GYN test review

Fundus, corpus, cervix

What are three major divisions of the uterus

Free fluid in posterior cul-de-sac

What normal anatomic variant may be demonstrated on a pelvic sonogram

corpus luteum

Which of the following best describes a thick-walled cystic mass with internal echoes that was demonstrated on day 20 of the menstrual cycle and resolved by day 5 of the following cycle

Only leiomyosarcoma will be singular

Which of the following is a false statement with respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma

5 mm

Miss Greenfield is 73 yrs old and asymptomatic. She is not on hormone replacement therapy. Her endometrium should not measure more than

None

Which imaging modality has proven to be able to distinguish between benign and malignant lesions

Resolution of follicular retention cyst

A sonogram of a post-pubertal woman demonstrated a 5 cm simple cyst on the left ovary. A follow-up exam 3 months later demonstrates a normal ovary. What do these findings likely represent?

Diminished blood flow with enlarged hypoechoic ovary with peripheral follicles

Best describes the sonographic appearance of ovarian torsion

MRI

Which imaging modality is often needed to determine uterine anomalies

pelvic inflammatory disease (PID)

Fitz-Hugh-Curtis syndrine is associated with:

Leiomyoma

52 yr old pt postmenopausal for 5 yrs, G-4, P4. Her uterus is enlarged upon palpation and is irregular in contour. You suspect:

Uterine dehiscence

A 35 yr old pt presents for a pelvic ultrasound with pelvic pain. She has a history of 2 C sections. What is the best diagnosis?

Leiomyosarcoma

A 55 yr old woman presents for a pelvic ultrasound for bleeding and pelvic pain. Her history includes prior radiation treatment to her pelvis. What is a possible diagnosis

Graafian follicle

A mature follicle ready for ovulation is referred to as the:

malignancy

A patient presents with abdominal swelling, low back pain, and an extremely elevated CA 125. These clinical findings suggest

Submucosal leiomyoma

A patient presents with an enlarged bulk uterus and menorrhagia. Which of the following is most likely to be the cause

Tubo-ovarian abscess

A patient presents with pelvic pain, infertility, and palpable right adnexal mass. Sonography demonstrated a multicystc complex right adnexal mass with dirty shadowing and bilateral hydrosalpinx. What is the most likely diagnosis?

Endometrial carcinoma

A postmenopausal pt presents with uterine bleeding. While scanning you measure the endometrium at 7 mm. What pathology should you consider?

ectopic pregnancy

A pt is referred for a pelvic sonogram because of RLQ pain. The serum pregnancy test is negative. Which of the following is not a possible consideration?

Fitz-Hugh-Curtis syndrome

A pt presents with a history of PID, RUQ pain, fluid in morrisons pouch and elevated liver enzyme. Sonography of the RUQ reveals adhesions between the liver and right hemi-diaphragm. What is most likely diagnosis?

pcos

A pt presents with a history of hirtuism, amenorrhea, and enlarged ovaries. What should the sonographer be looking for on the exam

Hemorrhagic ovarian cyst

A pt presents with a sudden onset of LLQ pain. Her serum hCG is pending, her LMP was 2.5 weeks ago. The sonographer identifies a 4 cm adnexal mass with low level echoes and posterior enhancement. What is the most likely diagnosis?

Ovulation

A pt presents with mittleschmerz. Sonography demonstrated a small amount of free fluid in the right adnexa. What is the likely cause?

Garter duct cyst

A sonogram demonstrates a simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent

Serous cystadenoma

An asymptomatic pt presents with bilateral large anechoic lesions that contain septations and papillary projections. What does this most likely represent?

Menarche that has not occurred by age 16 in a female patient

Definition of primary amenorrhea

Bicornate uterus

Describes a uterus that has two separate endometrial canals but a single cervix

Secretory phase

During which phase of the menstrual cycle is the endometrium at its thickest

PID

Early sexual contact, multiple sex partners, and/or history of STDs are all risk factors associated with what disease?

oral contraceptives

Endometrial hyperplasia may be caused by all of the following except

Infants and children

Endovaginal sonography is contraindicated for which patients

Sexually transmitted diseases

Fifty percent of PID cases are caused by what

A cervical carcinoma will demonstrate a solid mass whereas a Nabothian cyst will have all of the characteristics of a simple cyst

How can a sonographer distinguish a Nabothian cyst from a cervical carcinoma

Fallopian tube lumen

The endometrial cavity is contiguous with which other part of the female pelvis

Increase in overall size, most commonly because of neoplastic growth

The postmenopausal ovaries become increasingly difficult to visualize sonographically. This may be due to all the following except:

Mucinous cystadenoma

This ovarian malignancy most often presents as large multi-loculated cystic masses with papillary projections and thick echogenic material

The fallopian tube is usually only identified if there is an obstruction and it is distended with fluid

True about identifying fallopian tubes sonographically

Levator ani

Weakness in which of the following muscles leads to prolapse of the uterus

Follicular and luteal

What are the two phases of the ovarian cycle?

Infertility

What is a possible complication of chronic PID

Ectopic pregnancy

What is a possible complication of salpingitis due to PID

Release of follicle stimulating hormone by AP gland

What is responsible for the development of follicles on the ovaries

Basal layer endometrial tissue invades the myometrium

What is the cause of adenomyosis

Corpus luteum

What is the initial source of progesterone and estrogen if fertilization occurs

Septate uterus

What is the most common Mullerian duct anomaly?

Endometrial cancer

What is the most common gynecologic cancer in the US

PCOS

What is the most common hormonal disorder among women of reproductive age

serous cystadenoma

What is the most common malignant ovarian tumor

Ovarian vein-left renal vein-IVC

What is the path of venous drainage from the left ovary

Three line sign

What is the sonographic appearance of the late proliferative endometrium

Endometrium

What is the term used to describe the inner layer of the uterine wall

Adnexa

What is the term used to describe the normal location of the ovaries

Krukenberg tumor

What ovarian neoplasm is a result of metastases of a GI cancer

Anterior surface of the uterus and posterior surface of the bladder

What parts of the female pelvis define the vesicouterine space

Pouch of douglas

Where is free fluid most likely to collect in the female pelvis

posterior to bladder

Where would you see enhancement on a normal transabdominal ultrasound

Endovaginal scan

Which method of interrogation of the female pelvis is best for demonstrating the endometrium

Endometriosis

Which of the following disease process should NOT be seen in a postemenopausal pt

Cystadenoma

Which of the following is not considered a physiologic condition of the ovary

Endometrial hyperplasia

Which of the following is typically a precursor for endometrial carcinoma

Ovarian torsion

Which of the following pathologies is most likely to be demonstrated in a 12 yr old female pt

Kidneys

Which organs should be interrogated if uterine anomalies are demonstrated

Ovary

Which part of the female pelvis has a dual blood supply

Endometrioma

Which pelvic mass presents sonographically as a cystic mass with homogenous low-level internal echoes

Anteverted

Which term describes a straight uterus that tilts forward in the body forming a 90 degree angle with the vagina

Less penetration is required as structures are closer to the transducer

Why do endovaginal transducers utilize higher frequency ranges than transabdominal transducers

Hydrosalpinx

Your pt tests positive for chlamydia and presents with severe pelvic pain. THis finding is most typical of

Radial arteries

Which arteries in the uterus feed the functional layer of the endometrium

Hyperechoic to myometrium

How would you describe the echotexture of the normal endometrium

Homogenous

How would you describe the echotexture of the normal uterus

Functional layer

What layer of the endometrium is shed every month during menstruation

Imperforate hymen

A pt presents with amenorrhea, cyclic abdominal pain, and an enlarged uterus. Has hydrometrocolops. What is the most likely cause

Tub-ovarian complex

A pt presents with fever, leukocytosis, and pelvic pain. Sonography demonstrates a complex multicystic right adnexal mass in the area of the ovary and tube. Both ovary and tube are visualized separately but cannot be separated from one another within the vaginal probe. What does this represent?

<15 ml volume, hypoechoic (hyperechoic) to myometrium with multiple anechoic follicles

Best describes the normal appearance of a normal ovary: