GYN Quiz 1

Which of the following is a true statement with respect to fallopian tubes? A) The most common location for and ectopic pregnancy is in the infundibulum. B) The fallopian tube is usually only identified if there is an obstruction and it is distended with fluid. C) Infection of the fallopian tube is called pelvic inflammatory disease. Adenocarcinoma of the fallopian tube should be considered whenever a solid mass is identified within

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

Which of the following attaches to the ovary? A) peritoneum B) broad ligament C) tunica albuginea D) ovarian ligament

broad ligament

Which of the following non-invasive procedures has a 90% accuracy rate for detecting uterine malformations? A) Saline infusion sonohysterography B) Sonohysterography C) Hysterosalpingography D) 3D sonography

3D sonography

The position of the uterus in this transvaginal image is: A) Dextroposed B) Levoposed C) Retroflexed D) Anteflexed E) Retroverted

Anteflexed

Which of the following terms describes a straight uterus that tilts forward in the body forming a 90° angle with the vagina? A) Retroverted B) Retroflexed C) Anteverted D) Anteflexed

Anteverted

Which of the following best describes a uterus that has two separate endometrial canals but a single cervix? A) Septate uterus B) Bicornuate uterus C) Uterus didelphys D) Subseptate uterus

Bicornuate uterus

What is the term used to describe the inner layer of the uterine wall? A) Serosal layer B) Perimetrium C) Myometrium D) Endometrium

Endometrium

What lab value is compared to the ultrasound findings to determine when the ovary is ready to ovulate? A) Estrotest B) Estradiol C) hCG D) FSH E) LH

Estradiol

Which term best describes the appearance of this uterus? A) Normal B) Globular C) Anteflexed D) Atrophied E) Infantile

Globular

Hypogastric artery is another name for the: A) Right common iliac artery B) Left common iliac artery C) External iliac artery D) Internal iliac artery E) Femoral artery

Internal iliac artery

In this sagittal transvaginal image of the ovary the arrow is pointing to: A) Internal iliac artery B) Internal iliac vein C) Dilated ureter D) Hydrosalpinx E) Fluid-filled bowel

Internal iliac artery

Which part of the uterus is the least distinctive part? A) Isthmus B) Corpus C) Fundus D) Cervix E) Body

Isthmus

Why does an ovarian thecoma have the potential to cause endometrial thickening? A) It produces human chorionic gonadotropin. B) It produces estrogen. C) It produces progesterone. D) It produces alpha-fetoprotein.

It produces estrogen.

Which of the following is a false statement with respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma? A) They may be single or multiple. B) Serial ultrasounds over six months will demonstrate a large size difference in a leiomyosarcoma whereas a leiomyoma will likely be unchanged in size. C) Both can demonstrate a heterogeneous hypoechoic appearance with shadowing. D) Only leiomyosarcoma will be singular.

Only leiomyosarcoma will be singular.

What does precocious puberty describe? A) Onset of puberty prior to age 8 B) Delayed puberty later than age 12 C) Isolated breast development prior to age 5 D) Development of pubic hair after development of breast tissue

Onset of puberty prior to age 8

What is the path of venous drainage from the right ovary? A) Ovarian vein - uterine vein - internal iliac vein - common iliac vein - IVC B) Ovarian vein - IVC C) Ovarian vein - right renal vein - IVC D) Ovarian vein - internal iliac vein - common iliac vein - IVC

Ovarian vein - IVC

On bimanual pelvic examination, the clinician cannot palpate the uterus or ovaries. This image suggests: A) Patient obesity B) Atrophied organs C) Bowel obstruction D) Pelvic ascites E) Constipation

Pelvic ascites

On sonographic examination, two cervical canals are identified with separate right and left uterine horns. Which uterine malformation is demonstrated? A) Bicornuate uterus B) Septate uterus C) Subseptate uterus D) Uterus didelphys

Uterus didelphys

A Gartner's duct cyst is found in the: A) Vagina B) Cervix C) Fallopian tube D) Broad ligament Myometrium

Vagina

This sagittal sonogram most likely displays: A) a cervical mass B) a nabothian cyst C) a bicornuate uterus D) endometrial hyperplasia

a cervical mass

An additional sonographic finding commonly associated with this abnormality is: A) ascites B) hydrosalpinx C) endometrioma D) ectopic pregnancy

ascites

An asymptomatic patient presents with a history of an enlarged uterus on physical exam. A sagittal image of the uterus most likely displays a(n): A) nabothian cyst B) endometrial polyp C) cervical malignancy D) degenerating leiomyoma

nabothian cyst

Obstruction of an inclusion cyst results in a(n): A) nabothian cyst B) cystic teratoma C) endometrial polyp D) serous cystadenoma

nabothian cyst

A patient presents with a history of a palpable pelvic mass and the most recent menstrual period 2 weeks earlier. On further questioning, the patient admits to previous pelvic surgery for a ruptured appendix. A sonogram demonstrates the ovary (curved arrow) surrounded by anechoic fluid. Based on the clinical history, the sonographic findings are most suspicious for a(n): A) parovarian cyst B) serous cystadenoma C) tuboovarian abscess D) peritoneal inclusion cyst

peritoneal inclusion cyst

Suggested follow-up care on this patient would most likely include: A) surgical intervention B) nfertility assessment C) sonogram in 6 to 8 weeks D) sonogram in 2 to 3 weeks

sonogram in 6 to 8 weeks

A total breakdown of the normal adnexal anatomy is a sonographic finding associated with: A) pyosalpinx B) endometriosis C) Krukenberg tumors D) tuboovarian abscess

tuboovarian abscess

What is the normal cervix:uterus ratio in a prepubertal female? A) 2:1 B) 1:1 C) 1:2 D) 1:3

2:1

The proportions of the uterine body and fundus to the uterine cervix in the adult are: A) 1/2 body/fundus; 1/2 cervix B) 1/3 body/fundus; 2/3 cervix C) 2/3 body/fundus; 1/3 cervix D) 3/4 body/ fundus; 1/4 cervix

2/3 body/fundus; 1/3 cervix

The position of the uterus is: A) Anteverted B) anteflexed C) retroflexed D) retroverted

Anteverted

Which of these masses is considered androgenic? A) Fibroma B) Arrhenoblastoma C) Brenner's tumor D) Granulosa cell tumor E) Cystadenoma

Arrhenoblastoma

A benign cystic teratoma contains tissues from A) Ectoderm B) Ectoderm and mesoderm C) Ectoderm and endoderm D) Ectoderm, mesoderm, and endoderm E) None of the above

Ectoderm, mesoderm, and endoderm

"Chocolate cyst" is a lay term for a(n): A) Degenerating fibroid B) Endometrioma C) Hemorrhagic cyst D) Tubo-ovarian abscess E) Ectopic pregnancy

Endometrioma

Doppler waveforms of the uterine arterial flow typically show: A) Low-velocity, high-resistance pattern B) High-velocity, low-resistance pattern C) High-velocity, high-resistance pattern D) Low-velocity, low-resistance pattern E) Reverse-flow pattern

High-velocity, high-resistance pattern

To what is the arrow pointing in this transverse image? A) Uterus B) Right ovary C) Left ovary D) Broad ligament E) Muscle

Left ovary

Your patient has a suspicious adnexal neoplasm. To assist in ruling out metastasis, you scan the: A) Lymph nodes B) Liver C) Kidneys D) Spleen E) Breasts

Lymph nodes

An ovarian mass combined with a pleural effusion and ascites resolving after surgery is known as: A) Meigs syndrome B) Turner syndrome C) Asherman syndrome D) Stein-Leventhal syndrome

Meigs syndrome

Which of these adnexal pathologies is associated with Meigs' syndrome? A) Benign cystic teratoma B) Ovarian fibroma C) Endometrioma D) Tubo-ovarian abscess E) Polycystic ovaries

Ovarian fibroma

Estrogen is responsible for all of the following EXCEPT: A) Stimulating endometrial proliferation B) Inducing rhythmic contraction of the fallopian tubes C) Causing fibroids to enlarge D) Breast duct engorgement E) Premenstrual syndrome

Premenstrual syndrome

What is responsible for the development of follicles on the ovaries? A) Releases progesterone that induces secretory activity of endometrium. B) Releases estrogen that causes thickening of the endometrium. C) Release of luteinizing hormone by the anterior pituitary gland. D) Release of follicle-stimulating hormone by the anterior pituitary gland.

Release of follicle-stimulating hormone by the anterior pituitary gland.

Referring to the same image, how would you describe the mass being measured behind the uterus? A) Cystic B) Solid C) Solid but hypoechoic D) Complex E) Containing thick fluid

Solid

Which of the following typically results from uterine surgery or dilation and curettage procedures? A) Synechiae B) Polycystic ovary syndrome C) Endometrial hyperplasia D) Submucosal leiomyoma

Synechiae

A 60-year-old female patient presents with elevated estrogen levels, ovarian tumor, ascites, and pleural effusion. What is the most likely diagnosis for the ovarian tumor? A) Meigs syndrome B) Thecoma C) Granulosa cell tumor D) Endometrioid tumor

Thecoma

Embryologically, which system develops at the same time as the uterus? A) Urinary tract B) Gastrointestinal tract C) Central nervous system D) Skeletal system E) Cardiovascular system

Urinary tract

Ovarian torsion is commonly associated with a coexisting: A) uterine mass B) hydrosalpinx C) adnexal mass D) ectopic pregnancy

adnexal mass

An asymptomatic 60-year-old patient presents with a history of breast cancer. She has been treated with tamoxifen therapy for the previous 3 years. On the basis of this clinical history, the sonographic findings are most suspicious for: A) a leiomyoma B) adenomyosis C) Asherman syndrome D) an endometrial polyp

an endometrial polyp

The ovary is most likely demonstrating a(n): A) pyosalpinx B) parovarian cyst C) benign neoplasm D) anatomical variant

anatomical variant

A patient presents with a history of multiple miscarriages. Her last menstrual period was 3 weeks earlier. On the basis of this clinical history, the sonogram is most suspicious for a(n): A) arcuate uterus B) septae uterus C) uterine didelphys D) bicornuate uterus

bicornuate uterus

A rapid increasing pelvic mass is most suspicious for a(n): A) leiomyoma B) cystadenoma C) endometrioma D) cystic teratoma

cystadenoma

A reproductive-age patient demonstrates a complex adnexal mass with diffusely bright internal echoes. These sonographic findings most likely describe a: A) dysgerminoma B) cystic teratoma C) hemorrhagic cyst D) cystadenocarcinoma

cystic teratoma

The most common ovarian malignancy occurring in childhood is a: A) fibroma B) thecoma C) dysgerminoma D) Brenner tumor

dysgerminoma

The adnexal mass is most likely a(n): A) endometrioma B) cystic teratoma C) hemorrhagic cyst D) ectopic pregnancy

endometrioma

Fixation of the ovaries posterior to the uterus is a sonographic finding associated with: A) adenomyosis B) endometriosis C) tuboovarian abscess D) pelvic inflammatory disease

endometriosis

Which of the following hormones reflects the activity of the ovaries? A) estradiol B) progesterone C) luteinizing hormone D) follicle-stimulating hormone

estradiol

Prominent endometrial echo complex may be seen due to all of the following except A) hydrometra B) ovarian granulosa cell tumor C) endometrial carcinoma D) endometritis

hydrometra

Which of the following vessels is also known as the hypogastric artery? A) ovarian a. B) internal iliac a. C) internal iliac v. D) external iliac a

internal iliac a.

A fibroid is sonographically indistinguishable from: A) leiomyosarcoma B) nabothian cyst C) adenomyosis D) endometrial carcinoma

leiomyosarcoma

Which of the following muscles abuts the lateral walls of the urinary bladder? A) ileopsoas B) piriformis C) levator ani D) obturator internus

obturator internus

Which of the following is a surface region located below the pelvic floor? A) mesentery B) omentum C) perineum D) peritoneum

perineum

It is common to visualize a small amount of free fluid in the: A) prevesical space B) space of Retzius C) retrouterine space D) vesicouterine space

rectouterine space

Which congenital uterine anomaly does not distort the normal contour of the fundus? A) septae B) unicornuate C) didelphys D) bicornuate

septae

Locations of uterine fibroids do not include: A) cervical B) submucous C) interstitial D) tubal

tubal

A 20-year-old patient presents with a history of severe pelvic pain and fever. Her last menstrual period was 3 weeks earlier, and urine pregnancy testing produced a negative result. Based on this clinical history, the sonographic findings are most suspicious for a(n): A) endometrioma B) ectopic pregnancy C) tuboovarian abscess D) carcinoma of the fallopian tube

tuboovarian abscess

Uterine fibroids are associated with: A) Infertility B) Menstrual irregularities C) Back pain D) Frequency E) All of the above

All of the above

Whenever you suspect pelvic ascites, you should: A) Have the patient void and then rescan B) Always check Morison's pouch C) Scan the liver D) A and B E) B and C

Always check Morison's pouch

To what, in the bladder, is the arrow pointing? A) Thickened bladder wall B) Debris within the bladder C) Anterior reverberation artifact D) Cystitis E) Bladder flap hematoma

Anterior reverberation artifact

What does this transverse image demonstrate? A) Normal proliferative uterus B) Calcified fibroid C) Endometrial polyps D) Internal endometriosis E) Bicornuate uterus

Bicornuate uterus

Which of the following is NOT considered a physiologic condition of the ovary? A) Corpus luteum cyst B) Theca lutein cyst C) Follicular cyst D) Polycystic ovaries E) Cystadenoma

Cystadenoma

An adolescent patient presents with a history of severe acute right lower quadrant pain. Her last menstrual period was 2 to 3 weeks earlier. Based on this clinical history, which of the following circles demonstrates the mostly likely cause of this patient's pelvic pain? A) A B) B C) C D) D

D

What is the most common benign ovarian tumor that results from the retention of an unfertilized ovum? A) Sebaceous cyst B) Dermoid C) Thecoma D) Granulosa cell tumor

Dermoid

All of the following are considered physiologic conditions of the ovary EXCEPT: A) Follicular cyst B) Corpus luteal cyst C) Dermoid cyst D) Theca lutein cyst E) Polycystic ovaries

Dermoid cyst

Which of these masses is considered malignant? A) Endometrioma B) Cystadenoma C) Dermoid D) Dysgerminoma E) Pyosalpinx

Dysgerminoma

What hormone in the female body stimulates cervical mucus production? A) Progesterone B) Testosterone C) Estrogen D) Estradiol E) Luteinizing hormone F) Follicular stimulating hormone

Estrogen

The structure visible within the bladder in the preceding longitudinal scan most likely represents a/an: A) Foley catheter B) Ureterocele C) Bladder diverticulum D) Bladder tumor E) Artifact

Foley catheter

All of the following symptoms are consistent with uterine fibroids EXCEPT: A) Nausea and vomiting B) Menorrhagia C) Back pain D) Urinary frequency E) Constipation

Nausea and vomiting

Which of the following is not considered a layer of the uterus? A) Perimetrium B) Serosa C) Endometrium D) Myometrium E) Parietalis

Parietalis

Follicle-stimulating hormone (FSH) is produced by the: A) Ovary B) Corpus luteum C) Hypothalamus D) Pituitary E) Thyroid

Pituitary

Human choriogonadotropin (hCG) is produced by the: A) Fetal liver B) Fetal kidneys C) Maternal ovaries D) Placenta E) Yolk sac

Placenta

What is the primary role of gonadotropin-releasing hormone? A) Stimulates release of hormones by the anterior pituitary gland. B) Regulates release of hormones by the hypothalamus. C) Restricts the release of hormones from the thalamus. D) Allows for communication between the hypothalamus and the thalamus.

Stimulates release of hormones by the anterior pituitary gland.

Failure of fusion of the Mullerian ducts can lead to the all of the following except A) bicornuate uterus B) uterus didelphys C) T-shaped uterus D) arcuate uterus

T-shaped uterus

Which statement is TRUE for an infantile uterus? A) The size and shape remains constant throughout life. B) The corpus and fundus are the most prominent portions of the uterus C) The cervix occupies most of the length of the uterine body until puberty. D) Pubertal changes cause the uterus to atrophy and the ovaries to enlarge. E) Transvaginal sonography is the best technique for visualization

The cervix occupies most of the length of the uterine body until puberty.

A patient 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 with the vaginal probe. What does this represent? A) Salpingitis B) PID C) Tubo-ovarian abscess D) Tubo-ovarian complex

Tubo-ovarian complex

What is the term used to describe fusion of the ovaries with dilated fallopian tubes? A) Tubo-ovarian complex B) Tubo-ovarian abscess C) Salpingitis D) Oophoritis

Tubo-ovarian complex

Which pelvic ligament provides posterior support to the uterus? A) Broad ligament B) Suspensory ligament C) Cardinal ligament D) Uterosacral ligament

Uterosacral ligament

When scanning the female pelvis to observe the ovaries, where will they never be located? A) Vesicouterine pouch B) Posterior cul-de-sac C) Rectouterine space D) Pouch of Douglas

Vesicouterine pouch

A blood test used to screen for ovarian cancer is A) BhCG B) estrodial level C) CEA D) CA-125

CA-125

Fertilization usually occurs: A) In the uterus B) In the cornua C) In the isthmus D) In the ampulla E) In the fimbria

In the ampulla

What is the expected blood flow pattern when performing Doppler of an endometrial carcinoma? A) Low impedance, low velocity flow B) High impedance, high velocity flow C) High velocity triphasic flow pattern D) Low velocity biphasic flow pattern

Low impedance, low velocity flow

Which malignant ovarian tumor is often associated with pseudomyxoma peritonei? A) Mucinous cystadenocarcinoma B) Serous cystadenocarcinoma C) Krukenberg tumor D) Androblastoma

Mucinous cystadenocarcinoma

What is the path of venous drainage from the left ovary? A) Ovarian vein - left renal vein - splenic vein - portal vein - liver - hepatic vein - inferior vena cava (IVC) B) Ovarian vein - external iliac vein - common iliac vein - IVC C) Ovarian vein - left renal vein - IVC D) Ovarian vein - internal iliac vein - common iliac vein - IVC

Ovarian vein - left renal vein - IVC

The most common site for an extrauterine adnexal mass is the: A) Ovary B) Fallopian tubes C) Cervix D) Broad ligament E) Fornix

Ovary

This longitudinal sonogram through the right lower quadrant of the same patient suggests: A) Ruptured ectopic B) Pelvic inflammatory disease C) Ruptured appendix D) Endometriosis E) Pelvic ascites

Pelvic ascites

The influence of the follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are required for normal oogenesis. These hormones are produced by the: A) Ovaries B) Adrenal glands C) Hypothalamus D) Thymus E) Pituitary gland

Pituitary gland

What structures make up the posterior boundary of the pelvic cavity? A) Sacrum and coccyx B) Ilium and pubic symphysis C) Ischium and pubic symphysis D) Ischium and sacrum

Sacrum and coccyx

In a patient complaining of pelvic pain, fever and an increased WBC, a complex adnexal mass would most likely represent: A) endometrioma B) pyosalpinx C) TOA D) teratoma

TOA

Large pelvic masses, whether benign or malignant, may cause_______ ; therefore the ______ should be evaluated also: A) Metastatic lesions, liver B) Gallstones, gallbladder C) Biliary obstruction, liver and biliary tree D) Portal-splenic hypertension, liver and spleen E) Urinary obstruction, kidneys

Urinary obstruction, kidneys

A patient presents with a history of irregular menses and a large pelvic mass. Based on this clinical history, the sonographic finding is most suspicious for: A) surface epithelial cyst B) a mucinous cystadenoma C) polycystic ovarian disease D) overstimulation syndrome

a mucinous cystadenoma

Which of the following structures produces small amounts of estrogen? A) spleen B) kidney C) kidney D) adrenal gland

adrenal gland

An anechoic mass contiguous with the posterior wall of the urinary bladder is most consistent with a(n): A) ureterocele B) hydroureter C) ovarian cyst D) bladder diverticulum

bladder diverticulum

The spiral artery provides the primary blood supply to which of the following pelvic structures? A) vagina B) ovaries C) endometrium D) fallopian tubes

endometrium

Abnormal accumulation of blood within the vagina is termed: A) hydrometra B) hematometra C) hydrocolpos D) hematocolpos

hematocolpos

A large cystic mass posterior and lateral to the uterus in a patient with a history of a previous pelvic infection is most suspicious for a(n): A) hydrosalpinx B) endometrioma C) paraovarian cyst D) corpus luteal cyst

hydrosalpinx

Risk factors associated with developing endometrial carcinoma include: A) anorexia, multiparity, hypertension B) obesity, diabetes mellitus, nulliparity C) hypertension, obesity, thyroid disease D) multiparity, thyroid disease, hormone replacement therapy

obesity, diabetes mellitus, nulliparity

Inflammation within the fallopian tube is termed: A) adnexitis B) salpingitis C) pyosalpinx D) hydrosalpinx

salpingitis

Which of the following most accurately describes the sonographic appearance of a peritoneal inclusion cyst? A) complex ovarian cyst B) large unilocular adnexal mass C) small cluster of ovarian cysts D) septated fluid collection surrounding an ovary

septated fluid collection surrounding an ovary

A small cluster of ovarian cysts is a common sonographic finding associated with: A) theca lutein cysts: B) cystadenocarcinoma C) surface epithelial cysts D) polycystic ovarian disease:

surface epithelial cysts

The ovary is attached to the pelvic sidewall by the: A) broad ligament B) round ligament C) ovarian ligament D) suspensory ligament

suspensory ligament

Failure of the miillerian ducts to fuse will most likely result in: A) uterine septae B) uterine agenesis C) bicornuate uterus D) uterine didelphys

uterine didelphys

The cornua of the uterus is located between the: A) corpus and fundus of the uterus B) corpus and cervix of the uterus C) uterine fundus and fallopian tube D) uterine corpus and fallopian tube

uterine fundus and fallopian tube

Partial fusion of the caudal Mullerian ducts will most likely result in an anomaly of the: A) uterus B) ovary C) vagina D) fallopian tube

uterus

Which of the following tumors is composed of germ cells and patients present with elevated alpha-fetoprotein? A) Endodermal sinus tumor B) Endometrioid tumor C) Krukenberg tumor D) Dysgerminoma

Endodermal sinus tumor

Which of the following statements is NOT true of the fallopian tubes? A) They lie within the broad ligament B) Fertilization usually occurs within the ampullary portion C) The tube provides nutrients for the ova D) Fallopian tubes are routinely imaged sonographically E) The fimbria communicates with the peritoneal cavity.

Fallopian tubes are routinely imaged sonographically

A patient presents with abnormal uterine bleeding. What is the most common cause? A) Hormone imbalances B) Fibroid tumors invading the endometrial cavity C) Endometrial cancer D) Hypothyroidism

Fibroid tumors invading the endometrial cavity

All of these statements about endometrioma are true EXCEPT: A) It is a malignant tumor of the endometrium. B) It is sometimes referred to as a "chocolate cyst." C) It is associated with endometriosis D) It will be adnexal in location E) It is usually asymptomatic

It is a malignant tumor of the endometrium.

Which potential space lies between the urinary bladder and the pubic symphysis? A) Pouch of Douglas B) Vesicouterine space C) Rectouterine space D) Space of Retzius

Space of Retzius

Which arteries in the uterus feed the functional layer of the endometrium? A) Arcuate arteries B) Spiral arteries C) Straight arteries D) Radial arteries

Spiral arteries

A 35-year-old patient presents with a history of urinary frequency and normal menstrual cycles. She denies any history of urinary tract infection or trauma. A sagittal image of the uterus demonstrates a hypoechoic mass (arrow). On the basis of this clinical history, the mass most likely represents a: A) hematoma B) leiomyoma C) cystic teratoma D) mucinous cystadenoma

leiomyoma

Which of the following ovarian abnormalities may contain skin and hair? A) dysgerminoma B) cystic teratoma C) granulosa cell tumor D) mucinous cystadenoma

cystic teratoma

Which segment of the fallopian tube connects with the uterus? A) ampulla B) isthmus C) interstitial D) infundibulum

interstitial

The fallopian tube divides into which of the following segments? A) fimbria, isthmus, cornua, ampulla B) isthmus, ampulla, cornua, interstitial C) ampulla, infundibulum, fimbria, isthmus D) interstitial, isthmus, ampulla, infundibulum

interstitial, isthmus, ampulla, infundibulum

The most common location for a uterine leiomyoma to develop is: A) serosal B) subserosal C) intramural D) submucosal

intramural

The innermost layer of the myometrium is termed the: A) basal zone B) functional zone C) junctional zone D) albuginea zone

junctional zone

The hypoechoic structure identified by the arrow most likely represents the: A) pelvis bone B) levator ani muscle C) piriformis muscle D) obturator internus muscle

obturator internus muscle

Which pelvic ligament extends from the cornua of the uterus to the medial aspect of the ovary? A) round B) broad C) cardinal D) ovarian

ovarian

An asymptomatic patient presents with a history of a palpable pelvic mass on physical examination. Based on this clinical history, the sonographic findings are most suspicious for a: A) hydrosalpinx B) corpus luteum C) parovarian cyst D) physiological cyst

parovarian cyst

Which of the following is a clinical symptom associated with this finding? A) menorrhagia B) dysmenorrhea C) pelvic fullness D) spontaneous abortion

pelvic fullness

The position of the uterus in this sagittal sonogram is termed: A) anteflexion B) levoflexion C) retroflexion D) retroversion

retroversion

A fibroid is most likely to cause irregular uterine bleeding in which location? A) cervical B) subserosal C) intramural D) submucosal

submucosal

The uterosacral ligament extends from the lateral margins of the sacrum to the: A) cornua B) superior cervix C) inferior fundus D) inferior vagina

superior cervix

A Garner cyst is located within the: A) uterus B) cervix C) vagina D) oviduct

vagina

The pelvis is divided into the true and false pelvis by the: A) iliac bones B) broad ligaments C) iliopectineal line D) iliopsoas muscles

iliopectineal line

Which of the following structures is not lined by the peritoneum? A) cervix B) ovary C) bowel D) oviduct

ovary

The arrows in this transverse image point to: A) Enlarged ovaries B) Benign cystic teratomas C) Kruckenburg's tumors D) Pelvic bones E) Iliopsoas muscles

Iliopsoas muscles

A premenarchal 13-year-old presents with a history of abdominal pain and a palpable pelvic mass. On the basis of this clinical history, the sonographic findings are most suspicious for: A) hematometra B) hematocolpos C) endometrioma D) hemorrhagic cyst

hematometra

What pelvic muscle is often mistaken for the bowel? A) Iliopsoas B) Obturator internus C) Levator ani D) Piriformis

Iliopsoas

The coronal sonogram most likely identifies: A) arcuate uterus B) didelphys uterus C) septae uterus D) bicornuate uterus

bicornuate uterus

The ligament which attaches the ovary to the lateral pelvic wall and transits the ovarian vessels is: A) broad ligament B) infundibulopelvic ligament C) ovarian ligament D) gubernaculum

infundibulopelvic ligament

All of the following statements about transvaginal sonography are true EXCEPT: A) Resolution is improved by use of higher frequencies B) Does not require a full bladder technique C) Can penetrate up to 12 cm depth D) Can identify an intrauterine pregnancy at 4-5 weeks. E) Is contraindicated in virginal patients.

Can penetrate up to 12 cm depth

Visualization of pelvic ligaments appears on sonography as: A) hypoechoic ovoid structures B) hyperechoic linear structures C) hyperechoic tubular structures D) hypoechoic tortuous structures

hyperechoic linear structures

Congenital uterine anomalies are associated with coexisting anomalies of the: A) ovaries B) kidneys C) oviducts adrenal glands

kidneys

What does the term dextroverted uterus describe? A) A uterus that tilts to the left. B) A uterus that tilts to the right. C) A uterus that tilts anteriorly. D) A uterus that tilts posteriorly.

A uterus that tilts to the right.

A hyperechoic focus within a mature follicle most likely represents a: A) morula B) cumulus C) blastocyst D) corpus albicans

cumulus

Which of the following is the most common benign ovarian neoplasm? A) fibroma B) cystoadenoma C) cystic teratoma D) endometrioma

cystic teratoma

Increased serum estrogen levels clinically can be associated with all of the following sonographic findings except: A) thickened endometrium B) ovarian mass C) multiple ovarian follicles D) hydrosalpinx

hydrosalpinx

Which of the following abnormalities is most likely a consequence of pelvic inflammatory disease? A) adenomyosis B) hydrosalpinx C) endometriosis D) parovarian cyst

hydrosalpinx

A patient presents with a history of a palpable pelvic mass. Additional questions show a history of pelvic infection following an appendectomy. She denies pelvic pain or fever. The anechoic area in this sonogram is most suspicious for a(n): A) hydroureter B) hydrosalpinx C) parovarian cyst D) external iliac vein

hydroureter

Which of the following describes the typical sonographic appearance of Asherman syndrome? A) diffuse uterine enlargement B) discrete hypoechoic myometrial mass C) inability to distinguish an endometrial cavity D) hypoechoic irregularity to the endometrial cavity

inability to distinguish an endometrial cavity

The left ovarian vein drains into the _________, and the right ovarian vein drains into the ________ A) left renal vein; IVC B) IVC; IVC C) right renal vein; left renal vein D) IVC, right renal vein

left renal vein; IVC

The most dependent recess in the body is the: A) anterior cul-de-sac B) Morison's pouch C) pouch of Douglas D) posterior vaginal fornix

pouch of Douglas

A patient presents with a history of right lower quadrant pain. Her last menstrual period was 7 days earlier. She denies contraceptive hormone therapy. On the basis of this clinical history, the anechoic mass most likely represents a: A) simple cyst B) graafian follicle C) corpus luteal cyst cserous cystadenoma

simple cyst

The most common location of a cystic teratoma is: A) lateral to the cervix B) anterior to the fundus C) superior to the fundus D) adjacent to the isthmus

superior to the fundus

Which of the following ovarian masses does not secrete hormones? A) arrhenoblastoma B) theca lutein cyst C) thecoma D) corpus luteum

theca lutein cyst

Which of the following ovarian neoplasms will most likely demonstrate posterior acoustic shadowing? A) fibroma B) thecoma C) dysgerminoma D) Brenner tumor

thecoma

A 25-year-old woman presents with high-grade fever, pelvic pain, and leukocytosis. An ill-defined, complex mass is identified in the left adnexa. Based on this clinical history, the sonographic finding is most suspicious for: A) salpingitis B) pyosalpinx C) endometritis D) tuboovarian abscess

tuboovarian abscess

Secondary blood supply to the ovaries is through the: A) arcuate arteries B) uterine arteries C) ovarian arteries D) hypogastric arteries

uterine arteries

A dermoid cyst contains tissues from the: A) Ectoderm B) Ectoderm and mesoderm C) Ectoderm and endoderm D) Ectoderm, mesoderm, and endoderm E) None of the above

Ectoderm

What part of the uterus enveloped by the vagina? A) External os of cervix B) Isthmus C) Internal os of cervix D) Coccygeus and piriformis

External os of cervix

A 43-year-old female complains of lower back pain and menorrhagia. Her history and this longitudinal image suggest A) Fibroid uterus B) Ovarian tumor C) Trophoblastic disease D) Adenomyosis E) Endometrial carcinoma

Fibroid uterus

A patient presents with abdominal swelling, low back pain, and an extremely elevated CA-125. These clinical findings suggest: A) Pregnancy B) Infection C) Hemorrhage D) Malignancy E) Findings are nonspecific

Malignancy

Which is NOT a part of the fallopian tube? A) Interstitial B) Isthmus C) Ampulla D) Infundibulum E) Piriformis

Piriformis

Sonographic appearance of ovarian carcinoma is generally described as a(n): A) irregular hypoechoic ovarian mass B) smooth hyperechoic ovarian mass C) irregular hypoechoic adnexal mass D) irregular hyperechoic ovarian mass

irregular hypoechoic ovarian mass

The muscles most frequently mistaken for enlarged ovaries are the: A) Obturator internus B) Piriformis C) Iliopsoas D) Levator ani E) Coccygeus

Piriformis

When measuring endometrial thickness, calipers are placed from: A) superior interface to inferior interface B) echogenic interface to echogenic interface C) echogenic interface to hypoechoic interface D) hypoechoic interface to hypoechoic interface

echogenic interface to echogenic interface

Metastatic lesions in the adnexa are more commonly associated with a primary malignancy of the: A) respiratory system B) genitourinary tract C) reproductive organs D) gastrointestinal tract

gastrointestinal tract

When a sonographer discovers a bicornuate uterus, which area should also be evaluated? A) lymph nodes B) liver C) kidneys D) fallopian tubes

kidneys

Which of the following pelvic muscles is routinely imaged on pelvic sonography? A) levator ani m. B) piriformis m. C) coccygeus m. D) quadratus lumborum m.

levator ani m.

A patient presents with lower abdominal pain and a palpable pelvic mass. A septated fluid collection surrounds a normal-appearing right ovary. The patient has a previous history of a ruptured appendix. Based on this clinical history, the sonographic finding is most suspicious for which of the following pathologies? A) endometriosis B) tuboovarian abscess C) mucinous cystadenoma D) peritoneal inclusion cyst

peritoneal inclusion cyst

What is the term used to describe the normal location of the ovaries? A) Adnexa B) Vesicouterine space C) Uterine fossa D) Rectouterine space

Adnexa

Postcoital means: A) After stimulation B) After pregnancy C) After childbirth D) After sexual intercourse E) After induction

After sexual intercourse

The most common location for a benign cystic teratoma is: A) Anterior and superior B) Posterior and inferior C) In the right adnexa D) In the left adnexa E) In the false pelvis

Anterior and superior

The structure mentioned above (arrow) is located in the: A) Posterior myometrium B) Anterior myometrium C) Fundus of the uterus D) Cervix of the uterus E) Isthmus of the uterus

Anterior myometrium

What path does arterial blood take to supply the uterus? A) Aorta - gonadal arteries - uterine arteries B) Aorta - common iliac arteries - internal iliac arteries - uterine arteries C) Aorta - common iliac arteries - external iliac arteries - uterine arteries D) Aorta - gonadal arteries - ovarian arteries - uterine arteries

Aorta - common iliac arteries - internal iliac arteries - uterine arteries

Which pelvic ligament is often demonstrated suspending the uterus in the pelvis when a patient presents with gross ascites? A) Broad ligaments B) Suspensory ligaments C) Cardinal ligaments D) Ovarian ligaments

Broad ligaments

Which pelvic ligaments are not true ligaments but are actually double folds of peritoneum? A) Cardinal ligaments and broad ligaments B) Broad ligaments and suspensory ligaments of the ovary C) Suspensory ligaments of the ovary and cardinal ligaments D) Cardinal ligaments, broad ligaments, and suspensory ligaments of the ovary

Broad ligaments and suspensory ligaments of the ovary

For Doppler evaluation of the uterine artery, insonation at the following level provides the best access to the vessel: A) Cervical B) Isthmus C) Cornual D) Body E) Fundal

Cervical

If you discover an ovarian cyst measuring 2.5 cm in a 23-year-old female, what finding would suggest to you that this cyst is a dominant follicle rather than a corpus luteum cyst? A) Cul-de-sac fluid B) Debris within the cyst C) Clean smooth walls D) Fibrinous strands within E) Thick walls

Clean smooth walls

A patient is taking oral contraceptives would not be expected to develop a: A) Follicular cyst B) Corpus luteal cyst C) Nabothian cyst D) Paraovarian cyst E) Gartner's duct cyst

Corpus luteal cyst

Which ovarian tumor presents with elevated serum lactate dehydrogenase and precocious puberty if it presents in a child? A) Androblastoma B) Endodermal sinus tumor C) Yolk sac tumor D) Dysgerminoma

Dysgerminoma

Which pelvic mass presents sonographically as a cystic mass with homogenous low-level internal echoes? A) Fibroma B) Brenner tumor C) Granulosa cell tumor D) Endometrioma

Endometrioma

What is the term used to describe inflammation of the endometrium? A) Endometritis B) Endometriosis C) Pyometra D) Cervicitis

Endometritis

What are the four major divisions of the uterus? A) Fundus, corpus, cervix, and vagina B) Fundus, corpus, isthmus, and cervix C) Fundus, body, corpus, and vagina D) Fundus, corpus, fallopian tubes, and cervix

Fundus, corpus, isthmus, and cervix

Which statement best describes Kruckenburg's tumor? A) It is a solid, benign tumor of the ovary B) It is a metastatic tumor from a GI tract primary C) It is a cystic malignant tumor of the uterus D) A and B E) B and C

It is a metastatic tumor from a GI tract primary

Which other organ(s) should be interrogated if uterine anomalies are demonstrated? A) Kidneys B) Liver C) Spleen D) Bladder

Kidneys

What ovarian neoplasm is a result of metastases of a gastrointestinal cancer? A) Sertoli-Leydig cell tumor B) Krukenberg tumor C) Mucinous cystadenocarcinoma D) Granulosa cell tumor

Krukenberg tumor

Which of the following ovarian tumors is associated with GI primary malignancy? A) dysgerminoma B) Krukenberg tumor C) Brenner tumor D) struma ovarii

Krukenberg tumor

Of the following, the most common benign tumor of the uterus is: A) Leiomyosarcoma B) Endometrioma C) Leiomyoma D) Adenomyosa E) Kruckenburg's

Leiomyoma

The arrow in this image is pointing to what most likely is a/an: A) Arcuate vessel B) Myometrial cyst C) Leiomyoma D) Artifact E) Endometrioma

Leiomyoma

Which part of the pelvic space contains the uterus and ovaries? A) False pelvis B) Lesser pelvis C) Linea terminalis D) Major pelvis

Lesser pelvis

In the same patient, evaluation of her right upper quadrant indicates: A) Normal liver B) Abdominal ascites C) Perihepatitis D) Metastatic liver disease E) Liver abscess

Metastatic liver disease

Which of the following conditions is associated with sexual ambiguity? A) Mixed gonadal dysgenesis B) Pure gonadal dysgenesis C) Testicular feminization D) Turner's syndrome E) Noonan's syndrome

Mixed gonadal dysgenesis

If a patient presents with free fluid in the pelvic spaces, where else should the sonographer interrogate? A) Morison pouch B) Pleural cavity C) Pericardial space D) Synovial cavity

Morison pouch

Which part of the female pelvis has a dual blood supply? A) Uterus B) Endometrium C) Fallopian tube D) Ovary

Ovary

Transvaginal evaluation reveals a large cyst in the adnexa that is separate from the ovary. It is unilocular and thin-walled. This most likely represents: A) Paraovarian cyst B) Theca lutein cyst C) Corpus luteum cyst D) Mesenteric cyst E) Cystadenoma

Paraovarian cyst

Anatomically, the uterus lies _________ to the urinary bladder and _________ to the rectum A) Lateral, medial B) Medial, lateral C) Anterior, posterior D) Superior, inferior E) Posterior, anterior

Posterior, anterior

This mass is located in which pelvic space? A) Space of Retzius B) Anterior cul-de-sac C) Pouch of Douglas D) Morison's pouch E) Fornix

Pouch of Douglas

Describe the position of the uterus from this sagittal transvaginal image. A) Dextroposed B) Levoposed C) Anteflexed D) Retroflexed E) Prolapsed

Retroflexed

In the same image, the position of the uterus is best described as: A) Anteflexed B) Retroflexed C) Dextroposed D) Levoposed E) Prolapsed

Retroflexed

What is the most common Müllerian duct abnormality? A) Septate uterus B) Bicornis bicollis C) Uterus didelphys D) Unicornuate uterus

Septate uterus

On a transverse image of the pelvis, a complex mass is seen displacing the anterior bladder wall posteriorly. This mass is located in the: A) Pouch of Douglas B) Uterovesical space C) Morrison's pouch D) Space of Retzius E) Anterior cul-de-sac

Space of Retzius

The lavator ani muscles are seen, transversely, at the same level as the: A) Ovaries B) Uterine corpus C) Cervix D) Vagina E) Iliac vessels

Vagina

A patient complains of right flank and right lower quadrant pain. Based on this clinical history the sonogram most likely demonstrates: A) an ureterocele B) a hydroureter C) a bladder diverticulum D) fluid-filled loop of bowel

a hydroureter

Multiparity is a risk factor associated with which of the following abnormalities? A) adenomyosis B) endometriosis C) nabothian cyst D) polycystic ovarian disease

adenomyosis

The vesicouterine pouch is located: A) posterior to the uterus and anterior to the rectum B) anterior to the uterus and posterior to the urinary bladder C) posterior to the symphysis pubis and anterior to the uterus D) anterior to the symphysis pubis and posterior to the rectus abdominis

anterior to the uterus and posterior to the urinary bladder

Multiple serpentine vascular structures within the myometrium in a patient complaining of abnormal bleeding following a recent dilation curettage procedure is most suspicious for which of the following abnormalities? A) adenomyosis B) endometriosis C) arteriovenous fistula D) Asherman syndrome

arteriovenous fistula

The most common anomaly caused by the failure of the Mullerian ducts to fuse is: A) bicornuate uterus B) arcuate uterus C) Gartner's duct cyst D) uterus didelphys

bicornuate uterus

Which part of the uterus is indicated by the arrow? A) Corpus B) Fundus C) Isthmus D) Cervix E) Vagina

Isthmus

Pelvic ascites and right-sided pleural effusions can be associated with benign ovarian fibromas. This condition is: A) Carcinoid syndrome B) Turner's syndrome C) Stein-Leventhal syndrome D) Meigs' syndrome E) Pseudosyndrome

Meigs' syndrome

What is the term used to describe a cyst located in the broad ligament? A) Follicular retention cyst B) Theca lutein cyst C) Paraovarian cyst D) Corpus luteal cyst

Paraovarian cyst

If a primary malignant process is suspected in the pelvis, one should also scan the: A) Liver and lymph nodes B) Lymph nodes and kidneys C) Kidneys and pancreas D) None of the above E) All of the above

All of the above

A sonogram demonstrates a simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent? A) Gartner duct cyst B) Nabothian cyst C) Vaginal leiomyoma D) Vaginal ganglion

Gartner duct cyst

Which of the following best describes the normal appearance of a normal ovary? A) <15 mL volume, hypoechoic to myometrium with multiple anechoic follicles B) >15 mL volume, hyperechoic to the myometrium with multiple anechoic follicles C) >4 cm maximal diameter with presence of peripheral follicles in string of pearls arrangement D) Hypoechoic, almond-shaped mass in adnexa with high impedance blood flow pattern RI > 2.0

<15 mL volume, hypoechoic to myometrium with multiple anechoic follicles

How can the sonographer distinguish a nabothian cyst from a cervical carcinoma? A) A cervical carcinoma will demonstrate a solid mass whereas a nabothian cyst will have all the characteristics of a simple cyst. B) Nabothian cysts never have internal echoes; however, a cervical carcinoma will always demonstrate internal echoes. C) Shadowing will always be demonstrated from a cervical carcinoma. D) A cervical carcinoma will always be wider than tall.

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

All of the following are solid tumors except: A) Thecoma B) Fibroma C) Brenner's tumor D) Cystadenoma E) Teratoma

Cystadenoma

Which of the following best describes the sonographic appearance of ovarian torsion? A) Enlarged, hypoechoic ovaries with complete absence of blood flow in an area of the ovary. B) Complete absence of blood flow in a small atrophic ovary. C) Diminished blood flow along with enlarged hypoechoic ovary with peripheral follicles. Trace-free fluid in contralateral adnexa

Diminished blood flow along with enlarged hypoechoic ovary with peripheral follicles.

Which of the following statements is TRUE of nabothian cysts? A) They are a common cause for infertility B) They predispose patients to develop cervical cancer C) They are benign, common, and frequently multiple D) They are uncommon in postmenopausal patients E) They are clinically significant and require immediate intervention

They are benign, common, and frequently multiple

The fallopian tubes extend from which part of the uterus? A) corpus B) fundus C) myometrium D) cornua

cornua

A 28-year-old patient presents with a sudden onset of right lower quadrant pain. Her last menstrual period was approximately 3 weeks earlier. A duplex sonogram demonstrates a hypoechoic ovarian mass (arrow) with peripheral blood flow. This is most suspicious for a(n): A) graafian follicle B) ectopic pregnancy C) corpus luteal cyst D) nondominant follicle

corpus luteal cyst

Female pseudohermaphroditism is most often caused by: A) Failure of the mullerian ducts to fuse B) Testicular feminization C) Ovarian masculinization D) Adrenal hyperplasia E) Pituitary imbalance

Adrenal hyperplasia

A 13-year-old female presents with lower abdominal pain and pressure. On the basis of this longitudinal image through the uterus you suspect: A) Hematocolpos B) Hematometracolpos C) Hematosalpinx D) Hematoma E) Hematoperitoneum

Hematometracolpos

This image of a patient who presents with right lower quadrant pain demonstrates: A) Fecaloma B) Appendix C) Pelvic kidney D) Hydrosalpinx E) Bowel gas

Hydrosalpinx

Which vessel provides the best landmark for localizing the ovary? A) Common iliac artery B) Internal iliac artery C) External iliac artery D) Internal iliac vein E) External iliac vein

Internal iliac artery

All of these statements about the broad ligament are true EXCEPT: A) It is not a true ligament B) It divides the true pelvis into anterior and posterior compartments C) The ovaries attach to the posterior surface. D) It is a major suspensory ligament for the uterus. E) It can be seen when there is pelvic ascites

It is a major suspensory ligament for the uterus.

Hypervascularity within the endometrium is a characteristic finding in: A) endometritis B) adenomyosis C) Asherman syndrome D) endometrial hyperplasia

endometritis

Free fluid is identified in which of the following pelvic recesses? A) prevesical space B) retropubic space C) retrouterine space D) vesicouterine space

retrouterine space

Which uterine position displays the fundus of the uterus anterior to the cervix? A) anteversion B) anteflexion C) retroversion D) retroflexion

anteflexion

In this sagittal sonogram, the uterus is lying in which of the following positions? A) anteversion B) retroflexion C) anteflexion D) retroversion

anteversion