Practice exam

Question 1

Define polycystic ovary syndrome (2 marks)

Answer 1

an endocrine disorder
produces anovulation
results in infertility,
characterised by multiple cysts in the ovary

Question 2

What is the ultrasound appearance of PCO?

Answer 2

one or both ovaries have 20 or more antral follicles
An antral follicle is defined as a fluid filled cystic
space less than 8mm
The ovary size may be normal or enlarged
ovaries may appear more rounded with an increase in stromal echogenicity

Question 3

difference between Polycystic Ovaries and Polycystic ovarian syndrome

Answer 3

PCO refers to the ovaries containing multiple cysts

PCO Syndrome relates to the
associated features that occur with the abnormal hormone levels and an imbalance
of testosterone & oestrogen
i.e. may include clinical signs & symptoms such as
amenorrhea, obesity, hirsutism

Question 4

Discuss the advantages and disadvantages of trans-abdominal US of the pelvis

Answer 4

Adv
- wider field of view
- global imaging of pelvic structures
- achieve penetration to deeper structures
can measure entire uterus
visualisation of large pelvic masses

Disadv

• requires full bladder which is sometimes not possible
• in large patient resolution is compromised due to depth of structures
• delineation of pathology is inferior to TV scanning

Question 5

Discuss the advantages and disadvantages of trans-vaginal ultrasound of the pelvis

Answer 5

Adv

• better resolution due to higher frequency probe
• clearer imaging due to being closer to ROI
• ability to use dynamic assessment to assess for pain, adhesions, push bowel out of way etc.

Disadv

• limited field of view
• structures high and lateral in pelvis not imaged
• orientation can be difficult
• patient anxiety over invasiveness of test

Question 6

Briefly define the pathology and describe the ultrasound appearances of:
a) endometrioma

Answer 6

• a collection of blood surrounded by endometrial tissue
• a localised form of endometriosis in which ectopic endometrial tissue is deposited around the pelvic organs

US appearances:

• unilocular or multilocular cysts
• 95% seen as cysts containing a few low level echoes,(ground glass appearance)
• typically no internal vascularity

Question 7

Briefly define the pathology and describe the ultrasound appearances of:
b) hydrosalpinx

Answer 7

• fluid in the fallopian tube mostly as a result of PID.

US - dilated, tortuous(serpiginous) anechoic tubes

Question 8

Briefly define the pathology and describe the ultrasound appearances of:
c) endometritis

Answer 8

inflammation of the endometrium often related to PID but can be due to IUCD perforation, retained POC, post caesarean delivery

US appearances:

• normal uterus in 75% of cases
• uterine enlargement
• widened endometrium
• air in the endometrium from gas forming bacteria,
• fluid in endo cavity,
• hypoechoic halo around endometrium

Question 9

A 45 y.o. man presents with right scrotal pain. The request reads: scrotal US ?path
Q1.Define the following pathologies
a) epididymal cysts

Answer 9

cystic dilatation of the epididymal tubules
contain clear serous fluid
common in older men
most often found in the head of the epididymis.

Question 10

A 45 y.o. man presents with right scrotal pain. The request reads: scrotal US ?path
Q1.Define the following pathologies
b) orchcitis

Answer 10

Inflammation of the testes
may be diffuse or focal
usually a secondary infection from epididymitis or STD

Question 11

A 45 y.o. man presents with right scrotal pain. The request reads: scrotal US ?path
Q1.Define the following pathologies

c) testicular abscess

Answer 11

A localized or encapsulated area of infection
rare
follows epididymo-orchitis