Ovarian Pathology Flashcards by Rexlin Sebastin

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

True
False

True

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

they are not associated with OHS
mild
severe
moderate

severe

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

chocolate cyst
localoma
endometriosis cyst
teratoma cyst

chocolate cyst

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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

corpus luteum cyst

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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

corpus luteum with hemorrhage

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

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

thick irregular walls

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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

hemorrhagic cyst with retracting clot

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

10
12
6
9

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

True
False

True

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

Endometritis
Pelvic inflammatory disease
Peritoneal inclusion cyst
Endometriosis

Endometriosis

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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

all listed

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Typically, the fallopian tube is never torsed.

True
False

False
the ovary and/or fallopian tube can be torsed

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

benign
malignant

malignant

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___________________ is frequently as complication of ovulation induction.

ovarian hyperstimulation syndrome
ovarian torsion
peritoneal inclusion cysts
endometriosis

ovarian hyperstimulation syndrome

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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

severe OHS

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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

ovarian torsion

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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

paraovarian cyst

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Paraovarian cysts are located in __________ .

vesicouterine ligament
cardinal ligament
round ligament
broad ligament

broad ligament

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____________ 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

polycystic ovarian syndrome

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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

polycystic ovarian syndrome

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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

peritoneal inclusion cyst

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Which ovary is more likely to torse?
right
left

right

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

dysuria

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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

ovarian torsion

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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

ring of fire

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

localized

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

False

Which syndrome consists of oligomenorrhea or amenorrhea, obesity, and hirsutism? Leriches syndrome Stein-Leventhal syndrome May-Thurner syndrome Pagett-Schroetter syndrome Reyes syndrome

Stein-Leventhal syndrome

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

theca-lutein cysts

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

True

Regarding Corpus Luteum Cysts. Unilateral or Bilateral? More prone to what? SELECT 2. torsion bilateral unilateral hemorrhage

unilateral hemorrhage

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

True

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.

False

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

Mucinous

Transitional cell tumors are typically uncommon, asymptomatic, and almost always _________. cause ascites malignant rupture benign

benign

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

Brenner tumor

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

uncommon finding

Of all the types of epithelial-stromal tumors, which malignancy has a better prognosis than the others? mucinous clear cell tumor Brenner endometrioid serous

endometrioid

The endometroid tumor occurs most frequently in what decades of life? 3rd -4th 4th - 7th 5th - 6th

5th - 6th

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

25%

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

it is usually diagnosed at an earlier stage

What % of malignant tumors do epithelial tumors make up? 100% 25% 90% 50%

90%

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

family history

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

well-defined borders

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

Serum CA 125

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

serous

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

mucinous cystadenocarcioma

Which epithelial tumor occurs in the 3rd to 6th decade? endometroid mucinous cystadenoma serous cystadenoma clear cell tumor

mucinous cystadenoma

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

mucinous cystadenoma

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

diagnosis typically occurs in late stages of disease

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

7 cm

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

be atrophied

Which of the following tumors does pseudomyxoma peritonei occur with? serous clear cell tumors mucinous endometroids

mucinous

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

50%

What percentage of benign tumors do serous cystadenomas make up? 70% 25% 50% 90%

25%

What is another name for transitional cell tumor? Leydig Sertoli Brenner

Brenner

Clear cell tumors are almost always benign. True False

False

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

True

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

serous cystadenoma mucinous cystadenoma transitional cell tumor

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

True

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

enlarged, echogenic

What is the sonographic appearance of a serous cystadenoma? thick walled, multilocular thin walled, unilocular multiple cystic areas over 9mm

thin walled, unilocular

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

Brenner Tumor

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

Clear Cell Tumor

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

mucinous cystadenoma

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

pseudomyxoma peritonei

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

serous cystadenocarcinoma

When a patient has Fallopian Tube Carcinoma, it will most likely be what histological type of cancer? Adenocarcinoma Krukenburg Tumor Teratocarcinoma Cystadenocarcinoma

Adenocarcinoma

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

cystic teratoma

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

dermoid mesh

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

tip of the iceberg

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

Distal

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

dysgerminoma

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

endodermal sinus tumor

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

dysgerminoma

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

germ cell tumor

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

Granulosa Cell Tumor

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

dermoid plug

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

Krukenberg tumor

Which of the following is not a germ layer found in a cystic teratoma? mesoderm mectoderm endoderm ectoderm

mectoderm

___________ refers to pleural effusion and ascites that is associated with fibromas. Marfin syndrome Stein-Leventhal syndrome Meig's syndrome Dandy-Walker syndrome

Meig's syndrome

Which of the following is the most common estrogen-active ovarian tumor? thecoma granulosa cell tumor yolk sac tumor dysgerminoma

granulosa cell tumor

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

Ovarian mets

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

skin

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

sebum

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

Sertoli-Leydig cell tumor

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

Nose bleeds

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

Yolk Sac Tumor

What is the most common complication of a cystic teratoma? malignant transformation torsion rupture & hemorrhage metastatic spread

torsion

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

yolk sac tumor

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

thecoma

Thecomas are typically __________ and fibromas are ___________. malignant, malignant malignant, benign benign, malignant benign, benign

benign, benign

What is the least common gynecological cancer? Ovarian Cancer Fallopian Tube Cancer Endometrial Cancer

Fallopian Tube Cancer

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

yolk sac tumor immature teratoma dysgerminoma

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

True

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

thecomas