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: