Wek 6 Quiz

Which of the following noninvasive procedures has a 90% accuracy rate for detecting uterine malformations? Saline infusion sonohysterography Sonohysterography Hysterosalpingography 3D sonography

3D sonography

A 77-year-old nulliparous patient presents with abnormal uterine bleeding. She has a history of taking estrogen-based HRT. Biopsy was performed and demonstrated an endometrial malignancy. What is the most likely diagnosis? Adenocarcinoma of the endometrium Endometrial hyperplasia Granulossa cell tumor Stein-Leventhal syndrome

Adenocarcinoma of the endometrium

What is the term used to describe the normal location of the ovaries? Adnexa Vesicouterine space Uterine fossa Rectouterine space

Adnexa

What parts of the female pelvis define the vesicouterine space? Anterior surface of the uterus and posterior surface of the bladder Posterior surface of the uterus and anterior surface of the rectum Anterior surface of the bladder and anterior surface of the pubic symphysis Anterior surface of the uterus and anterior surface of the bladder

Anterior surface of the uterus and posterior surface of the bladder

An infertility patient presents with hypomenorrhea. Sonohysterography demonstrates endometrial septations. What is this most indicative of? Endometrial polyps Asherman syndrome Adenomyosis Endometritis

Asherman syndrome

Which of the following patients has an increased risk for developing endometrial hyperplasia? Patient with early menarche Breast cancer patient taking tamoxifen Pregnant patient Patient with yolk sac tumor

Breast cancer patient taking tamoxifen

Which of the following is a transitional cell tumor that often resembles a uterine fibroid? Brenner tumor Fibroma Thecoma Granulosa cell tumor

Brenner tumor

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

Broad ligaments

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

Cryptomenorrhea

Which of the following best describes the sonographic appearance of ovarian torsion? Enlarged, hypoechoic ovaries with complete absence of blood flow in an area of the ovary. Complete absence of blood flow in a small atrophic ovary. 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.

What causes menses to start? Drop in estrogen and progesterone Increase in estrogen Decrease in progesterone Increase in follicle-stimulating hormone

Drop in estrogen and progesterone

Patients undergoing gamete intrafallopian tube transfer have increased risk for which of the following? Endometrial hyperplasia Ectopic pregnancy Asherman syndrome Fitz-Hugh-Curtis syndrome

Ectopic pregnancy

What is a possible complication of salpingitis due to PID? Multiple gestations Retained products of conception Pleural effusion Ectopic pregnancy

Ectopic pregnancy

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

Endodermal sinus tumor

A sonohysterogram demonstrated a mass projecting into the endometrium with a defined stalk. What is demonstrated? Endometrial polyp Submucosal fibroid Endometrial carcinoma Endometrial diverticulum

Endometrial polyp

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

Endometrioma

A patient presents with an elevated CA-125 level, however, upon close examination, no cancers can be demonstrated. What is another cause of an elevated CA-125 level in a perimenopausal woman? Endometrial hyperplasia Endometrial polyp Ovarian fibroma Endometriosis

Endometriosis

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

Fibroid tumors invading the endometrial cavity

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

Gartner duct cyst

What is the typical cause of dysfunctional uterine bleeding? Hormonal imbalances resulting in endometrial changes Idiopathic Uterine fibroids Cervical polyps

Hormonal imbalances resulting in endometrial changes

Which of the following causes of abnormal uterine bleeding is most likely to result in hypomenorrhea? Endometrial polyps Hypothyroidism Adenomyosis Uterine fibroids

Hypothyroidism

What pelvic muscle is often mistaken for the bowel? Iliopsoas Obturator internus Levator ani Piriformis

Iliopsoas

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

Imperforate hymen

Endovaginal sonography is contraindicated for which of the following patient populations? Postmenopausal women Perimenopausal women Infants and children Women of childbearing age

Infants and children

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

It produces estrogen.

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

Krukenberg tumor

Why do endovaginal transducers utilize higher frequency ranges than transabdominal transducers? Less penetration is required as structures are closer to the transducer. Greater penetration and higher resolution are required to image the structures closer to the transducer. Greater penetration is required as structures are further away from the transducer. Lower resolution is required as structures are closer to the transducer.

Less penetration is required as structures are closer to the transducer.

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

Morison pouch

Which malignant ovarian tumor is often associated with pseudomyxoma peritonei? Mucinous cystadenocarcinoma Serous cystadenocarcinoma Krukenberg tumor Androblastoma

Mucinous cystadenocarcinoma

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

Onset of puberty prior to age 8

Which of the following pathologies is most likely to be demonstrated in a 12-year-old female patient? Ovarian torsion Ectopic pregnancy PCOS Pelvic inflammatory disease

Ovarian torsion

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

Ovarian vein - left renal vein - IVC

Which part of the female pelvis has a dual blood supply? Uterus Endometrium Fallopian tube Ovary

Ovary

What normal anatomic variant may be demonstrated on a pelvic sonogram? Hydronephrosis Ascites Free fluid in the posterior cul-de-sac Pelvic kidney

Pelvic kidney

In which of the following situations would 3D sonography be most beneficial when imaging the female pelvis? To demonstrate endometrial thickness in a postmenopausal patient with a very thin endometrium. To accurately demonstrate the presence of free fluid. To accurately diagnose ectopic pregnancy. Provide accurate representation of the location of an intrauterine contraceptive device.

Provide accurate representation of the location of an intrauterine contraceptive device.

What is the most common Müllerian duct abnormality? Septate uterus Bicornis bicollis Uterus didelphys Unicornuate uterus

Septate uterus

An asymptomatic patient presents with bilateral large anechoic lesions that contain septations and papillary projections. What does this most likely represent? Cystic teratoma Endometrioma Mucinous cystadenoma Serous cystadenoma

Serous cystadenoma

Which of the following conditions is characterized by amenorrhea, hirsutism, and obesity? Stein-Leventhal syndrome Endometriosis Bicornuate uterus Asherman syndrome

Stein-Leventhal syndrome

Which uterine arteries can be demonstrated in the periphery of the uterus in a multigravida patient? Spiral arteries Ascites Radial arteries Straight arteries

Straight arteries

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

Synechiae

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? Salpingitis PID Tubo-ovarian abscess Tubo-ovarian complex

Tubo-ovarian abscess

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

Tubo-ovarian complex

Which pelvic ligament provides posterior support to the uterus? Broad ligament Suspensory ligament Cardinal ligament Uterosacral ligament

Uterosacral ligament

What is the most likely explanation for abnormal uterine bleeding with an endometrial measurement of <5 mm in a postmenopausal patient? Endometrial hyperplasia Endometrial cancer Submucosal fibroids Endometrial atrophy

Endometrial hyperplasia

Which of the following exams would require surgical asepsis to be practiced? Transvaginal exam Sonohysterogram Transabdominal exam Infertility scan

Sonohysterogram

A 30-year-old patient presents with intermenstrual bleeding. Transvaginal ultrasound reveals a mass within the endometrial canal. What test can be used to further differentiate the mass? Hysterosalpingogram Sonohysterogram with color Doppler Endometrial biopsy Transrectal sonogram

Sonohysterogram with color Doppler

What is the typical sonographic appearance of an endometrium for a patient taking tamoxifen? Thickened heterogeneous endometrium with cystic changes Thin atrophic endometrium Normal appearing endometrium unless endometrial hyperplasia results Focal endometrial thickening with cystic changes

Thickened heterogeneous endometrium with cystic changes

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

Uterus didelphys

What is the cause of adenomyosis? Functional layer endometrial tissue invades the myometrium Basal layer endometrial tissue invades the myometrium Tiny areas of leiomyoma tissue form in the myometrium Development of arteriovenous malformations in the myometrium

Basal layer endometrial tissue invades the myometrium

Why are assisted reproduction patients prone to ovarian hyperstimulation syndrome? They have elevated human chorionic gonadotropin levels from ovulation induction. Very high levels of estrogen and progesterone induce hyperstimulation of the ovaries. Elevated levels of follicle-stimulating hormone cause the ovaries to overproduce follicles enlarging the ovaries. Theca lutein cysts occur due to elevated levels of estrogen.

They have elevated human chorionic gonadotropin levels from ovulation induction.

Which of the following is a possible complication of introduction of intrauterine contraceptive devices? Spontaneous abortion Ectopic pregnancy Perforation of the myometrium Asherman syndrome

Perforation of the myometrium

How can the sonographer 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. Nabothian cysts never have internal echoes; however, a cervical carcinoma will always demonstrate internal echoes. Shadowing will always be demonstrated from a cervical carcinoma. 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.

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

Dysgerminoma

Which of the following presents on ultrasound with an entrance and exit echo (from reverberation)? Synechiae Intrauterine contraceptive device Scarring Endometrial polyp

Intrauterine contraceptive device

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

Low impedance, low velocity flow

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

Only leiomyosarcoma will be singular.

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

Ovarian vein - IVC

What is the most effective method for preventing the spread of disease in the clinical setting? Proper handwashing Sterilization of equipment between each patient Reverse ventilation in all scan rooms Use of gloves for each patient

Proper handwashing

What term is used to describe fluid in the peritoneal cavity that contains septations, debris, and membranous components? Pleural effusion Meigs syndrome Pseudomyxoma peritonei Ascites

Pseudomyxoma peritonei

A 25-year-old patient presented with hirsutism and abnormal periods. Sonography demonstrated a solid, complex ovarian mass. What is the most likely diagnosis? Leiomyosarcoma Sertoli-Leydig cell tumor Thecoma Dysgerminoma

Sertoli-Leydig cell tumor

What signals the corpus luteum to continue to produce progesterone when a fertilized egg is approaching the endometrium? Gonadotropins released by the sperm cause the corpus luteum to continue to produce progesterone. The motion of the cilia in the fallopian tube causes the release of hCG which keeps the corpus luteum producing progesterone. The trophoblast cells produce estrogen which maintains the function of the corpus luteum. The syncytiotrophoblast cells produce hCG which keeps the corpus luteum producing progesterone.

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

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? Thecoma Meigs syndrome Granulosa cell tumor Endometrioid tumor

Thecoma

What condition includes symptoms of ambiguous genitalia, short stature, and webbing of the skin on the back of the neck? Turner syndrome Meigs syndrome Down syndrome Beckwith-Wiedemann syndrome

Turner syndrome

What is luteal phase deficiency? Over thickening of the endometrium due to excessive estrogen production Underdevelopment of the endometrium due to low progesterone production Implantation is prohibited due to fusion of the endometrial canal Heterogeneous endometrium produced by high levels of luteinizing hormone

Underdevelopment of the endometrium due to low progesterone production

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

Polymenorrhea

What is the sonographic appearance of the proliferative endometrium? Thin echogenic line <5 mm Three-line sign (echogenic basal layer - hypoechoic functional layer - echogenic canal - hypoechoic functional layer - echogenic basal layer) Thick echogenic endometrium >15 mm Hypoechoic thin echogenic line 3 to 7 mm

Three-line sign (echogenic basal layer - hypoechoic functional layer - echogenic canal - hypoechoic functional layer - echogenic basal layer)

What does the term metrorrhagia refer to? Absence of menstrual periods Painful and difficult menstruation Irregular cycles greater than 35 days apart Irregular menstrual bleeding between periods

Irregular menstrual bleeding between periods

Where would you see enhancement on a normal transabdominal sonogram? Anterior to the urinary bladder Posterior to the urinary bladder Posterior to the uterus Anterior to an ovarian follicle

Posterior to the urinary bladder

A patient presents with an enlarged bulky uterus and menorrhagia. Which of the following is most likely to be the cause? Subserosal fibroid Submucosal leiomyoma Adenomyosis Bicornuate uterus

Submucosal leiomyoma

A patient with polycystic ovarian syndrome presents with abnormal uterine bleeding. Endometrial measurement is 21 mm and the endometrium demonstrates tiny cystic areas. What is the most likely diagnosis? Endometrial hyperplasia Endometrial carcinoma Endometrial atrophy Endometrial polyp

Endometrial hyperplasia