Registry Review- OB/GYN Quiz 1

The anechoic areas on the sonogram are identified as which of the following structures?

Nabothian cysts

Bicornuate uterus may best be seen

Axially

When fertilization does not occur, the corpus luteum cyst regresses and progesterone levels decrease, or AFP levels increase, or estrogen levels increase, FSH increases, or LH decreases

Progesterone levels decrease

FSH and LH are produced by the ovary

False

Which uterine anomaly is most likely to have a heart-shaped bundle contour?

Bicornuate

Which of the following intrauterine devices would be recognized as five equally spaced shadowing structures within the endometrium?

Lippes loop

A dominant follicle will grow approximately 5–10 mm per day, 2–3 mm per day, 5–10 mm per week, 2–3 mm per week, or 15–20 mm per week

2–3 mm per day

The exam of choice to delineate polyps in the endometrium is

Saline infusion sonohysterography

HCG causes the spiral arteries to dilate

True

Which of the following best describes the normal ovarian Doppler flow during the secretory phase of the menstrual cycle?

Low-resistance flow pattern

Which of the following is a disadvantage of transabdominal pelvic imaging?

Decreased resolution in a retroverted uterus

Which technical change should occur in this examination if the bladder is very large and uterus is in far zone?

Partial voiding of the urinary bladder

A properly distended urinary bladder in the transabdominal imaging of the pelvis displaces the uterus

Posteriorly

Which of the following secretes luteinizing hormone?

Pituitary gland

A competent cervical os measures a minimum of

2.5 cm

The zona functionalis is the part that is sloughed off in menstruation

True

Which of the following is the correct formula for calculating ovarian volume?

Length × Width × Height × 0.523

Prominent anechoic structures near the periphery of the uterus most likely represent

Arcuate arteries

Which pelvic ligament extends from the uterus to the medial aspect of the ovary?

Ovarian ligament

Developing ovarian follicles produce which of the following hormones?

Estrogen

Which of the following requirements must be met in order for a mass to be considered cystic?

All of the above (posterior enhancement, no internal echoes, smooth walls)

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

Piriformis and iliopsoas

The normal fallopian tube is routinely visualized on ultrasound

True

The corpus luteum primarily secretes

Progesterone

Which of the following structures regulates ovulation?

Hypothalamus

Endometrial hyperplasia may be caused by all of the following except

Endometrial atrophy (caused by tamoxifen, hormone replacement therapy, estrogen replacement therapy)

Which of the following would best define abnormally heavy menstrual flow?

Menorrhagia

Hydatidiform moles have a higher occurrence in

Asian populations

Pedunculated fibroids may be found in all of the following areas except

Endometrium

Which ovarian process is most likely to cause hyperemesis?

Theca lutein cysts

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

Hirsutism

Theca lutein cysts are seen with molar pregnancies

True

A large left adnexa hypoechoic mass most likely represents

Endometrioma

Why would a patient be given progesterone along with estrogen instead of estrogen alone for hormone replacement therapy?

Estrogen with progesterone decreases the likelihood of endometrial carcinoma

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

Ovarian torsion

The cervix is anchored at the angle of the bladder by all of the following except

Perineum (more likely: peritoneum, parametrium, suspensory ligament)

A 15-year-old presents with a history of amenorrhea and pelvic fullness. Based on the sonogram showing thickened endometrium with mixed echoes, this is most likely

Hematometra

What are the characteristics of Stein-Leventhal syndrome?

All of the above (irregular menses, obesity, hirsutism)

A woman presenting large for dates with positive β-HCG of 180,000 and excessive hyperemesis most likely has

Molar pregnancy

Surgical removal of a fibroid is referred to as

Myomectomy

Dysfunctional uterine bleeding may be caused by

All of the above (polyps, adenomyosis, fibroids, hormones)

What name is given to a tumor containing bits of hair, teeth, and bone?

Cystic teratoma

The sonographic findings of an endometrial polyp include

Diffuse thickening of the endometrium

Which of the following best describes the sonographic appearance of uterine synechiae?

Bright bands of echoes within the endometrium

Endometriosis is

Endometrial tissue present outside of the uterus

The sonographic appearance of an ovarian carcinoma is generally described as

Irregular hypoechoic ovarian mass

An ovarian tumor which is metastatic from a primary GI tract, breast, or genital malignancy is called

Krukenberg tumor

The most common benign ovarian tumor is

Cystic teratoma

Symptoms of endometritis include

All of the above (fever, pain, bleeding, malodorous discharge)

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

Amylase (relevant: WBC, hematocrit, HCG)

The region that includes the ovaries and the fallopian tubes is termed

Annexae

The pelvis is divided into the true and false pelvis by the

Iliopectineal line

The blood supply to the ovaries is provided through

Ovarian and uterine arteries

The narrowest part of the uterus is the fundus

False

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

Vesico-uterine pouch

Decreases in estrogen in postmenopausal patients can decrease cervical mucous and cause uterus and cervix size reduction, vaginal wall and endometrium thinning, and vaginal length shortening

True

Which congenital anomaly does not distort the normal contour of the uterine fundus?

Septate uterus

A retroverted uterus can mimic a fibroid on an ultrasound scan

True

Failure of the Müllerian ducts to fuse will most likely result in

Uterine didelphys

At the onset of menarche, the uterus measures

5 × 1 × 4 cm

Precocious puberty is best defined as

Pubertal development before the age of 8

What type of cyst is commonly associated with molar pregnancy?

Theca lutein cyst

Pedunculated fibroids are attached to the uterus by a

Stalk

Theca lutein cyst will continue to persist after evacuation of the mole and subsequent decrease of β-HCG for up to 5 years

False

Pain in the right upper quadrant resulting from infection tracking up the right paracolic gutter and localizing in the subhepatic and parahepatic space is called

Fitzhugh–Curtis syndrome

Parovarian cysts are typically located in the

Broad ligament

Mittelschmerz is associated with

Ovulation

Metastatic lesions of the adnexa are more commonly associated with a primary malignancy in the

Gastrointestinal tract

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

PCOS (More likely: ascites, multiple leiomyoma, ovarian hyperstimulation disease)

Heavy and prolonged menstrual flow is termed

Menorrhagia

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

Ovarian carcinoma

An obese patient presents with a history of infertility. Based on this clinical finding, this image is most likely demonstrating

Polycystic ovarian disease

Simple fluid accumulation within the vagina, secondary to imperforate hymen, is

Hydrocolpos

Retained products of conception can increase the development of

Endometritis

Krukenberg tumors are the result of

Metastatic disease

A routine pelvic sonogram on a patient with a history of breast cancer reveals an endometrial mass. The sonographer should ask the patient

Are you on tamoxifen therapy?

The dominant follicle prior to ovulation is termed

Graafian follicle

What position is demonstrated by this uterus (options: retroflexion, dextroflexion, levoversion, anteversion, anteflexion)?

Retroversion

The structure within the Graafian follicle containing the developing ovum is

Cumulus oophorus

The first phase of the endometrial cycle is

Proliferative phase

The endometrium is composed of two layers

Zona basalis and zona functionalis

The endometrium is most likely demonstrating the “three-line sign”

Late proliferative phase

The thickest part of the uterus is the perimetrium

False

Regeneration of the endometrial lining is a function of the

Basal layer

“Dextro” refers to

The right

Depth placement during a transabdominal pelvic ultrasound should include the

Retrourterine pouch

Spiral arteries supply the

Zona functionalis (functional layer) of the endometrium

The “snowstorm sign” refers to

Edematous chorionic villi

Upon pelvic ultrasound, an irregular mixed echogenic mass with high WBC count, extreme pelvic pain, and fever most likely represents

Tubo-ovarian abscess

Menorrhagia is not caused by hormones, fibroids, polyps, or cancer

False

Difficult or painful intercourse is called

Dyspareunia

Inflammation within the fallopian tubes is termed

Salpingitis

The best description for endometrial polyps is

Benign nodules of hyperplastic endometrial tissue

The absence of menstrual bleeding is termed

Amenorrhea

An increase in the number of endometrial cells is termed

Endometrial hyperplasia

The classic symptoms of polycystic ovarian syndrome include

All of the above (obesity and acne, male pattern balding, hirsutism, oligomenorrhea)

The myometrium of the uterus denotes

Benign invasion of endometrial tissue into the myometrium

Endometrial polyps are usually benign, may be pedunculated or sessile, or A and E

A and E

Secondary amenorrhea can cause

Cessation of menstruation

An asymptomatic patient presents with a palpable left lower quadrant mass. The sonogram of the left adnexal region is most suspicious for

Cystic teratoma