Penny Chapter 15-19

Which of the following is an inherited bleeding disorder that is characterized by low levels of a specific clotting protein in the blood?

a. Stein-Leventhal disease

b. Fitz-Hugh-Curtis disease

c. Meis disease

d. von Willebrand disease

d. von Willebrand disease

What is the term for elevated white blood cell count?

a. Hematocrit

b. Leukemia

c. Leukocytosis

d. Leukopenia

c. Leukocytosis

What is another name for the anterior cul-de-sac?

a. Vesicouterine pouch

b. Pouch of Douglas

c. Morison Pouch

d. Rectouterine pouch

a. Vesicouterine pouch

Which of the following is also referred to as the space of Retzius?

a. Paracolic gutters

b. Retropubic space

c. Anterior cul-de-sac

d. Posterior cul-de-sac

b. Retropubic space

Which of the following would be the least likely indication for a pelvic sonogram?

a. Diarrhea

b. Palpable pelvic mass

c. Amenorrhea

d. Screening for malignancy

a. Diarrhea

Which of the following would be least likely associated with a palpable pelvic mass?

a. Ovarian hyperstimulation syndrome

b. Leiomyoma

c. Ovarian cyst

d. Endometrial hyperplasia

d. Endometrial hyperplasia

Which of the following is defined as painful or difficult urination?

a. Dyspareunia

b. Nocturia

c. Dyspnea

d. Dysuria

d. Dysuria

A linear structure coursing through an anechoic cyst separating it into two separate cavities may be referred to as a:

a. mural nodule.

b. septation.

c. polyp.

d. dringo.

b. septation.

Which of the following would least likely indicate the presence of a complex cyst?

a. Septation

b. Mural nodule

c. Acoustic enhancement

d. Internal debris

c. Acoustic enhancement

Which of the following is a protein produced by the fetal yolk sac, fetal gastrointestinal tract, fetal liver, and by some malignant tumors?

a. Lactate dehydrogenase

b. CA-125

c. Alpha-fetoprotein

d. Human chorionic gonadotropin

c. Alpha-fetoprotein

The "S" in the STAR criteria stands for:

a. Simple.

b. Sound.

c. Smooth walls.

d. Septations.

c. Smooth walls.

Which of the following is defined as pain during intercourse?

a. Dysuria

b. Dysmenorrhea

c. Dyspareunia

d. Hirsutism

c. Dyspareunia

Which of the following is defined as excessive hair growth in women in areas where hair growth is normally negligible?

a. Dyspareunia

b. Hirsutism

c. Meigs syndrome

d. Polycystic ovary syndrome

b. Hirsutism

Which of the following laboratory tests may be used as a tumor marker for an ovarian dysgerminoma?

a. Lactate dehydrogenase

b. Alpha-fetoprotein

C. CA-125

d. Tamoxifen

a. Lactate dehydrogenase

All of the following are associated with acute pelvic pain except:

a. pelvic inflammatory disease.

b. ruptured ovarian hemorrhagic cyst.

c. perforated intrauterine contraceptive device.

d. Asherman syndrome.

d. Asherman syndrome.

Which of the following is best defined as intermenstrual bleeding?

a. Dysmenorrhea

b. Menorrhagia

c. Menometrorrhagia

d. Metrorrhagia

d. Metrorrhagia

Having the same echogenicity means:

a. anechoic.

b. isoechoic.

c. echogenic.

d. hypochoic.

b. isoechoic.

Which of the following would typically not be associated with amenorrhea?

a. Asherman syndrome

b. Polycystic ovarian disease

c. Pregnancy

d. Adenomyosis

d. Adenomyosis

Which of the following is best defined as difficult or painful menstruation?

a. Dysmenorrhea

b. Dyspareunia

c. Dysuria

d. Menorrhagia

a. Dysmenorrhea

What term relates to the number of pregnancies a patient has had?

a. Para

b. Menarche

c. Menorrhagia

d. Gravida

d. Gravida

Which of the following definitions best describes the term adnexa?

a. The area posterior to the uterus, between the uterus and the rectum

b. The area located posterior to the broad ligaments and adjacent to the uterus

c. The area anterior to the uterus, between the uterus and the urinary bladder

d. The area lateral to the iliac crest and posterior to the pubic symphysis

b. The area located posterior to the broad ligaments and adjacent to the uterus

All of the following statements are true of endovaginal imaging except:

a. endovaginal imaging requires a full urinary bladder.

b. endovaginal imaging leads to reduced waiting time for the patient and quicker medical management.

c. endovaginal imaging offers improved resolution of the endometrium, uterus, and ovaries, especially in the obese patient.

d. endovaginal imaging is contraindicated for pediatric patients and for those with an intact hymen.

a. endovaginal imaging requires a full urinary bladder

What laboratory value would be most useful to evaluate in a patient with suspected internal hemorrhage?

a. White blood cells

b. Lactate dehydrogenase

c. Amylase

d. Hematocrit

d. Hematocrit

What abnormality results from the ovary twisting on its mesenteric connection?

a. Pelvic inflammatory disease

b. Fitz-Hugh-Curtis syndrome

c. Ovarian torsion

d. Ovarian hyperstimulation syndrome

c. Ovarian torsion

Which of the following most often leads to an elevation of CA-125?

a. Ovarian carcinoma

b. Fitz-Hugh-Curtis syndrome

c. Ovarian torsion

d. Ovarian hyperstimulation syndrome

a. Ovarian carcinoma

When does the Centers for Disease Control and Prevention recommend that alcohol-based hand rub be combined with hand washing?

a. After performing a sonogram

b. Before performing a sonogram

c. When your hands are visibly soiled

d. Between patients

c. When your hands are visibly soiled

The best way to communicate with a patient who speaks a language other than your own is to use:

a. sign language.

b. proper body cues.

c. an online search engine.

d. a trained medical interpreter.

d. a trained medical interpreter.

What artifact would be seen posterior to a tooth within a cystic teratoma?

a. Ring-down

b. Reverberation

c. Through transmission

d. Shadowing

d. Shadowing

Which of the following is best described as an artifact that is produced by a strong reflector and results in a copy of the anatomy being placed deeper than the correct location?

a. Reverberation

b. Mirror image

c. Acoustic shadowing

d. Comet tail

b. Mirror image

Which of the following statements is not true concerning transabdominal pelvic imaging?

a. Transabdominal imaging of the pelvis provides a global view of the entire pelvis.

b. Transabdominal imaging lacks the detail of endovaginal imaging.

c. Obese patients and patients with a retroverted or retroflexed uterus present a unique challenge to the transabdominal technique.

d. Transabdominal imaging is contraindicated for pediatric patients.

d. Transabdominal imaging is contraindicated for pediatric patients.

Malignant ovarian tumors may leak mucinous material, and this condition is known as:

a. Dandy-Walker syndrome.

b. pseudomyxoma peritonei.

c. Asherman syndrome.

d. Fitz-Hugh-Curtis syndrome.

b. pseudomyxoma peritonei.

All of the following are proper techniques for providing patient care for patients during a pelvic

sonogram except:

a. all transducers and their cords should be cleaned before performing a pelvic sonogram.

b. endovaginal transducers should be cleaned with a high-level disinfectant.

c. a probe cover should be placed on the transducer for transabdominal imaging to prevent the spread of infection.

d. a sterile jelly should be used as a lubricant for endovaginal imaging.

c. a probe cover should be placed on the transducer for transabdominal imaging to prevent the spread of infection.

The breast cancer drug that inhibits the effects of estrogen in the breast is:

a. CA-125.

b. methotrexate.

C. RA-916.

d. tamoxifen.

d. tamoxifen.

Which of the following statements would be considered an acceptable disadvantage of endovaginal imaging?

a. Endovaginal imaging has a limited field of view.

b. The resolution of endovaginal imaging is reduced compared to transabdominal imaging.

c. Endovaginal imaging is more time-consuming than transabdominal imaging.

d. Endovaginal imaging can be performed only by female sonographers.

a. Endovaginal imaging has a limited field of view.

What artifact could be noted emanating from air or gas within the endometrium in a patient with

endometritis?

a. Ring-down

b. Mirror image

c. Posterior enhancement

d. Dirty transmission

a. Ring-down

What Doppler artifact occurs when the Doppler sampling rate is not high enough to display the Doppler shift frequency?

a. Doppler noise

b. Aliasing

c. Twinkle artifact

d. Absent Doppler signal

b. Aliasing

Which of the following would be the least likely to cause abdominal distension?

a. Ascites

b. Multiple leiomyoma

c. Ovarian hyperstimulation syndrome

d. Polycystic ovarian disease

d. Polycystic ovarian disease

All of the following are common indications for a pelvic sonogram except:

a. evaluation of congenital anomalies.

b. evaluation of pelvic anatomy immediately following a motor vehicle accident.

c. localization of an intrauterine contraceptive device.

d. postmenopausal bleeding.

b. evaluation of pelvic anatomy immediately following a motor vehicle accident.

Precocious puberty is best defined as:

a. pubertal development before the age of 8.

b. pubertal development before the age of 13.

c. excessive hair growth in girls in areas where hair growth is normally negligible.

d. changes within the female that are caused by increased levels of alpha-fetoprotein.

a. pubertal development before the age of 8.

Amenorrhea is defined as:

a. the first menstrual cycle.

b. excessive bleeding after the cycle.

c. lack of menstrual flow.

d. painful menstrual flow.

c. lack of menstrual flow.

Which of the following would most likely be associated with hirsutism?

a. Polycystic ovary syndrome

b. Meigs syndrome

c. Adenomyosis

d. Adenomyomatosis

a. Polycystic ovary syndrome

Which of the following would be caused by a large acoustic interface and subsequent production of false echoes?

a. Posterior shadowing

b. Acoustic enhancement

c. Mirror image

d. Reverberation

d. Reverberation

Which of the following would be best defined as abnormally heavy menstrual flow?

a. Menometrorrhagia

b. Menorrhagia

c. Metrorrhagia

d. Hypomenorrhea

b. Menorrhagia

Which of the following would be best defined as regularly timed menses but light flow?

a. Menometrorrhagia

b. Menorrhagia

c. Metrorrhagia

d. Hypomenorrhea

d. Hypomenorrhea

All of the following would be relevant laboratory tests to evaluate before performing a routine pelvic sonogram except:

a. human chorionic gonadotropin.

b. hematocrit.

c. white blood cell count.

d. lipase.

d. lipase.

Which of the following could be described as an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes?

a. Pseudomyxoma peritonei

b. Pelvic inflammatory disease

c. Polycystic ovarian disease

d. Ovarian torsion

b. Pelvic inflammatory disease

Which of the following diagnostic tests is used to evaluate emitted radiation from the patient to assess the function of organs?

a. Magnetic resonance imaging

b. Nuclear medicine

c. Radiography

d. CT

b. Nuclear medicine

Endovaginal transducers may be disinfected by submerging in a(n)

-based solution.

a. glutaraldehyde

b. ascites

c. formaldehyde

d. alcohol

a. glutaraldehyde

Leukocytosis would most likely be associated with:

a. multiple degenerating fibroids.

b. ovarian teratoma.

c. adenomyosis.

d. pelvic inflammatory disease.

d. pelvic inflammatory disease.

Which of the following is not part of the colon that is located within the female pelvis?

a. Ascending

b. Descending

c. Sigmoid

d. Transverse

d. Transverse

2. Which of the following is a pelvic ligament that extends from the lateral surface of the cervix to the lateral fornix of the vagina?

a. Common iliac ligament

b. Cardinal ligament

c. Iliopsoas ligament

d. Broad ligament

b. Cardinal ligament

The uterine vasculature is located within the:

a, broad ligaments.

b. cardinal ligaments.

c. suspensory ligament of the ovary.

d. obturator internus ligament.

b. cardinal ligaments.

What is another name for the true pelvis?

a. Greater pelvis

b. Lesser pelvis

c. Superior pelvis

d. Major pelvis

b. Lesser pelvis

Which of the following muscles is located posteriorly within the pelvis and helps support the sacrum?

a. lliopsoas

b. Coccygeus

c. Obturator internus

d. Piriformis

b. Coccygeus

Which of the following is not supported by the broad ligaments?

a. Pelvic diaphragm

b. Uterus

c. Uterine tubes

d. Ovaries

a. Pelvic diaphragm

Which of the following is not a levator ani muscle?

a. Pubourethralis

b. Pubovaginalis

c. Puboileacus

d. lliococcygeus

c. Puboileacus

What artery directly supplies blood to the basal layer of the endometrium?

a. Spiral

b. Arcuate

c. Straight

d. Radial

c. Straight

Which of the following is not true of the uterine

plexus?

a. They are tortuous like the arteries.

b. They supply blood to the uterine tubes.

c. They anastomose with each other and the ovarian vein.

d. They are located along the sides of the cervix and the cornua.

b. They supply blood to the uterine tubes.

What is the fibrous structure located along the midline of the abdomen that separates the rectus abdominis muscles?

a. Linea terminalis

b. Linea rectus

c. Linea alba

d. Linea aspera

c. Linea alba

What is the relationship of the lesser pelvis to the greater pelvis?

a. It is located more inferiorly.

b. It is located more laterally.

c. It is located more anteriorly.

d. It is located more superiorly.

a. It is located more inferiorly.

What part of the cervix is closest to the vagina?

a. Internal os

b. Internal canal

c. Adventitia

d. External os

d. External os

What midline, anterior pelvic structure may produce an acoustic shadow when scanning the female pelvis?

a. Iliac crest

b. Anterior superior iliac spine

c. Pubic symphysis

d. Ischial ramus

c. Pubic symphysis

The common iliac veins combine to create the:

a inferior vena cava..

b. external iliac vein.

c. internal iliac vein.

d. abdominal aorta.

a inferior vena cava..

You are performing a female pelvic sonogram and identify a solid mass adjacent to the right ovary, just right lateral to the uterus. What is the most likely location of this mass?

a. Within the right adnexa

b. Within the pouch of Douglas

c. Within the pelvic diaphragm

d. Within the space of Retzius

a. Within the right adnexa

What structure within the female pelvis lies posterior to the urinary bladder and anterior to the rectum?

a. Broad ligament

b. Rectus abdominis muscle

c. Space of Retzius

d. Uterus

d. Uterus

Both the straight and spiral arteries are branches of the:

a. common iliac artery.

b. radial artery.

c. arcuate artery.

d. external iliac artery.

b. radial artery.

Fluid noted posterior to the uterus would most likely be located within the:

a. space of Retzius.

b. pouch of Douglas.

c. anterior cul-de-sac.

d. adnexa.

b. pouch of Douglas

The left ovarian vein drains directly into the:

a. right renal vein.

b. inferior vena cava.

c. aorta.

d. left renal vein.

d. left renal vein.

Pelvic bones, when visualized on sonography, will produce:

a. posterior shadowing.

b. posterior enhancement.

c. mirror image artifact.

d. minimal enhancement.

a. posterior shadowing.

The uterine arteries supply blood to all of the following except:

a. fallopian tubes.

b. rectum.

c. ovaries.

d. uterus.

b. rectum.

The anterior cul-de-sac is also referred to as the:

a. space of Retzius.

b. rectouterine pouch.

c. pouch of Douglas.

d. vesicouterine pouch.

d. vesicouterine pouch.

What is considered the most dependent part of the peritoneal cavity?

a. Space of Retzius

b. Anterior cul-de-sac

c. Pouch of Douglas

d. Rectovesical pouch

c. Pouch of Douglas

The right ovarian vein drains directly into the:

a. right renal vein.

b. aorta.

c. inferior vena cava.

d. common iliac vein.

c. inferior vena cava.

The innominate bones of the pelvis consist of the:

a. ischium, ilium, and pubic bones.

b. ilium, sacrum, and coccyx bones.

c. sacrum, coccyx, and pubic bones.

d. sacrum, ischium, and ilium bones.

a. ischium, ilium, and pubic bones.

What other term is used to describe the space of Retzius?

a. Posterior cul-de-sac

b. Anterior cul-de-sac

c. Murphy pouch

d. Retropubic space

d. Retropubic space

The true pelvis is delineated from the false pelvis by the:

a. space of Retzius.

b. adnexa.

c. linea terminalis.

d. linea alba.

c. linea terminalis.

33. The vagina is located _ to the uterus:

a. anterior

b. posterior

c. inferior

d. medial

c. inferior

The muscles that may be confused with the ovaries on a pelvic sonogram include the:

a. rectus abdominis and obturator interns muscles.

b. levator ani and coccygeus muscles.

c. obturator interns and levator ani muscles.

d. piriformis and iliopsoas muscles.

d. piriformis and iliopsoas muscles.

Which vessels supply blood to the deeper layers of the myometrium?

a. Radial arteries

b. Spiral arteries

c. Straight arteries

d. Arcuate arteries

a. Radial arteries

Pelvic muscles appear:

a. echogenic.

b. anechoic.

c. hypoechoic.

d. complex.

c. hypoechoic.

The abdominal aorta bifurcates into the:

a. internal iliac arteries.

b. common iliac arteries.

c. ovarian arteries.

d. external iliac arteries.

b. common iliac arteries.

Which of the following are the paired anterior abdominal muscles that extend from the xiphois process of the sternum to the pubic bone?

a. Iliopsoas muscles

b. Rectus abdominis muscles

c. Obturator internus muscles

d. Piriformis muscles

b. Rectus abdominis muscles

Peritoneal spaces located posterior to the broad ligament are referred to as the:

a. rectouterine spaces.

b. anterior cul-de-sacs.

c. lateral cul-de-sacs.

d. adnexa.

d. adnexa.

The paired muscles that are located lateral to the uterus and anterior to the iliac crest are the:

a. iliopsoas muscles.

b. rectus abdominis muscles.

c. obturator interns muscles.

d. piriformis muscles.

a. iliopsoas muscles.

Fluid noted anterior to the uterus would most likely be located within the:

a. pouch of Douglas.

b. vesicouterine pouch.

c. space of Retzius.

d. rectouterine pouch.

b. vesicouterine pouch.

The bilateral muscles that are located posterior to and extend from the sacrum to the femoral greater trochanter are the:

a. levator ani muscles.

b. rectus abdominis muscles.

c. obturator interns muscles.

d. piriformis muscles.

d. piriformis muscles.

The pelvic ligament that provides support to the ovary to the pelvic side wall is the:

a. cardinal ligament.

b. ovarian ligament.

c. broad ligament.

d. suspensory ligament of the ovary.

d. suspensory ligament of the ovary.

The pelvic muscle group that is located between the coccyx and the pubis is the:

a. levator ani muscles.

b. rectus abdominis muscles.

c. obturator interns muscles.

d. piriformis muscle.

a. levator ani muscles.

The sonographic pelvic examination of a female patient reveals an extensive amount of ascites.

In the transverse plane, you visualize two echogenic structures extending from the side walls of uterus to the pelvic side walls bilaterally.

These structures are most likely the:

a. broad ligaments.

b. cardinal ligaments.

c. ovarian ligaments.

d. uterosacral ligaments.

a. broad ligaments.

The space of Retzius is located:

a. between the uterus and the bladder.

b. between the bladder and the ilium.

c. along the lateral aspect of the uterus.

d. between the bladder and the pubic bone.

d. between the bladder and the pubic bone.

The right ovarian artery branches off of the:

a. aorta.

b. right renal artery.

c. uterine artery.

d. internal iliac artery.

a. aorta.

48. The muscle located lateral to the ovaries is the:

a. iliopsoas muscle.

b. rectus abdominis muscle.

c. obturator interns muscle.

d. piriformis muscle.

c. obturator interns muscle.

The arteries that directly supply blood to the functional layer of the endometrium are the:

a. radial arteries.

b. spiral arteries.

c. straight arteries.

d. arcuate arteries.

b. spiral arteries.

Another name for the rectouterine pouch is the:

a. space of Retzius.

b. pouch of Retzius.

c. pouch of Douglas.

d. anterior cul-de-sac.

c. pouch of Douglas.

A patient presents to the sonography department with a history of uterine prolapse.

Which of the following best describes this disorder?

a. A condition that results from the weakening of the pelvic diaphragm muscles and allows for the displacement of the uterus, often through the vagina.

b. A congenital anomaly that results in the duplication of the uterus.

c. A condition that results in the abnormal invasion of the myometrium through the bladder wall, leading to hematuria.

d. An abnormality that describes the inversion of the myometrium and endometrium.

a. A condition that results from the weakening of the pelvic diaphragm muscles and allows for the displacement of the uterus, often through the vagina.

The pelvic ligament that extends from the lateral aspect of the uterus to the side walls of the pelvis is the:

a. broad ligament.

b. ovarian ligament.

c. piriformis ligament.

d. round ligament.

a. broad ligament.

The uterine artery branches off of the:

a. abdominal aorta.

b. uterine plexus.

c. internal iliac artery.

d. external iliac artery.

c. internal iliac artery.

The peripheral arteries of the uterus are the:

a. radial arteries.

b. spiral arteries.

c. straight arteries.

d. arcuate arteries.

d. arcuate arteries.

The urinary bladder, uterus, and ovaries are located within the:

a. true pelvis.

b. false pelvis.

a. true pelvis.

The pelvic ligament that provides support to the ovary and extends from the ovary to the lateral surface of the uterus is the:

a. cardinal ligament.

b. ovarian ligament.

c. broad ligament.

d. suspensory ligament of the ovary.

b. ovarian ligament.