Penny Ch. 18, 19, & 20

A 55-year-old patient presents to the ultrasound department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. 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

Causes of postmenopausal bleeding include all of the following except: a. Asherman syndrome b. Endometrial atrophy c. Endometrial hyperplasia d. Intracavitary fibroids

A

Possible benefits of estrogen replacement therapy include: a. Reduction in osteoporosis risk b. Reduction in colon cancer risk c. Reduction in breast cancer risk d. Reduction in endometrial cancer risk

A

Tamoxifen effects on the endometrium will monographically appear as: a. Cystic changes within a thickened endometrium b. Cystic areas within a thin endometrium c. Thin endometrium d. No apparent effect on endometrial thickness or appearance

A

The most common benign ovarian tumor is the: a. Cystic teratoma b. Mucinous cystadenoma c. Fibroma d. Sertoli-Leydig cell tumor

A

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

The sonographic findings of an endometrial polyp include: a. Diffuse thickening of the endometrium b. Menometrorrhagia c. Intermenstrual bleeding d. Infertility

A

The second phase of the endometrial cycle is the: a. Secretory phase b. Follicular phase c. Luteal phase d. Proliferative phase

A (According to Penny, there are two phases to the endometrial cycle- The proliferative and secretory phase)

A change in menstrual bleeding associated with lesions within the uterus relates to: a. Dysfunctional uterine bleeding b. Abnormal uterine bleeding c. Pelvic inflammatory disease d. Fibroids

B

Ectopic endometrial tissue within the uterus that leads to abnormal uterine bleeding is termed: a. Endometriosis b. Adenomyosis c. Fibroids d. Endometrial hyperplasia

B

The corpus luteum primarily releases: a. Estrogen b. Progesterone c. Luteinizing hormone d. Follicle-stimulating hormone

B

The most common cause of postmenopausal bleeding is: a. Endometrial carcinoma b. Endometrial atrophy c. Endometrial leiomyoma d. Cervical carcinoma

B

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

B

Asherman syndrome is associated with: a. Uterine leiomyoma b. Endometrial polyps c. Endometrial adhesions d. Ovarian fibroma

C

Miegs syndrome is associated with what ovarian tumor? a. Ovarian cystadenoma b. Cystic teratoma c. Fibroma d. Yolk sac tumor

C

Tamoxifen has been linked with all of the following except: a. Endometrial polyps b. Endometrial hyperplasia c. Endometrial leiomyoma d. Endometrial carcinoma

C

The measurement of the endometrium during the proliferative phase ranges from: a. 6 to 10 mm b. 8 to 12 mm c. 4 to 8 mm d. 1 to 2 mm

C

The most common female genital tract malignancy is: a. Ovarian carcinoma b. Cervical carcinoma c. Endometrial carcinoma d. Pelvic inflammatory disease

C

The structure noted within the graafian follicle containing the developing ovum is the: a. Corpus luteum b. Corpus albicans c. Cumulus oophorus d. Theca internal cells

C

Which hormone released by the ovary during the proliferative phase stimulates endometrial thickening? a. Follicle-stimulating hormone b. Luteinizing hormone c. Estrogen d. Progesterone

C

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

C

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

D

Stein-Leventhal syndrome is released to: a. Infertility b. Anovulatory cycles c. Hirsutism d. All of the above

D

The corpus luteum is maintained during pregnancy by which hormone? a. Follicle-stimulating hormone b. Luteinizing hormone c. Progesterone d. Human chorionic gonadotropin

D

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

D

The most distal part of the fallopian tube is the: a. Cornu b. Fimbria c. Interstitial d. Infundibulum

D

The ovarian cyst associated with distinctly elevated levels of human chorionic gonadotropin is the: a. Corpus luteum cyst b. Parovarian cyst c. Dermoid cyst d. Theca lutein cyst

D

The sonographic appearance of a 59-year-old woman on hormone replacement therapy is: a. Hypoechoic and thickened b. Hyperechoic and thickened c. Cystic areas within a thickened endometrium d. Variable depending upon the menstrual cycle

D

Unopposed estrogen therapy has been shown to increase the risk of developing: a. Alzheimer disease b. Colon cancer c. Coronary heart disease d. Endometrial carcinoma

D

With endometrial atrophy, the endometrial thickness should not exceed: a. 6 mm b. 3 mm c. 8 mm d. 5 mm

D

The first phase of the endometrial cycle is the: a. Secretory phase b. Follicular phase c. Luteal phase d. Proliferative phase

D (According to Penny, there are only two phases to the endometrial cycle- The proliferative and secretory.)

All of the following are clinical findings with endometrial hyperplasia except: a. Obesity b. Polycystic ovary syndrome c. Abnormal uterine bleeding d. Thickened endometrium

D (Thickened endometrium would be considered a sonographic finding, the other three are clinical findings associated with EM hyperplasia)