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Edelman Cards OB 1

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1

What are the bones of the pelvic skeleton?

innominate

sacrum

coccyx

2

What is the innominate bone made of?

ilium

ischium

pubic

3

How is the true and false pelvis divided?

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sacral promontory to the pubis symphysis

4

What are the ligaments of the uterus and ovaries

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suspensory

- cardinal

- broad

- sacrouterine

- round

5

What ligaments maintain the uterine forward position?

no data

6

When can the pelvic ligaments be seen on ultrasound?

only in the presence of ascites

7

What muscles are sonographically visible?

rectus abdominal

psoas muscle

obturator internus muscle

levator ani muscle

8
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levator ani muscle

9
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obturator internus muscle

10

When is the bladder full enough for a transabdominal exam?

when the domw of the bladder extends above the uterine fundus

11

Why should the bladder be empty for a transvag exam?

to place the organs closer to the probe

12

What is the names given to the gutters between the vagina and cervix?

fornix

anterior

posterior

2 laterals

13

Which fornix is the most likely to contain gravity dependent fluid, while the patient is supine?

posterior

(largest)

14

What are the parts of the uterus from inferior to superior?

cervix

isthmus

body (corpus)

fundus

15

What is the name of the two openings of the cervix?

internal os

external os

16

What are the layers of the uterus?

perimetrium (serosal)

myometrium (muscular)

endometrium (inner)

17

What are the layers of the endometrium?

basal (permanent)

functional

18

How should the endometrium be measured?

anterior to posterior

19

How should the endometrium be measured with fluid within?

two sides then added

20

What are the uterine positions?

antiflexed (toward bladder)

anteversion (90o)

retroversion (straight)

retroflexed (toward rectum)

21

What is the most common uterine position?

anteversion

22

Where are the follicles produced within the uterus?

cortex

23

What is the ovarian volume and measurement of premenopausal patient?

9.8 cm3

3.5 x 2.0 x 1.5 cm

24

What is the ovarian volume and measurement of menopausal patient?

5.8 cm3

2.0 x 1.0 x 0.5 cm

25

What are the parts of the fallopian tubes from proximal to distal?

interstitual

isthmus

ampulla

infundibulum

frimbrae

26

Where is the space of retzius?

between the pubic bone and anterior uterine wall

27

what are other names for the space of retzius?

retropubic space

prevesical space

28

Where is the vesicouterine space?

anterior cul-de-sac

29

Where is the rectouterine space?

posterior cul-de-sac

30

What is another name for the rectouterine space?

Pouch of Douglas

31

What is the significance of complex fluid within the pelvic recesses?

can be associated with hemorrhage or infection

32

What arteries feed the uterus?

card image

uterine arteries branch from the internal iliacs

- arcuate

- radial

- spiral

33

What arteries feed the ovaries?

ovarian artery branched from the aorta (gonadal)

34

What veins drain the ovaries?

right ovarian drains into IVC

left ovarian drains into the left renal vein

35

Why are dilated veins near the uterus significant?

may be associated with the pelvic congestion syndrome?

36

What is GnRH?

gonadotropic releasing hormone secreted by the hypothalamus

when serum estadiol levels fall

stimulates FSH and LH from anterior pituitary

37

What is FSH?

Follicle Stimulating Hormone secreted by the anterior pituitary gland

stimulates growth and development of ovarian folicles

38

What is LH?

Lutenizing hormone secreted by the anterior pituitary gland

stimulates maturation of ovarian follicles and is responsible for graafian follicle rupture causing ovulation

39

What is the role of estrogen?

estrogen is secreted by the ovarian follicles and corpus luteum

Creates proliferative endometrium

40

What is the role of proestrogen?

secreted by the corpus luteum and placenta during pregnancy

Maintains secretory endometrium

41

What are the ovaian phases?

follicular phase: 1 - 14 days

luteal phase: 15 - 28 days

42

What is a graffian follicle?

the dominant follicle that ruptures during ovulation

43

How big can the graafian follicle get?

15 - 30 mm

44

no data

  • proliferative = 4 - 8 mm (4 - 14 days)
    • early proliferative = hypoechoic
    • later proliferative = tri layered
  • secretory = 8 - 16 mm (hyperechoic) (14 - 26 days)
  • menses
45
card image

no data

46

What is the spectral Doppler patterns of the uterine arteries?

high velocity

high resistance

*uterine and radial higher velocity and resistance in proliferative phase

47

What is the spectral Doppler patterns of the ovarian arteries?

low velocity

high resistance

48

What is the spectral Doppler patterns of the ovarian arteries after ovulation?

impedance drops on the side with dominant follicle resulting in low resistance

49

What is the sonographic appearance of an IUD?

hyperechoic

shadow

50

What is IVF?

in vitro fertilization

  • ovarian stimulation
  • needle aspiration
  • fertilization
  • catheter delivery into uterus
51

What is IVF with ZIFT?

zygote interfallopian tube transfer

52

What is IVF with Gift?

gamete intrafallopian tube transfer

sperm and egg placed in fallopian tube for fertilize

53

What is IUI?

intrauterine insemination

sperm placed in fundus

54

What is OHSS?

ovarian hyperstimulation syndrome

excessive stimulation of ovaries with fertility druge

55

What is the sonographic appearance of OHSS?

bilateral large simple cysts > 5 cm

ascites

pleural effusion

56

What is the sonographic appearance of the normal pediatric uterus?

2.5 - 3 cm length

cervix = 1/2

body = 1/2

57

What is precocious puberty?

onset of secondary sex characteristics before the age of 9

* can be caused by hypothalmic tumor

58

What is hematocolpus in adolescence generally secondary to ?

imperforate hymen

59

What is hematocolpus?

vagina fills with menstrual blood

60

What is hematometrocolpus?

expanded fluid filled vaginal cavity and uterus

61

#24

no data

62

What is the most common cause of post-menopausal bleeding in women not receiving HRT?

other causes ?

atropic endometrium

other causes

endometrium cancer

cervical cancer

estrogen producing tumor of ovary

63

What is tamoxifen?

nonsteroidal antiestrogen used as a chemotherapeutic agent

patients with breast cancer

64

What is the sonographic appearance of patients taking tamoxifen?

subendometrial cysts (between endo & myo)

endometrial hyperplasia

endometrial carcinoma

65

What are the mullerian duct abnormalities?

bicornuate uterus

uterus didelphys

septated uterus

66

What is the most common mullerian duct anomaly?

bicornuate uterus

67

What should the sonographer also look for when mullerian anomolies are found?

urinary anomolies

68

What is the most common tumor of the female pelvis?

fibroids

69

What are the different types of fibroids?

submucous (most symptomatic)

intramural

subserosal

cervical

peductulated

intraligamentous

70

What are all the different names for fibroids?

leiomyomas

myomas

fibromyomas

71

What are the clinical symptoms of fibroids?

menometrorrhagia

frequent urination

enlarged uterus

infertility

spontaneous abortion

alterations in menstrual flow

72

What is the sonographic appearance of fibroids?

hypoechoic mass

lobulated uterine contour

shadowing

whorled internal architecture

displacement of endometrial echoes

hypoechoic adnexal mass

73

What is adenomyosis?

invasion of endometrial glands and stroma into myometrium

74

What is the sonographic appearance of adenomyosis?

diffuse or focal

usually posterior

myometrial cysts

mottled

Venetian blind type shadowing

75

What is the most common GYN malignancy?

endometrial carcinoma

76

What are the risk factors of endometrial cancer?

obesity

anovulatory cycles

HRT - menopausal

atypical hyperplasia of endometrium

family history

77

What are the clinical signs of endometrial cancer?

postmenopausal bleeding

hypermenorrhea

intermenstral bleeding

pain from uterine distension

78

What is the sonographic appearance of endometrial cancer?

inhomogeneity

thickening > 4-5 mm

fluid in endometrium cavity

79

What is a nabothian cyst?

mucus retention cysts in the cervix

due to obstructed and dilated endocervical glands

80

What is a Gartner's duct cyst?

failure of disaperance of wolffian (mesonephric) ducts

81

What is a paraovarian cyst?

arise from the persistance of the cephalad portion of wolffian duct

appear as cyst next to ovary

82

What may be encountered while scanning a patient whose mother took DES?

T-shaped uterus

(infertility)

83

What is endometrium hyperplasia?

proliferation of endometrial glandular tissue

84

What are the causes of endometrium hyperplasia?

HRT

anovulatory cycles

PCOD

obesity

estrogen producing tumors

85

What is the clinical signs in patients with endometrium hyperplasia?

abnormal bleeding

86

What is the sonographic protocol for endometrium hyperplasia?

performed immediately following menses

87

What is an endometrial polyp?

localized overgrowth of endometrial tissue

88

What is the sonographic appearance of an endometrial polyp?

non-specific thickening

may be echogenic mass

hard to see without sonohistogram

89

What is the clinical presentation of endometrial polyp??

usually asymtomatic

abnormal bleeding

90

# 37

no data

91

What is the most common cause of ovarian enlargement in young women?

physiologic cysts

92

What are the physiologic cysts?

follicular cysts

corpus luteum

theca lutein

93

What is a theca lutein cyst?

cysts originate when HCG is elevated to an abnormally high level,

multifetal gestations

molar pregnancies.

*Typically associated with gestational trophoblastic conditions

94

What are follicular cysts caused by?

over stimulation of follicle that fails to rupture

95

What is the sonographic appearance of a follicular cyst?

anechoic

unilocular

thin-walled

exceeding 3 cm

96

What is the maximum measurement of a normal dominant follicle?

3 cm

97

What is the sonographic appearance of a corpus luteum cyst?

ovarian mass

thick hyperechoic irregular walls

possible complex

98

What does a corpus luteal cyst secrete?

progesterone

*small amount of estrogen

99

When does the corpus luteal cyst usually resolve?

16 weeks

100

What is the sonographic appearance of a theta luteal cyst?

biateral large multilocular ovarian cysts

101

What is the clinical presentation of a patient with a hemorrhagic ovarian cyst?

acute onset of pelvic pain

102

What is the sonographic appearance of a hemorrhagic ovarian cyst?

acute: hyperechoic (mimicking a solid mass but with posterior acoustic enhancement

subacute: complex

varied

103

What factors may predispose a patient to ovarian torsion?

ovarian mass

104

What is the sonographic appearance of ovarian torsion?

enlarged ovary

multiple follicles

absent color and spectral

adnexal mass

105

# 42 ALARA

no data

106

What is PCOS?

Polycystic ovarian syndrome

endocrinologic disorder of chronic anovulation

107

What is another name for PCOS?

stein-leventhal sysndrome

108

What is the clinical presentation of PCOS?

infertility

obesity

amenorrhea

hirsuitism

109

What is the sonographic appearance of PCOS?

multiple small cysts (12 or more)

string of pearls

bilateral always

enlarged or normal size ovaries

110

What is the sonographic appearance of serous ovarian tumors?

  • benign

sharpy marginated

anechoic

unilocular

possible internal thin-walled septations

  • Malignant

multilocular

multple papillary projections or sepations

echogenic material internally

ascites

111

What is the sonographic appearance of mucinous ovarian tumors?

  • benign

multiloculated

thick numerous septations

fine gravity dependent echoes

  • Malignant

multiloculated

multple papillary projections

echogenic material internally

112

What condition may occur with patients with mucinous ovarian tumors?

pseudomyxoma peritonel

penetration of the tumor casule or rupture into peritoneal cavity

113

What is the most commonly encountered germ cell tumors of the ovary?

benign cyctic teratoma

114

What is the sonographic appearance of benign cyctic teratoma?

# 47 more

mostly cystic adnexal mass

complex mass with calcifications

fat-fluid level

diffusely echogenic

tip of iceberg

dermoid plug

dermoid mesh

115

which malignant germ cell tumor may be seen in younger women?

dysgerminomas

endodermal sinus tumor

116

What is a dysgerminomas?

homologous to testicular seminoma

117

What is an endodermal sinus tumor?

yolk sac tumor

w/ elevated AFP

118

What is Meigs syndrome?

ascites

pleural effusion

fibrous ovarian tumor

119

What is the sonographic appearance of ovarian fibroma?

homogen

hypoechoic mass

acoustic enhancement

ascites

pleural effusion

120

What hormones are secreted by Thecoma?

estrogen

121

What hormones are secreted by granulosa cell tumor?

estrogen

122

What hormones are secreted by androblastoma?

testosterone

123

Ovarian metastases are most likely to arise from which primary malignancies?

breast

GIT tract

124

What is a krukenberg tumor?

arise from GIT

125

What is CA 125?

biological tumor marker elevated in women with ovarian cancer

126

What is the most deadly GYN cancer?

ovarian carcinoma

127

What is PID?

pelvic inflammatory disease

usually sexually transmitted infection

128

What are the clinical symptoms of PID?

fever

leukocytosis

lower abdominal pain

purulent vaginal discharge

pelvic tenderness

cervical motion tenderness

constant dull pain

dyspareunia

129

What is dyspareunia?

pain with sexual activity

130

What are the stages of PID?

Stage 1: early PID - endometritis

Stage 2: acute/subacute salpingitis / pyosalpinx

Stage 3: severe - broad ligament and ovarian involvement

131

What is the sonographic appearance of stage 1 PID?

thickened irregular endometrium

fluid

gas

fluid in post cul-de-sac

132

What is the sonographic appearance of stage 2 PID?

pyosalpinx

dilated tube with debris

echogenic material

133

What is the sonographic appearance of stage 3 PID?

TOA - complex adnexal mass

TOC - visible inflamed tube and ovary

134

What is the sonographic appearance of stage chronic PID?

hydorsalpinx

uterus and ovaries central in pelvis

lobster-claw sign

135

What is endometriosis?

presence of functional endometrial tissue outside of the endometrium and myometrium

diffuse or focal

136

What is a chocolate cyst?

discrete mass of endometriosis

137

What are the stages of endometriosis?

stage 1: minimal

stage 2: mild presence of adhesions

stage 3: moderate ovary involvement

stage 4: severe multiple adhesions

138

At what stage is endometriosis lore likely to show on U/S?

stage 3 with ovarian involvement

139

What are the clinical signs of endometriosis?

chronic pain

infertility

  • 4 ds

dysmenorrhea - painful menses

dyspareunia - painful sex

dysuria - difficult urination

dyschezia - difficult defecation

140

What is the sonographic appearance of endometriosis?

well defined unilocular

multilocular

diffuse

homogeneous

low-level echoes

posterior acoustic enhancement

141

What type of endometriosis is rarely detected with U/S?

diffuse

142

#60

no data

143

What is autosomal dominant?

only takes one parent

50% probaility

144

What is autosomal recessive?

takes two parents

25% probabilty

145

#62

no data


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