Davies Questions Part 3

What is the anatomic orientation of the uterus to (1) the urinary bladder and (2) the rectum?

(1) posterior and (2) anterior

How soon after conception will pregnancy tests produce positive results?

1-2 weeks

If a patient relates a history of normal menses every 28 days, on which day of her cycle should ovulation occur?

14

In the absence of fertilization, the corpus luteum cyst should regress after:

14 days

The premenarcheal fundal-to-cervical ratio is typically:

1:2

Until ovulation, a dominant ovarian follicle grows at a rate of:

2-3 mm per day

A normal cervical length in a nulliparous women measures:

2.0-3.0 cm

Ovulation usually occurs when the dominant follicle reaches the follow size?

2.5 cm

Fertilization usually occurs how many hours after ovulation?

24-36 hours

The normal menstrual cycle occurs every:

28 days

One should be able to image a normal intrauterine gestational sac transabdominally when the 1st interenational reference preparation (1st IRP or FIRP) level for beta-hCG is equal to or greater than:

3600 mLU/ml

If the second international standard for beta-hCG is 2000, the first international reference preparation level would be?

4000

When monitoring the hormone levels during early pregnancy, you should see normal beta-hCG levels doubling every:

48 hours

Miss Crenshaw is 74 years old and is not taking hormones. Her endometrium should not measure more than?

5 mm

If a 30-year-old female is on day 8 of her menstrual cycle and she has normal regular periods, her endometrium will typically measure?

6-10 mm

Your patient is 21 years old and is a nulligravida. If her uterus is normal, her uterine length, width, and anteroposterior dimensions should measure approx?

7x4x3 cm

The endometrium of a patient receiving hormone replacement therapy would be considered abnormal if it measured more than:

8mm

In an infertility patient, what is the typical measurement of ovarian volume associated with a higher conception rate?

>3 cc

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

A

All of the following are sonographic signs of a tossed ovary in the pediatric patient EXCEPT: A. Low-resistance Doppler flow within the ovary B. Ovarian swelling with areas of infarction C. Free fluid in the pelvic D. Peripherally displace follicle E. Enlarged, hypoechoic ovary

A

All of the following could cause PID EXCEPT: A. Exposure to DES B. TORCH infections C. Ruptured appendix D. Tuberculosis E. Sexually transmitted disease

A

All of the following sonographic findings are associated with adenomyosis EXCEPT a/an: A. Asymmetrical enlarged uterus with focal subserosal mass B. Indistinct endometrial-myometrial interface C. Focal and diffuse bulkiness of the posterior uterine wall D. Focal cystic areas within the myometrium E. Heterogenous uterine myometrial texture

A

Diethylstilberstol DES is known to increase a patient's risk for all of the following EXCEPT: A. Multiple gestation B. Preterm labor C. Ectopic pregnancy D. Uterine malformations E. Cervical cancer

A

The menstrual cycle is influenced by all of the following EXCEPT: A. Adrenal glands B. Hypothalamus C. Pituitary D. Ovaries E. A and B

A

Which of the following conditions is the most common among pediatric patients? A. Pelvic inflammatory disease B. Cervical carcinoma C. Sarcoma botryoides D. Cystadenoma E. Endometriosis

A

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

A

Which of the following is TRUE about GIFT? A. GIFT is an abbreviation for gamete intrafallopian transfer B. GIFT has a higher incidence of success than in vitro fertilization (IVF) C. GIFT is an option for treating infertility only if both tubes are normal D. GIFT involves the use of donor eggs E. During a GIFT procedure the eggs are fertilized in a perti dish

A

Which of the following ovarian tumors would cause precocious puberty in a female child? A. Granulosa cell tumor B. Sertoli-leydig tumor C. Benign cystic teratoma D. Cystadenoma E. Arrhenoblastoma

A

Which of the following will alter the way the uterus is measured, requiring two longitudinal measurements instead of just one? A. Retroflexed uterus B. Retroverted uterus C. Anteverted uterus D. Involuted uterus E. Bicornuate uterus

A

Which of these masses is considered androgenic: A. Granulosa cell tumor B. Arrhenoblastoma C. Brenden tumor D. Fibroma E. Cystadenoma

A

Which of these patient is NOT a good candidate for a transvaginal exam? A. Patient with a large fibroid uterus B. Patient with a threatened abortion C. Patient with an adnexal mass D. Patient with a possible ectopic pregnancy E. Patient who is morbidly obese and postmenopasual

A

Which statement about postmenopausal ovaries is NOT true? A. They can always be identified transvaginally B. They should not exceed 8 cubic centimeters in volume each C. They can be recognized by the multiple echogenic foci within them D. They should measure less than 2 cm in their greatest dimension E. The incidence of ovarian cancer is higher in postmenopausal patients

A

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

A

The benign overgrowth of endometrial tissue into the myometrium is called:

Adenomyosis

Female pseudohermaphroditism is most often caused by:

Adrenal hyperplasia

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 cysts?

After dilatation and curettage

Whenever you suspect pelvic ascites, you should:

Always check Morrison's pouch

The term for "absence of menses" is:

Amenorrhea

The failure to ovulate is termed:

Anovulation

When the urinary bladder is empty, the uterus is normally:

Anteflexed

All of the following Doppler ultrasound findings can be associated with ovarian torsion EXCEPT: A. Ovarian enlargement B. Ovarian hyperemia C. Ovarian mass D. Absent ovarian parenchymal blood flow E. Hypoechoic ovary

B

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

B

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

B

Choose the statement that most accurately describes the anatomic relationship among the ureter, ovary, and iliac vessels: A. The ureter and iliac vessels are anterior to the ovary B. The ureter and iliac vessels are posterior to the ovary C. The ureter and iliac vessels are medial to the ovary D. The ureter is posterior to the ovary, and the iliac vessels are anterior E. The ureter is anterior to the ovary, and the iliac vessels are posterior

B

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

B

The advantages of transvaginal over transbadominal ultrasound when tracking follicular development include all of the following EXCEPT: A. Greater comfort B. Limited field of view C. No preparation D. Better resolution E. More precise information

B

The true pelvis includes all of the following structures EXCEPT: A. Fallopian tubes B. Bowel C. Bladder D. Uterus E. Ovaries

B

Using the 2nd international standard for beta-hCG, which of the following levels should allow us to see a normal intrauterine gestational sac transabdominally? A. 1200 B. 1800 C. 2500 D. 3000 E. 3600

B

Which method of birth control is most effective in preventing pregnancy? A. Progesterone-only pill B. Combination oral contraceptives C. Rhythm method D. Spermicidal foam E. Condoms

B

Which of the following patients is most likely to have a malignant adnexal mass? A. Teenager with complex solid mass showing calcifications B. Patient with a large, thick-walled cyst with multiple thick septations and free fluid C. Postmenopausal patient with thin-walled, unilocular fluid-filled mass D. Symptomatic patient with dilated pelvic vasculature E. Premenopausal patient with mass that measures less than 6 cm

B

Which of the following statements about diagnostic ultrasound imaging is correct? A. Sonography i an excellent method for imaging the bowel B. A cystic mass can be readily identified with sonography C. Contrast agents must be used to image soft tissue D. Ultrasound imaging can determine organ function and size E. Diagnostic ultrasound can differentiate benign from malignant tissue

B

Which of the following, when elevated produces a positive pregnancy test? A. Follicle-stimulating hormone (FSH) B. HCG C. AFP D. LH E. AFI

B

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

B

The most common cause of postmenopausal bleeding is:

Benign hyperplasia

All of the following are solid tumors EXCEPT: A. Brenden tumor B. Teratoma C. Cystadenoma D. Fibroma E. Thecoma

C

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

C

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

C

Which of the following disease processes should NOT be seen in the postmenopausal patient? A. Leiomyomas B. Endometrial carcinoma C. Endometriosis D. Ovarian cancer E. Endometrial hyperplasia

C

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

C

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

C

Which statement about the ovaries is TRUE: A. Most are malignant B. Most are solid C. Most are benign D. Most develop postmenopausally E. Most are seen in adolescents

C

Which statement is TRUE for an infantile uterus? A. The corpus and fundus are the most prominent portions of the uterus B. The size and shape remain constant throughout life 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

C

Nabothian cysts are found in the:

Cervix

The drug of choice MOST commonly used to induce ovulation is:

Clomiphene citrate

What is the official-asked procedure that may be performed by a gynecologist to visualize the cervix in more detail?

Colposcopy

A patient who is taking oral contraceptives would not e expected to develop a?

Corpus luteum cyst

Most common adnexal masses are:

Cystic and ovarian in origin

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

D

Which of the BEST describes a granulosa cell tumor? A. Androgenic B. Estrogenic C. Androgenic and benign D. Benign and estrogenic E. Benign

D

Which of the following are considered symptoms of endometriosis? A. Menorrhagia and cyclic pain B. Menorrhagia, dysmenorrhea, and dyspareunia C. Dysmenorrhea and dyspareunia D. Menorrhagia, dysmenorrhea, and cyclic pain E. Menorrhagia and dysmenorrhea

D

Which of the following conditions is associated with sexual ambiguity? A. Tuner syndrome B. Pure gonadal dysgenesis C. Testicular feminization D. Mixed gonadal dygenesis E. Nooan syndrome

D

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

D

Which of the following is considered the most common gynecological malignancy in the United States? A. Cervical B. Tubal C. Ovarian D. Endometrial E. Bladder

D

Which of the following statements is TRUE for postmenopausal patients? A. Uterine size and echogenicity increase with age B. Endometrial cancer is the most common cause of postmenopausal bleeding C. Hormone replacement therapy decreases one's chances of developing endometrial cancer D. Endometrial fluid collections are common E. Postmenopausal ovaries frequently exhibit follicles

D

In relation to the central endometrial stripe, the endometrial echo appears somewhat hypoechoic:

During the periovulatory stage of the menstrual cycle

All of th following are characteristics associated with true precocious puberty EXCEPT: A. Childhood obesity B. Increase in ovarian volume C. Appearance of secondary sexual characteristics D. Uterine enlargement E. Unchanged fundal:cervical ratio

E

Of the following statements, which is TRUEST for postmenopausal patient: A. The ovaries become more prominent than the uterine corpus B. The endometrium becomes calcified C. The uterus becomes hypoechoic and globular D. The uterus undergoes autohysterectomy E. The uterus decreases i size and is infantile in appearance

E

Of the following, the most common benign tumor of the uterus is a/an: A. Endometrioma B. Krunkenberg tumor C. Leiomyosarcoma D. Serotonin-Leydig tumor E. Leiomyoma

E

Uterine leiomyomas (fibroids) are associated with: A. Infertility B. Back pain C. Frequent urination D. Menstrual irregularities E. All of the above

E

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

E

Which of these agents is NOT considered satisfactory for use as a disinfectant for the vaginal transducer? A. Cider B. Transeptic C. Sporicidin D. Bleach E. Betadine

E

Which of these conditions would cause infertility? A. Tubal damage B. Ovulatory failure C. Endometriosis D. Sperm failure E. All of the above

E

Which of these statements is NOT true of endometriosis? A. There is a hereditary predisposition B. It is more common among Caucasians C. It is more common among women who have delayed childbearing D. Symptoms are cyclic E. It is associated with multi parity

E

A "dermoid" cyst typically contains tissues originating from:

Ectoderm, mesoderm, and endoderm

A benign (mature) cystic teratoma may contain tissues from:

Ectoderm,mesoderm, endoderm

If a postmenopausal patient is asymptomatic and fluid is identified within her endometrial cavity, the most likely cause of the fluid is:

Endometrial atrophy

Sonohysterography is a common procedure used to determine some cause of infertility, including:

Endometrial polyps

The medical term for a chocolate cyst is:

Endometrioma

It is estimated that up to 20%-50% of women with the following problem will have trouble conceiving:

Endometriosis

Endometrial proliferation is stimulated by:

Estrogen

What hormone in the female body stimulate cervical mucus production?

Estrogen

In vitro fertilization:

Facilities retrieval of many oocytes

Perihepatitis can be associated with PID, causing right upper quadrant tenderness and pain. This condition is called:

Fits-Hugh-Curtis syndrome

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

Graafian follicle

In infertility patients, a hormone used to trigger ovulation is:

HCG

A patient who has taken oral contraceptives for more than 5 years is at increased risk for?

Hepatic adenoma

Doppler waveforms of the uterine arterial flow typically show:

High velocity, high resistance pattern

Androgenic tumors, such as sertoli-leydig cell tumors, cause:

Hirsutism

What is the invasive x-ray test used to visualize the uterus and Fallopian tubes?

Hysterosalpingography

Endometrial polyps are most easily seen and best demonstrated by:

Hysterosonography

Fertilization usually occurs:

In the ampulla

The beat-hCG titers associated with an ectopic pregnancy:

Increase to a point and then plateau

DES was prescribed to pregnancy women from the 1940's to the 1960's to:

Inhibit spontaneous abortion

The endometrium can be defined as the:

Inner mucosal later of the uterus

Which vessel provides the best landmark for localizing the ovary?

Internal iliac artery

Which part of the uterus is the least distinctive part?

Isthmus

What is the orientation of the iliac vessels to the ovaries?

Lateral

What anatomic region should be assessed in order to perform a Doppler examination on the uterine artery?

Lateral to the cervix

A 52-year-old female presents as postmenopausal for 5 years G4P4. Her uterus is enlarged upon palpation and is irregular in contour. You suspect?

Leiomyoma

If a primary malignant process is suspected in the pelvis, one should also scan the:

Liver, lymph nodes, kidneys and pancreas

On color Doppler sonography, most malignant ovarian tumors yield flow signals that are best characterized as:

Low-impedance

Doppler waveforms of arterial flow in the dominant ovary in a premenopausal women typically show:

Low-velocity, low-resistance pattern

The hormone responsible for inducing ovulation during the normal menstrual cycle is:

Lutenizing hormone

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

Malignancy

Pelvic ascites and right sided pleural effusions can be associated with benign ovarian fibromas. This conditions is known as?

Meigs syndrome

The onset of the first menstruated cycle is known as:

Menarche

The normal cessation of menses is called:

Menopause

The term that refers to mid-cycle or ovulation pain is:

Mittelschmerz

Embryologically which ducts fuse to form the uterus, vagina, and Fallopian tubes?

Mullerian

Bicornuate uterus is a congenital malformation that results from incomplete fusion of the:

Müllerian ducts

Stein-Leventhal syndrome is characterized by:

Obesity, hirsutism, and infertility

Which group of muscles form the lateral pelvic sidewalls?

Obturator internus

An ovarian tumor associated by pelvic ascites usually suggests malignancy. An exception to this rule would be ascites associated with:

Ovarian fibroma

The most common site for extrauterine adnexal mass is the:

Ovary

In the female, circulating testosterone is derived mostly from:

Ovary and adrenal gland

Fits-Hugh-Curtis syndrome is associated with:

PID

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:

Paraovarian cyst

Follicle-stimulating hormone (FSH) is produced by the:

Pituitary gland

The influence of the follicle-stimulating hormone (FSH) and lutenizing hormone (LH) is required for normal oogenesis. These hormones are produced by the:

Pituitary gland

HCG is produced by the:

Placenta

The muscles more frequently mistaken for enlarged ovaries are the:

Priformis

The hormone mostly responsible for premenstrual symptoms and those of early pregnancy is:

Progesterone

How would you characterize the endometrium of a 24-year-old patient at day 14 of her menstrual cycle?

Proliferative

The endometrium is its thinnest at the beginning of the:

Proliferative phase

In the evaluation of pelvic pathology, color Doppler may be used to determine?

Resistivity indices

Fits-Hugh-Curtis syndrome consists of:

Right upper quadrant pain and PID

The phase of the menstrual cycle following ovulation is referred to as the:

Secretory phase

Snographically, how will the uterus of a nulliparous female appear compared to that of a multiparious female?

Smaller

On a transverse image of the pelvis, a complex mass is seen displacing the anterior bladder wall posterior you. This mass is located in the:

Space of retzuis

How does the second international standard for beta-hCG (2nd IS) relate to the first international reference preparation level (FIRP)?

The 2nd IS is one-half of FIRP

What is the appearance of the ovaries in a patient who has had bilateral scalping-oophorectomy?

The ovaries are not visualized in this patient

The normal endometrium of a postmenopausal patient is usually:

Thin and smooth

The most common cause of gonadal dysgenesis is:

Tuner syndrome

Whether benign or malignant, what can large pelvic masses cause, and therefore what should also be evaluated?

Urinary obstruction; kidneys

Embryologically, which system develops at the same time as the uterus?

Urinary tract

Which vessel of the female pelvis is best interrogated at the level of the cervix?

Uterine artery

A gartner's duct cyst is found in the:

Vagina

The levator ani muscles are seen, transversely, at the same level as:

Vagina

The potential space around the cervix is called the:

Vaginal fornix

The most common complication related to pharmaceutical stimulation of follicular growth laparoscopically or transcervically is:

ZIFT

Immediately after the ovum has been fertilized, it is known as the:

Zygote

What lab value is compared to the ultrasound findings to determine when the ovary is ready to ovulate?

estradiol

What is the most common procedure for determining if Fallopian tubes have been compromised during some event, causing infertility?

hysterosalpingography

Hypogastric artery is another name for the:

internal iliac artery

The floor of the pelvis is formed by the:

levator ani muscles

Your patient has a suspicious adnexal neoplasm. To assist in ruling out metastasis, you scan the:

lymph nodes

If a 24-year-old female shows a multilayered endometrium measuring 8 mm, she is probably:

mid-cycle