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
