UTERUS ENDO CERVICAL PATHOLOGIES

In which of the following structures would a Gartner’s duct cyst be found?

Vagina

The clinical signs include irregular bleeding, menorrhagia, enlarged uterus, pelvic pain, and bladder symptoms most likely represent which one of the following?

Leiomyoma

Which one of the following is the most common site for a leiomyoma to occur?

Intramural

Complications in delivery may occur with pregnancy if a fibroid is located in or near which one of the following structures?

Near the cervix

Hydrometra appears sonographically as a(n) ______

Sonolucent fluid collection in the uterine canal

A benign invasion of endometrial tissue into the myometrium is known as which one of the following conditions?

Adenomyosis

Which one of the following conditions is described as a hyperplasia protrusion of the epithelium of the cervix that may be broad based or pedunculated?

Cervical polyps

Which one of the following sonographic characteristics is the most common finding in endometrial carcinoma?

Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women

Leiomyomas that displace or distort the endometrial cavity with subsequent irregular or heavy menstrual bleeding is called:

Submucosal

Which one of the following is most likely the result of an acquired condition with obstruction of the cervical canal?

Cervical stenosis

The size and shape of the normal uterus are related to all of the following except:

Family history

Which one of the following locations of a fibroid will most likely cause heavy irregular uterine bleeding

Submucosal

The most common cause of uterine calcification is which one of the following?

Myomas

On ultrasound, the characteristics appearance of a degenerating leiomyoma is ____

Heterogeneous

Which one of the following statements about adenomyosis is false?

Elevated progesterone levels may promote the growth of myometrial islands of endometrium

Uterine arteriovenous malformation (AVM):

Usually involves the myometrium

The endometrium should be measured from ___ layer to ___ layer

Hyperechoic to hyperechoic

Endometrial hyperplasia develops from which one of the following?

Unopposed estrogen stimulation

A 3-day postpartum woman complains of intense pelvic pain. Sonographically, the uterus appears hypoechoic with an irregular endometrium. This condition most likely represents which one of the following?

Endometritis

In postmenopausal patients, an endometrial thickness of less than ___ millimeters (mm) reliably excludes an endometrial abnormality

5

Only __ 10 % of women with postmenopausal bleeding have endometrial carcinoma

10

Patients on tamoxifen therapy have an increased risk of which one of the following reactions?

All of the above reactions

A 28-year-old woman reports left lower quadrant pain. Her last menstrual period 2 weeks earlier. Sonographically, the uterine body displays a highly echogenic structure in the endometrial cavity. This appearance most likely represents which one of the following conditions?

Intrauterine contraceptive device (IUD)

Irregular, acyclic bleeding is defined as which one of the following?

Metrorrhea

In a patient after a hysterectomy, the normal vaginal cuff should not exceed ___ cm

2

What is the most common congenital abnormality of the female genital tract?

Imperforate hymen

A condition defined as fluid distention of both the uterus and vagina due to obstruction of the vaginal outlet is called:

Hydrometrocolpos

Which of the following best defines hydrocolpos?

Fluid accumulation in the vagina

Which condition refers to blood accumulation within the uterine cavity?

Hematometra

Vaginal atresia is best described as:

Absence of the vaginal canal

Amenorrhea is defined as:

Absence of menstrual periods

Dysmenorrhea refers to:

Painful menstruation

Menorrhagia is defined as:

Excessive or prolonged menstrual bleeding

Oligomenorrhea refers to:

Infrequent menstrual cycles

Hypermenorrhea is defined as:

Excessive menstrual bleeding during normal cycle intervals

Cervical stenosis is best defined as:

Acquired obstruction of the cervical canal

Cervical stenosis may lead to which of the following conditions?

Accumulation of fluid in uterine cavity

A cervical polyp is best described as:

Benign protrusion of the epithelium of endocervix or ectocervix

Which symptom is most commonly associated with cervical polyps?

Irregular bleeding

A Gartner duct cyst arises from remnants of which embryologic structure?

Wolffian (mesonephric) duct

On ultrasound, a Gartner duct cyst most commonly appears as:

Anechoic cystic structure along the vaginal wall

A Bartholin duct cyst occurs when:

The Bartholin gland duct becomes blocked

Bartholin duct cysts are typically found:

At the posterior vagina (labia majora region)

Which ultrasound feature is most typical of a Bartholin duct cyst?

Simple cystic lesion near the vaginal opening

A sonographer identifies a small echogenic mass protruding from the endocervical canal attached by a thin stalk. What is the most characteristic shape of a cervical polyp?

Pedunculated mass attached by a stalk

Which of the following is the most important ultrasound feature suggesting a cervical polyp?

Internal vascular stalk on Doppler

Cervical polyps most commonly occur in:

Multiparous women aged 40–50

A nabothian cyst is best described as:

Endocervical glands become blocked, causing mucus accumulation.

Which of the following is the typical ultrasound appearance of a nabothian cyst?

Small anechoic cyst within the cervix

Which of the following is the most important risk factor for cervical carcinoma?

Infection with Human Papillomavirus (HPV)

Which symptom is most commonly associated with cervical carcinoma?

Vaginal discharge and bleeding

Which ultrasound finding is most suggestive of cervical carcinoma?

Irregular hypoechoic cervical mass with increased vascularity

Leiomyomas are best defined as:

Benign tumors arising from uterine smooth muscle

Leiomyomas are:

The most common benign tumor of the female pelvis

Which symptom is most commonly associated with uterine leiomyomas?

Heavy menstrual and irregular bleeding

Leiomyomas occur most frequently in:

Women of reproductive age

Which ultrasound finding is most typical of a uterine leiomyoma?

Solid hypoechoic uterine mass

A leiomyoma located just beneath the endometrium and projecting into the endometrial cavity is classified as:

Submucosal

Which type of leiomyoma is located within the myometrium?

Intramural

A leiomyoma that grows toward the outer uterine surface is called:

Subserosal

Leiomyomas may contribute to infertility primarily by:

Distorting the endometrial cavity or fallopian tubes

Degeneration of leiomyomas most commonly occurs due to:

Vascular compromise and insufficient blood supply

The most common type of fibroid degeneration is:

Hyaline degeneration

Leiomyomas are considered estrogen-dependent tumors, meaning they:

Increase in size with estrogen stimulation

A patient taking tamoxifen therapy may experience which effect on uterine fibroids?

Increased growth of fibroids

Which ultrasound finding is most commonly associated with uterine fibroids?

Enlarged uterus with irregular contour

On ultrasound, the myometrium in a uterus with fibroids often appears:

Heterogeneous with focal masses

A calcified leiomyoma will most likely produce which ultrasound artifact?

Posterior acoustic shadowing

Adenomyosis is best defined as:

Endometrial tissue located within the myometrium

The most common symptoms associated with Adenomyosis include:

Hypermenorrhea, menorrhagia, and metrorrhea

A patient with adenomyosis most commonly presents with:

Enlarged tender uterus

The most common ultrasound finding in Adenomyosis is:

Globular enlargement of the uterus

Which sonographic feature is most characteristic of adenomyosis?

Heterogeneous myometrium with small myometrial cysts

Another common ultrasound finding in adenomyosis is:

Asymmetric thickening of the myometrium

Initial management of symptomatic Adenomyosis may include:

Hormonal therapy (oral contraceptives or progestins)

The definitive treatment for severe symptomatic adenomyosis in women who do not desire fertility is:

Hysterectomy

Which condition may mimic adenomyosis due to uterine enlargement and heterogeneous myometrium?

Leiomyoma

On Color Doppler imaging, how does vascularity in Adenomyosis differ from that in Uterine Fibroids?

Adenomyosis shows no feeding arteries; fibroids do

Leiomyosarcoma is best described as:

Malignant tumor arising from uterine smooth muscle

Which symptom is most commonly associated with Leiomyosarcoma?

Abnormal vaginal bleeding, pelvic pain, and an enlarged uterus

On ultrasound, Leiomyosarcoma may appear as:

Irregular heterogeneous uterine mass

Which sonographic feature raises suspicion for leiomyosarcoma?

Poorly defined margins with cystic degeneration

A key clinical warning sign that may suggest leiomyosarcoma rather than a fibroid is:

Rapid growth of a uterine mass, especially after menopause

Nabothian Cyst is best defined as:

Mucus-filled retention cyst of the cervical glands

Large Nabothian cysts may occasionally cause:

Pelvic discomfort or fullness

On ultrasound, Nabothian Cyst typically appears as:

Small anechoic cyst within the cervix

Sonohysterography is best defined as:

Ultrasound evaluation of the uterus after infusion of sterile saline into the uterine cavity

The primary clinical indication for performing Sonohysterography is:

Evaluation of intracavitary uterine abnormalities

During Sonohysterography, the uterine cavity is distended with:

Saline solution

Endometrial Hyperplasia is best defined as:

Abnormal proliferation of the endometrial glands

Endometrial hyperplasia most commonly results from:

Excess estrogen without progesterone opposition

The most common clinical symptom of Endometrial Hyperplasia is:

Abnormal uterine bleeding

Endometrial hyperplasia is most commonly diagnosed in:

Perimenopausal and postmenopausal women

The most common ultrasound finding in Endometrial Hyperplasia is:

Thickened endometrium

In a premenopausal woman, an endometrial thickness greater than approximately 14 mm on transvaginal ultrasound raises suspicion for:

Endometrial Hyperplasia

In a postmenopausal woman, an endometrial thickness greater than 8 mm should prompt further evaluation for:

Endometrial Hyperplasia

Adding progesterone therapy in patients with endometrial hyperplasia generally results in:

Regression of endometrial thickening

Endometrial Polyp is best defined as:

Focal hyperplastic growth of endometrial tissue into the uterine cavity

Endometrial polyps are most commonly seen in:

Postmenopausal and perimenopausal women

On transvaginal ultrasound, an endometrial polyp typically appears as:

Focal, echogenic mass projecting into the endometrial cavity