Question 1

Which is a benefit to using transvaginal (TV) ultrasound compared to the transabdominal (TA) approach?&#10;A) The TA approach provides lower resolution images.&#10;B) The TV approach uses higher frequency transducers than those of TA.&#10;C) The TA approach requires a full bladder to improve visualization.&#10;D) The TV approach allows for closer proximity to desired structures.

Accepted Answer

The TV approach allows for closer proximity to desired structures, resulting in higher resolution images.

Question 2

The practitioner is having difficulty locating the ovaries on a pelvic ultrasound examination. Which structures can be used to assist in locating the ovaries?&#10;A) The uterus.&#10;B) The myometrium.&#10;C) The urinary bladder.&#10;D) The internal iliac vessels.

Accepted Answer

D

Question 3

While completing a transabdominal pelvic ultrasound, the practitioner notes the uterus is in a more horizontal position. Which is the best interpretation of this finding?&#10;A) The full bladder will naturally cause more horizontal positioning of the uterus.&#10;B) The uterus is abnormally positioned and requires further in-depth examination.&#10;C) The uterus is demonstrating signs of pregnancy and a cervix measurement is needed.&#10;D) The bladder should be filled by drinking water to force correct positioning for the exam.

Accepted Answer

A full bladder during a transabdominal pelvic ultrasound can push the uterus into a more horizontal position, which is a normal occurrence.

Question 4

While completing training for ultrasound, the practitioner notices that some exam subjects demonstrate a thinner endometrium than others. How should these findings be interpreted?&#10;A) The women demonstrate similarities due to birth control use.&#10;B) The women demonstrate differences due to menstrual cycles.&#10;C) The women with thicker endometria are in early pregnancy.&#10;D) The women with thinner endometria are all post-menopausal.

Accepted Answer

The thickness of the endometrium varies throughout the menstrual cycle, being thinner during the early phase and thicker during the secretory phase.

Question 5

The post-menopausal woman presents for a transvaginal ultrasound examination due to bleeding. Which finding suggests the woman may have pathology present?&#10;A) The endometrial wall shows up as a triple line.&#10;B) The endometrial wall has a measurement of 6 mm.&#10;C) The endometrial wall has a measurement of 3 mm.&#10;D) The endometrial wall shows up as a thin echogenic stripe.

Accepted Answer

In post-menopausal women, an endometrial thickness greater than 4-5 mm is considered abnormal and may suggest pathology such as endometrial hyperplasia or cancer.

Question 6

The practitioner needs to improve the visualization of the cervix and the uterus during the ultrasound examination. Which technique would accomplish this goal?&#10;A) Place the transvaginal transducer near the external os.&#10;B) Partially insert the transvaginal transducer into the cervix.&#10;C) Partially remove the transvaginal transducer from the vagina.&#10;D) Place the transvaginal transducer at the opening of the vagina.

Accepted Answer

Placing the transvaginal transducer near the external os allows for better visualization of the cervix and uterus as it provides a closer and more direct view of these structures.

Question 7

The 25-year-old woman presents with irregular menses and is being evaluated for polycystic ovary syndrome (PCOS). Which of the following findings is most suggestive of the condition?&#10;A) Ovarian volume is 8 cm3 and 8 follicles are present.&#10;B) Ovarian volume is 12 cm3 and 10 follicles are present.&#10;C) 14 follicles are present with an average measurement of 5 mm.&#10;D) 12 follicles per ovary, peripheral distribution, and stromal brightness are present.

Accepted Answer

The presence of 12 or more follicles per ovary, peripheral distribution, and increased stromal brightness are characteristic ultrasound findings suggestive of PCOS.

Question 8

The woman who has had stimulated in vitro fertilization demonstrates three follicles at 12, 14, and 15 mm, and 2 follicles at 7 and 8 mm. What is the best interpretation of this information?&#10;A) No follicles are likely to become mature oocytes.&#10;B) 2 follicles will likely become mature oocytes while 3 will not.&#10;C) 3 follicles will likely become mature oocytes while 2 will not.&#10;D) All follicles have an equal likelihood of becoming mature oocytes.

Accepted Answer

Follicles typically need to be around 18-20 mm to be considered mature. The follicles at 12, 14, and 15 mm are closer to this size and more likely to mature than the smaller ones at 7 and 8 mm.

Question 9

The woman with an IUD presents to the clinic with concerns that she is no longer able to feel the strings. They are not visible during the speculum exam. Which of the following makes ultrasound the preferred method for determining position of this IUD?

A) The ultrasound examination presents no risk to the patient.
B) The ultrasound technology is less expensive than other methods and is readily available.
C) The ultrasound examination will reveal the IUD no matter where it is.
D) The ultrasound technology can be used to retrieve any misplaced IUD.

Accepted Answer

The answer of The woman with an IUD presents to...

Question 10

The practitioner has performed an ultrasound examination of a woman who has been treated for reproductive care. Which best describes the documentation that the practitioner should include in the medical record for this woman?

A) The general follicular characteristics.
B) The need for a follow-up examination.
C) The measurements of endometrial thickness.
D) The appearance of each anatomical structure.

Accepted Answer

The practitioner should document the appearance of each anatomical structure to provide a comprehensive record of the ultrasound findings, which is crucial for ongoing reproductive care and treatment planning.

Deck 3: Ultrasound in Gynecology and Reproductive Technologies