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OBGYN > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

An acute hemorrhagic cyst usually appears hyperechoic and may resemble a solid mass.

True
False

A

True

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2
Q

Ascites and pleural effusions can be associated with which form of OHS?

they are not associated with OHS
mild
severe
moderate

A

severe

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3
Q

The localized form of endometriosis is a discrete mass called an endometrioma or ___________.

chocolate cyst
localoma
endometriosis cyst
teratoma cyst

A

chocolate cyst

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4
Q

These cysts tend to be unilateral, are more prone to hemorrhage, and may accompany an IUP:

theca-lutein cyst
parovarian cyst
corpus luteum cyst
follicular cyst

A

corpus luteum cyst

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5
Q

A 26 year old female comes to the ER for severe pelvic pain. The physician orders a pelvic exam to rule out an ectopic pregnancy since the patient has irregular menstrual cycles. The patient has a positive urine pregnancy test. She states that the first day of her LMP was about 3 weeks ago. While performing the exam, you obtain the following images. The most probable cause of the pain is:

theca-lutein cyst
ovarian torsion
parovarian cyst
large follicular cyst
corpus luteum with hemorrhage

A

corpus luteum with hemorrhage

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6
Q

All of the following are criteria for a simple cysts except:

posterior shadowing
anechoic
thin smooth walls
posterior acoustic enhancement
thick irregular walls

A

thick irregular walls

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7
Q

During a pelvic ultrasound exam on a 31 year old female with a history of acute onset pelvic pain, you find what appears to be a mass in the right ovary. However, color Doppler shows no flow within in the mass, but there is flow in the ovary. You take the following images. What pathology is most likely demonstrated?

ovarian torsion
ectopic pregnancy
hemorrhagic cyst with retracting clot
polycystic ovarian syndrome

A

hemorrhagic cyst with retracting clot

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8
Q

The diagnostic criteria for polycystic ovaries is _______ or more follicles measuring 2-9 mm that persist on follow-up studies.

10
12
6
9

A

12

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9
Q

With endometriosis, the ectopic endometrial tissue proliferates and bleeds on a cyclic basis.

True
False

A

True

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10
Q

________ is a common condition in which functioning endometrial tissue is located outside of the uterus.

Endometritis
Pelvic inflammatory disease
Peritoneal inclusion cyst
Endometriosis

A

Endometriosis

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11
Q

Of the following, which are common locations where ectopic endometrial tissue may be found?

broad ligament
all listed
bladder and bowel
peritoneum
ovary and fallopian tube

A

all listed

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12
Q

Typically, the fallopian tube is never torsed.

True
False

A

False
the ovary and/or fallopian tube can be torsed

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13
Q

The more complex a mass appears with sonography, the more likely it is ________, especially if it is associated with ascites.

benign
malignant

A

malignant

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14
Q

___________________ is frequently as complication of ovulation induction.

ovarian hyperstimulation syndrome
ovarian torsion
peritoneal inclusion cysts
endometriosis

A

ovarian hyperstimulation syndrome

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15
Q

A 27 year old female presents to the ER with severe pelvic pain and noticeable abdominal distention. The patient mentioned she has been seeing an infertility specialist for treatment. While scanning, you see the following images and also note the presence of abdominal ascites. What is the most likely diagnosis?

severe OHS
theca lutein cysts
Endometrioma
moderate OHS

A

severe OHS

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16
Q

Which of the following pathologies is an acute abdominal condition that requires prompt diagnosis and surgical intervention?

ovarian hyperstimulation
polycystic ovarian syndrome
GTD
ovarian torsion
endometrosis

A

ovarian torsion

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17
Q

Diagnosis of this cyst is made by demonstrating the normal ipsilateral ovary adjacent to but separate from the cyst.
paraovarian cyst
theca-lutein cyst
follicular cyst
hemorrhagic cyst
corpus luteum cyst

A

paraovarian cyst

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18
Q

Paraovarian cysts are located in __________ .

vesicouterine ligament
cardinal ligament
round ligament
broad ligament

A

broad ligament

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19
Q

____________ is a complex endocrine disorder of abnormal estrogen and androgen production. It results in chronic anovulation; therefore, it is a common cause of infertility and higher-than-usual rate of early pregnancy loss.

pelvic inflammatory disease
ovarian remnant syndrome
polycystic ovarian syndrome
ovarian hyperstimulation syndrome
endometriosis

A

polycystic ovarian syndrome

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20
Q

You are scanning a 26 year old female who presents with amenorrhea, infertility, obesity, and hirsutism. The following images demonstrate your findings. What is the most likely pathology?

polycystic ovarian syndrome
theca-lutein cysts
hemorrhagic cysts
corpus luteum cysts
ovarian hyperstimulation

A

polycystic ovarian syndrome

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21
Q

Your patient is a 41 year old female who is having an ultrasound to evaluate a large pelvic mass. The patient has been experiencing pelvic pain for several weeks and has a history of endometriosis and two abdominal surgeries. During the ultrasound exam, you find an adnexal multiloculated cystic mass with an intact ovary amongst the septations and fluid. The most likely diagnosis is:

ovarian hyperstimulation syndrome
peritoneal inclusion cyst
ovarian torsion
chocolate cyst
paraovarian cyst

A

peritoneal inclusion cyst

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22
Q

Which ovary is more likely to torse?
right
left

A

right

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23
Q

The common clinical symptoms for endometriosis include all of the following except:
infertility
dysuria
dysmenorrhea
dyspareunia

A

dysuria

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24
Q

A 13 year old female comes into the ER with acute, severe right-sided pain with nausea, vomiting, and fever. The ER physician feels a mass in RLQ and orders an ultrasound to rule out appendicitis. The patient’s mother tells you that the patient has had intermittent right-sided pain during the past 2 weeks, but the pain has never been this bad before. Your sonographic findings include the following images. Color Doppler did not reveal any blood flow and some free fluid was visualized in the cul-de-sac. What is the most likely diagnosis?
ovarian torsion
pelvic inflammatory disease
ectopic pregnancy
endometrioma

A

ovarian torsion

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25
Q

What is the name of the “sign” used to describe the Doppler flow of a corpus luteum cyst?
ring of fire
halo
ring of light
chorionic ring

A

ring of fire

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26
Q

There are two forms of endometriosis; which is the most common manifestation?
localized
diffuse

A

localized

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27
Q

Sonography is a common, reliable way to diagnose diffuse endometriosis.
True
False

A

False

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28
Q

Which syndrome consists of oligomenorrhea or amenorrhea, obesity, and hirsutism?

Leriches syndrome
Stein-Leventhal syndrome
May-Thurner syndrome
Pagett-Schroetter syndrome
Reyes syndrome

A

Stein-Leventhal syndrome

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29
Q

A 27 year old female comes to the imaging department for a pelvic exam to determine if she has an IUP. She presents with nausea and vomiting times 2 weeks. Her lab report shows high level of human chorionic gonadotropin. The ultrasound reveals large, multiloculated cysts bilaterally. The image below is one of the images you obtain. What does this most likely represent?

endometriomas
follicular cysts
peritoneal inclusion cysts
theca-lutein cysts
ovarian torsion

A

theca-lutein cysts

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30
Q

A postmenopausal patient who has with a mass and ovarian torsion is more likely to have a malignancy.
True
False

A

True

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31
Q

Regarding Corpus Luteum Cysts.

Unilateral or Bilateral?

More prone to what?

SELECT 2.

torsion
bilateral
unilateral
hemorrhage

A

unilateral
hemorrhage

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32
Q

The sonographic appearance of PCOS is bilaterally enlarged polycystic ovaries with increased echogenicity, containing multiple tiny cysts.
True
False

A

True

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33
Q

The sonographic appearance of PCOS is an enlarged ovary, with no color doppler, and an edematous/complex appearance.

True
False
This describes the appearance of ovarian torsion.

A

False

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34
Q

Which epithelial tumor is the second most common?
Mucinous
Serous
Endometroid
Transitional Cell

A

Mucinous

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35
Q

Transitional cell tumors are typically uncommon, asymptomatic, and almost always _________.

cause ascites
malignant
rupture
benign

A

benign

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36
Q

During a pelvic ultrasound exam, the sonographer notices a hypoechoic solid mass in the right ovary. The outer wall of the mass is hyperechoic, suggesting some calcification of the tumor wall. The mass has similar sonographic appearance as ovarian fibroma or thecoma. What is the most likely pathology present?

clear cell tumor
Brenner tumor
serous cystadenoma
mucinous cystadenocarcinoma

A

Brenner tumor

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37
Q

With a Brenner tumor, a cystic component is ____________.
uncommon finding
common finding
always present
never present

A

uncommon finding

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38
Q

Of all the types of epithelial-stromal tumors, which malignancy has a better prognosis than the others?

mucinous
clear cell tumor
Brenner
endometrioid
serous

A

endometrioid

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39
Q

The endometroid tumor occurs most frequently in what decades of life?

3rd -4th
4th - 7th
5th - 6th

A

5th - 6th

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40
Q

What % of endometroid tumors are bilateral?
25%
50%
90%
75%

A

25%

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41
Q

Why do endometrioid tumors typically have a better prognosis than the other malignancies?
it is usually diagnosed at an earlier stage
more types of chemotherapy drugs are available for this particular malignancy
it occurs in only young women
it responds to all forms of treatment

A

it is usually diagnosed at an earlier stage

42
Q

What % of malignant tumors do epithelial tumors make up?

100%
25%
90%
50%

A

90%

43
Q

Which of the following risk factors for ovarian cancer is considered to be the most important?

pt. history of breast, endometrial, or colon cancer
nulliparity
increasing age
family history

A

family history

44
Q

All of the following are considered characteristics that indicate malignancy in a cystic lesion except:

solid, echogenic elements
thick sepatations
irregular, thick walls
well-defined borders
irregular septations

A

well-defined borders

45
Q

Which of the following labs is used in the diagnosis of some ovarian cancers? It is useful in patients undergoing chemo.
Serum CA 125
beta HcG
PSA
alpha feta protein

A

Serum CA 125

46
Q

Of the 5 types of epithelial-stromal cell tumors, which is the most common?
serous
clear cell
mucinous
transitional cell
endometrioid

A

serous

47
Q

This tumor was filled with mucinous material and was deemed malignant. The patient was 50 years old.

serous cystadenoma
mucinous cystadenoma
serous cystadenocarcinoma
mucinous cystadenocarcioma

A

mucinous cystadenocarcioma

48
Q

Which epithelial tumor occurs in the 3rd to 6th decade?

endometroid
mucinous cystadenoma
serous cystadenoma
clear cell tumor

A

mucinous cystadenoma

49
Q

A 36 year old female has arrived for her pelvic ultrasound. While scanning, you see a large cystic mass in the pelvic region that measures 21cm in diameter. It contains several thin septations and low-level echoes caused by mucoid material can be visualized with the cystic mass. It most likely is a:
mucinous cystadenoma
metastatic mass
Brenner tumor
serous cystadenocarcinoma

A

mucinous cystadenoma

50
Q

Ovarian cancer has highest mortality rate of gynecological malignancies due to:

lack of professional knowledge regarding the disease
diagnosis typically occurs in late stages of disease
lack of effective treatment option

A

diagnosis typically occurs in late stages of disease

51
Q

It is usually recommended that an ovarian cyst measuring greater than ________ be surgically removed.

7 mm
7 cm
3 mm
5 cm
2.5 cm

A

7 cm

52
Q

Normally, in a postmenopausal woman, you would expect the ovaries to __________.
be atrophied
contain multiple follicles
be hypertrophied
to remain unchanged from appearance prior to menopause

A

be atrophied

53
Q

Which of the following tumors does pseudomyxoma peritonei occur with?

serous
clear cell tumors
mucinous
endometroids

A

mucinous

54
Q

What percentage of malignant tumors do serous cystadenocarcinomas make up?
50%
25%
75%
90%

A

50%

55
Q

What percentage of benign tumors do serous cystadenomas make up?

70%
25%
50%
90%

A

25%

56
Q

What is another name for transitional cell tumor?

Leydig
Sertoli
Brenner

A

Brenner

57
Q

Clear cell tumors are almost always benign.

True
False

A

False

58
Q

Serous cystadenocarcinoma and mucinous cystadenocarcinoma can have a similar sonographic appearance with multiple loculations, papillary projections, and echogenic material.
True
False

A

True

59
Q

Select the benign epithelial tumors.
serous cystadenoma
mucinous cystadenoma
transitional cell tumor
endometroid
clear cell

A

serous cystadenoma
mucinous cystadenoma
transitional cell tumor

60
Q

Endometriosis is associated in 50-70% of patients with Clear Cell Tumors.
True
False

A

True

61
Q

Abnormal ovaries suggestive of malignancy are typically defined as _________ and __________ ovaries.
enlarged, echogenic
atrophied, anechoic

A

enlarged, echogenic

62
Q

What is the sonographic appearance of a serous cystadenoma?

thick walled, multilocular
thin walled, unilocular
multiple cystic areas over 9mm

A

thin walled, unilocular

63
Q

This tumor was found incidentally during a patient’s abdominal surgery. The patient had not had any symptoms. This was removed and tested and it was benign, it also is very uncommon.

Serous Cystadenoma
Brenner Tumor
Mucinous Cystadenocarcinoma
Clear Cell Tumor

A

Brenner Tumor

64
Q

This is a malignancy that was found in a patient who was 66 and also found out to have endometroid cancer origins.

Serous Cystadenoma
Endometroid tumor
Mucinous Cystadenoma
Clear Cell Tumor

A

Clear Cell Tumor

65
Q

This patient was 34, the tumor measure 28.5 cm. The patient had it removed and it was benign which of the following is this tumor most likely?
serous cystadenoma
Brenner Tumor
mucinous cystadenoma
serous cystadenocarcinoma

A

mucinous cystadenoma

66
Q

This patient had a tumor on her ovary (they were thinking it was of mucinous origin), she was scheduled for surgery but came into the ER with severe pain, elevated WBC and this was what was found on the ultrasound. What is this?

pelvic inflammation
endometriosis
pseudomyxoma peritonei

A

pseudomyxoma peritonei

67
Q

This was found to be malignant once it was removed. These types of tumors account for 50% of all ovarian neoplasms. The patient had ascites too.
Endometroid Tumor
serous cystadenocarcinoma
Clear Cell Tumor
mucinous cystadenocarcinoma

A

serous cystadenocarcinoma

68
Q

When a patient has Fallopian Tube Carcinoma, it will most likely be what histological type of cancer?

Adenocarcinoma
Krukenburg Tumor
Teratocarcinoma
Cystadenocarcinoma

A

Adenocarcinoma

69
Q

Dermoid cyst is another name for:
cystic teratoma
serous cystadenoma
dysgerminoma
yolk sac tumor

A

cystic teratoma

70
Q

In some cystic teratomas, floating hair can create multiple hyperechogenic interfaces within the cyst, as demonstrated in the image below. What is it called?
dermoid mesh
dermoid plug
tip of iceberg sign
starry night

A

dermoid mesh

71
Q

When a mixture matted hair and sebum produces acoustic shadowing that obscures the posterior wall of the lesion as seen below, it is called the _______ sign.
dermoid mesh
wall echo
tip of the iceberg
dermoid plug

A

tip of the iceberg

72
Q

Which portion of the fallopian tube is the usually the involved portion when fallopian tube carcinoma is present?

Proximal
Ampulla
Distal

A

Distal

73
Q

Which of the following malignant germ cell tumors have the sonographic appearance of being solid, echogenic masses possibly with small anechoic areas? The tumors are very radio-sensitive; therefore they have a high survival rate.
yolk sac tumor
dysgerminoma
immature teratoma
dermoid

A

dysgerminoma

74
Q

The yolk sac tumor is also called the:
endodermal sinus tumor
dermoid cyst
teratoma
androblastoma

A

endodermal sinus tumor

75
Q

Which of the malignant germ cell tumors is identical to the testicular seminoma found in males?
dysgerminoma
yolk sac tumor
Dermoid
immature teratoma

A

dysgerminoma

76
Q

This tumor is the most common ovarian malignancy found in children and young women:

sex cord-stromal tumor
germ cell tumor
metastatic tumor
epithelial tumor

A

germ cell tumor

77
Q

This tumor occurred in a 7 year old girl. She started showing major signs of puberty so her parents become worried. Lab tests revealed an abnormal increase in her estrogen levels. What is it?

Thecoma
Yolk Sac Tumor
Fibroma
Granulosa Cell Tumor

A

Granulosa Cell Tumor

78
Q

Your patient is a 33 year old female who is scheduled for a pelvic ultrasound. During her yearly gynecological checkup, the physician felt a mass in the LLQ. Her lab values were all within normal range. Patient has not been experiencing pain and her menstrual cycles have been normal. First day of LMP was 10 days ago. While scanning the area of interest, you see a mass that demonstrated mixed echogenicity. The image below is obtained. What is the most likely pathology?

ectopic pregnancy
fibroma
dermoid plug
yolk sac tumor

A

dermoid plug

79
Q

This metastatic tumor usually originates in the gastric or colonic region. It contains signet ring cells which produce mucin.

Granulosa tumor
Sertoli-Leydig tumor
Krukenberg tumor

A

Krukenberg tumor

80
Q

Which of the following is not a germ layer found in a cystic teratoma?

mesoderm
mectoderm
endoderm
ectoderm

A

mectoderm

81
Q

___________ refers to pleural effusion and ascites that is associated with fibromas.

Marfin syndrome
Stein-Leventhal syndrome
Meig’s syndrome
Dandy-Walker syndrome

A

Meig’s syndrome

82
Q

Which of the following is the most common estrogen-active ovarian tumor?

thecoma
granulosa cell tumor
yolk sac tumor
dysgerminoma

A

granulosa cell tumor

83
Q

You are scanning a 45 year old patient who has presented with abdominal bloating recently and pain in the pelvic region. This patient has a history of Breast cancer. You find a mass in the right and left adnexal regions. They appear complex and there’s ascites present. What is the most likely pathology?
Ovarian mets
Immature Teratoma
Thecoma
Fallopian tube carcinoma

A

Ovarian mets

84
Q

The most common primary sites for metastatic ovarian cancer includes all of the following except:

breast
skin
gastrointestional
endometrial

A

skin

85
Q

The cystic component of the dermoid is usually which of the following?
sebum
blood
secum
saliva

A

sebum

86
Q

Which tumor sonographically typically presents as a solid hypoechoic mass and is also called an androblastoma?

granulosa cell tumor
Sertoli-Leydig cell tumor
yolk sac tumor
thecoma

A

Sertoli-Leydig cell tumor

87
Q

Which of the following would NOT be considered a typical symptom of fallopian tube carcinoma?
Nose bleeds
Pelvic pain
Palpable pelvic mass

A

Nose bleeds

88
Q

This patient presented with increased levels of Alpha Feta Protein in their blood stream. The patient is 19 years old and when the tumor was removed it was found to be malignant. The life expectancy for this patient is not good.

Immature Teratoma
Yolk Sac Tumor
Granulosa cell tumor
Dysgerminoma

A

Yolk Sac Tumor

89
Q

What is the most common complication of a cystic teratoma?

malignant transformation
torsion
rupture & hemorrhage
metastatic spread

A

torsion

90
Q

Which malignant germ cell tumor is rare with a poor prognosis, typically affects women under 20 years of age, and causes increased levels of AFP?

No answer text provided.
yolk sac tumor
granulosa cell tumor
immature teratoma
dysgerminoma

A

yolk sac tumor

91
Q

This tumor was found in a post menopausal woman with increased estrogen levels. She is NOT taking supplemental hormones.
thecoma
yolk sac tumor
granulosa cell tumor
fibroma

A

thecoma

92
Q

Thecomas are typically __________ and fibromas are ___________.

malignant, malignant
malignant, benign
benign, malignant
benign, benign

A

benign, benign

93
Q

What is the least common gynecological cancer?

Ovarian Cancer
Fallopian Tube Cancer
Endometrial Cancer

A

Fallopian Tube Cancer

94
Q

Select the malignant germ cell tumors.
yolk sac tumor
dermoid
immature teratoma
chocolate cyst
dysgerminoma

A

yolk sac tumor
immature teratoma
dysgerminoma

95
Q

Dermoid and serous cystadenoma are the 2 most common ovarian neoplasms.
True
False

A

True

96
Q

Thecomas and fibromas can be difficult to distinguish between, but ________ tumors will often exhibit clinical signs of estrogen production.
thecomas
fibromas

A

thecomas

97
Q
A
98
Q
A
99
Q
A
100
Q
A

OBGYN (5 decks)

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