188
Q

Days 6-13 in the uterus are considered the ____ phase

A

Proliferative

189
Q

The thin outer layer of the uterus is separated from the intermediate layer by

A

Arcuate vessels

190
Q

What muscle group may be seen in the false pelvis along the lateral side wall of the pelvis

A

Iliopsoas

191
Q

The endometrium demonstrates the three line sign in what phase

A

Proliferative

192
Q

In transvaginal scanning, the true scanning plane that is 90° from the sagittal plane is the _____ plane

A

Coronal

193
Q

The most likely result of an acquired condition with obstruction of the cervical canal

A

Cervical stenosis

194
Q

The term that refers to mid cycle or ovulatory pain

A

Mittelschmerz

195
Q

Nabothian cyst’s are found near what atomic structure

A

Endocervical canal

196
Q

Muscles found in the true pelvis

A

Iliociccygeus, levator ani, obturator internus

197
Q

The middle layer of the uterus

A

Myometrium

198
Q

In the secretory phase, the endometrium should be measured from the _____ layer to the _____ layer

A

Hyperechoic, hyperechoic

199
Q

Which vessel provides the best landmark for localizing the ovary

A

Internal iliac artery

200
Q

A mature follicle typically measures ____ right before ovulation

A

2cm

201
Q

In a patient after a hysterectomy, the normal vaginal cuff should not exceed

A

2cm

202
Q

The most common site for a leiomyoma to occur

A

Intramural

203
Q

An 80-year-old patient presents for sonographic evaluation for vaginal bleeding. What is most important to obtain

A

Endometrial thickness measurement

204
Q

Irregular, acyclic bleeding is defined as

A

Amenorrhea

205
Q

In what structure would a Gartners duct cyst be found

A

Vagina

206
Q

The retrouterine space is also known as

A

Posterior cul-de-sac

207
Q

The ovary produces two hormones. Estrogen is secreted by _____, whereas progesterone is secreted by the ____

A

Follicles, corpus luteum

208
Q

The hormone responsible for proliferation of the endometrium is

A

Estrogen

209
Q

What condition is described as a hyperplastic protrusion of the epithelium of the cervix that may be broad-based or pedunculated

A

Cervical polyp

210
Q

The normal size of the menarchal uterus should measure ____ long and ______ wide

A

8cm, 4cm

211
Q

A female patient who is over the age of 18 and has never had a menstrual cycle is said to have

A

Primary amenorrhea

212
Q

A three day postpartum woman complains of intense pelvic pain. Sonographically, the uterus appears hypoechoic with an irregular endometrium. This condition most likely represents

A

Endometritis

213
Q

Symmetrical bilateral pelvic mass like structures are likely to be

A

Pelvic muscles

214
Q

Which of the following ligaments provides support to the cervix

A

Cardinal and uterosacral

215
Q

The paired embryonic ducts that develop into the female urogenital tract are

A

Mullerian ducts

216
Q

Patients on tamoxifen therapy have an increased risk of

A

Endometrial hyperplasia, endometrial polyp, endometrial carcinoma

217
Q

The first phase of the ovarian cycle

A

Follicular phase

218
Q

Asherman syndrome is associated with

A

Endometrial adhesions

219
Q

The vagina has two sources of blood supply, they are

A

Uterine artery and vaginal artery

220
Q

Abnormally heavy or long menses is termed

A

menorrhagia

221
Q

Most common form of endometrial carcinoma

A

Adenocarcinoma

222
Q

What ligament occupies the space between the layers of another ligament and occurs in front of and below the Fallopian tubes

A

Round

223
Q

During which days of the menstrual cycle does blood flow to the ovaries have the highest resistance in the lowest diastolic flow

A

First 10 days

224
Q

What is another name for endodermal sinus tumor

A

Yolk sac tumor

Diagnostic Sonography Hagen--OB/GYN (6 decks)

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