Chapter 43

In a patient after an hysterectomy, the normal vaginal cuff should not exceed _____ centimeters (cm). Select one: a. 1 b. 2 c. 3 d. 4

b. 2

In postmenopausal patients, an endometrial thickness of less than _____ millimeters (mm) reliably excludes an endometrial abnormality. Select one: a. 4 b. 5 c. 8 d. 10

b. 5

Irregular, acyclic bleeding is defined as which one of the following? Select one: a. Menorrhagia b. Metrorrhea c. Dysmenorrhea d. Amenorrhea

b. Metrorrhea

On ultrasound, the characteristic appearance of a degenerating leiomyoma is ____________________. Select one: a. Homogeneous b. Heterogeneous c. Isoechoic d. Anechoic

b. heterogeneous

Which one of the following locations of a fibroid will most likely cause heavy irregular uterine bleeding? Select one: a. Subserosal b. Submucosal c. Intramural d. Pedunculated

b. submucosal

A large solid mass images on the pelvic ultrasound in the area of the cervix in a 32-year-old woman. What is your differential?

Cervical leiomyoma or cervical carcinoma

An elderly woman on cyclic hormone replacement therapy demonstrated a large endometrial fluid collection. What is your differential?

Cervical stenosis (either fluid filled or bloody)

A 62-year-old woman had a pelvic ultrasound because of spotting. The endometrium measured 23 mm. What would you suspect?

Endometrial cancer or hyperplasia

A 26-year-old woman presented to the emergency department with pelvic pain, fever, bleeding, and a positive pregnancy test. She had an intrauterine contraceptive device in the uterus without an intrauterine gestational sac. Explain your next steps.

Evaluate the adnexal area for the presence of an ectopic pregnancy

The endovaginal sagittal image of the cervix showed multiple small cysts inferior to the endometrial cavity in the center of the cervix with increased through transmission. What do you suspect these to represent?

Nabothian cysts

Which one of the following conditions is described as a hyperplastic protrusion of the epithelium of the cervix that may be broad based or pedunculated? Select one: a. Cervical stenosis b. Pyometrium c. Cervical polyps d. Cervical obstruction

c. Cervical polyps

Uterine arteriovenous malformation (AVM): Select one: a. Involves the endometrium. b. Can be managed with dilation and curettage (D&C). c. Involves the myometrium. d. Is always acquired.

c. Involves the myometrium

Hydrometra appears sonographically as a(n) _______________________. Select one: a. Sonolucent tubular structure in the adnexa b. Echogenic thickening of the endometrium c. Sonolucent fluid collection in the uterine canal d. Sonolucent fluid collection in the uterus, cervix, and vagina

c. Sonolucent fluid collection in the uterine canal

Which one of the following is most likely the result of an acquired condition with obstruction of the cervical canal? Select one: a. Leiomyoma b. Cervical carcinoma c. Cervical stenosis d. Adenomyosis

c. cervical stenosis

A 3-day postpartum woman complains of intense pelvic pain. Sonographically, the uterus appears hypoechoic with an irregular endometrium. This condition most likely represents which one of the following? Select one: a. Adenomyosis b. Degenerating submucosal leiomyoma c. Endometritis d. Endometrial hyperplasia

c. endometritis

Which one of the following is the most common site for a leiomyoma to occur? Select one: a. Submucosal b. Subserosal c. Pedunculated d. Intramural

d. intramural

The most common cause of uterine calcification is which one of the following? Select one: a. Adenomyosis b. Endometritis c. Arcuate artery calcification d. Myomas

d. myomas

In which of the following structures might a Gartner's duct cyst be found? Select one: a. Fallopian tube b. Ovary c. Cervix d. Vagina

d. vagina

The size and shape of the normal uterus are related to all of the following EXCEPT: Select one: a. Family history b. Age c. Hormonal status d. Parity

a. family history

Only _____% of women with postmenopausal bleeding have endometrial carcinoma. Select one: a. 10 b. 25 c. 50 d. 75

a. 10

Which one of the following statements about adenomyosis is FALSE? Select one: a. Elevated progesterone levels may promote the growth of myometrial islands of endometrium. b. Adenomyosis can be managed with hormone therapy. c. Adenomyosis may cause abnormal uterine bleeding. d. Adenomyosis may cause pelvic pain during menstruation.

a. Elevated progesterone levels may promote the growth of myometrial islands of endometrium.