OBGYN URR Chapter Review

List three glands that are a part of the female genitourinary system.

paraurethral glands (Skene glands), Bartholin glands (on either side of vagina), mammary glands (within breasts)

What is the imaginary line called that connects the superior sacrum to the symphysis pubis and separates the true and false pelvis?

a. linea terminalis

b. linea alba

c. labia minora

d. labia majora

a

What muscles form the anterior abdominal wall?

a. transverse abdominis

b. levator ani

c. psoas

d. rectus abdominis

d

What muscles form the floor of the pelvis?

a. transverse abdominis

b. levator ani

c. psoas

d. piriformis

b

What two muscles form the pelvic diaphragm?

a. levator ani and coccygeus

b. psoas and piriformis

c. levator ani and piriformis

d. coccygeus and obturator internus

a

Pelvic muscles are typically:

a. hypoechoic to pelvic organs

b. hyperechoic to pelvic organs

c. isoechoic to pelvic organs

d. all the above

a

What pelvic space is most likely to collect free fluid?

a. vesicouretine space

b. Space of Retzius

c. Pouch of Douglas

d. anterior cul-de-sac

c

Which pelvic space is least likely to collect free fluid?

a. vesicouretine space

b. Space of Retzius

c. Pouch of Douglas

d. anterior cul-de-sac

b

The mesovarium and mesosalpinx are portions of the:

a. round ligaments

b. cardinal ligaments

c. uterosacral ligaments

d. broad ligament

d

What is the term for the spaces within the peritoneal cavity that are posterior to the broad ligaments?

a. vesicouterine space

b. Space of Retzius

c. adnexa

d. posterior cul-de-sac

c

What two ligaments determine the cervix position/orientation in the pelvis?

a. uterosacral and cardinal

b. round and cardinal

b. broad and round

d. uterosacral and suspensory

a

Which ligament supports the medial aspect of the ovary and its position relative to the uterine cornua?

a. round

b. ovarian

c. cardinal

d. suspensory

b

The vagina is positioned between what 2 pelvic muscles?

a. RT and LT piriformis

b. RT and LT levator ani

c. RT and LT obturator internus

d. RT and LT rectus abdominis

b

What segment of the uterus is only referred to during pregnancy?

a. fundus

b. body

c. isthmus

d. lower uterine segment

d

The ______ layer of the uterine wall is involved in the menstrual cycle and the ______ layer of the uterine wall is involved in the birthing process.

a. endometrium, serosa

b. perimetrium, myometrium

c. endometrium, myometrium

d. perimetrium, serosa

c

How is the length of the uterus measured correctly?

a. sagittal plane, from UT fundus to the level of the external OS

b. sagittal plane, from UT fundus to the level of the internal OS

c. sagittal plane, from UT fundus to the level of the vaginal cuff

d. sagittal plane, from UT fundus to the level of the vaginal opening

a

A uterus with <90 degrees to the cervix and the cervix angles anterior from its origin at the vaginal cuff is described as:

a. anteverted

b. retroverted

c. anteflexed

d. retroflexed

a

A uterus with the body folded posteriorly at a very sharp angle to the cervix is described as:

a. anteverted

b. retroverted

c. anteflexed

d. retroflexed

d

Levo - indicates a structure is positioned more to the ____, while dextro- indicates a structure is positioned more to the _____.

a. midline, right

b. left, right

c. right, left

d. midline, left

b

How does flow change in the uterine artery as a patient ages?

a. decreased resistance with a lower RI value

b. increased diastolic flow velocities

c. increased resistance with higher RI value

d. decreased systolic velocities

c

The uterine artery originates from:

a. the external iliac artery

b. the common iliac artery

c. the aorta

d. the internal iliac artery

d

The uterine artery supplies blood to multiple branches that perfuse which of the following?

a. uterus

b. ovaries

c. fallopian tubes

d. all the above

d

The _________ arteries supply the basal endometrium, while the _________ arteries supply the functional endometrium.

a. arcuate, spiral

b. straight, spiral

c. spiral, straight

d. arcuate, straight

b

The inernal iliac veins are _______ to the internal iliac arteries.

a. posterior and medial

b. anterior and lateral

c. superior and lateral

d. inferior and medial

a

The ________ ligament connects the ovary to the uterine cornua, while the _______ ligament connects the ovary to the lateral pelvic wall.

a. mesovarium, mesosalpinx

b. ovarian, infundibulopelvic

c. ovarian, mesovarium

d. infundibulopelvic, mesovarium

b

What sonographic landmark is preferred for locating ovaries?

a. iliac vessels

b. broad ligament

c. mesovarium

d. psoas muscles

a

Graafian follicle is another term for the:

a. corpus luteum

b. corpus albicans

c. dominant follicle

d. non-dominant follicle

c

Which of the following is involved in supplying blood to the ovaries?

a. uterine artery

b. ovarian artery

c. internal iliac artery

d. all the above

d

What part of the fallopian tube is described as a trumpet-shaped end that opens into the pelvic peritoneal cavity?

a. isthmus

b. infundibulum

c. ampulla

d. interstitial

b

An ectopic pregnancy is most likely to form in the ______ segment of the fallopian tubes, while the most dangerous location for an ectopic pregnancy to form is the ______ segment.

a. isthmus, infundibulum

b. infundibulum, ampulla

c. ampulla, interstitial

d. interstitial, isthmus

c

Menarche refers to:

a. onset of puberty

b. onset of menses

c. onset of ovarian follicle development

d. onset of menopause

b

Thelarche refers to:

a. onset of breast development

b. onset of ovarian follicle development

c. onset of puberty

a

What is the most common cause of precocious puberty?

a. use of ibuprofen as a child

b. hypothalamic or pituitary tumor

c. breast tumor

b

What of the following is sloughed off during menstruation?

a. functionalis layer

b. decidual layer

c. spiral arteries

d. all the above

d

The hypothalamus releases gonadotropin hormone which stimulates the pituitary gland to release:

a. estrogen and progesterone

b. luteinizing hormone and follicle stimulating hormone

c. estriol and estrone

d. follicle stimulating hormone and progesterone

b

Which of the following is responsible for ovulation?

a. FSH

b. progesterone

c. estriol

d. LH

d

Which of the following causes development of secondary sex characteristics?

a. FSH

b. progesterone

c. estriol

d. estrogen

d

Levels of _______ are monitored to predict ovulation in patients undergoing fertility treatments.

a. estrogen

b. progesterone

c. estradiol

d. estriol

c

What is the only type of estrogen found in the postmenopausal women?

a. estriol

b. estradiol

c. estrone

d. prolactin

c

Which of the following correctly describes progesterone?

a. produced by the corpus luteal cells post-ovulation

b. responsible for premenstrual symptoms and symptoms of pregnancy

c. responsible for endometrial proliferation AFTER ovulation to prepare for implantation

d. all the above

d

Which of the following is involved in breast development/lactation?

a. oxytocin

b. prolactin

c. progesterone

d. all the above

d

When is estrogen at its lowest level during the menstrual cycle?

a. secretory phase

b. during menses

c. early proliferative phase

d. late proliferative phase

b

During what phase of the menstrual cycle does the endometrium appear trilaminar?

a. secretory phase

b. during menses

c. early proliferative phase

d. late proliferative phase

d

When endometrial fluid is present, how is the endometrial thickness reported?

a. measure the thickness of the two functionalis layers and add them together

b. place the calipers from the border of the functionalis layer and basalis layer to the opposite border of the functionalis layer with the basalis layer

c. place the calipers from the outer edge of the basalis layer to the outer edge of the basalis layer

d. endometrial thickness cannot be assessed with the presence of fluid in the chamber

a

Postmenopausal symptomatic patients with no hormone replacement therapy demonstrates a normal endometrial thickness of:

a. < 3 mm

b. <5 mm

c. <8 mm

d. <12 mm

b

Non-dominant follicles are typically _______ or less in size.

a. 5 mm

b. 8 mm

c. 10 mm

d. 15 mm

c

A surge in what hormone causes ovulation?

a. FSH

b. estrogen

c. LH

d. progesterone

c

Why does the corpus luteal cyst secrete progesterone?

a. to cause ovulation

b. to stimulate the endometrium to slough off in menstruation

c. to promote the development of dominant follicles

d. to stimulate the endometrium to prepare for implantation

d

What produces progesterone to maintain pregnancy until the placenta takes over at 14 weeks?

a. pituitary gland

b. corpus luteal cyst

c. corpus albicans

d. hypothalamus

b

The ________ secretes human chorionic gonadotropin (hCG) which is detected in maternal urine.

a. trophoblast

b. blastocyst

c. corpus luteum

d. corpus albicans

a

Oral contraceptive pills (OCP) prevent:

a. ovulation

b. endometrial proliferation

c. formation of dominant follicles

d. all the above

d

A benign tumor formation in what organ has been most associated with the use of OCP?

a. kidney

b. liver

c. ovary

d. pancreas

b

What is included in the construction of some IUDs that makes them visible on x-ray examinations?

a. barium sulfate

b. air

c. colloid gel

d. mercury

a

What is the gold standard method of evaluation of IUD position in the endometrial cavity?

a. x-ray of the pelvis

b. CT of the pelvis

c. 3D transvaginal ultrasound

d. 2D transvaginal ultrasound

c

A Mirena IUD secrets _______ to prevent implantation of the embryo.

a. estrogen

b. progesterone

c. prolactin

d. progestin

d

Essure devices are coils that are placed in the _________ to prevent pregnancy.

a. LUS

b. fallopian tubes

c. cervix

d. uterine corpus

b

All the following are symptoms of menopause except:

a. uterine atrophy

b. fatty replacement of breast tissue

c. hypermenorrhea

d. hot flahses

c

Hormone replacement therapy (HRT) reduces the risk of:

a. coronary artery disease

b. pulmonary embolism

c. DVT

d. all the above

a

Hormone replacement therapy (HRT) increases the risk of:

a. pulmonary embolism

b. DVT

c. endometria hyperplasia/cancer

d. all the above

d

Why is combined HRT preferred over unopposed estrogen therapy?

a. reduced risk of embolism

b. reduced risk of osteoporosis

c. reduced risk of endometrial cancer

d. reduced risk of DVT

c

Tamoxifen therapy is used to treat patients with a history of what condition?

a. endometrial cancer

b. uterine cancer

c. ovarian cancer

d. breast cancer

d

What is the best way to confirm the identity of a patient?

a. look at the chart for the patient description

b. confirm the birthdate and name with what is listed in the chart

c. confirm the birthdate and name with what is listed on the wristband

d. ask the transportation personnel who the patient is that they brought down to to

c

The informed consent form is required to include all of the following except:

a. signature line to indicate patient consent

b. description of the procedure

c. percentage of patients that have experienced complications after the same procedure at the facility

d. possible complications that the patient may experience

c

A sonographer can discuss the patient exam results with:

a. the patient

b. the patient’s caregiver

c. the patient’s spouse

d. none of these

d

A patient must drink 24-32 oz of water to fill their bladder for which of the following exams?

a. pelvic US

b. 1st trimester OB US

c. 2nd trimester OB US

d. all the above

d

What is the proper order for putting on PPE?

a. gown, mask, goggles, gloves

b. gloves, goggles, gown, mask

c. mask, gloves, goggles, gown

d. gown, gloves, mask, goggles

a

What is the proper order for removing PPE?
a. gown, mask, goggles, gloves

b. gloves, goggles, gown, mask

c. mask, gloves, goggles, gown

d. gown, gloves, mask, goggles

b

MRSA requires _________ precautions and tuberculosis requires ________ precautions.

a. contact, airborne

b. droplet, contact

c. airborne, droplet

d. contact, droplet

a

Glutaraldehyde, hydrogen peroxide, metricide, and Cidex are examples of:

a. thermal sterilization

b. chemical cleansing

c. high level disinfectants

d. intermediate level disinfectants

c

Which of the following characteristics of high level disinfectants varies with the type of disinfectant used?

a. soak time

b. rinse time

c. duration of use of solution

d. all the above

d

The “A” in amenorrhea or anovulation means what descriptive term?

a. excessive

b. absent

c. difficult

d. reduced

b

The “dys-” in dysmenorrhea or dyspareunia means what descriptive term?

a. excessive

b. absent

c. difficult

d. reduced

c

Which of the following is a cause of abnormal uterine bleeding?

a. fibroid formation

b. estrogen imbalance

c. unopposed estrogen therapy

c. combination hormone replacement therapy

a

Which of the following is a cause of dysfunctional uterine bleeding?

a. fibroid formation

b. estrogen imbalance

c. endometrial polyps

d. endometrial carcinoma

b

The difference between a total and partial hysterectomy depends on if the _____ is removed during the procedure.

a. vaginal cuff

b. ovary

c. fallopian tube

d. cervix

d

A myomectomy indicates a _______ was surgically removed.

a. endometrial polyp

b. vaginal cyst

c. leiyomyoma

d. ovarian cyst

c

What does GPMAL stand for in pregnancy annotation?

G - gravida

P - parity

M - miscarriage

A - abortion

L - living children

What does GTPAL stand for in pregnancy annotation?

G - gravida

T - term births

P - premature births

A - abortions or miscarriages

L - living children

What characteristic indicates the bladder is sufficiently full for a pelvic US?

a. the frequency of complaints from the patient

b. the ability to visualize the ovaries

c. the ability to visualize the cervix

d. the ability to visualize the UT fundus

d

What technique is recommended to displace bowel gas from the pelvis?

a. graded compression

b. Valsalva maneuver

c. scan the patient in the reverse Trendelenburg position

d. scan the patient in the decubitus position

a

When attempting to image the fundus of an anteverted uterus with TV US, the transducer should be angled so the handle is:

a. farther away from the bed

b. centered between the patient’s knees

c. closer to the bed

d. level with the bed

c

Patients with normal menses are best evaluated during the:

a. last 5 days of their cycle

b. first 7-10 days of their cycle

c. 14th to 21st days of their cycle

d. first 3 days of their cycle

b

Patients with suspected congenital uterine abnormalities are best evaluated in the:

a. secretory phase

b. first 5 days of their cycle

c. early proliferative phase

d. late proliferative phase

a

What muscles are landmarks to locate the ovaries during an US exam?

a. piriformis

b. levator ani

c. rectus abdominis

d. iliopsoas

d

Which of the following correctly describes ovarian doppler evaluation?

a. doppler evaluation of the ovaries is preferred during day 9 through 28 of ovarian cycle

b. resistance of lower in the ovary that contains the dominant follicle

c. doppler of the perimeter of the dominant follicle will demonstrate high velocity flow with increased diastolic flow

d. all the above

d

Which of the following is an indication for translabial sonography in a pregnant patient?

a. measure the fetal head

b. measure the cervical length

c. evaluate suspected urinary incontinence

d. evaluate uterine prolapse

b

Which of the following correctly describes pelvic sonography of an adolescent?

a. a full bladder is not required

b. only a transvaginal scan is performed to limit US exposure

c. a transvaginal exam is not performed on those with no history of sexual activity

d. a CT scan is preferred due to the small size of the uterus and ovaries

c

Higher frequency transducers offer:

a. improved spatial resolution with limited penetration

b. improved penetration with degraded spatial resolution

c. improved spatial resolution and increased penetration

d. improved penetration with no effect on resolution

a

What acoustic artifact is seen with air inside the probe cover for a TV ultrasound?

a. mirror image

b. side lobe

c. edge shadowing

d. ring down

d

Reducing the sector width for TV ultrasound will:

a. increase frame rate

b. improve temporal resolution

c. improve lateral resolution

d. all the above

d

Laparoscopy is used during the treatment of:

a. fibroids

b. ectopic pregnancy

c. infertility

d. menopause

b

Dilatation and Curretage (D&C) increases the risk of what critical finding on an US exam?

a. polyp formation

b. endometriosis

c. cervical ectopic pregnancy

d. ovarian cancer

c

A sonohysterogram should be performed during:

a. follicular phase of the menstrual cycle

b. active menses

c. 1st trimester of pregnancy

d. 2nd trimester of pregnancy

a

What is the primary purpose of a sonohysterogram?

a. to evaluate the ability of implantation to occur

b. to evaluate the cervix for dilatation

c. to evaluate focal endometrial abnormalities

d. to treat endometriosis

c

What is the typical appearance of a submucosal fibroid in sonohysterography?

a. hypoechoic mass connected to the endometrium by a stalk

b. solid mass covered by a layer of endometrium as it protrudes into the cavity

c. hyperechoic mass conected to the endometrium by a stalk

d. solid mass that does not disrupt the endometrium

b

Which of the following is an absolute contraindication for sonohysterography?

a. active bleeding

b. prior history of vasovagal response

c. systemic HTN

d. pregnancy

d

What preliminary evaluation must be performed prior to performing a hysterosalpingogram?

a. PT and INR levels

b. bhCG levels

c. estrogen levels

d. hematocrit levels

b

Hysterosalpingography is performed to evaluate the proper function of:

a. Mirena IUD

b. ParaGuard IUD

c. Essure devices

d. all the above

c

What findings indicate patent fallopian tubes on a hysterosalpingogram?

a. free fluid in the adnexa on the post procedure ultrasound

b. fluid moves from the fallopian tubes into the uterine cavity during the procedure

c. free fluid in the adnexa on the preliminary ultrasound

d. all the above

a

When a congenital uterine defect is identified:

a. the pelvic vasculature should be evaluated for defects

b. the external genitalia should be evaluated for defects

c. the urinary system should be evaluated for defects

d. the lower GI tract should be evaluated for defects

c