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Gyne > Module 1 > Flashcards

Module 1 Flashcards

1
Q

______________ sonography generally uses the lowest frequency transducer.

A. Endoluminal

B. Endovaginal

C. Transabdominal

D. Transperineal

A

C Transabdominal sonography generally uses the lowest frequency transducers; in contrast, the highest frequencies are used with endoluminal sonography.

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2
Q

______________ is the anatomic direction represented at the top of the screen with a coronal endovaginal scan with the sound beam aimed towards the body of an anteverted uterus.

A. Anterior

B. Inferior

C. Posterior

D. Superior

A

B The four anatomic directions in a coronal endovaginal scan are inferior (top of the screen), superior (bottom of the screen), right (left side of the screen) and left (right side of the screen).

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3
Q

______________ is the anatomic direction represented at the bottom of the screen with a transverse transabdominal scan.

A. Anterior

B. Right

C. Posterior

D. Left

A

C The four anatomic directions in a transverse transabdominal scan are anterior (top of the screen), posterior (bottom of the screen), right (left side of the screen) and left (right side of the screen).

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4
Q

The four anatomic directions represented on a sagittal endovaginal scan are:

A. right, anterior, posterior, and left.

B. right, superior, posterior, and left.

C. superior, anterior, posterior, and inferior.

D. left, superior, anterior, and right.

A

C The four anatomic directions in a sagittal endovaginal scan are superior (bottom of the screen), anterior (right or left of the screen depending on presentation format), posterior (right or left of the screen depending on presentation format), and inferior (top of the screen).

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5
Q

On a transverse transabdominal scan, the left ovary, if situated lateral to the uterine body, should be seen on the _____________ of the image.

A. left side

B. top part

C. right side

D. bottom part

A

C On a transverse transabdominal scan, the left ovary, if situated lateral to the uterine body, should be seen on the right side of the image.

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6
Q

______________ is normally used as a contrast agent for sonohysterography.

A. Barium

B. Iodine

C. Saline

D. Gadolinium

A

C Saline is normally used as a contrast agent for sonohysterography.

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7
Q

______________ is assigned to the strongest echo in a standard grayscale ultrasound image.

A. Black

B. The lightest shade of gray

C. The darkest shade of gray

D. White

A

D With a conventional ultrasound image display, the background is black (zero echo amplitude) and the strongest echo amplitudes are seen as white echoes.

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8
Q

The two major sonographic parameters determined by transducer frequency are:

A. penetration and lateral resolution.

B. speed of sound and lateral resolution.

C. penetration and axial resolution.

D. speed of sound and axial resolution.

A

C The two major sonographic parameters determined by transducer frequency are penetration and axial resolution. These two parameters are inversely related.

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9
Q

______________ is the absence of echoes or the significant reduction in the intensity of echoes due to attenuation.

A. Absorption

B. Scattering

C. Shadowing

D. Enhancement

A

C Shadowing is the absence of echoes or the significant reduction in the intensity of echoes due to attenuation.

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10
Q

The general function or purpose of Time Gain Compensation (TGC) is to:

A. optimize lateral resolution.

B. increase real-time frame rate.

C. counteract the effects of attenuation.

D. optimize axial resolution.

A

C The general purpose of Time Gain Compensation (TGC) is to counteract the effects of attenuation by providing gain or amplification to returning echoes on the basis of echo depth.

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11
Q

______________ is the transducer manipulation which correctly switches from a sagittal to transverse plane of section during transabdominal pelvic sonography.

A. Compression

B. Rotating

C. Tilting

D. Rocking

A

B Rotating the transducer correctly switches from a sagittal to transverse plane of section during transabdominal pelvic sonography.

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12
Q

______________ is the transducer manipulation used during transabdominal pelvic sonography to find the best window or to move to a different area of the pelvis in any direction.

A. Compression

B. Tilting

C. Rocking

D. Sliding

A

D Sliding of the transducer is used during transabdominal pelvic sonography to find the best window or to move to a different area of the pelvis in any direction.

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13
Q

Assume the transducer is positioned suprapubically to scan in a midsagittal plane and the bladder and uterus are identified. From this position, the transducer can be _______________ caudally to visualize the vagina.

A. compressed

B. rotated

C. tilted

D. rocked

A

D Rocking the transducer during transabdominal pelvic sonography is used in a sagittal plane to visualize deep structures located caudal or cephalic relative to the transducer’s skin position. For example, when the uterus is visualized in the midsagittal plane, the transducer is rocked caudally to visualize the vagina.

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14
Q

For endovaginal sonography, the urinary bladder:

A. should preferably be empty.

B. should preferably be approximately half full.

C. should preferably be maximally distended.

D. may be any volume between full and empty.

A

A For endovaginal sonography the urinary bladder should preferably be empty.

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15
Q

______________ is generally the minimum frequency (MHz) for an endovaginal transducer.

A. 2

B. 3.5

C. 5

D. 7.5

A

C The minimum frequency for an endovaginal transducer is generally 5 MHz.

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16
Q

If transducer frequency is increased, and all other technical factors remain the same, axial resolution should:

A. improve.

B. worsen.

C. remain the same.

A

A If transducer frequency is increased, and all other technical factors remain the same, axial resolution should improve. The improvement in axial resolution is due to a shorter wavelength and therefore a shorter spatial pulse length which determines axial resolution.

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17
Q

Transducers that are used for transabdominal pelvic sonography should be:

A. disinfected with a mid-level disinfectant after each examination.

B. disinfected with a high-level disinfectant after each examination.

C. sterilized after each examination.

D. cleaned after each examination.

A

D Transducers that are used for transabdominal pelvic sonography should be cleaned after each examination with soap and water or quaternary ammonium sprays or wipes.

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18
Q

The ______________ position favors maximal pooling of intraperitoneal fluid in the posterior cul-de-sac.

A. reversed Trendelenburg

B. left decubitus

C. supine

D. Trendelenburg

A

A The reversed Trendelenburg position encourages the pooling of free peritoneal fluid in the pelvis (posterior cul-de-sac).

19
Q

Endovaginal transducers are classified as ____________ devices and should undergo ____________ after each examination.

A. noncritical; cleaning only

B. semicritical; high-level disinfection

C. noncritical; mid-level disinfection

D. semicritical; low-level disinfection

A

B Endovaginal transducers are classified as semicritical devices and should undergo high-level disinfection after each examination.

20
Q

To switch correctly from a sagittal to a coronal plane during endovaginal sonography performed with an end-firing transducer, the transducer must be rotated from the _______________ to the _____________ position.

A. 9 o’clock; 12 o’clock

B. 3 o’clock; 6 o’clock

C. 6 o’clock; 3 o’clock

D. 12 o’clock; 9 o’clock

A

D To switch correctly from a sagittal to a coronal plane during endovaginal sonography performed with an end-firing transducer, the transducer must be rotated from the 12 o’clock to the 9 o’clock position.

21
Q

During endovaginal sonography, ______________ of the transducer is performed to center a structure in the field of view by inserting the transducer more or less in the vagina.

A. compression

B. rotating

C. tilting

D. sliding

A

D Sliding of the endovaginal transducer allows the user to center structures in the field of view.

22
Q

The main objective of the ALARA principle is:

A. sonographer safety.

B. equipment safety.

C. patient safety.

D. increased productivity.

A

C The main objective of the ALARA principle is patient safety.

23
Q

______________ best describes the purpose of controlled transducer compression during endovaginal evaluation.

A. Displacement of gas-containing loops of bowel

B. Positioning of the beam’s focal zone in the area of interest

C. Avoidance of near field acoustic artifacts

D. Determining if a structure is associated with tenderness and the source of a patient’s pain

A

D The main purpose of controlled transducer compression during endovaginal evaluation is to determine if a structure is associated with tenderness and the source of a patient’s pain.

24
Q

The following are sonographic characteristics of simple cysts except:

A. distal acoustic enhancement.

B. thin, smooth walls.

C. higher than average attenuation.

D. anechoic cavity.

A

C Simple cysts are associated with lower than average attenuation which is why they exhibit distal acoustic enhancement.

25
Q

______________ is an advantage of transabdominal pelvic sonography compared to endovaginal sonography.

A. Greater penetration

B. Better axial resolution

C. Better approach for evaluation of a retroverted uterus

D. Better contrast resolution

A

A Lower frequency transducers are used with TAS which are capable of greater penetration (lower attenuation) than higher frequency EVS transducers.

26
Q

______________ is a display artifact helpful for the diagnosis of fluid-filled masses.

A. Reverberation

B. Acoustic shadowing

C. Distal acoustic enhancement

D. Ringdown

A

C Distal acoustic enhancement is virtually always seen behind fluid-filled masses and is very helpful for the diagnosis of cystic masses. It is one of the three defining characteristics of simple cysts.

27
Q

The following are sonographic display artifacts associated with air except:

A. reverberation.

B. ringdown.

C. comet tail.

D. acoustic shadowing.

A

C Ringdown is an artifact that is specific for layers of air bubbles in a fluid medium. Reverberation and shadowing occur with air and other media. Comet tail is a reverberation artifact associated mainly associated with metallic objects (not air).

28
Q

Sonohysterography is helpful to further distinguish the following lesions except:

A. intrauterine adhesions.

B. submucous myoma.

C. benign and malignant focal lesions.

D. endometrial polyps.

A

C Sonohysterography is helpful to further distinguish endometrial abnormalities including adhesions, submucous myomas, and polyps, however it is unreliable to distinguish focal benign and malignant lesions.

29
Q

The main purpose of focusing of the sound beam is to:

A. improve axial resolution.

B. improve contrast resolution.

C. improve lateral resolution.

D. eliminate near field artifacts.

A

C The main purpose of focusing of the sound beam is to narrow the beam width which improves lateral resolution.

30
Q

______________ is a Doppler waveform measurement that is dependent on mean velocity.

A. Resistive index

B. Systolic/diastolic ratio

C. Pulsatility index

A

C Mean velocity is required to calculate the pulsatility index which is determined by subtracting the end diastolic velocity by the peak systolic velocity and dividing by the mean velocity.

31
Q

The following imaging modalities use a contrast agent to enhance visualization of the uterine cavity and tubes except:

A. hysterosalpingography.

B. sonohysterography.

C. endovaginal sonography.

D. hysterosalpingo-contrast sonography.

A

C Endovaginal sonography does not use a contrast agent.

32
Q

With Power Doppler, all Doppler signals are displayed with the same basic color and the brightness of this color represents the_______________ of the Doppler signal.

A. average flow velocity

B. amplitude

C. direction of the Doppler shift

D. peak flow velocity

A

B With power Doppler, the displayed color brightness of a Doppler shifted echo is determined by the power or amplitude (strength) of the returning echo. In contrast, with color Doppler, the displayed color brightness is a function of the average echo velocity.

33
Q

Doppler is least likely to be helpful:

A. to identify the corpus luteum.

B. for the diagnosis of ovarian torsion.

C. to distinguish a large varicose vein and hydrosalpinx.

D. for the diagnosis of chronic salpingitis.

A

D Doppler is least likely to be helpful for the diagnosis of chronic salpingitis.

34
Q

______________ is least likely to be part of the work up for female infertility.

A. Hysterosalpingography

B. Magnetic resonance imaging

C. Sonohysterography

D. Colposcopy

A

D Colposcopy is least likely to be part of the work up for female infertility. This test is used to evaluate the cervix when the Pap smear is abnormal.

35
Q

The following statements are false about axial and lateral resolution except:

A. axial resolution is better than lateral resolution.

B. beam width determines axial resolution.

C. focusing improves axial resolution.

D. lateral resolution is uniform with depth.

A

A Axial resolution is better than lateral resolution. Axial resolution is constant with depth. Lateral resolution is determined by beam width and varies with depth and focusing. Focusing improves lateral resolution and has no effect on axial resolution.

36
Q

Hysteroscopic metroplasty is a surgical procedure performed for the treatment of:

A. endometrial polyps.

B. submucous myoma.

C. cancer of the cervix.

D. septate uterus.

A

D Hysteroscopic metroplasty is surgical reconstruction of the uterus and is mainly performed for treatment of a septate uterus.

37
Q

______________ provides the best results for pelvic sonography in obese women.

A. A transabdominal full bladder approach with low frequencies

B. A transabdominal empty bladder approach with low frequencies

C. An endovaginal approach

D. A transabdominal full bladder approach with high frequencies

A

C An endovaginal approach, with lower transducer frequencies if needed, provides the best results for pelvic sonography in obese women.

38
Q

A patient scheduled for pelvic sonography indicates she had an infused CT scan of the abdomen and pelvis two days ago. The ultrasound examination:

A. should be rescheduled in 3 to 5 days.

B. may be performed at the scheduled time.

C. should be rescheduled in 7 to 10 days.

D. is no longer required and can be cancelled.

A

B Pelvic sonography may be performed as scheduled since contrast media used for CT or other radiographic studies does not interfere with sonographic visualization or interpretation.

39
Q

Transabdominal sonography should be a helpful adjunct to endovaginal sonography:

A. if the patient is grossly obese.

B. for better visualization of a retroverted uterus.

C. if an enlarged uterus appears to extend into the lower abdomen.

D. whenever the patient presents with abnormal uterine bleeding.

A

C Transabdominal scanning may be helpful whenever a large field-of-view or more penetration is required such as an enlarged uterus that extends into the lower abdomen.

40
Q

The following are sonographic findings strongly predictive of benignity when seen in an adnexal mass except:

A. unilocularity.

B. acoustic shadowing.

C. very strong blood flow in any solid component on color or power Doppler.

D. predominantly cystic and any solid component less than 7 mm in diameter.

A

C Very strong blood flow in any solid component on color or power Doppler seen in an adnexal mass is very concerning for malignancy.

41
Q

Endovaginal sonography is generally contraindicated in:

A. women with a sexually transmitted pelvic infection.

B. during menstruation.

C. older postmenopausal women.

D. in women who have never been sexually active.

A

D EVS is generally contraindicated in women who have never been sexually active.

42
Q

The following actions respect the ALARA principle applied to diagnostic ultrasound imaging except:

A. that it should be used only for a valid medical reason.

B. that repeat or follow-up studies should be minimized.

C. the use of high output power and low receiver gain.

D. the implementation of an effective quality control program to maintain equipment in good operating condition.

A

C The operator should minimize output power and optimize receiver gain when setting up transducer scanning functions because the ultrasound exposure increases with output power.

43
Q
A

Gyne (1 decks)

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