OB Review CH. 16-20

Which of the following is a transitional cell tumor that often resembles a uterine fibroid?

Brenner tumor

The endometrial cavity is contiguous with which other part of the female pelvis?

Fallopian tube lumen

What is the sonographic appearance of the proliferative endometrium?

Hypoechoic thin echogenic line 3 to 7 mm

What is the cause for increased risk of coronary artery disease and osteoporosis after menopause?

Lack of circulating estrogen in the blood

A 49-year-old female patient presents w/ symptoms of night sweats, dyspareunia, hot flashes, and a decrease in libido. What is the most likely cause?

Menopause

What is the typical sonographic appearance of an endometrium for a patient taking tamoxifen?

Normal appearing endometrium unless endometrial hyperplasia results

What does precocious puberty describe?

Onset of puberty prior to age 8

What is the most common indication for performing postmenopausal sonography?

Postmenopausal bleeding

Where is free fluid most likely to collect in the female pelvis?

Pouch of douglas

What is the most common cause of secondary amenorrhea?

Pregnancy

Which of the following exams would require surgical asepsis to be practiced?

Sonohysterogram

Which potential space lies between the urinary bladder and the pubic symphysis?

Space of Retzius

What days of the menstrual cycle correlate w/ the menstrual phase?

1 to 5

What is the normal cervix:uterus ratio in a prepubertal female?

2:1

What is the average age for climacteric to occur?

51

How can the sonograher distinguish a nabothian cyst from a cervical carcinoma?

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

What does the term dextroverted uterus describe?

A uterus that tilts to the right

What path does arterial blood take to supply the uterus?

Aorta, common iliac arteries, internal iliac arteries, uterine arteries

A patient presents with monthly symptoms of menstruation but does not have any bleeding. What is the term used to describe this condition?

Cryptomenorrhea

What is the most common benign ovarian tumor that results from the retention if an unfertilized ovum?

Dermoid

What causes menses to start?

Drop in estrogen and progesterone

A 75-year old patient presents w/ vaginal bleeding. Previous ultrasound was negative for any structural abnormalities and she is not taking HRT. Endometrial thickness was 17 mm. What is the most likely cause for the bleeding?

Endometrial hyperplasia

What is the main risk associated w/ estrogen hormone replacement therapy(HRT)?

Endometrial hyperplasia and endometrial carcinoma

Which pelvic mass presents monographically as a cystic mass with homogenous low-level internal echoes?

Endometrioma

What layer of the endometrium is shed every month during menstruation?

Functional layer

What are the four major divisions of the uterus?

Fundus, corpus, isthmus, and cervix

How would you describe the echo texture of the normal uterus?

Homogenous

Which other organ(s) should be interrogated if uterine anomalies are demonstrated?

Kidneys

What part of the pelvic space contains the uterus and ovaries?

Lesser pelvis

Weakness in which of the following muscles leads to prolapse of the uterus?

Levator ani

Which of the following is a false statement with respect to differentiating the appearance of a leiomyosarcoma from that of a leiomyoma?

Only leiomyosarcoma will be singular

Which disorder presents with leukocytosis?

Pelvic inflammatory disease

What is responsible for the development of follicles on the ovaries?

Release of follicle-stimulating hormone by the anterior pituitary gland

What is the primary role of gonadotropin-releasing hormone?

Stimulates release of hormones by the anterior pituitary gland

Which uterine arteries can be demonstrated in the periphery of the uterus in a multigravida patient?

Straight arteries

What does menstruation cease at menopause?

The ovaries stop producing estrogen and progesterone which halts the cycle

Which of the following noninvasive procedures has a 90% accuracy rate for detecting uterine malformations?

3D sonography

What parts of the female pelvis define the vesicouterine space?

Anterior surface of the uterus and posterior surface of the bladder

What are the two phases of the ovarian cycle?

Follicular and luteal

What happens to the dominant follicle during the luteal phase?

It becomes the corpus luteum, produces progesterone, preparing the endometrium for implantation

Which pelvic muscles supply support to the pelvic organs?

Levator ani and coccyges

What is the definition of primary amenorrhea?

Menarche has not occurred by age 16 in a female patient

If a patient presents with free fluid in the pelvic spaces, where else should the monographer interrogate?

Morisons pouch

Which part of the female pelvis has a dual blood supply?

Ovary

Which term is used to describe a cyst located in the broad ligament?

Paraovarian cyst

What is the most common Müllerian duct abnormality?

Septate uterus

Which of the following is a true statement w/ respect to fallopian tubes?

The fallopian tube is usually only identified if there is an obstruction and it is distended w/ fluid

What is the most common cause of nosocomial infection?

Urinary tract infection from poor catheter care

Which pelvic ligament provides posterior support to the uterus?

Uterosacral ligament

On sonographic examination, two cervical canals are identified with separate right and left uterine horns. Which uterine malformation is demonstrated?

Uterus didelphys

What is the term used to describe the normal location of the ovaries?

Adnexa

What is the cause of adenomyosis?

Basal layer endometrial tissue invades the myometrium

What is the most likely cause of postmenopausal bleeding when the endometrial thickness measurement is <5 mm?

Endometrial atrophy

What is the term used to describe the inner layer of there uterine wall?

Endometrium

A sonogram demonstrates a simple cystic mass altering the contour of the vagina and bladder. What does this most likely represent?

Gartner duct cyst

What causes the endometrium to become thicker in the first phase of the menstrual cycle?

Increased estrogen levels

What is the path of venous drainage from the right ovary?

Ovarian vein, internal iliac vein, common Lilian vein, IVC

What is the path of venous drainage from the left ovary?

Ovarian vein, l. renal vein, IVC

Which pelvic muscle group is most often mistaken for ovaries?

Piriformis

A patient presents w/ a history of hirsutism, amenorrhea, and enlarged ovaries. What should the sonographer be looking for on the exam?

Polycystic ovary

If a patient has menstrual cycles that are 17 days apart, what would you describe this as?

Polymenorrhea

When scanning the female pelvis to observe the ovaries, where will they never be located?

Posterior cul-de-sac

What structures make up the posterior boundary of the pelvic cavity?

Sacrum and coccyx

Which arteries in the uterus feed the functional layer of the endometrium?

Spiral arteries

A patient presents with an enlarged bulky uterus and menorrhagia. Which of the following is most likely to be the cause?

Submucosal leiomyoma

Which of the following can result in endometrial hyperplasia?

Tamoxifen therapy

What signals the corpus luteum to continue to produce progesterone when a fertilized egg is approaching the endometrium?

The syncytiotrophoblast cells produce hCG which keeps the corpus luteum producing progesterone

What pelvic muscle is often mistaken for the bowel?

iliopsoas

Which of the following patients has an increased risk for developing endometrial hyperplasia?

Breast cancer patient taking tamoxifen

A patient presents with mittelschmerz. Sonography demonstrated a small amount of free fluid in the right adnexa. What is the likely cause?

Ovulation

Which of the terms describes a straight uterus that tilts forward in the body forming a 90˚ angle with the vagina?

Anteverted

Which pelvic ligament is often demonstrated suspending the uterus in the pelvis when a patient presents with gross ascites?

Broad ligaments

What part of the uterus enveloped by the vagina?

External os of cervix

A patient presents with amenorrhea, cyclic abdominal pain, and an enlarged uterus. Sonography demonstrates hydrometrocolpos. What is the most likely cause?

Imperforate hymen

Which pelvic ligaments are not true ligaments but are actually double folds of peritoneum?

Broad ligaments and suspensory ligaments of the ovary

During which phase of the menstrual cycle is the endometrium at its thickest?

Secretory phase

Which of the following best describes the normal appearance of a normal ovary?

Hypo echoic, almond-shaped mass in adnexa w/ high impedance blood flow pattern RI > 2.0

Why is it important to document the type of hormone replacement a patient is taking prior to completing their sonogram?

Normal endometrial thickness measurements will vary depending on the type of HRT used

Which of the following best describes a uterus that has two separate endometrial canals but a single cervix?

Septate uterus