W10_07 Ultrasound in Gynecology

Question 1

which two types of transducers are typically used in gynecology?

Answer 1

transabdominal or transvaginal

Question 2

pros of trans-vaginal probe?

Answer 2

higher resolution (lower penetrance); unaffected by BMI

Question 3

recall piezoelectrical phenomenon

Answer 3

ok

Question 4

what’s A mode imaging?

Answer 4

amplitude - one slice, height proportional to intensity of signal

Question 5

what’s B mode imaging?

Answer 5

brightness - 2D image. Typically used in clinic

Question 6

what’s M mode imaging?

Answer 6

motion - records amplitudes in a slice wrt time

Question 7

what does ALARA stand for?

Answer 7

As Low As Reasonably Achievable

Question 8

what’s the purpose of a hysterosalpingogram?

Answer 8

use contrast to check patency of fallopian tubes

Question 9

what does cervical motion tenderness indicate?

Answer 9

peritoneal irritation or PID?

Question 10

when do you see a gestational sac?

Answer 10

5.5 weeks (TA), 5 weeks (TVS)

Question 11

when do you see a double decidual sign?

Answer 11

5.5-6 weeks

Question 12

when do you see the fetal heart beat?

Answer 12

6.5 weeks (TAS), 5-6 weeks (TVS)

Question 13

when do you see the fetal pole?

Answer 13

6-7 weeks

Question 14

read the slides for images

Answer 14

read the slides for images

Question 15

how to tell the gestational sac from the pseudogestational sac?

Answer 15

gestational sac has the double-decidual sign

Question 16

how do hemoperitoneums look on ultrasound?

Answer 16

hypoechoic area, posterior to uterus

Question 17

note: hemorrhagic cyst is hypoechoic, not anechoic

Answer 17

note that they retract and clot after a while

Question 18

what’s the point of the hysterosonogram?

Answer 18

distend endometrial cavity to see the lining better. With saline

Question 19

define primary amenorrhea

Answer 19

absence of: secondary sex characteristics by 14;
menses by 16
menses after 4 years post thelarche
menses after 1 year post pubarche

Question 20

define secondary amenorrhea

Answer 20

6 months of amenorrhea after 1st menstruation or 3 cycles with no menstruation

Question 21

disorders of which organs can cause amenorrhea?

Answer 21

hypothalamus, pituitary, thyroid, adrenals, ovary, outflow tract

Question 22

what’s sheehan syndrome?

Answer 22

at birth, some event results in hypovolemia. They recover okay, but then can’t breastfeed because of an infarct in the pituitary and can’t secrete prolactin

Question 23

how does hyperthyroidism affect the luteal phase?

Answer 23

shortens it

Question 24

what’s kallman’s syndrome?

Answer 24

failure to get to puberty. Also anosia. Caused by failure of neurons that make GnRH to migrate into the hypothalamus

Question 25

what’s the ferriman-gallwey score?

Answer 25

scores various body parts for the presence of hair. Total = 36

Question 26

what’s the tanner scale?

Answer 26

looks at breast and pubic/armpit hair development

Question 27

when to order labs for LH/FSH/estradiol?

Answer 27

when the person is not having their period, these are helpful

Question 28

which labs to order when there’s amenorrhea?

Answer 28

LH/FSH/estradiol;
TSH;
prolactin;
bone age;
pregnancy test;
ultrasound;
bone densitometry if long hx

Question 29

note: prolactin is the only inhibited hormone. It’s inhibited by dopamine

Answer 29

ok

Question 30

how to treat hyperprolactinemia?

Answer 30

dopamine agonist

Question 31

what’s the minimum treatment for PCOS?

Answer 31

cyclic provera to prevent endometrial growth

Question 32

define oligomenorrhea

Answer 32

reduction in frequency of menses

Question 33

define hypomenorrhea

Answer 33

reduction in number of days and volume of flow

Question 34

define menometrorrhagia

Answer 34

prolonged, heavy uterine bleeding occuring at irregular intervals

Question 35

define menorrhagia

Answer 35

prolonged, heavy uterine bleeding occuring at regular intervals

Question 36

what causes menorrhagia?

Answer 36

uterus is unable to contract down on open venous sinuses in the zona basalis

Question 37

define anovulatory bleed

Answer 37

the endometrium gets huge and can’t maintain itself - causing huge downpour and shedding of the tissues

Question 38

what’s the medical management for menorrhagia?

Answer 38

NSAIDs, danazol (less commonly used now), antifibrinolytics, OCP, IUD w/progesterone, GnRH agonist, conjugated estrogens for acute bleeding