Sue's Final

The sonographic finding of the "three-line-sign" indicates which of the following? An endometrium in the periovulatory phase An endometrium in the post ovulatory phase An endometrium immediately following menses An endometrium during menses

An endometrium in the periovulatory phase

Pt. hx PID now infertile. Soon-Normal ut.&ov. and anechoic dilated serpiginous tubular structure left adnexa. Probably.. Hydrosalpinx Pyosalpinx Perionteal adhesions Tubo-ovarian abscess

Hydrosalpinx

Which of the following is responsible for the production and secretion of gonadatropin releasing hormones? Pituitary gland Hypothalamus Uterus Ovaries

Hypothalamus

Which muscle group is located anterior and lateral within the false pelvis? Levatro ani Iliopsoas Piriformus Obturator internus

Iliopsoas

Which of the following is a risk factor for ovarian carcinoma? Premenopause Multiparity Infertility Family history lung cancer

Infertility

Endovaginal scanning techniques are beneficial for all of the following except: Large pelvic masses Endometrial pathology Retropositioned uterus Distinguishing bowel from adnexal masses

Large pelvic masses

24yoF uls. Endo is isoechoic to myometrium and outlined by hyperechoic line with hyperechoic line in center. Stage mense Early proliferative Late proliferative Secretory phase Luteal phase

Late proliferative

34F AA-irregular, heavy periods. Sono-diffusely enlarged ut containing multiple hypo echoic masses. Most consistent with PID Leiomyomas Endometriosis Uterine cancer

Leiomyomas

A 24F presents for sono eval of the pelvis to r/o mass lt. adnexa. On trv. image of ut, noticed ut fundus is left of ML. Anteverted Retroverted Levoverted Dextroverted

Levoverted

A patient is instructed to position herself so that her knees are flexed with her feet in exam stirrups. Name; Decutitus Trendelenberg Reverse Trendelenberg Lithotomy position

Lithotomy position

Which of the following best describes the scanning technique to document endometrial thickness? Coronally, through the double thickness layers, at the level of the fundus Coronally, through a single thickness layer, at the level of the corpus Midline sagittal, through the thickest portion of the double layers Midline sagittal, through the thickest portion of a single layer.

Midline sagittal, through the thickest portion of the double layers

Which of the following anomalies may warrant further evaluation of the kidneys? Mullerain anomalies of the uterus A T-shaped uterus because of DES exposure Agenesis of the ovaries Multiple ovarian cysts

Mullerain anomalies of the uterus

The fusion of these paired embryologic ducts are responsible for the formation of the uterus: Gartners Uterine Mullerian Fallopian

Mullerian

Which of the following best describes sonohysterography? Iodine injected pts. veins, which provides contrast enhancement of uteru An iodine solution is injected into the patient's uterine cavity to outline Normal saline is instilled into the pts. ut cavity during sono The uterine cavity is evaluated by a transducer on a hysteroscope

Normal saline is instilled into the pts. ut cavity during sono

Using the information from the prev. question, which of the following best describes the most likely appear. of the ovary A corpus luteum may be evident The ovaries will most likely contain multiple small follicles One ovary will most likely demonstrate a collapsed follicle One ovary will most likely demonstrate a dominant follicle approach 2 cm

One ovary will most likely demonstrate a dominant follicle approach 2 cm

32F, undergoing fertility treatment-sono for pel pain. Considering medical hx. which unique abnormality might be seen Ovarian hyperstimulation syndrome Uterine fibroids DES exposure Adenomyosis

Ovarian hyperstimulation syndrome

Which of the following is responsible for the production and secretion of estrogen and progesterone? Pituitary gland Hypothalamus Uterus Ovaries

Ovaries

Which of the following infertility treatments in NOT considered an assisted reproductive technique? Ovulation stimulation with clomiphene citrate IVF ZIFT GIFT

Ovulation stimulation with clomiphene citrate

Which of the following is most likely to increase a female's risk for infertility? Having a retroverted uterus A history of ovarian cysts using contraceptives for more than 5 years Pelvic Inflammatory Disease

Pelvic Inflammatory Disease

Which of the following demonstrates the lowest uterine artery resistance Doppler waveform? Postmenopausal uterus Uterus during menstruation Uterus immediately after ovulation Pregnant uterus

Pregnant uterus

75F sono due to suspected mass. What patient history would be most helpful? Medication history Obstetrical history Menstrual history Prior imaging studies

Prior imaging studies

Why is it necessary to add progestin to hormone therapy in a postmenopausal patient who has not had a hysterectomy? Progestin protects against osteoporosis Progestin protects against heart attacks Progestin counteracts endo prolif. decreasing risk of ut ca Progestin helps reactivate the ovaries and relieve the symptoms of menopaus

Progestin counteracts endo prolif. decreasing risk of ut ca

Which of the following HRT's regiments demonstrates cyclic variations in endometrial thickness in the postmenopausal ut Continuous estrogen Sequential therapy Daily progestin and estrogen Estrogen cream

Sequential therapy

Which of the following represents the most common form of ovarian cancer? Brenner tumor Dysgerminoma Endometriod tumor Serous cystadenocarcinoma

Serous cystadenocarcinoma

Which of the following arteries feed the functional layer of the endometrium? Arcuate Radial Spiral Straight

Spiral

What is the effect of estrogen on the uterus? Stimulates growth and repair of the endometrium Prepares the endometrium for implantation Causes endometrial atrophy Causes menstrual bleeding

Stimulates growth and repair of the endometrium

Which of the following best describe the dual supply of the ovaries? The Ov artery which originates from the AO, and the OV branch of the UT art The OV Art which origi from the IIA, and the gonadal branch from the spiral The internal and external ov arteries, which branch of the IIA The ov art which branches of the CIA, and GA which branches of AO

The Ov artery which originates from the AO, and the OV branch of the UT art

Which of the following best describes how to sonographically assess if the pt.'s bladder is distended adequately for exa Trv. eval should demonstrate the bladder occupying most of the pelvic space If the ovs. can be demonstrated trans, the bladder is sufficiently filled The bladder should extend just beyond the uterine fundus on sag imaging sag. image, the bl. is adequately distended when ut is parallel to table

The bladder should extend just beyond the uterine fundus on sag imaging

In a uterus bicornis, bicollis, there will be Select one: a. 2 uterine bodies, 2 cervices and 1 vagina b. 1 uterine body, 2 cervices, and 1 vagina c. 1 uterine body with a septation, 2 cervices and 1 vagina d. 2 uterine bodies, 1 cervix and 3 vaginas

The correct answer is: 2 uterine bodies, 2 cervices and 1 vagina

A history of vag bleeding with a neg preg test should prompt the sonographer to pay close attention to which of the foll The ovaries They myometrium The endometrium The fallopian tubes

The endometrium

7F-premature secondary sex characteristics, seen pear shaped ut,fundas larger than cx, 2 cm ov follicle- This is normal finding in pediatric patients The findings are associated with true precocious puberty The findings are characteristics of precocious puberty The patient should be evaluated for associated congenital renal anomalies

The findings are associated with true precocious puberty

32F undergoing ART would like to schedule oocyte retrieval WI next 2 days. Sono-largest Ov follicle 1.2cm, True statement The follicles are ready for administration of hCG -oocyte retrieval 30-34hr The follicles are not ready for administration of hCG or oocyte retrieval Sono irrelevant. Ov. Follicle maturity evaluation is thru a blood test As long as there is no evidence of ovulation, oocyte retrieval can be sched

The follicles are not ready for administration of hCG or oocyte retrieval

Which of the following is best evaluated on a sagittal image to the right of midline in the uterus? The vagina The cervix The endometrium The myometrium

The myometrium

15F-intense pelvic pain. Sonographer should focus on which of the following? The endometrium for signs of endometrial cancer The ovaries for evidence of a dermoid The uterus for evidence of a fibroid The ovaries for signs of torsion

The ovaries for signs of torsion

Which of the following gestational structures produces hCG? Zona pellucida Mesoderm Trophoblast Zygote

Trophoblast

The two-cell stage of an embryo is called a/an: Zygote Morula Oogonia Blastocyst

Zygote

Which statement is true of Asherman's syndrome (uterine synechiae)? Select one: a. Among patients with Asherman's syndrome who conceive, there is a higher incidence of complications including premature labor b. Asherman's syndrome involves hyperplastic overgrowths of glands and stroma that are localized in the myometrium c. Careful pathologic inspection of the uterus reveals that it is present in more than 80% of women. d. Human papilloma virus DNA is present in virtually all cases

a. Among patients with Asherman's syndrome who conceive, there is a higher incidence of complications including premature labor

The echogenicity of an IUD should be Select one: a. greater than the myometrium b. lesser than the myometrium c. lesser than the endometrium d. same as the myometrium

a. greater than the myometrium

The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following? Select one: a. Early pregnancy b. Leiomyoma c. Ruptured ovarian cyst d. Ruptured follicular cyst

b. Leiomyoma

Uterine bleeding at irregular intervals is defined as which one of the following? Select one: a. Menorrhagia b. Metrorrhagia c. Dysmenorrhea d. Amenorrhea

b. Metrorrhagia

The classic appearance of a fibroid is Select one: a. a well defined calcified mass b. a focal hypoechoic mass that displaces the myometrium with poor sound through transmission c. an area of increased echogenicity with acoustic enhancement d. bright echoes within the myometrium

b. a focal hypoechoic mass that displaces the myometrium with poor sound through transmission

This benign uterine disease caused by the development and extension of endometrial tissue into the myometrium is called Select one: a. endometriosis b. adenomyosis c. endometrioma d. myometriosis

b. adenomyosis

Which of the following statements is false about fibroids? Select one: a. They are stimulated by estrogen, a steroid hormone produced by the ovaries b. They can cause urinary frequency c. They may be asymptomatic d. They tend to grow most rapidly after menopause

d. They tend to grow most rapidly after menopause

Abnormal uterine bleeding can be caused by Select one: a. uterine tumors b. hormonal abnormalities c. pregnancy d. all of the above e. None of the above

d. all of the above

The differential for endometrial fluid includes all of the following except Select one: a. pregnancy b. chronic PID c. iatrogenic d. endometrial polyps

d. endometrial polyps

Endometrial cancer Select one: a. arises most often from polyps found in the endometrium b. can be diagnosed with certainty on Ultrasound c. patients often present with an abnormal pap smear d. may be a consequence of unopposed estrogen therapy

d. may be a consequence of unopposed estrogen therapy

Which of the following describes how to calculate ovarian volume? (Length x Width x Height) divided by 5 (Length x Width x Height) x 0.523 (Length + Width + Height) divided by 5 (Length + Width + Height) x 0.523

(Length x Width x Height) x 0.523

What is considered a normal average ovarian volume in menstrual-age female? 1 cm^3 - 5 cm^3 5 cm^3 - 10 cm^3 10 cm^3 - 20 cm^3 20 cm^3 - 30 cm^3

10 cm^3 - 20 cm^3

What is the normal thickness of the endometrium in the secretory phase? 1 mm - 4 mm 4 mm - 6 mm 6 mm - 8 mm 8 mm - 14 mm

8 mm - 14 mm

Sonographic evidence of a hypoechoic, irregular-shaped structure within the ovary most likely represents the following; A corpus luteum A graafian follicle A primordial follicle A secondary ovarian follicle

A corpus luteum

In which portion of the fallopian tube does fertilization occur? Infundibulum Interstitial Isthmus Ampulla

Ampulla

The longest portion of the fallopian tube is the: Isthmus Ampulla Interstitial Infundibulum

Ampulla

29F Pel.locate IUD string. No sonographic evidence of IUD. Which is the next step in evaluation? It can be assumed the IUD is expulsed, an no other studies are neccesary An x-ray should be taken of the abd to r/o perf of the IUD into peritonuem A HSG should be ordered to r/o migration of the IUD into the fallopian tube A HSG should be performed to better outline the endometrial cavity

An x-ray should be taken of the abd to r/o perf of the IUD into peritonuem

What is the most common position of the uterus? Anteverted Retroverted Levoverted Dextroverted

Anteverted

Before performing an EV exam, which questions should be asked of the patient before selecting the proper TrX sheath? Do you have sensitivity to vinyl products? Are you allergic to ultrasound gel? Are you allergic to iodine? Do you have latex allergies?

Do you have latex allergies?

For a trans abdominal pelvis sonogram, the patient should do which of the following prior to the examination? Fast for 12 hours Take a cleansing enema Drink 24 oz - 32 oz of water 1 hour prior There are no preparations necessary for this examination

Drink 24 oz - 32 oz of water 1 hour prior

Which of the following hormones is responsible for abnormal proliferation of the endometrium? Estrogen Progesterone Lutenizing hormone Follicle stimulation hormone

Estrogen

Follicle-stimulating hormone (FSH) is a gonadotropin, and secreted by the anterior pituitary gland. It stimulates and triggers ovulation. Select one: True False

False

The bumps and ridges that are like pleats of extra tissue (rugae) are found in the uterus? Select one: True False

False

The proximal portion of the fallopian tube that enters the cornea of the uterus is the: Ampulla Isthmus Interstitial Infundibulum

Interstitial

Which of the following is the junction of the uterine body and the cervix? Fundus Vagina Cornua Isthmus

Isthmus

Which of the following best describes an advantage of the trans abdominal pelvic imaging technique? It provides a global view of the pelvis High frequency transducers can typically be used The patient does no need to fill her bladder A relatively close look at the uterus and ovaries is possible

It provides a global view of the pelvis

Which of the following is a gonadatropin? Estrogen Progesterone Luteinizing hormone Follicle stimulating hormone releasing factor

Luteinizing hormone

Which of the following is most suggestive of ovarian malignancy? Thin septations Anechoic Mural nodules Increased vascular impedance

Mural nodules

Which of the following will appear as a cyst in the cervical region? Nabothian cyst Cervical cancer Cervical myoma Garner's duct cyst

Nabothian cyst

originates on the medial surface of the obturator membrane, the ischium near the membrane, and the rim of the pubis.

Obtrurator internus

Posterolateral border

Piriformis muscle

Which of the following is the most common indication for sonographic evaluation for endometrial carcinoma? Pelvic pain Postmenopausal bleeding Abnormal vaginal discharge Abnormal bleeding in the premenopausal patient.

Postmenopausal bleeding

How do high levels of estrogen affect FSH? Production of FSH from the hypothalamus with increase Production of FSH from the ovaries will increase Production of FSH from the ovaries will decrease Production of FSH from the pituitary will decrease

Production of FSH from the pituitary will decrease

Which of the following uterine variants are best evaluated using the sagittal scanning plane? Levoflexion Dextroflexion Retroflexion Uterine duplication

Retroflexion

Which of the following ligaments help hold the uterus in its anteverted position? Round Broad Cardinal Suspensory

Round

Which type of leiomyoma tends to be most symptomatic? Subserosal Intramural Interstitial Submucosal

Submucosal

What is the purpose of putting pressure or rubbing the tip of the endovaginal probes after sheathing? To check for leaks To eliminate air bubbles To make sure sheath will not fall off To distribute the gel to the sides of the transducers

To eliminate air bubbles

Failure of fusion of the müllerian ducts results in uterus didelphys or bicornuate uterus Select one: True False

True

Mullerian uterine malformations arise from three different causes: failure of development of the müllerian ducts, failure of fusion of the müllerian ducts, or failure of resorption of the median septum Select one: True False

True

The cervix has both an internal and external os Select one: a. True b. False

True

The first appearance of the gonad is essentially the same in the two sexes, and consists in a thickening of the mesothelial layer of the peritoneum. The thick plate of epithelium extends deeply, pushing before it the mesoderm and forming a distinct projection. This is termed the gonadal ridge. The gonadal ridge, in turn, develops into a gonad. This is a testis in the male and the ovary in the female. Select one: True False

True

The fused caudal ends of the two müllerian (paramesonephric) ducts form the uterus, cervix, and the upper vagina Select one: True False

True

There is a strong association of upper urinary tract anomalies with congenital uterine malformations. Anomalies including hypoplasia or agenesis, renal agenesis and ectopic pelvic kidney Select one: True False

True

Whereas minor anomalies (arcuate uterus with just a mild fundal indentation) probably have no clinical consequence, others are associated with pregnancy loss (septate uterus) and various obstetric complications such as premature delivery. Select one: True False

True

18F., hx of 2 vaginas. Sono 2 ut horns and 2 cervices. This is assoc. with which of the following; Uterine aplasia Bicornuate uterus Uterus didelphys Septate uterus

Uterus didelphys

A 55YO PM female on HRT presents with pelvic pain. The imager notes an endometrial thickness of 4.5 mm. This is .. Within normal limits Abnormally thick Abnormally thin Indeterminate, as it depends on which hormones the patient is taking

Within normal limits

Which of the following best describes the ovaries? Retroperitoneal and adjacent to pelvic rim Within the true pelvis, anterior to the internal iliac artery Within the true pelvis, posterior to the external iliac artery Intraperitoneal, within the false pelvis, and anterior to the CIA

Within the true pelvis, anterior to the internal iliac artery

Only______% of women with PMP bleeding have endometrial CA? Select one: a. 10 b. 25 c. 50 d. 75

a. 10

In a uterus bicornis, bicollis, there will be Select one: a. 2 uterine bodies, 2 cervices and 1 vagina b. 1 uterine body, 2 cervices, and 1 vagina c. 1 uterine body with a septation, 2 cervices and 1 vagina d. 2 uterine bodies, 1 cervix and 3 vaginas

a. 2 uterine bodies, 2 cervices and 1 vagina

Which one of the following ligaments contains the uterine blood vessels and nerves? Select one: a. Broad b. Round c. Uretosacral d. Endometrial

a. Broad

Which one of the following ligaments contains the uterine blood vessels and nerves? Select one: a. Broad b. Round c. Uterosacral d. Endometrial

a. Broad

Which ligament has the ovaries attached to the posterior side of the ligament? Select one: a. Broad ligament b. Cardinal ligament c. Round ligament d. Suspensory ligament

a. Broad ligament

To image the fundus of the uterus with transvaginal sonography, the transducer should be angled so that the handle is positioned as described in which one of the following? Select one: a. Closer to the bed b. Farther from the bed c. Lateral to the patient d. Perpendicular to the patient

a. Closer to the bed

Which one of the following tends to have a narrow base attachment to the endometrium with avascular pedicle feeding it? Select one: a. Endometrial polyp b. Submucosal fibroid c. Endometrial carcinoma d. Synechiae

a. Endometrial polyp

The ovary produces two hormones. Estrogen is secreted by __, whereas progesterone is secreted by the __. Select one: a. Follicles; corpus luteum b. Secretory: proliferative c. Follicles, corpuscle d. Corpus luteum, nabothian

a. Follicles; corpus luteum

The T-shaped uterus is a congenital anomaly caused by which one of the following? Select one: a. In utero exposure to diethylstilbestrol (DES) b. Partial fusion of the müllerian ducts c. Partial fusion of the müllerian ducts d. Exposure to radiation

a. In utero exposure to diethylstilbestrol (DES)

Select the imaginary line that separates the true and false pelvis Select one: a. Linea terminalis b. Obturator line c. Arcuate line d. Intercristal line

a. Linea terminalis

Which one of the following endocrine disorders is associated with chronic anovulation? Select one: a. Polycystic ovarian syndrome b. Endometriosis c. Ovarian hyperstimulation syndrome d. Theca-lutein cysts

a. Polycystic ovarian syndrome

The Doppler measurement that uses peak systole minus peak diastole divided by the mean over one cardiac cycle is the _________ index. Select one: a. Pulsatility b. Resistive c. Mean systolic d. Mean diastolic

a. Pulsatility

The difference between the peak systole and the peak diastole is the __________. Select one: a. S/D ratio b. L/S ratio c. D/S ratio d. CI ratio

a. S/D ratio

A 35-year-old woman presents with bloating and a palpable mass. During the sonographic examination, a large unilocular predominately cystic mass with a few septations and smooth walls is imaged. What is the most likely differential for these findings Select one: a. Serous Cystadenoma b. Brenner tumor c. Granulosa d. Thecoma

a. Serous Cystadenoma

A T-shaped uterus and an increased risk for clear cell adenocarcinoma is associated with Select one: a. The daughter of a woman who was prescribed diethylstilbestrol (DES) while pregnant b. trauma to the supporting structure of the uterus c. relative deficiency of vitamins d. none of the above

a. The daughter of a woman who was prescribed diethylstilbestrol (DES) while pregnant

Which one of the following techniques is the best way to measure the cervical-fundal dimension of the uterus? Select one: a. Transabdominal b. Transvaginal c. Translabial d. Endorectal

a. Transabdominal

Endometrial hyperplasia can develop from which one of the following? Select one: a. Unopposed estrogen b. Unopposed progesterone c. Follicular-stimulating hormone d. follicular phase

a. Unopposed estrogen

Which of the following is the result of one normal development and one failure of the Mullerian duct to form? Select one: a. Uterus unicornis b. Uterus bicornis bicollis c. Uterus bicornis unicollis d. Bicornuate uterus

a. Uterus unicornis

The pelvic recess between the bladder and the uterus is which one of the following? Select one: a. Vesicouterine pouch b. Anterior space c. Rectouterine pouch d. Space of Retzius

a. Vesicouterine pouch

The ovary has a dual blood supply via the: Select one: a. aorta and internal iliac b. aorta and arcuate artery c. external iliac and internal d. common iliac and the aorta

a. aorta and internal iliac

Nabothian cysts Select one: a. are usually anechoic and found in the cx b. are uncommon c. are found in the cervix, uterus and the vagina d. are always hyperechoic

a. are usually anechoic and found in the cx

Sertoli stromal cell tumors are also known as: Select one: a. arrhenoblastoma b. gonadoblastomas c. androthecomas d. dysgerminoma

a. arrhenoblastoma

The most common adnexal mass found during early pregnancy is which one of the following cysts? Select one: a. corpus luteal b. theca lutein c. follicular d. paraovarian

a. corpus luteal

When evaluating the patient who is infertile, in addition to assessing uterine structural anatomy, the sonographer should evaluate the: Select one: a. endometrium b. adnexal vessels c. broad ligament d. vagina

a. endometrium

Which of the following describes sonographic evidence of impending ovulation? Select one: a. evidence of anechoic follicles measuring 18mm - 22mm (1.8 - 2.0cm) b. 4mm endometrium c. fluid in the cul de sac

a. evidence of anechoic follicles measuring 18mm - 22mm (1.8 - 2.0cm)

Hormones secreted by the ovaries are classified as Select one: a. gonadotrophins b. steroids c. cortisones d. androgens

a. gonadotrophins

The myometrium of the uterus can be described as: Select one: a. homogenous with low to moderate echogenicity b. heterogenous with low to moderate echogenicity c. homogenous with hyperechoic texture d. heterogenous with, hyperechoic to the level of the endometrium

a. homogenous with low to moderate echogenicity

All of the following are associated with PID except: Select one: a. hormonal imbalance of progesterone b. exposure to chlamydia or gonorrhea c. pain in lower abdomen d. fever or difficult urination

a. hormonal imbalance of progesterone

The primary function of LH is to Select one: a. induce ovulation b. stimulate growth of the primary follicles c. ensure maturation of the graafian follicle d. inhibit the secretion of the hormone

a. induce ovulation

Ovarian carcinoma is classified into four stages. Stage II is limited to which one of the following? Select one: a. is one or two ovaries and has spread to the pelvic region b. one ovary c. broad ligament d. two ovaries

a. is one or two ovaries and has spread to the pelvic region

A fully distended bladder in a patient undergoing transvaginal sonography will Select one: a. occupy most of the image and displace organs of interest out of the focal range b. increase the focal range, allowing better image enhancement c. allow better visualization of pelvic organs d. produce low attenuation, resulting in reduced magnification

a. occupy most of the image and displace organs of interest out of the focal range

The uterine anomaly most frequently associated with a high incidence of infertility is a ___________ uterus. Select one: a. septate b. bicornuate c. didelphys d. T-shaped

a. septate

What is the effect of estrogen on the uterus? Select one: a. stimulates growth and repair of the endometrium b. causes endometrial atrophy c. causes menstrual bleeding d. causes menstrual thinning

a. stimulates growth and repair of the endometrium

Which one of the following is not true of the urinary bladder with transvaginal sonography? Select one: a. the wall of the bladder cannot be identified when the bladder is nearly empty b. the nearly empty bladder can be on the right of the screen c. the nearly empty bladder can be on the left of the screen d. the nearly empty bladder may be in the true anatomic position

a. the wall of the bladder cannot be identified when the bladder is nearly empty

Hydrocolpos Select one: a. watery fluid in the vagina b. pus in the uterus c. blood in the uterus and vagina d. tag of mucous membrane resembling a tumor with a pedicle

a. watery fluid in the vagina

Sonographically, the broad ligaments are best demonstrated Select one: a. when surrounded by ascites b. with transvaginal sonography c. with over distention of the urinary bladder d. with a large myoma

a. when surrounded by ascites

The transvaginal transducer should be soaked in disinfectant between uses for a minimum of ______ Select one: a. 3-5 minutes b. 10- 20 minutes c. 30-60 minutes d. 1 - 2 hours

b. 10- 20 minutes

Multiple gestations occur in approximately _____% of in vitro fertilization (IVF) pregnancies. Select one: a. 15 b. 30 c. 50 d. 75

b. 30

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

Sonohysterography is usually performed on premenopausal women between days ________ of the menstrual cycle. Select one: a. 3 and 5 b. 6 and 10 c. 10 and 14 d. 21 and 28

b. 6 and 10

The vesicouterine pouch is a: a. double folding of the peritoneum between the ureter and the posterior wall of the uterus b. A double folding of the peritoneum between the anterior surface of the uterus and the bladder c. Retroperitoneal space d. Visceral peritoneum

b. A double folding of the peritoneum between the anterior surface of the uterus and the bladder

A 24-year-old woman has a fever, vaginal discharge, and intense pelvic pain. Transabdominal and transvaginal images demonstrate a complex multiloculated irregular mass in the pouch of Douglas. This clinical presentation most likely represents which one of the following? Select one: a. Ovarian torsion b. A tubo-ovarian abscess c. Degenerating pedunculated fibroid d. Endometrioma

b. A tubo-ovarian abscess

An abnormal tangle of blood vessels connecting arteries and veins Select one: a. Pelvic congestion b. AVM c. Ovarian torsion d. Malignancy

b. AVM

Which one of the following sonographic characteristics is the most common finding in endometrial carcinoma? Select one: a. Abnormal thinning of the endometrial cavity, usually with irregular bleeding in postmenopausal women b. Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women c. Irregular bleeding d. Heavy bleeding with a thickening of the myometrium

b. Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women

Which one of the following portions of the fallopian tube is the most coiled? Select one: a. Infundibulum b. Ampulla c. Isthmus d. Interstitial

b. Ampulla

Bending forward of the fundus and body of the uterus toward the cervix (the most common position) is called which one of the following positions? Select one: a. Retroflexion b. Anteverted c. Dextroversion d. Retroversion

b. Anteverted

Which one of the following are small vessels found along the periphery of the uterus? Select one: a. Uterine b. Arcuate vessels c. Iliac arteries d. Peripheral arteries

b. Arcuate vessels

Which one of the following ligaments attaches the cervix to the lateral pelvic sidewall? Select one: a. Round b. Cardinal c. Suspensory d. Ovarian

b. Cardinal

Which one of the following ligaments provides support to the cervix? Select one: a. Round b. Cardinal c. Suspensory d. Ovarian

b. Cardinal

Flexion refers to the axis of the uterine body relative to the ___________. Select one: a. Fundus b. Cervix c. Vagina d. Cornua

b. Cervix

Select the term describing painful menstruation Select one: a. Amennorrhea b. Dysmenorrhea c. Menorrhagia d. Polymenorrhea

b. Dysmenorrhea

Which one of the following statements about diffuse endometriosis is false? Select one: a. It can cause painful menses b. Endometriosis is easily diagnosed by sonography. c. Endometriomas are a form of endometriosis. d. Its appearance can be similar to PID.

b. Endometriosis is easily diagnosed by sonography.

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

b. Endometritis

Perihepatic inflammation ascending from a pelvic infection is called ____________ syndrome. Select one: a. Stein-Leventhal b. Fritz-Hugh-Curtis c. Turner's d. de Quervain's

b. Fritz-Hugh-Curtis

Krukenberg tumors are characterized as ovarian metastases, usually from a ________ primary cancer. Select one: a. brain b. GI c. Melanoma d. breast

b. GI

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

b. Homogeneous echotexture

An asymptomatic 32-year-old woman is diagnosed with a left adnexal mass on physical examination. A history of PID has been reported. Transabdominal and transvaginal images demonstrate an anechoic tubular structure in the left lower quadrant. This finding most likely represents which one of the following? Select one: a. iliac vessels b. Hydrosalpinx c. Theca-lutein cysts d. Ectopic pregnancy

b. Hydrosalpinx

Which one of the following muscle groups may be seen in the false pelvis along the lateral sidewall of the pelvis? Select one: a. Obturator internus b. Iliopsoas c. Rectus sheath d. Psoas sheath e. Coccygeal major

b. Iliopsoas

Which one of the following statements about infertility is false? Select one: a. Infertility is the inability to conceive within 12 months with regular coitus b. Infertility affects one in three couples in the United States c. Infertility in 30-50% of patients is attributable to men d. Varicoceles, an abnormally enlarged vein in males can be a factor in male infertility

b. Infertility affects one in three couples in the United States

The thickness of the endometrium should be measured in which one of the following planes? Select one: a. Transverse b. Longitudinal c. Coronal d. Oblique

b. Longitudinal

Lack of progesterone production is known as which one of the following? Select one: a. Secondary infertility b. Luteal phase deficiency c. Polycystic ovarian syndrome d. Ovarian hyperstimulation syndrome

b. Luteal phase deficiency

Sexually transmitted PID is spread via which one of the following? Select one: a. Bloodstream b. Mucosa c. serosa d. Fallopian tubes

b. Mucosa

Which one of the following is an infection within the uterine serosa and broad ligaments? Select one: a. PID b. Parametritis c. Myometritis d. Peri-ovarian inflammation

b. Parametritis

Inflammation of the serous membrane lining the abdominal cavity and covering the viscera is which one of the following? Select one: a. Retroperitonitis b. Peritonitis c. Omentitis d. Periangitis

b. Peritonitis

In the luteal phase, the endometrial lining may be thinner than expected from an inadequate level of which of the following? Select one: a. Estrogen b. Progesterone c. Luteinizing hormone d. Follicle-stimulating hormone

b. Progesterone

The endometrium demonstrates the "three-line" sign in which one of the following phases? Select one: a. Menstrual b. Proliferative c. Secretory d. Luteal

b. Proliferative

In a patient with unicornuate uterus, what organ system would be imaged? Select one: a. Intestinal b. Renal c. Gastric d. Colonic

b. Renal

Which one of the following is the most common cause of PID? Select one: a. Intrauterine devices b. Sexually transmitted diseases c. Postsurgical complications d. Endometritis

b. Sexually transmitted diseases

Which one of the following arteries is most superficial and sheds blood during menses? Select one: a. Radial b. Spiral c. Arcuate d. Vaginal

b. Spiral

Which of the following fibroids is the most symptomatic? Select one: a. Subserosal b. Submucosal c. Intramural d. Pedunculated

b. Submucosal

Which one of the following statements is false? Select one: a. The ovaries are almond shaped b. The ovaries are suspended from the anterior segment of the broad ligaments c. The ovaries lie in the ovarian fossa d. The ovaries receive blood from the ovarian and uterine arteries

b. The ovaries are suspended from the anterior segment of the broad ligaments

An infection that involves the fallopian tube and the ovary is called which one of the following conditions? Select one: a. Endometritis b. Tubo-ovarian abscess (TOA) c. Pyosalpinx d. Salpingitis

b. Tubo-ovarian abscess (TOA)

The vagina has two sources of blood supply; they are the: Select one: a. Ovarian artery and uterine artery b. Uterine artery and the vaginal artery c. Internal iliac and vaginal d. Aorta and external iliac atery

b. Uterine artery and the vaginal artery

Which ligament originates at the level of internal os and passes downward to the sacrum Select one: a. Broad Ligament b. Uterosacral ligaments c. Round ligament d. none of the above

b. Uterosacral ligaments

The potential space around the inferior cervix and superior vagina is called the: Select one: a. Pouch of Douglas or posterior cul de sac b. Vaginal fornix c. Morrison's pouch d. Space of Retzius e. Anterior cul de sac

b. Vaginal fornix

After the transducer has been soaked in a glutaraldehyde-type solution, which one of the following is an important step to ensure safe handling? Select one: a. Check the cord for damage b. Wear gloves when handling the transducer c. Immediately place the transducer in a protective container d. Thoroughly rinse the transducer with water

b. Wear gloves when handling the transducer

The superficial layer of glands and stroma of the endometrium is called which one of the following? Select one: a. Zona basalis b. Zona functionalis c. Zona stromata d. Zona endometria

b. Zona functionalis

Select the organ found in the false pelvis Select one: a. Ovaries b. ascending colon c. Bladder d. Rectum

b. ascending colon

A specific diagnosis of a paraovarian cyst is possible only by: Select one: 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

A rare but the most common malignant germ cell tumor. Sonographically appears as a solid, homogenous mass that can have irregular or lobulated borders Select one: a. mature teratoma b. dysgerminoma c. brenner tumor d. thecoma

b. dysgerminoma

A hypoechoic unilocular mass filled with low level echoes adjacent to the ovary is most likely which one of the following? Select one: a. teratoma b. endometrioma c. paraovarian cyst d. serous cystadenoma

b. endometrioma

Functioning endometrial tissue is present outside of the uterus in which one of the following conditions? Select one: a. adenomyosis b. endometriosis c. endometritis d. hemorrhagic cyst

b. endometriosis

PID is an inclusive term that refers to all of the following pelvic infections except: Select one: a. oophoritis b. endometriosis c. parametritis d. myometritis

b. endometriosis

Sonographic findings of PID include all of the following except: Select one: a. endometritus b. endometriosis c. peri-ovarian inflammation d. salpingitis

b. endometriosis

Patients who undergo assisted reproductive procedures have an increased risk factor for a(n) ________________ pregnancy. Select one: a. molar b. heterotopic c. anembryonic d. monoamniotic and monochorionic

b. heterotopic

Which of the following is responsible for monitoring hormones, and the pulsatile secretion of gonadatropin releasing hormones (GrnRH)? Select one: a. Pituitary gland b. hypothalmus c. uterus d. ovaries

b. hypothalmus

The major limitation of transvaginal sonography is that Select one: a. it can be used only for pre menopausal women b. its field of view is limited c. it doesn't add much detail d. it can be used only to evaluate follicles

b. its field of view is limited

Mucinous cystadenomas are usually __________ than serous cystadenomas Select one: a. smaller b. larger c. more frequently bilateral d. more malignant

b. larger

Psuedomyxoma peritonei is a rare tumor caused by a metastasis of a _________ producing tumor Select one: a. serous b. mucinous c. epithelial d. plasma

b. mucinous

The posterior surface of the ovary is: Select one: a. Closest to the fallopian tube b. not covered by the broad ligament c. also known as the mesovarian border d. connected to the broad ligament

b. not covered by the broad ligament

Which one of the following pelvic organs is more commonly involved with metastatic disease? Select one: a. uterus b. ovaries c. bladder d. fallopian tubes

b. ovaries

The fallopian tubes are evaluated by a sonographic and saline examination to determine which one of the following characteristics? Select one: a. size b. patency c. length d. duplication

b. patency

Risk factors in pelvic inflammatory disease (PID) include all of the following except: Select one: a. early sexual contact b. single sexual partner c. sexually transmitted disease d. intrauterine contraceptive device

b. single sexual partner

Which one of the following masses is a rare but benign stromal cell ovarian neoplasm most often seen in menopausal or postmenopausal women? Select one: a. dermoid b. thecoma c. yok sac tumor d. dysgerminoma

b. thecoma

An anteverted uterus is a: Select one: a. tilting backward of the uterus b. tilting forward of the uterus c. a congenital abnormailty d. A tilting back at a 90 degree angle

b. tilting forward of the uterus

An ovary is generally considered abnormal if its volume is _____ the size of the contralateral ovary. Select one: a. one half b. twice c. three times d. one quarter

b. twice

The vagina has two sources of blood supply; they are the: Select one: a. ovarian artery and uterine artery b. uterine artery and vaginal artery c. internal iliac artery and vaginal artery d. aorta and external iliac artery

b. uterine artery and vaginal artery

Ovarian induction therapy requires documentation of all follicles greater than _____ mm in both longitudinal and transverse planes. Select one: a. 5 b. 20 c. 10 d. 17

c. 10

A normal endometrial response associated with overstimulation is an increasing thickness between 2 to 3 mm and __________ mm. Select one: a. 7-10 b. 10-20 c. 12-14 d. 20-25

c. 12-14

The normal menstrual cycle occurs every: Select one: a. 20 days b. 24 days c. 28 days d. 32 days e. 40 days

c. 28 days

Mucinous cystadenocarcinoma most frequently occurs in women over the age of _______ years. Select one: a. 20 b. 30 c. 40 d. 35

c. 40

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

c. 5

The normal size of the menarchal uterus should measure ______ centimeters (cm) long and _____ cm wide. Select one: a. 3;5 b. 2;3 c. 8;4 d. 6;2

c. 8;4

Define hematometracolpos: Select one: a. Retention of blood in the uterine cavity b. Accumulation of menstrual blood in the vagina resulting from a lower vaginal obstruction or imperforate hymen or other obstruction c. Accumulation of menstrual blood in the uterus and vagina caused by either an imperforate hymen or other obstruction d. Accumulation of watery fluid in the uterine cavity

c. Accumulation of menstrual blood in the uterus and vagina caused by either an imperforate

Which of the following anatomy is not included on a routine transabdominal pelvic scan Select one: a. Uterus b. Cervix c. Appendix d. Recto uterine recess (cul-de-sac) e. Rt & Left adnexa

c. Appendix

The thin outer layer of the uterus is separated from the immediate layer by which one of the following? Select one: a. Peripheral arteries b. Uterine arteries c. Arcuate vessels d. Radial arteries

c. Arcuate vessels

Select the term describing anatomy on the opposite side of the abdomen Select one: a. Ipsilateral b. Orthogonal c. Contralateral d. Axial

c. Contralateral

After ovulation, progesterone is secreted by which one of the following? Select one: a. Graafian follicle b. Follicular cyst c. Corpus luteum d. Hyperstimulation

c. Corpus luteum

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

c. Dermoid tumor

Limitations of translabial scanning may be overcome by which one of the following? Select one: a. Emptying the patient's bladder b. Elevating the patient's head c. Elevating the patient's hips d. Assuming the left lateral decubitus position

c. Elevating the patient's hips

A 25-year-old woman complains of painful menstrual cycles and infertility. Transabdominal and transvaginal images demonstrate a hypoechoic well-defined adnexal mass. Normal ovaries are seen bilaterally. This sonographic appearance most likely represents which one of the following? Select one: a. A tubo-ovarian abscess b. Para-ovarian cyst c. Endometrioma d. Hemorrhagic corpus luteum cyst

c. Endometrioma

Choose the definition of a blood filled ovarian cyst resulting from endometrial implants Select one: a. Chorioadenoma destruens b. Brenners tumor c. Endometrioma d. Nabothian cyst

c. Endometrioma

What layers of the endometrium are sloughed off during menstruation? a. Basal b. Serosal c. Functional d. Peritoneal

c. Functional

Early in the disease, the clinical presentation of both PID and endometriosis may mimic which one of the following? Select one: a. Para-ovarian cyst b. Subserosal fibroid c. Functional bowel disease d. Adenomyosis

c. Functional bowel disease

The corpus luteum cyst is maintained by which hormone? Select one: a. Estrogen b. Progesterone c. HCG d. LH

c. HCG

Select the vessel that drains directly into the left renal vein Select one: a. Uterine arcuate arteries b. Uterine veins c. Left ovarian vein d. Iliac vessels

c. Left ovarian vein

The left ovarian vein drains into which one of the following veins? Select one: a. Inferior vena cava b. Uterine c. Left renal d. External iliac

c. Left renal

Which of the following muscles plays an important role in supporting and positioning the organs on the floor of the true pelvis. Select one: a. Psoas major b. Pectineus muscle c. Levator ani muscle d. Iliacus muscle

c. Levator ani muscle

Which of the following is the middle uterine lining? Select one: a. Perimetrium b. Endometrium c. Myometrium d. Mesometrium

c. Myometrium

The ovary receives its primary blood supply from which one of the following arteries? Select one: a. Uterine b. Internal iliac c. Ovarian d. External iliac

c. Ovarian

Which one of the following syndromes demonstrates enlarged ovaries with multiple cysts, abdominal ascites, and pleural effusion? Select one: a. Polycystic ovarian b. Fritz-Hugh-Curtis c. Ovarian hyperstimulation d. Stein-Leventhal

c. Ovarian hyperstimulation

Which one of the following statements about polycystic ovarian syndrome (PCOS) is false? Select one: a. PCOS includes amenorrhea. b. PCOS includes early pregnancy loss c. PCOS occurs in the middle-to-late 40s. d. PCOS includes hirsutism.

c. PCOS occurs in the middle-to-late 40s.

Symmetrical bilateral pelvic masses are likely to be which one of the following? Select one: a. Ovarian cysts b. Uterine fibroids c. Pelvic muscles d. Iliac vessels Your answer is correct. The correct answer is: Pelvic muscles

c. Pelvic muscles

Select the muscle located in the true pelvis attached from the sacrum to the greater trochanter Select one: a. Rectus abdominus b. Psoas major c. Piriformis d. Iliacus

c. Piriformis

Producing more luteinizing hormone (LH) than follicle-stimulating hormone (FSH) is present in which one of the following conditions Select one: a. Meigs syndrome b. Luteal phase deficiency c. Polycystic ovarian syndrome d. Ovarian hyperstimulation syndrome

c. Polycystic ovarian syndrome

The retrouterine space is also known as which one of the following? Select one: a. Anterior cul de sac b. Space of Retzius c. Posterior cul de sac d. Pouch od Dodd

c. Posterior cul de sac

The retrouterine space is also known as which one of the following? Select one: a. Anterior cul de sac b. Space of retzius c. Posterior cul de sac d. Pouch of dodd

c. Posterior cul de sac

Arcuate artery calcifications may be observed in patients who are _______________. Select one: a. Pregnant b. Perimenopausal c. Postmenopausal d. Premenopausal

c. Postmenopausal

The Doppler measurement that takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak is which one of the following? Select one: a. Pulsatility index b. Mean doppler gradient c. Pourcelot resistive index d. Mean systolic index

c. Pourcelot resistive index

Which one of the following ligaments occupies the space between the layers of another ligament and occurs in front of and below the fallopian tubes? Select one: a. Uretosacral b. Broad c. Round d. Tubal

c. Round

Which ligament is found between layers of broad ligament, occurs in front & below the tubes,and courses from the superior aspect of the uterus lateral to inguinal canal and labia majora Select one: a. Broad Ligament b. Uterosacral ligaments c. Round ligament d. None of the above

c. Round ligament

Which one of the following techniques uses a catheter inserted into the endometrial cavity with the insertion of saline or contrast media to fill the endometrial cavity to demonstrate abnormalities within the cavity or uterine tube? Select one: a. Transvaginal b. Perineal c. Sonohysteropraphy d. Transendometrography

c. Sonohysteropraphy

Which one of the following statements about the fallopian tube is false? Select one: a. The normal lumen is not usually visualized b. Detection is easier if fluid or pus is in the tube c. The tube is best seen transabdominally d. Ascites is helpful to outline the tube

c. The tube is best seen transabdominally

Arrested development of one müllerian duct results in variable forms of a ________ Select one: a. Bicornuate b. Septate c. Unicornuate d. Didelphys

c. Unicornuate

A hyperechoic linear strand of tissue extending from one wall of the uterine cavity to the other describes which one of the following? Select one: a. Adenomyosis b. Decidua basalis c. Uterine synechiae d. Normal proliferative phase

c. Uterine synechiae

A benign invasion of endometrial tissue into the myometrium is known as Select one: a. endometriosis b. pelvic inflammatory disease (Pill) c. adenomyosis d. endomyosarcoma

c. adenomyosis

Leimyosarcomas Select one: a. are benign overgrowth of a leiomyoma b. contain areas of calcification, which differentiate them from a fibroid c. are a smooth muscle malignancy, and have a hallmark pattern of rapid enlargement d. are the malignant degeneration of a polyp

c. are a smooth muscle malignancy, and have a hallmark pattern of rapid enlargement

Hematometrocolpos Select one: a. watery fluid in the vagina b. pus in the uterus c. blood in the uterus and vagina d. tag of mucous membrane resembling a tumor with a pedicle

c. blood in the uterus and vagina

Patients with polycystic ovarian syndrome may have the clinical triad of all the following characteristics except: Select one: a. oligomenorrhea b. hirsutism c. bulimia d. obesity

c. bulimia

Complications associated with assisted reproductive technologies include all of the following except: Select one: a. hyperstimulation b. multiple gestations c. cervical stenosis d. ectopic pregnancy

c. cervical stenosis

The fallopian tubes enter into the fundus of the uterus at the Select one: a. isthmus b. apex c. cornua d. perimetrium

c. cornua

The triple-line sign is associated with which one of the following structures? Select one: a. cervix b. vagina c. endometrium d. uterus

c. endometrium

Which one of the following cysts occurs when a dominant follicle does not succeed in ovulating but remains active although immature? Select one: a. nabothian b. corpus luteum c. follicular d. paraovarian

c. follicular

Teratomas can either be immature which are _______ or mature which are _______ tumors. Select one: a. benign, malignant b. benign, benign c. malignant, benign d. malignant, malignant

c. malignant, benign

Endometrial cancer Select one: a. can be diagnosed with certainty by US b. arises most often from polyps in the endometrium c. may be a consequence of unopposed estrogen d. Only occurs in post menopausal women

c. may be a consequence of unopposed estrogen

_______ is a part of the broad ligament Select one: a. urogenital sinus b. common primordial c. mesovarium d. mesoderm

c. mesovarium

Tissue type tumors can arise from just one germ layer. When this occurs the tumor is referred to generally as Select one: a. cystic teratoma b. dermoid c. monodermal d. struma ovarii

c. monodermal

Which is not a muscle of the pelvis? Select one: a. Psoas b. Piriformis c. Pectoralis d. Obturator internus e. Levator ani

c. pectoralis

The differential considerations of PID may include all of the following except: Select one: a. dermoid b. endometriosis c. pedunculated fibroid d. ovarian neoplasm

c. pedunculated fibroid

Sonographic criteria for a simple ovarian cyst include all of the following except: Select one: a. anechoic b. smooth walls c. posterior shadowing d. acoustic enhancement

c. posterior shadowing

If you discover an ovarian cyst measuring 2.5 cm in a 23 yr old female, what finding would suggest to you that this cyst is a dominant follicle rather than a corpus luteum cyst? Select one: a. Thick walls b. Debris within c. smooth walls d. Collapsed appearance

c. smooth walls

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

The functional layers of the endometrium are vascularized by the ______ arteries Select one: a. uterine b. straight c. spiral d. radial

c. spiral

A mucinous cystadenoma is all of the following except: Select one: a. a large cystic mass with multilocular cystic spaces b. bilateral in 15-20% of cases c. the most common cystic tumor d. Can grow very large

c. the most common cystic tumor

The dermoid tumor is typically associated with which one of the following ultrasound signs? Select one: a. sandwhich b. silhouette c. tip of the iceberg d. mickey mouse

c. tip of the iceberg

The reproductive system develops concurrent with the: Select one: a. cardiac b. intestinal c. urinary d. adrenal

c. urinary

Uterine arteriovenous malformation (AVM): Select one: a. usually involves the endometrium. b. can be managed with dilation and curettage (D&C). c. usually involves vessels in the myometrium. d. is always acquired.

c. usually involves vessels in the myometrium.

During in vitro fertilization, the optimal placement of the embryos is considered to be within 2 cm of the apex of which one of the following structures? Select one: a. Cervix b. uterine body c. uterine fundus d. cornua

c. uterine fundus

Germ cell tumors are principally found in ___________ women. Select one: a. nulliparous b. multiparous c. young d. postmenopausal

c. young

On a baseline pelvic ultrasound, an ovarian cyst greater than ____ mm could interfere with ovarian stimulation and may represent a persistent follicle. Select one: a. 5 b. 8 c. 10 d. 15

d. 15

A dominant follicle grows at a rate of _____ to _____ millimeters per day (mm/day). Select one: a. 0.5; 1 b. 1; 1.5 c. 1; 2 d. 1; 3

d. 1;3

The vagina is directed upward and backward forming a _____ degree angle with the uterine cervix. Select one: a. 20 b. 40 c. 70 d. 90

d. 90

The size and shape of the uterus varies with: Select one: a. age b. parity c. hormone replacement d. All of the above

d. All of the above

The uterus is held in place by Select one: a. Broad Ligament b. Round ligament c. Uterosacral ligaments d. All of the above

d. All of the above

On transabdominal imaging of the female pelvis, the distended urinary bladder: Select one: a. is an acoustic window to view the pelvic anatomy. b. serves as a "cystic" reference c. Displaces bowel into the false pelvis d. All of the above are correct

d. All of the above are correct

A fibroid Select one: a. May calcify b. May grow during pregnancy c. May become a mixed mass due to central tissue necrosis d. All of the above are true e. None of the above are true

d. All of the above are true

WHere does the uterine artery anastomose with the ovarian artery? Select one: a. Arcuate arteries b. Radial arteries c. At the iliac artery d. At the uterine cornua

d. At the uterine cornua

Select the most common benign ovarian neoplasm Select one: a. Serous cystadenoma b. Benign stromal c. Brenner tumor d. Cystic teratoma

d. Cystic teratoma

Which one of the following statements about interventional pelvic sonography is true? Select one: a. Is not a valuable diagnostic tool b. Lacks a safe biopsy route c. Decreases patient care d. Decreases patient cost

d. Decreases patient cost

Which of the following describes the sonographic appearance of a mature teratoma? Select one: a. Unilocular, thin walled cyst with low level debris b. Ascites with a large multiseptate tumor c. Solid, hypoechoic mass with posterior enhancement d. Echogenic foci with fluid/solid levels, sometimes with a "tip of the iceberg" sign

d. Echogenic foci with fluid/solid levels, sometimes with a "tip of the iceberg" sign

Nabothian cysts are found near which one of the following anatomic structures? Select one: a. Vagina b. Corpus c. Isthmus d. Endocervical canal

d. Endocervical canal

Which one of the following hormones, along with follicle size determine the approximate time of ovulation? Select one: a. Follicle-stimulating hormone b. Progesterone c. Human chorionic gonadotropin d. Estradiol

d. Estradiol

Select the sonographic description for a leiomyoma Select one: a. Diffuse cystic structures b. Loculated complex mass with posterior enhancement c. 6mm myometrial defect d. Heterogenous:may be hypo or hyperechoic, may include calcification

d. Heterogenous:may be hypo or hyperechoic, may include calcification

A pelvic abscess will likely appear as any of the following except: Select one: a. Complex cul-de-sac mass that distorts the pelvic anatomy b. Complex diffuse hypo or hyperechoic adnexal mass c. Complex mass with fluid in the cul-de-sac fluid d. Homogenous well defined, thin walled, round anechoic structure within the ovary

d. Homogenous well defined, thin walled, round anechoic structure within the ovary

Which one of the following is used as a substitute for luteinizing hormone (LH) to trigger ovulation? Select one: a. clomid b. estradiol c. progesterone d. Human chorionic gonadotropin (hCG)

d. Human chorionic gonadotropin (hCG)

Which ligament anchors the ovary to the lateral pelvic sidewall? Select one: a. Ovarian ligament b. Mesovarium c. Tunica Albuginea d. Infundibulopelvic (suspensory ligament)

d. Infundibulopelvic (suspensory ligament)

The endometrium is at its greatest thickness and echogenicity with posterior enhancement in which one of the following phases? Select one: a. Menses b.Proliferative c. Ovulatory d. Luteal

d. Luteal

The middle layer of the uterus is which one of the following? Select one: a. Serosa b. Endometrium c. Body

d. Myomertium

The middle layer of the uterus is which one of the following? Select one: a. Serosa b. Endometrium c. Body d. Myomertium

d. Myomertium

Which one of the following statements about PID is false? Select one: a. PID is almost always a bilateral collection of pus and fluid. b. Patients may experience pelvic pain and have a history of infertility. c. PID includes vaginal discharge with bleeding d. PID confers a decreased risk of ectopic pregnancy

d. PID confers a decreased risk of ectopic pregnancy

A complex serpiginous adnexal mass with low level echoes most likely represents which one of the following? Select one: a. Salpingitis b. Hydrosalpinx c. Oophoritis d. Pyosalpinx

d. Pyosalpinx

Which one of the following is an infection in the fallopian tube? Select one: a. Parametritis b. Oophoritis c. Hydrosalpinx d. Salpingitis

d. Salpingitis

The pelvic recess between the anterior bladder wall and the pubic symphysis is which one of the following? Select one: a. Vesicouterine pouch b. Anterior cul de sac c. Retrouterine pouch d. Space of Retzius

d. Space of Retzius

The ovaries are laterally supported by which one of the following ligaments? Select one: a. Ovarian b. Cardinal c. Round d. Suspensory

d. Suspensory

Which ligaments connect the lateral ovary to the pelvic wall? Select one: a. Ovarian b. Broad c. Round d. Suspensory

d. Suspensory

Which one of the following statements about ovarian torsion is false? Select one: 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.

Fusion of the inflamed dilated tube and ovary is called which one of the following? Select one: a. A tubo-ovarian abscess b. Pyosalpinx c. Pelvic inflammatory disease d. Tubo-ovarian complex

d. Tubo-ovarian complex

Originates at the internal iliac artery and carries blood to the uterus Select one: a. Arcuate vessels b. Ovarian vessels c. External iliac artery d. Uterine artery

d. Uterine artery

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

d. Vagina

In which portion of the fallopian tube does fertilization normally occur? Select one: a. infundibulum b. interstitial c. isthmus d. ampulla

d. ampulla

Paraovarian cysts arise from which one of the following structures? Select one: a. fallopian tube b. round ligament c. peritoneum d. broad ligament

d. broad ligament

In transvaginal scanning, the scanning plane that is 90 degrees from the sagittal plane is the ______________ plane. Select one: a. transverse b. parasagital c. axial d. coronal

d. coronal

A tumor that may mimic gas or bowel in the pelvis is which one of the following masses? Select one: a. leiomyoma b. lipoma c. granulosa d. dermoid

d. dermoid

Clinical symptoms of PID may include all but the following? Select one: a. Fever b. Dull pelvic aching c. painful intercourse d. extremity pain

d. extremity pain

Theca-lutein cysts are associated with high levels of which one of the following hormones? Select one: a. estrogen b. progesterone c. luteinizing hormone d. human chorionic gonadotropin (hCG)

d. human chorionic gonadotropin (hCG)

What blood vessel usually can be depicted posterolateral to the ovary? Select one: a. ovarian vein b. ovarian artery c. external iliac artery d. internal iliac artery

d. internal iliac artery

The partial or complete rotation of the ovarian pedicle on its axis is defined as which one of the following? Select one: a. hemorrhagic cyst b. endometrioma c. paraovarian cyst d. ovarian torsion

d. ovarian torsion

Which of the following is responsible for the production and secretion of estrogen and progesterone? Select one: a. Pituitary gland b. hypothalmus c. uterus d. ovaries

d. ovaries

How do high levels of estrogen affect FSH? Select one: a. production of FSH from the hypothalmus will increase b. production of FSH from the ovaries will increase c. production of FSH from the ovaries will decrease d. production of FSH from the pituitary will decrease

d. production of FSH from the pituitary will decrease

On the sagittal image with endovaginal sonography, the cervix of an anteverted uterus is seen in the _____________ of the screen, whereas the fundus of the anteverted uterus is found in the _____________ of the screen. Select one: a. upper portion; lower portion b. right side; lower portion c. left side; right side d. right side; left side

d. right side; left side

A rare group of ovarian neoplasms that can develop in either male or a female direction are the Select one: a. endometroid tumors b. mixed mesodermal tumors c. teratomas d. sex cord stromal tumors

d. sex cord stromal tumors

Sonographic appearances of a TOA include all of the following except Select one: a. complex fluid in post cul de sac b. complex mass with thick irregular walls c. tubular mass in the adnexal region d. simple cystic mass

d. simple cystic mass

The differential considerations of a cystic or partially cystic -appearing adnexal mass include all of the following except Select one: a. endometrioma. b. hemorrhagic cyst c. hydrosalpinx. d. solid pedunculated uterine fibroid

d. solid pedunculated uterine fibroid

The space between the bladder and pubis that is filled with extraperitoneal adipose tissue iscalled Select one: a. posterior cul-de-sac b. pouch of Douglas c. vesicouterine pouch d. space of Retzius e. retrouterine pouch

d. space of Retzius

A submucosal leiomyoma is found Select one: a. under the serosa on the peritoneal surface b. pedunculated in the adnexa c. attached to the broad ligament d. under the endometrium

d. under the endometrium

What degree of angle does the uterus normally have with the long axis of the vagina on an empty bladder? Select one: a. 50 degrees b. 10 degrees c. 45 degrees d. 80 degrees e. 90 degrees

e. 90 degrees

A useful landmark for orientation in transvaginal sonography is Select one: a. Residual fluid in bladder b. Rectus Abdominis muscle c. Sacrum d. External oblique e. Answers A & D

e. Answers A & D

A mature follicle ready for ovulation is referred to as the: Select one: a. Corpus luteum b. Corpus albicans c. Preantral follicle d. Theca lutein cyst e. Graafian follicle

e. Graafian follicle

In DES exposure, sonography may demonstrate a diffuse decrease in the size of the uterus and an irregular ____ -shaped uterine cavity Select one: a. L b. V c. U d. S e. T

e. T

19F, +PREG, beta hCG 800 mIU/ml (FIRP). No IUP seen. Which of the following is true? hCG levels do not relate to sonographic findings and are irrelevant hCG level is ^ the discriminatory zone, assume ectopic pregnancy hCG level is below discriminatory zone, may be too early to detect hCG level is markedly elevated, and is worrisome for trophoblastic disease

hCG level is below discriminatory zone, may be too early to detect

Pelvic floor muscle

levator ani

The central canal of the uterus is a potential space Select one: a. True b. False

true

Which of the following endometrial thickness measurement represents the upper-limits of normal in the premenopausal pt? 5 mm 8 mm 14 mm 24 MM

14 mm

What is the normal length of the uterus in a nulliparous, menstrual-age female? 1 cm - 3 cm 3 cm - 5 cm 6 cm - 8 cm 9 cm - 10 cm

6 cm - 8 cm

Which layer of the endometrium is shed during menses? Basal Serosal Parietal Functional

Function

What effect do high levels of follicle stimulating hormone (FSH) have? Growth and maturation of the corpus luteum Growth and maturation of ovarian follicles Growth and maturation of the endometrium Stimulates ovulation

Growth and maturation of ovarian follicles

12F per sono, abd pain. no lmp,not sexually active. soon sees large fluid collection within ut and vag cavity-finding? Hematometrocolpus Endometrial carcinoma Cervical stenosis Septate uterus

Hematometrocolpus

75F, increasing abd girth. Sono 20 cm complex, cystic, multiple nodular components/septations,vasc flow Most consistent Cystic teratoma Cystadenocarcinoma Hemorrhagic cyst Enodmetrioma

Cystadenocarcinoma

23F Rt ad.mass palpated on clinical exam. Sono mass rt. adnexa, complex, echogenic foci casts strong shadow- probably... Corpus luteum cyst Endometrioma Cystic teratoma Mucinous cyst adenoma

Cystic teratoma

A small T-shaped uterus is associated with which of the following? Unicornuate uterus Bicornuate uterus DES exposure Septate uterus

DES exposure

An enlarged, heterogenous uterus is associated with which form of adenomyosis? Diffuse Focal Atypical Degenerative

Diffuse

25F pelvic pain. Seen high reflective echo collection in ut. cavity. Which question should the sonographer ask the pt.? Do you have a history of irregular menses? Do you have an IUD in place for contraception? Do you have a family history of cancer Are you taking any medication?

Do you have a family history of cancer

Which of the following describes sonographic evidence of impending ovulation? Evidence of anechoic follicles measuring 18 mm - 22 mm Evidence of a corpus luteum A thick, hyperechoic endometrium Endometrial thickness less than 10 mm

Evidence of anechoic follicles measuring 18 mm - 22 mm

Which of the following describes an indication for sonohysterography? Evidence of focal thickening of the endometrium Evaluate for a penduculated fibroid Confirm intrauterine pregnancy Rule out PID

Evidence of focal thickening of the endometrium

Which best describes the diff. between First International Reference Preparation (FIRP) & Second International Standard FIRP standards are inaccurate; only 2nd IS is accepted by the medical commu 2nd IS is considered substandard, and only FIRP is accurate FIRP values are two times greater than 2nd IS 2nd IS is more pure than FIRP, so 2nd IS detects more beta subunits of hCG

FIRP values are two times greater than 2nd IS

72F with vag. bleeding. Sono notes an endo thickness of 12 mm. This would be suggestive of... A normal finding Adenomyosis Endometriosis Endometrial cancer

Endometrial cancer

Which of the following represents the most common cause of abnormal uterine bleeding in pre-MP and post-MP women? Uterine cancer Endometrial polyps Uterine leiomyomas Endometrial hyperplasia

Endometrial hyperplasia

30F with dysfunctional ut. bleeding. Sono endo focal area of thickness, small cystic component. CD demonstrates feeding V Endometriosis Submucosal fibroid Endometrial polyp Endometrial atrophy

Endometrial polyp

Which of the following best describes the inner mucosal layer of the uterus? Serosa Myometrium Endometrium Perioneum

Endometrium