Obgyn Test 1 — Uterine Pathology

Question 1

What surgical procedure is the most likely to cause asherman syndrome?

Answer 1

D&C (dilation & curettage)

Note: procedure involving dilating the cervix and scraping the uterine lining to remove tissue.

Question 2

What is Adenomyosis?

Answer 2

Invasion of endometrial tissue into the myometrium

Question 3

What is the most likely diagnosis for a 72 year old female with vaginal bleeding and sonographic findings of an endometrial thickness measuring 12.0 mm?

Answer 3

Endometrial cancer

Question 4

What tends to have a narrow base attachment to the endometrium with a vascular pedicle feeding it?

Answer 4

Endometrial polyp

Question 5

True/False

Endometrial carcinoma is the most common gynecologic malignancy in North America

Answer 5

True

Question 6

What is the most likely underlying cause of Hematometracolpos/hematocolpos in an adolescent?

Answer 6

Imperforate hymen

Question 7

What is the cause of a T-shaped uterus

Answer 7

In utero exposure to diethylstilbestrol (DES)

Question 8

What is the most common cause of abnormal uterine bleeding?

Answer 8

Endometrial hyperplasia

Question 9

What will appear as a cystic structure in the cervical region?

Answer 9

Nabothian cyst

Question 10

True/False
Adenomyosis is a rare condition

Answer 10

False

Question 11

True/False

Endometrial atrophy is a common cause of postmenopausal bleeding

Answer 11

True

Question 12

What is the upper limit for the thickness of a normal endometrium in a premenopausal woman?

Answer 12

14mm

Question 13

What are three things that are associated with congenital uterine developmental anomalies?

Answer 13

infertility
unilateral renal agenesis
spontaneous abortion

Note: NOT Post-term pregnancy

Question 14

What are three things that Carcinoma of the cervix is associated with?

Answer 14

Early sexual activity
Herpes virus type 2
Smoking

Note: NOT Jewish women

Question 15

What is the major limitation to vaginal sonography?

Answer 15

Small field of view

Question 16

Which classification of leiomyoma is most common?

Answer 16

Intramural

Question 17

Which location of a Leiomyomas would be most likely to cause infertility?

Answer 17

Submucosal

Question 18

True/False

Endometrial hyperplasia affects the entire endometrium and may be echogenic or have sonographically evident cysts present

Answer 18

False

Question 19

Hydrometra appears sonographically as a(n)

Answer 19

Sonolucent fluid collection in the uterine canal

Question 20

What is the most common pattern of spread for cervical cancer?

Answer 20

Direct invasion of adjacent structures

Question 21

***Written

What imaging technique/modality will help you differentiate between endometrial hyperplasia and an endometrial polyp?

Answer 21

Sonohystography

Question 22

What group is most at risk for endometrial carcinoma?

Answer 22

Postmenopausal women

Question 23

True/False
Leiomyosarcoma typically have a good prognosis.

Answer 23

False

Question 24

True/False

Endometrial carcinoma has a high survival rate

Answer 24

True

Question 25

An increase in which hormone may lead to endometrial hyperplasia or endometrial cancer?

Answer 25

Estrogen

Question 26

What is the most sensitive test for evaluation of Leiomyomas ?

Answer 26

MRI

Question 27

What is a Papanicolaou test screen for?

Answer 27

Cervical cancer

Question 28

True/False Intrauterine synechiae are usually congenital in origin

Answer 28

False

Question 29

What is the effect of tomoxifen on the female body?

Answer 29

Antiestrogenic effect on the breasts, but opposite effect on the endometrium

Question 30

Once the Müllerian ducts fuse the septum must then reabsorb. If this does not occur then you are left with what type of uterine anomaly?

Answer 30

Uterus subseptus

Question 31

What is the benefit of adding progestin to hormone therapy in a postmenopausal patient?

Answer 31

Decreases the risk of uterine cancer

Question 32

Neovascularity associated with a malignant neoplasm in the pelvis would most likely exhibit (blank) on a Doppler waveform pattern?

Answer 32

High (increased) diastolic flow

Question 33

***Written Explain what a parasitic fibroid is and which ones are more predisposed to becoming parasitic

Answer 33

A parasitic fibroid is a type of fibroid that "detaches" from the uterus and attaches itself to other tissues or organs, essentially becoming like a parasite. Pedunculated fibroids and subserosal fibroids are more predisposed to becoming parasitic. Pedunculated fibroids are attached to the uterus by a stalk or stem, making it easier for them to break away and move to other areas, and Subserosal fibroids grow on the outer wall of the uterus, so they are also more prone to detaching.