Chapter 18 The Ovaries and Fallopian Tubes by Penny

The dominant follicle prior to ovulation is termed the: A. Graafian follicle B. corpus albicans C. corpus luteum D. medulla

A. Graafian follicle

The cystic mass commonly noted with a pregnancy is the: A. corpus luteum B. dermoid cyst C. dysgerminoma D. serous cystadenoma

A. corpus luteum

The most common benign ovarian tumor is the: A. cystic teratoma B. mucinous cystadenoma C. fibroma D. sertoli-leydig cell tumor

A. cystic teratoma

All of the following adnexal masses may appear sonographically similar to a uterine leiomyoma except: A. thecoma B. paraovarian cyst C. fibroma D. granulosa cell tumor

B. paraovarian cyst

Meigs Syndrome is associated with ovarian tumor? A. ovarian cystadenoma B. cystic teratoma C. Fibroma D. Yolk sac tumor

C. Fibroma

Hairlike projections within the fallopian tube are called: A. interstitia B. fimbria C. cilia D. peristalsis

C. cilia

After the graafian follicle ruptures, the remaining structure is termed the: A. Graafian remnant B. Corpus albicans C. corpus Luteum D. theca lutein cyst

C. corpus luteum

The most distal part of the fallopian tube is the: A. cornu B. fimbria C. interstital D. infundibulum

D. infundibulum

Predominantly cystic mass with low-level echoes that resembles the sonographic appearance of a hemorrhagic cyst and may demonstrate a fluid-fluid level

Endometrioma

Thecomas are most often bilateral. True or False

False

Benign ovarian masses that may be complicated by Meigs Syndrome (ascites and pleural effusion) and are not estrogen producing.

Fibroma

Hypoechoic solid mass with posterior attenuation; may mimic a pedunculated uterine leiomyoma

Fibroma

Ascites, pleural effusion in the presence of a benign ovarian fibroma

Meigs Syndrome

Clinical findings of follicular cysts?

asymptomatic pain associated with hemorrhagic and enlargement of cyst

What is the physiologic cyst that develops after ovulation has occured and due to the rupture of the graafian follicle and is responsible for producing progesterone?

corpus luteum cyst

The most common benign ovarian tumor is the?

cystic teratoma or dermoid cyst

Benign, blood-containing tumor that forms from the implantation of ectopic endometrial tissue

endometrioma (chocolate cyst)

hemorrhage from endometriosis forms into focal areas of blood tumors known as:

endometriomas

what do thecomas produce?

estrogen; patients have postmenopausal bleeding associated with unconstrained estrogen stimulation upon the endometrium

What are the sex cord-stromal tumors?

fibroma, granulosa cell tumors, thecoma

Theca lutein cysts are also visualized with:

gestational trophoblastic disease and ovarian hyperstimulation syndrome

What is the most common estrogenic tumor, most commonly found in postmenopausal patients but can also be found in younger patients?

granulosa tumors (sec cord-stromal tumor)

Corpus luteum is maintained due to?

hCG and pregnancy

Theca lutein cysts are associated with:

high levels of hCG

Sonographic Findings of Theca Lutein Cysts:

markedly elevated levels of hCG nausea and vomiting pain associated with hemorrhage, rupture, and ovarian torsion large, bilateral, multiloculated ovarian cystic masses

What is the term for removal of an ovarian cyst?

ovarian cystectomy

What does a dermoid plug produce?

posterior shadowing

What does a dermoid mesh produce?

produced by hair and will appear as numerous linear interfaces within the cystic area of the mass

What maintains the endometrium during early pregnancy?

progesterone produced by the CL cyst

Large and bilateral ovarian neoplams; anechoic lesion contains septations or/and papillary projections

serous cystadenoma

What is the largest and least common of the functional cysts?

theca lutein cysts

A benign ovarian sex cord-stromal tumor found most often in postmenopausal women and may be associated with Meigs syndrome?

thecoma

what is it called when the anterior portion of the mass is seen, while the greater part of the mass is obscured by shadowing?

tip of the iceberg dermoid/cystic teratoma

What age group are dermoids found in?

usually in those of reproductive age but can happen in postmenopausal patients

What is the size range of follicular cysts?

3-8 cm

The ovarian tumor associated with an elevated serum lactate dehydrogenase is the: A. dysgerminoma B. sertoli-leydig cell tumor C. androblastoma D. mucinous cystadenocarcinoma

A. dysgerminoma

A 55 year old patient presents to the ultrasound department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic sonogram reveals a large, multilocualted cystic mass with papillary projections. What is the most likely diagnosis? A. Serous cystadenocarcinoma B. cystic teratoma C. androblastoma D. dysgerminoma

A. serous cystadenocarcinoma

The malignant ovarian tumor with GI origin is the: A. Brenner tumor B. Krukenberg Tumor C. yolk sac tumor D. granulosa tumor

B. Krukenberg Tumor

The inner layer of the wall of the fallopian tube is the: A. muscular layer B. mucosal layer C. myometrial layer D. serosal layer

B. muscosal layer

Pus within the fallopian tube is termed: A. hematosalpinx B. pyosalpinx C. hydrosalpinx D. hemosalpinx

B. pyosalpinx

The ovarian cyst associated with gestational trophoblastic disease is the: A. corpus luteum cyst B. theca lutein cyst C. dermoid cyst D. paraovarian cyst

B. theca lutein cyst

Hysterosalpingography utilizes what substance for the visualization of the uterine cavity and fallopian tubes: A. saline B. x-ray dye C. water D. betadine

B. x-ray dye

transitional cell tumor most often small, solid, hypoechoic, unilateral tumors that may contain calcifications

Brenner tumor

Which of the following is the correct fomula for calculating ovarian volume? A. length x width x height x 0.6243 B. length x width x height x 0.3899 C. length x width x height x 0.5233 D. ovarian volume cannot be calculated

C. length x width x height x 0.5233

A 24 year old female patient presents tothe ER with severe LLQ pain, nausea, and vomiting. The sonographic examination reveals an enlarged ovary with no detectable Doppler signal. What is the most likely diagnosis? A. ovarian cystadenocarcinoma B. cystic teratoma C. ovarian torsion D. endometriosis

C. ovarian torsion

Which of the following is an estrogen-producing ovarian tumor? A. Brenner tumor B. fibroma C. thecoma D. Endometrioma

C. thecoma

During a pelvic sonogram you visualize a small cyst located adjacent to the ovary. What is the most likely etiology of this cyst? A. Dermoid cyst B. ovarian cystadenoma C. endometrioma D. Parovarian Cyst

D. Paraovarian cyst

The segment of the fallopian tube where fertilization typically occurs is the: A. cornu B. fimbria C. interstitial D. ampulla

D. ampulla

Which of the following is a tumor of ectopic endometrial tissue? A. Brenner tumor B. cystic teratoma C. yolk sac tumor D. endometrioma

D. endometrioma

The malignant ovarian mass that is associated with pseudomyxoma peritonei is the: A. dysgerminoma B. sertoli-Leydig cell tumor C. serous cystadenocarcinoma D. mucinous cystadenocarcinoma

D. mucinous cystadenocarcinoma

The ovarian cyst associated with distinctively elevated levels of hCG is the: A. corpus luteum cyst B. parovarian cyst C. Dermoid Cyst D. theca lutein cyst

D. theca lutein cyst

A patient with an ovarian mass presents with an elevated MSAFP. Which of the following would be most likely? A. ovarian fibroma B. ovarian thecoma C. cystic teratoma D. yolk sac tumor

D. yolk sac tumor

what are cystic teratoma/dermoid cyst composed of?

endoderm, mesoderm and ectoderm (germ cell tumors)

Sonographic Findings of a Thecoma?

hypoechoic, solid mass with posterior attenuation no posterior enhancment in large, may mimic a pedunculated leiomyoma

up to 50 cm in size; septations and papillary projections; not as often bilateral; internal debris secondary to the solid components of material contained within it

mucinous cystadenoma

What size can granulosa cell tumors reach?

40 cm and have malignant potential

The longest and most tortuous segment of the fallopian tube is the: A. fimbria B. ampulla C. Isthmus D. interstitial

B. ampulla

What is a follicular cyst that contains blood?

hemorrhagic cyst

The ovarian mass that contains fat, sebum, and teeth is the: A. cystic teratoma B. fibroma C. mucinous cystadenoma D. Yolk sac tumor

A. cystic teratoma

The fingerlike extensions of the fallopian tube are called: A. fimbria B. infundibulum C. cilia D. ampulla

A. fimbria

The short and narrow segment of the fallopian tube distal to the interstitial segment is the: A. ampulla B. fimbria C. infundibulum D. isthmus

D. isthmus

What are small cysts located adjacent to the ovary?

paraovarian cysts

When do corpus luteum cysts usually reslove during pregnancy?

16 weeks

Blood within the fallopian tube is termed: A. hydrosalpinx B. hematosalpinx C. pyosalpinx D. hemosalpinx

B. hematosalpinx

Normal ovarian flow is said to be: A. low resistant during menstruation and high resistant during the proliferative phase B. high resistant during menstruation and low resistant at the time of ovulation C. Low resistant D. High resistant

B. high resistant during menstruation and low resistant at the time of ovulation