Diagnostic Sonography - Chapter 44: Pathology of the Ovaries

The ovarian tumor associated with an elevated serum lactate dehydrogenase is the: A) Dysgerminoma B) Sertoli-Leydig cell tumor C) Androblastoma D) Mucinous cystadenocarcinoma

A) Dysgerminoma

After the graafian follicle ruptures, the remaining structure is termed the: A. Graafian remnant B. Corpus albicans C. corpus Luteum D. theca lutein cyst

C. corpus Luteum

Which of the following is also referred to as a chocolate cyst? a. Endometrioma b. Endometroid c. Cystic teratoma d. Androblastoma

a. Endometrioma

Which origin classification accounts for most ovarian neoplasms? a. Epithelial cell origin b. Germ cell origin c. Stromal cell origin d. Follicular origin

a. Epithelial cell origin

Which of the following is associated with the "whirlpool sign"? a. Ovarian torsion b. Hydrosalpinx c. Ovarian hyperstimulation syndrome d. Ovarian Carcinoma

a. Ovarian torsion

The sonographic "string of pearls" sign is indicative of: a. PCOS b. Tubo-Ovarian disease c. PID d. OHS

a. PCOS

Ovarian carcinoma is classified into four stages. Stage II is limited to which one of the following? a. Pelvis b. One ovary c. Broad ligament d. Two ovaries

a. Pelvis

Which if the following endocrine disorders is associated with chronic anovulation? a. Polycystic ovarian syndrome b. Endometriosis c. Ovarian hyperstimulation syndrome d. Theca-luetien cysts

a. Polycystic ovarian syndrome

In PCOS, the ovaries have which one of the following shapes? a. Rounded b. Irregular c. Elongated d. Smooth

a. Rounded

A 55-year-old patient presents to the sonography department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic sonogram reveals a large multiloculated cystic mass with papillary projections. What is the most likely diagnosis? a. Serous cystadenocarcinoma b. Cystic teratoma c. Androblastoma d. Dysgerminoma

a. Serous cystadenocarcinoma

The most common adnexal mass found during early pregnancy is which one of the following cysts? a. Corpus luteal b. Theca-lutein c. Follicular d. Paraovarian

a. corpus luteal

The cystic mass commonly noted with a pregnancy is the: a. corpus luteum b. dermoid cyst c. dysgerminoma d. serous cystadenoma

a. corpus luteum

The most common benign ovarian tumor is the: a. cystic teratoma b. mucinous cystadenoma c. fibroma d. sertoli-leydig cell tumor

a. cystic teratoma

The ovarian mass that contains fat, sebum and teeth is the: a. dermoid b. fibroma c. mucinous cystadenoma d. yolk sac tumor

a. dermoid

The dominant follicle prior to ovulation is termed the: a. graafian follicle b. corpus albicans c. corpus luteum d. medulla

a. graafian follicle

Fluid collections in adhesions can create cystic structures of odd shapes throughout the abdomen. a. true b. false

a. true

Germ cell tumors often occur as mixed tumors with elements of two or three varieties of germ cell tumors. a. true b. false

a. true

Ovarian torsion is an acute abdominal condition requiring prompt diagnosis and surgical intervention. a. true b. false

a. true

The appearance of the ovary varies with age and the menstrual cycle. a. true b. false

a. true

The ovaries can vary in position and are influenced by the uterine location and the ligament attachments. a. true b. false

a. true

A pelvic sonogram of a 14 year old female demonstrates a large complex mass within the left adnexa. Her lab results indicated elevated serum alpha-fetoprotein levels. what is the most likely cause? a. yolk sac tumor b. serous cystadenoma c. dysgerminoma d. fibroma

a. yolk sac tumor

A specific diagnosis of a paraovarian cyst is possible only by: a. Intervening surgically b. Demonstrating an ipsilateral ovary separate from the cyst c. Demonstrating thin deformable walls d. Demonstrating a lack of peripheral blood flow

b. Demonstrating an ipsilateral ovary separate from the cyst

Theca Lutein cysts are associated with all of the following except: a. Ovarian Hyperstimulation syndrome b. Ectopic pregnancy c. Molar pregnancy d. Multiple gestations

b. Ectopic pregnancy

A hypoechoic mass adjacent to the ovary is most likely which one of the following masses? a. Teratoma b. Endometrioma c. Paraovarian cyst d. Mucinous cystadenoma

b. Endometrioma

Functioning endometrial tissue is present outside of the uterus in which one of the following common conditions? a. Adenomyosis b. Endometriosis c. Endometritis d. Hemorrhagic cyst

b. Endometriosis

Normal ovarian flow is said to be: a. Low resistant during menstruation and high resistant during the proliferative phase b. High resistant during menstruation and low resistant at the time of ovulation c. Low resistant d. High resistant

b. High resistant during menstruation and low resistant at the time of ovulation

The normal ovary exhibits which one of the following characteristic appearances? a. Heterogeneous echotexture b. Homogeneous echotexture c. Central hypoechoic medulla d. Both a heterogeneous echotexture and a central hypoechoic medulla

b. Homogeneous echotexture

the malignant ovarian tumor with gastrointestinal origin is the: a. Brenner tumor b. Krykenberg tumor c. yolk sac tumor d. Granulosa cell tumor

b. Krykenberg tumor

All of the following adnexal masses may appear sonographically similar to a uterine leiomyoma except: a. Thecoma b. Paraovarian cyst c. Fibroma d. Granulosa cell tumor

b. Paraovarian cyst

Which of the following is the most common malignancy of the ovary? a. Cystic teratoma b. Serous cystadenocarcinoma c. Krukenberg tumor d. Sertoli-Leydig cell tumor

b. Serous cystadenocarcinoma

The ovarian cyst associated with gestational trophoblastic disease is the: a. Corpus luteum b. Theca lutein c. Dermoid d. Paraovarian

b. Theca lutein

A patient undergoing fertility treatment presents for a pelvic sonogram complaining of pelvic pain and fullness. What adnexal finding would be the most likely cause? a. Corpus luteum cyst b. Theca-lutein cyst c. Hemorrhagic cyst d. Cystic teratoma

b. Theca-lutein cyst

Which one of the following masses is a rare but benign ovarian neoplasm most often seen in postmenopausal women? a. Fibroma b. Thecoma c. Granulosa d. Dysgerminoma

b. Thecoma

An ovary is generally considered abnormal if its volume is _____ the size of the contralateral ovary. a. One half b. Twice c. Three times d. One quarter

b. Twice

Which one of the following pelvic organs is more commonly involved with metastatic disease? a. Uterus b. Ovaries c. Bladder d. Fallopian tubes

b. ovaries

The sonographic appearance of an ovarian dermoid tumor in which the anterior elements of the mass can be seen, while the greater part of the mass is obscured by shadowing is consistent with: a. whirlpool sign b. tip of the iceberg sign c. dermoid mesh sign d. dermoid plug sign

b. tip of the iceberg sign

PCOS may also be referred to as: a) fitz hugh curtis syndrome b) plateau syndrome c) stein leventhal syndrome d) asherman syndrome

c) stein leventhal syndrome

Mucinous cystadenocarcinoma most frequently occurs in women over the age of _______ years. a. 20 b. 30 c. 40 d. 50

c. 40

Simple ovarian cysts in postmenopausal women are not likely malignant when measuring less than _____ centimeters (cm). a. 3 b. 4 c. 5 d. 6

c. 5

What is another name for endometrioma? a. Dermoid b. Teratoma c. Chocolate cyst d. String of pearl

c. Chocolate cyst

The most common benign tumor of the ovary is which one of the following masses? a. Serous cystadenoma b. Endometrioma c. Dermoid d. Mucinous cystadenoma

c. Dermoid

A hypoechoic solid mass is seen within the right ovary of a 24-year-old female. Lab values reflect an elevation of serum lactase dehydrogenase. What is the most likely pathology? a. Yolk sac tumor b. Serous cystadenocarcinoma c. Dysgerminoma d. Thecoma

c. Dysgerminoma

What ovarian tumor will most likely have a moth-eaten appearance on sonography? a. Cystic teratoma b. Serous cystadenocarcinoma c. Krukenburg tumor d. Sertoli-Leydig cell tumor

c. Krukenburg tumor

A 24 year old female patient presents to the ED with severe right lower quadrant pain, nausea, and vomiting. The sonographic examination reveals an enlarged ovary with no detectable Doppler signal. What is the most likely diagnosis? a. Ovarian cystadenocarcinoma b. Cystic teratoma c. Ovarian torsion d. Endometriosis

c. Ovarian torsion

Which one of the following statements about polycystic ovarian syndrome (PCOS) is false? a. PCOS includes amenorrhea. b. PCOS includes early pregnancy loss. c. PCOS occurs in the middle-to-late 30s. d. PCOS includes hirsutism

c. PCOS occurs in the middle-to-late 30s.

Sonographic criteria for a simple ovarian cyst include all of the following except: a. Anechoic appearance b. Smooth walls c. Posterior shadowing d. Acoustic enhancement

c. Posterior shadowing

Which of the following is an estrogen-producing ovarian tumor? a. Cystic teratoma b. Fibroma c. Thecoma d. Endometrioma

c. Thecoma

Sonographically, which of the following would most likely be confused for a pedunculated fibroid tumor because of its solid appearing structure? a. serous cystadenoma b. mucinous cystadenoma c. fibroma d. theca lutein cyst

c. fibroma

With what ovarian tumor is Meigs syndrome most likely associated? a. dysgerminoma b. cystic teratoma c. fibroma d. yolk sac tumor

c. fibroma

Which one of the following cysts occurs when a dominant follicle does not succeed in ovulating but remains active although immature? a. Nabothian b. Corpus luteum c. Follicular d. Paraovarian

c. follicular

An endometrioma most likely appears as a : a. simple, anechoic mass with through transmission b. complex mass with internal shadowing components c. mostly cystic mass with low level echoes d. solid, hyperechoic shadowing mass

c. mostly cystic mass with low level echoes

What would be a predisposing condition that would increase the risk for suffering from ovarian torsion? a. hirsutism b. excessive exercise c. ovarian mass d. sonohysterography

c. ovarian mass

The dermoid tumor is typically associated with which one of the following ultrasound signs? a. Sandwich b. Silhouette c. Tip of the iceberg d. Mickey Mouse

c. tip of the iceberg

Paraovarian cysts arise from which one of the following structures? a. Fallopian tube b. Round ligament c. Peritoneum d. Broad ligament

d. Broad ligament

A tumor that may mimic gas or feces in the pelvis is which one of the following masses? a. Leiomyoma b. Lipoma c. Granulosa d. Dermoid

d. Dermoid

Which of the following is a tumor of ectopic endometrial tissue? a. Brenner Tumor b. Cystic teratoma c. Yolk sac tumor d. Endometrioma

d. Endometrioma

Theca-lutein cysts are associated with high levels of which one of the following hormones? a. Estrogen b. Progesterone c. Luteinizing hormone d. Human chorionic gondotropin (HCG)

d. Human chorionic gondotropin (HCG)

The malignant ovarian mass that is associated with pseudomyxoma peritonei is the: a. Dysgerminoma b. Sertoli-Leydig cell tumor c. Serous cystadenocarcinoma d. Mucinous cystadenocarcinoma

d. Mucinous cystadenocarcinoma

The partial or complete rotation of the ovarian pedicle on its axis is defined as which one of the following? a. Hemorrhagic cyst b. Endometrioma c. Paraovarian cyst d. Ovarian torsion

d. Ovarian torsion

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

d. PCOS

Which of the following conditions may result in loculated ascites due to rupture of a amass filled with gelatinous material? a. Fitz-Hugh-Curtis Syndrome b. Ovarian torsion c. Paraovarian cyst d. Pseudomyxoma peritonei

d. Pseudomyxoma peritonei

What ovarian mass is associated with virilization? a. Krukenberg tumor b. cystic teratoma c. serous cystadenoma d. Sertoli-Leydig cell tumor

d. Sertoli-Leydig cell tumor

Which one of the following statements about ovarian torsion is false? a. Ovarian torsion is usually associated with a mass. b. Torsion frequently involves the ovary and the fallopian tube. c. The ovary appears enlarged. d. The left ovary is three times more likely to develop torsion than the right.

d. The left ovary is three times more likely to develop torsion than the right.

A patient with an ovarian mass presents with elevated serum AFP. Which of the following would be the most likely? a. Ovarian fibroma b. Thecoma c. Cystic teratoma d. Yolk sac tumor

d. Yolk sac tumor

Which of the following sonographic findings would not increase the likelihood of an ovarian malignancy? a. septation measuring > 3mm in thickness b. irregular borders c. solid wall nodule d. anechoic components with acoustic enhancement

d. anechoic components with acoustic enhancement

Which of the following is the most common benign ovarian neoplasm? a. Serous cystadenocarcinoma b. mature teratoma c. thecoma d. dermoid

d. dermoid

During a pelvic sonogram you visualize a small cyst located adjacent to the ovary. What is the most likely etiology of this cyst? a. dermoid cyst b. ovarian cystadenoma c. endometrioma d. paraovarian cyst

d. paraovarian cyst

The ovarian cysts that are most often bilateral and are associated with markedly elevated levels of hCG are the: a. corpus luteum cysts b. paraovarian cysts c. granulosa cell cysts d. theca lutein cysts

d. theca lutein cysts

A mucinous cystadenoma is all of the following except: a. Large cystic mass with multilocular cystic spaces b. Unilateral c. Most common cystic tumor d. Thick with irregular walls and septations

d. thick with irregular walls and septations