Lecture 9 Quiz

C

Infertility is defined as: (Write the corresponding letter) A) The inability to conceive a child after 2 years of unprotected intercourse B) The inability to conceive a child after 5 years of unprotected intercourse C) The inability to conceive a child after 1 year of unprotected intercourse D) The inability to conceive a child after 3 months of unprotected intercourse

Salpingitis

Inflammation within the fallopian tube is termed: Adnexitis Salpingitis Pyosalpinx Hydrosalpinx

STDs

Most common cause of PID

Ovary

Most common site for implantation of ectopic endometrial tissue caused by endometriosis

Theca Lutein Cysts

OHS can cause multiple large follicles to develop on the ovaries termed: Theca lutein cysts Chocolate cysts Corpus luteum cysts Dermoid cysts

Chocolate Cyst

Other name for endometrioma

PCOS

PID can lead to all of the following except: Infertility PCOS Ectopic pregnancy Scar formation in the fallopian tubes

Ovarian Torsion

Patients with OHS are at increased risk for: Ovarian torsion Chlamydia Gonorrhea Vaginitis

Stein-Leventhal Syndrome

Polycystic ovarian syndrome may also be referred to as: Fitz-Hugh-Curtis syndrome Plateau syndrome Stein-Leventhal syndrome Asherman syndrome

Arcuate Vessels

Prominent anechoic structures near the periphery of the uterus most likely represent: Endometrioma Arcuate vessels Nabothian cysts Physiological cysts

RUQ pain, Right side pleuritic pain

Signs and symptoms of Fitzhugh-Curtis Syndrome

PID

Signs and symptoms of __________: Lower abdominal pain, pelvic pain, pelvic tenderness, Dull pain increased with movement or intercourse, vaginal discharge, abnormal vaginal bleeding, fever and increased WBC

Asymptomatic, Pelvic Pain, Dysmenorrhea, Dyspareunia, Infertility

Signs and symptoms of endometriosis

Oliguria

Sonographic findings of OHS include all of the following except: Cystic enlargement of the ovaries Ascites Pleural effusions Oliguria

Thin, Hyperechoic Endometrium

Sonographic findings of the endometrium in a patient with a history of PID, fever, and elevated white blood cell count would include all of the following except: Ring-down artifact posterior to the endometrium Thin, hyperechoic endometrium Endometrial fluid Thickened, irregular endometrium

PID

Stages of ______ 1) Normal, 2) Endometritis, 3) Pyosalpinx, 4) Hydrosalpinx, 5) Tubo-Ovarian Abscess

Endometrioma

The adnexal mass is most likely a(n): Endometrioma Cystic teratoma Hemorrhagic cyst Ectopic pregnancy

Fitz-Hugh-Curtis Syndrome

The development of adhesions between the liver and the diaphragm as a result of PID is termed: Fitz-Hugh-Curtis Syndrome Dandy-Walker Syndrome Stein-Leventhal Syndrome Asherman Syndrome

Asherman Syndrome

The development of adhesions within the uterine cavity is termed: Fitz-Hugh-Curtis syndrome Dandy-Walker syndrome Stein-Leventhal syndrome Asherman syndrome

Vaginitis

The most common initial clinical presentation of PID is: Endometritis Tubo-ovarian abscess Vaginitis Pyosalpinx

Heterotopic Pregnancy

The occurrence of having both an intrauterine and extrauterine pregnancy at the same time describes: PID Ectopic pregnancy Heterotopic pregnancy Molar pregnancy

Normal Anatomic Variant

The ovary most likely demonstrates a: Hemorrhagic cyst Suspicious solid mass Normal anatomic variant Suspicious isoechoic mass

Endometriosis

The presence of functional, ectopic endometrial tissue outside the uterus is termed: Adenomyosis Asherman syndrome Fitz-Hugh-Curtis syndrome Endometriosis

Pyometra

The presence of pus within the uterus defines: Pyosalpinx Pyometra Pyocolpos Pyomyoma

PCOS

The sonographic "string of pearls" sign is indicative of: PCOS Tubo-ovarian disease PID OHS

Salpingitis

The sonographic evidence of a hyperemic fallopian tube is consistent with: Pyosalpinx Hydrosalpinx Endometritis Salpingitis

Hydrosalpinx

The sonographic finding of a tubular, simple-appearing, anechoic structure within the adnexa is most consistent with: Dyspareunia Hematometra Hydrosalpinx Endometritis

Hydrosalpinx

Ultrasound Appearance for _________: Tubes filled with serous fluid May be unilateral or bilateral Located in the adnexa Anechoic structure with good through transmission Tubular structure 1-4 cm in diameter Walls are thin Described as sausage shaped or tail shaped

Tubo-Ovarian Abscess (TOA)

Ultrasound appearance of ________: Involves a large portion of pelvis Thick walled masses with heterogeneous echo patterns with solid and/or cystic areas Tube shaped elongated oval Fixed and tethered (usually to ovary) Usually bilateral Sometimes impossible to identify uterus

Endometritis

Ultrasound appearance of ________: Uterus hypoechoic with indistinct margins Endometrium may be hyperechoic Fluid collection may be present in endometrial cavity Fluid may be present in the cul de sac

Pyosalpinx

Ultrasound appearance of _________: Tubes filled with pus Usually in adnexa, may involve cul de sac Usually unilateral May appear as a string of bead-like adnexal masses May have smooth or shaggy walls Most are anechoic with low level echoes Usually measures 3-8 cm and ovoid in shape Almost all have acoustic enhancement

Essure Devices

What form of permanent birth control would be seen sonographically as echogenic, linear structures within the lumen of both isthmic portions of the fallopian tubes? Essure devices ParaGards Lippes loops Mirenas

Synechiae

What is another name for adhesions within the endometrial cavity? Endometritis Synechiae Septation Mural nodules

Chocolate cyst

What is another name for an endometrioma? Dermoid Teratoma Chocolate cyst String of pearl

Hysterosalpingography

What is the radiographic procedure used to evaluate the patency of the fallopian tubes? Sonohysterography Hysterosalpingography Hysteroscopy Hysteroscopic fallopian septoplasty

Fitzhugh-Curtis Syndrome

What syndrome is the result of PID progressing to peritonitis or abscess

Dyspareunia

What term is used to describe painful intercourse? Dyspareunia Dysuria Dysmenorrhea Dysconception

Hydrosalpinx

Which of the following abnormalities is most likely a consequence of pelvic inflammatory disease? Adenomyosis Hydrosalpinx Endometriosis Parovarian Cyst

Pyelonephritis

Which of the following is not a potential cause of PID is? Intrauterine contraception use Post abortion Chlamydia Pyelonephritis

B

Which of the following most accurately describes an endometrioma? (Write the corresponding letter) A) Overgrowth of endometrial tissue B) A collection of ectopic endometrial tissue C) Ectopic location of active endometrial tissue D) Ectopic endometrial tissue within the myometrium

D

Which of the following most accurately describes endometriosis? (Write the corresponding letter) A) Proliferation of the endometrial lining B) Collection of ectopic endometrial tissue C) Ectopic endometrial tissue located in the myometrium D) Active endometrial tissue invading the peritoneal cavity

Theca Lutein Cysts

Which of the following would be described as functional cysts that are found in the presence of elevated levels of human chorionic gonadotropin? Theca lutein cysts Chocolate cysts Corpus luteum cysts Endometrial cysts

Hyperandrogenism

Which of the following would be the least likely clinical finding for a patient with endometriosis? Pelvic pain Dysmenorrhea Painful bowel movements Hyperandrogenism

Tubo-ovarian abscess

A 20-year-old patient presents with a history of severe pelvic pain and fever. Her last menstrual period was 3 weeks earlier, and urine pregnancy testing produced a negative result. Based on this clinical history, the sonographic findings are most suspicious for a(n): Endometrioma Ectopic pregnancy Tubo-ovarian abscess Carcinoma of the fallopian tube

Cystic mass with low-level echoes

A 25-year-old patient presents to the sonography department complaining of pelvic pain, dyspareunia, and oligomenorrhea. An ovarian mass, thought to be a chocolate cyst, is noted during the examination. Which of the following is consistent with the sonographic appearance of a chocolate cyst? Simple-appearing anechoic mass Echogenic mass with posterior shadowing Cystic mass with low-level echoes Anechoic mass with posterior shadowing

Tubo-Ovarian Abscess

A 25-year-old woman presents with high-grade fever, pelvic pain, and leukocytosis. An ill-defined, complex mass is identified in the left adnexa. Based on this clinical history, the sonographic finding is most suspicious for: Salpingitis Pyosalpinx Endometritis Tubo-ovarian abscess

PCOS

A 26-year-old patient presents to the sonography department with a history of infertility and oligomenorrhea. Sonographically, you discover that the ovaries are enlarged and contain multiple, small follicles along their periphery, with prominent echogenic stromal elements. What is the most likely diagnosis? Ovarian torsion OHS PID PCOS

Cystic Teratoma

A 30-year-old patient presents with a history of mild pelvic pain during the previous year. Her last menstrual period was 2 weeks earlier. She denies a history of hormone contraceptive therapy or the possibility of pregnancy. Based on this clinical history, the sonographic findings are most suspicious for: Endometrioma Cystic teratoma Ovarian carcinoma Tubo-ovarian abscess

C

A 32-year-old patient presents with a history of endometriosis. Endometriosis is a result of: (Write the corresponding letter) A) Previous pelvic inflammatory disease B) Endometrial tissue within the myometrium C) An accumulation of ectopic endometrial tissue D) Endometrial tissue within the peritoneal cavity

Ectopic Pregnancy

A 35-year-old patient presents to the sonography department with a history of tubal ligation and positive pregnancy test. What condition should be highly suspected? Asherman syndrome Polycystic ovarian disease Endometriosis Ectopic pregnancy

Krukenberg Tumors

A 55-year-old patient presents with a 6-month history of pelvic fullness. She has a history of breast cancer and a recent diagnosis of metastatic liver disease. Based on this clinical history, the sonographic findings are most suspicious for: Endometriomas Ovarian carcinoma Pedunculated fibroid Krukenberg tumors

D

A common sonographic finding associated with an endometrioma is a(n): (Write the corresponding letter) A) Irregular, hypoechoic ovarian mass B) Well-defined anechoic ovarian mass C) Heterogeneous, complex adnexal mass D) Hypoechoic, homogeneous adnexal mass

Dysmenorrhea

A common symptom of endometriosis is: Amenorrhea Menorrhagia Dysmenorrhea Urinary frequency

OHS

A female patient presents to the sonography department with a clinical history of Clomid treatment. She is complaining of nausea, vomiting, and abdominal distension. What circumstance is most likely causing her clinical symptoms? Stein-Leventhal syndrome Polycystic ovarian disease Fitz-Hugh-Curtis syndrome OHS

Hydrosalpinx

A large cystic mass posterior and lateral to the uterus in a patient with a history of a previous pelvic infection is most suspicious for a(n): Hydrosalpinx Endometrioma Parovarian Cyst Corpus Luteal Cyst

Salpingitis

A nodular tubular adnexal mass demonstrating posterior acoustic enhancement is most suspicious for: Salpingitis Pyosalpinx Hydrosalpinx Endometrioma

Uterine Adhesions

A patient presents to the sonography department with a fever, chills, and vaginal discharge. Sonographically, what findings would you most likely not encounter? Cul-de-sac fluid Uterine adhesions Dilated uterine tubes Ill-defined uterine border

D

A patient presents to the sonography department with a history of Chlamydia and suspected PID. Which of the following would be indicative of the typical sonographic findings of PID? (write corresponding letter) A) Enlarged cervix, thin endometrium, and theca lutein cysts B) Atrophic uterus, free fluid, and small ovaries C) Bilateral, cystic enlargement of the ovaries with no detectable flow D) Thickened irregular endometrium, cul-de-sac fluid, and complex adnexal masses

Endometrioma

A patient presents to the sonography department with complaints of infertility and painful menstrual cycles. Sonographically, you discover a cystic mass on the ovary consisting low-level echoes. Based on the clinical and sonographic findings, what is the most likely diagnosis? Cystic teratoma Endometrioma PID OHS

Hydrosalpinx

A patient presents with a history of a palpable pelvic mass. Additional questions show a history of a pelvic infection following an appendectomy. She denies pelvic pain or fever. The anechoic area in this sonogram is most suspicious for a(n): Hydroureter Hydrosalpinx Parovarian cyst External iliac vein

Endometrioma

A patient presents with a history of dyspareunia and irregular menstrual cycles. A complex mass is identified adjacent to a normal-appearing ovary. Based on this clinical history, the sonographic finding is most suspicious for: Endometrioma Cystic teratoma Hemorrhagic cyst Pedunculated leiomyoma

Leiomyosarcoma

A patient presents with a history of postmenopausal bleeding. A heterogeneous intrauterine mass is identified on sonography. On the basis of the clinical history, the sonographic findings are most suspicious for: Leiomyoma Endometrioma Leiomyosarcoma Endometrial Hyperplasia

Peritoneal Inclusion Cyst

A patient presents with lower abdominal pain and a palpable pelvic mass. A septated fluid collection surrounds a normal-appearing right ovary. The patient has a previous history of a ruptured appendix. Based on this clinical history, the sonographic finding is most suspicious for which of the following pathologies? Endometriosis Tubo-ovarian abscess Mucinous cystadenoma Peritoneal inclusion cyst

Cystadenoma

A rapid increasing pelvic mass is most suspicious for a(n): Leiomyoma Cystadenoma Endometrioma Cystic Teratoma

Tubo-Ovarian Abscess

A total breakdown of the normal adnexal anatomy is a sonographic finding associated with: Pyosalpinx Endometriosis Krukenberg tumors Tubo-ovarian abscess

Uterine Leiomyoma

All of the following are considered risk factors for PID except: IUD Multiple sexual partners Post childbirth Uterine leiomyoma

A

All of the following are sonographic findings of a tubo-ovarian abscess except: (Write the corresponding letter) A) The presence of 10 or more small cysts along the periphery of the ovaries B) Cul-de-sac fluid C) Thickened, irregular endometrium D) Fusion of the pelvic organs as a conglomerated mass

PID is typically a unilateral condition

All of the following statements concerning PID are true except: PID is typically a unilateral condition PID can be caused by douching. PID can lead to a tubo-ovarian abscess. Dyspareunia is a clinical finding in acute PID

Stein-Leventhal Syndrome

Amenorrhea, hirsutism, and obesity describe the clinical features of: Fitz-Hugh-Curtis syndrome Stein-Leventhal syndrome Asherman syndrome Endometriosis

Ascites

An additional sonographic finding commonly associated with this abnormality is: Ascites Hydrosalpinx Endometrioma Ectopic pregnancy

Paraovarian Cyst

An asymptomatic patient presents with a history of a palpable pelvic mass on physical examination. Based on this clinical history, the sonographic findings are most suspicious for a: Hydrosalpinx Corpus luteum Parovarian cyst Physiological cyst

Subserosal Fibroids

An asymptomatic patient presents with a history of an enlarged uterus. Based on this clinical history, the demonstrated pathology most likely represents a(n): Endometrioma Subserosal fibroids Intramural fibroids Submucosal fibroids

Simple Ovarian Cyst

Approximately 15% of postmenopausal patients will exhibit a(n): Hydrosalpinx Endometrioma Simple ovarian cyst Ovarian malignancy

Asherman Syndrome

Assisted reproductive therapy can result in all of the following except: Heterotopic pregnancy Multiple gestations OHS Asherman syndrome

Previous IUD use

Causes of female infertility include all of the following except: Previous IUD use Polycystic ovary syndrome Asherman syndrome Endometriosis

Pyosalpinx

Complex-appearing fluid within the fallopian tubes seen with PID is most likely: Pyosalpinx Pyometra Hydrosalpinx Hematometra

PID

Definition for _______: Infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tube caused by bacterial infection

Endometrioma

Differential Diagnosis _________: PID, Neoplasm, Hemorrhagic Corpus Cyst, Ectopic Pregnancy

B

Differential considerations for this pelvic mass would most likely include: (Write the corresponding letter) A) Hydrosalpinx versus simple cyst B) Simple cyst versus parovarian cyst C) Hydrosalpinx versus endometrioma D) Parovarian cyst versus endometrioma

Endometriosis

Ectopic endometrial tissue located outside of the uterus

Stein-Leventhal Syndrome

Excessive hair growth in women in areas where hair growth is normally negligible would be seen with: Ectopic pregnancy Fitz-Hugh-Curtis syndrome Asherman syndrome Stein-Leventhal syndrome

A

Fitz-Hugh-Curtis syndrome could be described as: (Write the corresponding letter) A) Clinical findings of gallbladder disease as a result of PID B) The presence of uterine fibroids and adenomyosis in the gravid uterus C) Coexisting intrauterine and extrauterine pregnancies D) The presence of pyosalpinx, hydrosalpinx, and endometritis

Endometriosis

Fixation of the ovaries posterior to the uterus is a sonographic finding associated with: Adenomyosis Endometriosis Tubo-ovarian abscess PID