Deck 43: Pathology of the Uterus

Question 1

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

A) 4
B) 5
C) 8
D) 10

Answer 1

B

Question 2

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

A) Submucosal
B) Subserosal
C) Pedunculated
D) Intramural

Answer 2

D

Question 3

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

A) Endometriosis
B) Pelvic inflammatory disease (PID)
C) Adenomyosis
D) Endomyosarcoma

Answer 3

C

Question 4

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

A) Abnormal thinning of the endometrial cavity, usually with irregular bleeding in postmenopausal women
B) Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women
C) Irregular bleeding
D) Heavy bleeding with a thickening of the myometrium

Question 5

Endometrial hyperplasia develops from which one of the following?

A) Unopposed estrogen stimulation
B) Unopposed progesterone stimulation
C) Follicular-stimulating hormone
D) Endometrial polyp

Question 6

A small percentage of leiomyomas are located in which one of the following structures?

A) Body
B) Fundus
C) Myometrium
D) Cervix

Question 7

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

A) family history.
B) age.
C) hormonal status.
D) parity.

Question 8

Only _____% of women with postmenopausal bleeding have endometrial carcinoma.

A) 10
B) 25
C) 50
D) 75

Question 9

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

A) Leiomyoma
B) Cervical carcinoma
C) Cervical stenosis
D) Adenomyosis

Question 10

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

A) Near the fundus
B) Pedunculated off the fundus
C) Near the cervix
D) Near the ovary

Question 11

Uterine arteriovenous malformation (AVM):

A) usually involves the endometrium.
B) can be managed with dilation and curettage (D&C).
C) usually involves the myometrium.
D) is always acquired.

Question 12

Which one of the following statements about adenomyosis is false?

A) Elevated progesterone levels may promote the growth of myometrial islands of endometrium.
B) Adenomyosis can be managed with hormone therapy.
C) Adenomyosis may cause abnormal uterine bleeding.
D) Adenomyosis may cause pelvic pain during menstruation.

Question 13

On ultrasound, the characteristic appearance of a degenerating leiomyoma is ____________________.

A) homogeneous
B) heterogeneous
C) isoechoic
D) anechoic

Question 14

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

A) Subserosal
B) Submucosal
C) Intramural
D) Pedunculated

Question 15

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?

A) Adenomyosis
B) Degenerating submucosal leiomyoma
C) Endometritis
D) Endometrial hyperplasia

Question 16

The endometrium should be measured from ___________ layer to ___________ layer.

A) hypoechoic; hypoechoic
B) hyperechoic; hyperechoic
C) hyperechoic; hypoechoic
D) hypoechoic; hyperechoic

Question 17

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

A) Adenomyosis
B) Endometritis
C) Arcuate artery calcification
D) Myomas

Question 18

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

A) Cervical stenosis
B) Pyometrium
C) Cervical polyps
D) Cervical obstruction

Question 19

The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following?

A) Early pregnancy
B) Leiomyoma
C) Ruptured nabothian cyst
D) Ruptured follicular cyst

Question 20

Hydrometra appears sonographically as a(n) ________________________________.

A) sonolucent tubular structure in the adnexa
B) echogenic thickening of the endometrium
C) sonolucent fluid collection in the uterine canal
D) sonolucent fluid collection in the uterus, cervix, and vagina

Question 21

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

A) Fallopian tube
B) Ovary
C) Cervix
D) Vagina

Question 22

A 28-year-old woman reports left lower quadrant pain. Her last menstrual period was 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?

A) Endometritis
B) Calcified submucosal fibroid
C) Intrauterine contraceptive device (IUD)
D) Calcified arcuate arteries

Question 23

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

A) Menorrhagia
B) Metrorrhea
C) Dysmenorrhea
D) Amenorrhea

Question 24

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

A) Endometrial hyperplasia
B) Endometrial polyp
C) Endometrial carcinoma
D) All of the above reactions

Question 25

In a patient after a hysterectomy, the normal vaginal cuff should not exceed _____ centimeters (cm).

A) 1
B) 2
C) 3
D) 4