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DS 3262 Ch 42- The Sono & Doppler Evaluation of the Female Pelv

Total questions: 167

Worksheet time: 1hrs 24mins

Name
Class
Date
1.

When preparing a patient for a pelvic ultrasound, what is the first step?

a)

Perform the pelvic examination

b)

Obtain a complete patient history

c)

Review previous imaging studies after the exam

d)

Check laboratory tests only if cancer is suspected

2.

Which of the following should be included in a routine patient questionnaire for pelvic ultrasound?

a)

Date of last menstrual period (LMP)

b)

Patient’s favorite food

c)

Patient’s exercise routine

d)

Travel history

3.

Why is it important to correlate patient history findings with differential considerations?

a)

To choose the fastest imaging technique

b)

To improve diagnostic accuracy

c)

To avoid performing the ultrasound

d)

To reduce exam time

4.

Which of the following is NOT typically part of the patient history for a pelvic ultrasound?

a)

Past pelvic surgeries

b)

Hormone regimen

c)

Family history of cancer

d)

Patient’s shoe size

5.

Reviewing previous imaging studies is recommended:

a)

Only if symptoms are severe

b)

Before starting the exam

c)

After the exam is completed

d)

Only when the patient requests it

6.

What does premenarche refer to?

a)

The time after menopause

b)

The period before menstruation begins

c)

The first menstrual period

d)

The transition stage before menopause

7.

How long is a normal menstrual cycle after menarche?

a)

14–20 days

b)

21–28 days

c)

30–35 days

d)

40–45 days

8.

What is perimenopause or premenopause?

a)

The time before puberty

b)

The permanent cessation of menstruation

c)

A transition stage 2 to 10 years before menopause

d)

The start of menstruation

9.

During premenopause, what changes typically occur?

a)

Increase in estrogen and regular cycles

b)

Decrease in estrogen and irregular cycles

c)

No change in estrogen levels or cycles

d)

Menstrual cycles stop immediately

10.

What defines menopause?

a)

Irregular menstrual cycles

b)

The first menstrual period

c)

Permanent cessation of menstruation

d)

The transition period before puberty

11.

What should be done before starting the pelvic ultrasound exam?

a)

Begin the transabdominal scan immediately

b)

Explain the examination to the patient

c)

Start with the endovaginal scan without informing the patient

d)

Skip patient positioning

12.

If both transabdominal (TA) and endovaginal (EV) scans will be performed, what is important?

a)

Only tell the patient after the exam

b)

Inform the patient about both scans prior to the exam

c)

Perform the scans without explaining

d)

Only perform one scan

13.

What position is the patient placed in for the exam (TA and/or TV)?

a)

Prone

b)

Standing

c)

Supine

d)

Sitting

14.

What type of table is preferably used for the TB and/or TV exam?

a)

Cardiology table

b)

Gynecologic table

c)

Orthopedic table

d)

Standard hospital bed

15.

How is the transabdominal (TA) exam performed?

a)

With the bladder empty, using a high-frequency transducer

b)

Through the anterior abdominal wall with a distended bladder, using a curvilinear transducer up to 5 MHz

c)

Using an endovaginal probe only

d)

With the patient standing

16.

What is required for the endovaginal (EV) exam regarding the bladder?

a)

Bladder must be full

b)

Bladder must be empty

c)

Bladder size does not matter

d)

Bladder must be partially filled

17.

Which transducer frequency is typically used for the EV exam?

a)

Up to 5 MHz

b)

1 MHz

c)

7.5 MHz or higher

d)

3 MHz

18.

What advantage does the EV exam have over the TA exam?

a)

Better near field focusing and resolution

b)

Less detail of the uterus and adnexa

c)

Lower frequencies for deeper penetration

d)

Does not require patient preparation

19.

What planes are commonly used during the EV exam?

a)

Coronal and axial

b)

Sagittal and axial or coronal

c)

Transverse only

d)

Oblique only

20.

During a transabdominal sonographic exam, when a mass is found, what should be characterized first?

a)

Patient’s symptoms

b)

Location of the mass

c)

Laboratory test results

d)

Type of transducer used

21.

Which of the following locations might a mass be found in during a pelvic ultrasound?

a)

Only in the uterus

b)

Uterine or extrauterine

c)

Only in the ovaries

d)

Only outside the pelvis

22.

What aspects of a mass’s external contour should be assessed?

a)

Color and temperature

b)

Well-defined, ill-defined, or irregular borders

c)

Weight and consistency

d)

Size only

23.

How should the internal consistency of a mass be described?

a)

Only solid or cystic

b)

Cystic, complex, predominantly cystic, predominantly solid, or solid

c)

Hard or soft only

d)

Based on color Doppler only

24.

What size-related characteristic is important when evaluating a mass sonographically?

a)

Its size

b)

Patient’s age

c)

Blood pressure

d)

Height of the patient

25.

What does the transabdominal sonographic technique primarily visualize?

a)

Only the uterus

b)

The entire pelvis

c)

Only the bladder

d)

Only the ovaries

26.

What is one advantage of the transabdominal technique?

a)

Provides a detailed view of small structures only

b)

Provides a global overview of the pelvis

c)

Does not require patient preparation

d)

Can be used with an empty bladder

27.

The transabdominal exam may be limited in patients who are:

a)

Underweight

b)

Obese

c)

Athletes

d)

Children

28.

What patient condition can limit the transabdominal exam?

a)

Unable to fill their bladder

b)

Having high blood pressure

c)

Wearing tight clothes

d)

Being pregnant

29.

Which uterine position may cause limitations in the transabdominal exam?

a)

Anteverted uterus

b)

Retroverted uterus

c)

Mid-positioned uterus

d)

None of the above

30.

When is the transabdominal (TA) ultrasound recommended?

a)

For the final detailed study

b)

For the initial study

c)

Only after the endovaginal exam

d)

Only if the bladder is empty

31.

What is required for the transabdominal ultrasound?

a)

Full bladder

b)

Empty bladder

c)

No preparation needed

d)

Patient fasting

32.

How does a full bladder help during the TA ultrasound?

a)

It makes the uterus smaller

b)

It flattens the anteflexed uterus, making it more perpendicular to the transducer angle

c)

It hides the uterus

d)

It fills the bladder for easier scanning of the kidneys

33.

When is the bladder considered optimally full for a transabdominal pelvic ultrasound?

a)

When it covers the cervix

b)

When it covers the fundus of the normal-sized uterus

c)

When it is completely empty

d)

When it causes discomfort to the patient

34.

What can happen if the bladder is overdistended during the transabdominal exam?

a)

It improves image quality

b)

It compromises sonographic evaluation by compressing, distorting, and displacing anatomy

c)

It has no effect

d)

It makes the uterus appear larger

35.

What should be done if the bladder is overdistended before the exam?

a)

Have the patient drink more water

b)

Have the patient empty their bladder slightly

c)

Proceed with the exam without changes

d)

Schedule a different type of imaging

36.

What frequency range is typically used for a transabdominal anatomic survey?

a)

1 MHz

b)

3.5 MHz

c)

7.5 MHz

d)

10 MHz

37.

(TA exam) If the ovaries are higher or more superficial, what should be done regarding transducer frequency?

a)

Use a lower frequency

b)

Use a higher frequency

c)

Frequency does not matter

d)

Use the same frequency

38.

For an obese patient, which frequency is preferred during transabdominal ultrasound?

a)

Higher frequency

b)

Lower frequency

c)

Frequency is not adjusted

d)

Use endovaginal probe instead

39.

What shape is the bladder typically described as on ultrasound?

a)

Circular

b)

Triangular or elongated

c)

Square

d)

Irregular

40.

What is recommended if there is uncertainty about bladder identification?

a)

Ignore it and continue

b)

Take a pre-void image, have the patient void, then take a post-void image

c)

Use color Doppler only

d)

Perform a CT scan instead

41.

In transabdominal sonography, how should the uterus be identified?

a)

In the transverse axis

b)

In the long axis

c)

In the coronal axis only

d)

It does not need to be identified

42.

The uterus can normally deviate toward which directions?

a)

Only to the right

b)

Only to the left

c)

Either right or left

d)

Neither direction

43.

After establishing the uterine long axis, what is the next step?

a)

Take transverse scans only

b)

Perform parallel long scans from right to left to evaluate uterine margins and adnexa

c)

Start endovaginal scanning

d)

Perform Doppler imaging only

44.

Which anatomical structure can be used as a landmark to identify the lateral border of the adnexa?

a)

Ureter

b)

Iliac vessels

c)

Bladder

d)

Rectum

45.

After identifying the true long plane of the uterus in a transabdominal exam, what is the next step?

a)

Rotate the transducer 45 degrees

b)

Rotate the transducer 90 degrees and scan from inferior to superior

c)

Remove the transducer

d)

Perform an endovaginal exam

46.

How do the ovaries tend to move with increasing bladder distention?

a)

Travel caudally

b)

Travel laterally

c)

Travel cephalad (upward)

d)

Stay in the same position

47.


Where may the ovaries lie when the bladder is distended?

a)

Inferior to the uterine fundus

b)

Superior to the uterine fundus

c)

Behind the bladder

d)

On the cervix

48.

What types of scans are included in the routine transabdominal pelvic protocol?

a)

Only sagittal scans

b)

Longitudinal and transverse scans

c)

Only coronal scans

d)

Only endovaginal scans

49.

Which structures should be evaluated during the transabdominal pelvic exam?

a)

Uterus, cervix, rectouterine recess, right and left adnexa

b)

Liver and spleen only

c)

Heart and lungs

d)

Brain and spine

50.

What measurements should be taken of normal structures and pathology?

a)

Only length

b)

Length, width, and depth

c)

Only width and depth

d)

No measurements needed

51.

If pathology is present, which additional areas require documentation?

a)

RUQ (Morrison’s pouch and subphrenic area) and bilateral renal areas

b)

Left upper quadrant only

c)

Pelvic muscles only

d)

No additional documentation needed

52.

What is one advantage of endovaginal (EV) ultrasonography over transabdominal?

a)

Requires a full bladder

b)

Shortens the distance from the transducer to pelvic organs

c)

Uses lower frequency transducers

d)

Cannot visualize adnexal regions

53.

How does EV ultrasonography affect resolution?

a)

Decreases resolution

b)

Has no effect on resolution

c)

Increases resolution

d)

Makes images blurry

54.

What pelvic structures benefit from a better visual survey with EV ultrasound?

a)

Liver and kidneys

b)

Ovaries, uterus, and adnexal regions

c)

Brain and spinal cord

d)

Heart and lungs

55.

What should patients do with their bladder before an endovaginal (EV) ultrasound?

a)

Have a full bladder

b)

Empty their bladder

c)

No bladder preparation needed

d)

Drink a lot of water

56.

Why might patients need to re-void during the EV exam?

a)

Because the bladder may refill rapidly

b)

To improve image quality

c)

Because it helps the uterus position

d)

To reduce pain

57.

What is important to explain to the patient before the EV procedure?

a)

How long the exam will last

b)

The EV procedure itself

c)

The cost of the exam

d)

The radiologist’s name

58.

What kind of consent is required before performing an EV ultrasound?

a)

No consent is needed

b)

Verbal or written consent

c)

Only written consent

d)

Only verbal consent

59.

What is essential for anyone performing an EV ultrasound?

a)

To have the room darkened

b)

To have an additional female in the room

c)

To perform the exam without a chaperone

d)
  1. To use only transabdominal technique

60.

What should be applied directly on the face of the endovaginal probe?

a)

Sterile lubricant

b)

Gel

c)

Water

d)

Powder

61.

How should the probe be covered during EV ultrasound?

a)

With a protective sheath

b)

Left uncovered

c)

With a cloth

d)

With adhesive tape

62.

What type of sheath is recommended for the EV probe?

a)

Latex sheath

b)

Latex-free sheath

c)

Metal sheath

d)

Plastic wrap only

63.

What type of lubricant is applied outside the protective covering of the probe?

a)

Sterile external lubricant

b)

Regular body lotion

c)

Oil-based lubricant

d)

Water only

64.

For infertility patients, what is recommended to lubricate the transducer?

a)

Oil-based lubricant

b)

Water

c)

No lubricant

d)

Regular gel

65.

In an anteverted uterus, where is the cervix located on the ultrasound screen?

a)

lt side

b)

right side

c)

center

d)

not visible

66.

In an anteverted uterus, where is the fundus located on the ultrasound screen?

a)

lt side

b)

rt side

c)

center

d)

not visible

67.

In a retroverted uterus, where is the cervix located on the ultrasound screen?

a)

lt side

b)

rt side

c)

center

d)

not visible

68.

In a retroverted uterus, where is the fundus located on the ultrasound screen?

a)

lt side

b)

rt side

c)

center

d)

not visible

69.

What image plane is first obtained to locate the ovaries during an EV scan?

a)

Sagittal (longitudinal)

b)

Coronal (transverse)

c)

Axial

d)

Oblique

70.

To locate the ovaries, the probe is angled toward which anatomical structures?

a)

Fundus and cervix

b)

Cornua and ovarian ligament

c)

Bladder and urethra

d)

Rectum and sigmoid colon

71.

What imaging technique may be used to help locate the ovaries during an EV scan?

a)

Color Doppler

b)

MRI

c)

CT scan

d)

X-ray

72.

Which vessels are located posterior to the ovaries and can serve as a landmark?

a)

Internal iliac vessels

b)

External iliac vessels

c)

Femoral vessels

d)

Renal vessels

73.

Which Doppler techniques may be used during EV ultrasound to assess pathology?

a)

Color flow Doppler

b)

Power Doppler

c)

Pulsed Doppler

d)

All of the above

74.

When measuring the endometrium, what should NOT be included?

a)

Any endometrial fluid

b)

Thickness of the endometrium

c)

Width of the uterus

d)

Length of the ovaries

75.

What measurements should be taken during an EV ultrasound?

a)

Only the uterus length

b)

Length, width, and axial measurements of the uterus and ovaries

c)

No measurements are necessary

d)

Only the ovaries

76.

What is one reason to perform translabial sonography instead of endovaginal ultrasound?

a)

Obesity

b)

Cervical incompetence

c)

Gas in the bowel

d)

Lack of equipment

77.

Which of the following is not a typical indication for translabial sonography?

a)

Uterine prolapse

b)

Premature rupture of membranes

c)

Cervical incompetence

d)

Ovarian torsion

78.

What type of transducer is typically used for translabial sonography?

a)

7.5–10 MHz linear

b)

3.5 to 5 MHz curved linear

c)

1–2 MHz sector

d)

10 MHz endocavitary

79.

How is the transducer prepared and positioned for translabial scanning?

a)

Uncovered and inserted vaginally

b)

Covered with a sterile probe cover and placed at the vaginal introitus

c)

Placed on the abdomen with no cover

d)

Inserted rectally

80.

What may assist with visualization of the cervix during translabial sonography?

a)

Full bladder

b)

Completely empty bladder

c)

Partial bladder filling

d)

Lying in prone position

81.

What imaging techniques are used to evaluate pelvic vascularity?

a)

MRI and X-ray

b)

Real-time imaging and Doppler

c)

CT and PET

d)

Ultrasound only without Doppler

82.

What are Doppler velocity measurements typically expressed as?

a)

Absolute pressure

b)

Time intervals

c)

Ratios

d)

Voltage levels

83.

What does the S/D ratio in Doppler imaging stand for?

a)

Speed/Distance

b)

Systole/Diastole

c)

Signal/Drop

d)

Strength/Duration

84.

How is the Resistive Index (RI) calculated?

a)

(S × D)/Mean

b)

(S + D)/2

c)

(S - D)/S

d)

(S - D)/Mean

85.

What is the typical RI of uterine flow in a nonpregnant patient during the proliferative phase?

a)

0.55

b)

0.70

c)

0.88

d)

1.00

86.

The ovary receives blood supply from which of the following sources?

a)

Renal artery and iliac vein

b)

Aorta and ovarian branch of the uterine artery

c)

Femoral artery and aorta

d)

Internal iliac artery and renal artery

87.

What happens to ovarian blood flow during the follicular phase of the menstrual cycle?

a)

High velocity and low resistance

b)

Low velocity and high resistance index (RI)

c)

No measurable blood flow

d)

Maximum velocity and low RI

88.

What describes ovarian blood flow at ovulation?

a)

Low velocity and high RI

b)

No change in blood flow

c)

Maximal velocity and low RI

d)

Decreased perfusion

89.

Which phase of the menstrual cycle is associated with high resistance in ovarian blood flow?

a)

Luteal phase

b)

Ovulation phase

c)

Follicular phase

d)

Secretory phase

90.

In postmenopausal women, calcifications may commonly be seen in which uterine arteries?

a)

Radial arteries

b)

Spiral arteries

c)

Arcuate arteries

d)

Uterine arteries

91.

What imaging feature is typically associated with calcifications in the arcuate arteries?

a)

Cystic appearance

b)

Shadowing

c)

Bright flow signals

d)

Anechoic regions

92.

Calcifications in arcuate arteries should be distinguished from which of the following?

a)

Endometriomas

b)

Functional cysts

c)

Calcified leiomyomas

d)

Hydrosalpinx

93.

In which population are arcuate artery calcifications most commonly seen?

a)

Pregnant women

b)

Premenarchal girls

c)

Postmenopausal women

d)

Adolescents

94.

What structure separates the body of the uterus from the cervix?

a)

Endometrium

b)

External os

c)

Isthmus

d)

Vagina

95.

At what anatomical level is the isthmus located?

a)

External os

b)

Fundus

c)

Internal os

d)

Cervical fornix

96.

On ultrasound, how should the tissue echogenicity surrounding the cervical canal appear?

a)

Heterogeneous with shadowing

b)

Hypoechoic with cysts

c)

Homogenous

d)

Mixed echogenicity with calcifications

97.

What is the normal position of the cervix in relation to the midline?

a)

Deviated to the right

b)

Deviated to the left

c)

Fixed in the midline

d)

Mobile and shifting

98.

What part of the uterus is difficult to assess by transabdominal sonography when the uterus is retroverted or retroflexed?

a)

cervix

b)

fundus

c)

isthmus

d)

endometrium

99.

What is the best imaging method for measuring the cervical-fundal dimension of the uterus in the longitudinal plane?

a)

MRI

b)

CT

c)

Transabdominal sonography (TA)

d)

Translabial sonography

100.

When measuring the uterus in the longitudinal plane, where is the measurement taken?

a)

From the external os to the isthmus

b)

From the fundus to the distal end of the cervix

c)

From the bladder to the fundus

d)

From the vagina to the uterine body

101.

Where is the transverse measurement of the uterus taken?

a)

From fundus to cervix

b)

At the thinnest part of the uterus

c)

At the widest point, 90 degrees from the long axis

d)

Across the endometrium

102.

Which of the following factors influence the size and shape of the normal uterus?

a)

Age

b)

Hormonal status

c)

Parity

d)

All of the above

103.

What is the shape of the uterus in the neonatal period?

a)

Round

b)

Irregular

c)

Pear-shaped

d)

Cylindrical

104.

In a neonate, what portion of the uterus does the cervix occupy?

a)

One-third

b)

Half

c)

Two-thirds

d)

Entire length

105.

n the prepuberty stage, what proportion of the uterine length does the cervix occupy?

a)

1/3

b)

1/2

c)

2/3

d)

Entire length

106.

What is the average uterine length in a prepubertal female?

a)

3–5 cm

b)

6–8 cm

c)

1–3 cm

d)

0.5–1 cm

107.

In a nulliparous uterus, what proportion of the uterine length is occupied by the cervix?

a)

1/3

b)

2/3

c)

1/2

d)

Entire Length

108.

What are the average dimensions of a nulliparous uterus?

a)

3–5 cm length, 2–3 cm width

b)

6–8 cm length, 3–5 cm diameter and width

c)

1–3 cm length, 0.5–1 cm diameter

d)

4–6 cm length, 1–2 cm width

109.

In postmenopausal women, what portion of the uterine length does the cervix occupy?

a)

1/3

b)

1/2

c)

2/3

d)

Same as uterine body

110.

What are typical uterine dimensions postmenopause?

a)

1–3 cm length, 0.5–1 cm width

b)

3–5 cm length, 2–3 cm diameter and width

c)

6–8 cm length, 3–5 cm width

d)

4–6 cm length, 1–2 cm width

111.

During menstruation days 1-5, how does the endometrial canal typically appear on ultrasound?

a)

Hyperechoic central line

b)

Hypoechoic central line representing blood and tissue

c)

Anechoic cystic structure

d)

Isoechoic with myometrium

112.

As menstruation progresses, what happens to the hypoechoic echo in the endometrium?

a)

It becomes thicker and more hypoechoic

b)

It disappears, and the endometrial stripe becomes a thin hyperechoic line

c)

It turns into a cystic area

d)

It calcifies

113.

What is the typical measurement of the endometrial stripe during menstruation days 1-5?

a)

5-7 mm

b)

4-6 mm

c)

2-3 mm

d)

1-2 mm

114.

During the proliferative phase (days 5-14), how does the endometrial canal appear on ultrasound?

a)

Thick hyperechoic band

b)

Single thin stripe

c)

Anechoic fluid-filled area

d)

Irregular hypoechoic mass

115.

What layer is seen as a hypoechoic halo surrounding the endometrial canal during the proliferative phase?

a)

Basalis layer

b)

Myometrium

c)

Functionalis layer

d)

Serosa

116.

Which layer represents the thin surrounding hyperechoic outermost echo creating the "3-line sign"?

a)

Functionalis layer

b)

Basalis layer

c)

Endometrial canal

d)

Myometrium

117.

What is the typical endometrial thickness measurement between days 5-9?

a)

2-3 mm

b)

6 mm

c)

10 mm

d)

12 mm

118.

What is the typical endometrial thickness measurement between days 10-14?

a)

3-5 mm

b)

6 mm

c)

8 mm

d)

10 mm

119.

During the secretory (luteal) phase (days 15-28), how does the endometrium typically appear on ultrasound?

a)

Thin and hypoechoic

b)

At its greatest thickness and echogenicity with posterior enhancement

c)

Anechoic with fluid pockets

d)

Irregular and heterogeneous

120.

In the secretory phase, the functionalis layer becomes:

a)

Hypoechoic compared to the basalis layer

b)

Isoechoic with the basalis layer

c)

Not visible

d)

Hyperechoic compared to the basalis layer

121.

What is the typical measurement range of the endometrial complex during the secretory phase?

a)

2-4 mm

b)

4-6 mm

c)

7-14 mm

d)

15-20 mm

122.

When measuring the endometrium sonographically in the long axis, which of the following guidelines should be followed?

a)

Include the hypoechoic area in the measurement

b)

Measure only the anterior layer of the endometrium

c)

Measure from the highly reflective interface of the basalis layer, including both anterior and posterior layers

d)

Measure in transverse view to get the most accurate thickness

123.

During a sonographic evaluation of the pelvis, how is fluid seen within the endometrium handled during measurement?

a)

It is included in the total endometrial thickness

b)

Only half of the fluid-filled area is measured

c)

It is measured separately from the endometrial thickness

d)

It is excluded from the endometrial measurement

124.

Which of the following statements is TRUE regarding the sonographic appearance of the fallopian tubes?

a)

They are easily identified in all pelvic ultrasounds

b)

They appear as round structures with a diameter over 15 mm

c)

They are usually difficult to identify unless surrounded by fluid or dilated

d)

They are located anterior to the uterus and extend toward the bladder

125.

Which of the following is TRUE about the sonographic evaluation of the ovaries?

a)

Ovaries are fixed structures that do not change position

b)

They are best visualized transabdominally in the sagittal plane

c)

They are typically located lateral to the uterus and anteromedial to the internal iliac vessels

d)

The best way to locate the ovary is in the transverse plane with a full bladder

126.

Which of the following best describes the sonographic appearance and behavior of ovarian follicles during the proliferative phase?

a)

All follicles remain the same size throughout the cycle

b)

A dominant follicle enlarges to about 2–2.5 cm, while others become atretic

c)

Follicular cysts only appear during menopause

d)

The cortex of the ovary remains anechoic during this phase

127.

What happens to the corpus luteum if fertilization does not occur?

a)

It enlarges and forms a solid mass

b)

It involutes before menstruation

c)

It becomes a follicular cyst

d)

It remains unchanged until the next ovulation

128.

Which of the following sonographic features is typical of follicular cysts?

a)

Multilocular with thick irregular walls

b)

Unilocular, anechoic with well-defined thin walls and posterior enhancement

c)

Solid with no posterior enhancement

d)

Highly echogenic with calcifications

129.

What is the normal size range of a mature Graafian follicle?

a)

0.5–1.0 cm

b)

1.8–2.4 cm

c)

3.0–4.5 cm

d)

5.0–6.0 cm

130.

On color Doppler, how can a corpus luteum cyst typically be distinguished?

a)

It has a thin wall with no vascularity

b)

It shows a peripheral rim of color around a thicker wall

c)

It appears completely avascular

d)

It shows central color flow only

131.

How are the dimensions of the ovary typically measured during a sonographic exam?

a)

Length and anteroposterior (AP) dimension in the sagittal/long plane; width in the transverse or coronal plane

b)

Width and depth only in the transverse plane

c)

Only length in the transverse plane

d)

Diameter measured in any single plane

132.

What is the average volume of a normal menstruating ovary?

a)

3 cc

b)

5.8 cc

c)

9.8 cc

d)

12 cc

133.

Which statement about the posterior cul-de-sac (Pouch of Douglas) is TRUE?

a)

It is located between the bladder and uterus

b)

Fluid is rarely seen here during the menstrual cycle

c)

It is a common site for initial intraperitoneal fluid accumulation

d)

Pathologic fluid collections here never result from infection

134.

Where is the posterior cul-de-sac (Pouch of Douglas) located?

a)

Between the bladder and uterus

b)

Between the rectum and vagina

c)

Between the uterus and ovaries

d)

Anterior to the uterus

135.

What is a common normal finding in the posterior cul-de-sac during all phases of the menstrual cycle?

a)

Thickened endometrium

b)

Free fluid

c)

Calcifications

d)

Solid masses

136.

Which of the following can cause pathologic fluid collections in the posterior cul-de-sac?

a)

Ascites

b)

Blood from ruptured ectopic pregnancy or hemorrhagic cyst

c)

Pus from infection

d)

All of the above

137.

What is another name for hysterosonography?

a)

Transvaginal ultrasound

b)

Saline infused sonography (SIS)

c)

Doppler ultrasound

d)

Endometrial biopsy

138.

What is instilled into the endometrial cavity during hysterosonography?

a)

Air

b)

Sterile saline solution

c)

Contrast dye

d)

Gel

139.

Hysterosonography is primarily used to evaluate which of the following conditions?

a)

Ovarian cysts

b)

Thickened endometrium or suspected polyps

c)

Uterine fibroids only

d)

Pelvic inflammatory disease

140.

From where is the endometrium measured in sonographic evaluation?

a)

From the hypoechoic area inside the endometrium

b)

From the highly reflective interface of the basalis layer in the long view

c)

From the anterior layer only

d)

Including fluid seen inside the endometrium

141.

Which of the following is NOT included in the endometrial thickness measurement?

a)

A) Anterior and posterior layers of the basalis

b)

B) Hypoechoic areas within the endometrium

c)

C) Fluid seen inside the endometrium

d)

D) Both B and C

142.

Which of the following statements about fallopian tubes is true?

a)

They are easily identified sonographically regardless of fluid presence

b)

They are tubular structures measuring 8-10 mm in width

c)

They run from the ovaries to the uterus anteriorly

d)

They have 2 portions: intramural and isthmus only

143.

On a transvaginal coronal scan, the fallopian tube is easier to identify when:

a)

It is surrounded by free fluid

b)

It is collapsed and not distended

c)

It is surrounded by thick tissue

d)

It is less than 5 mm in width

144.

Which is true about the sonographic appearance of ovaries?

a)

They are spherical and immobile

b)

They are ovoid and mobile, changing location with bladder volume

c)

They are located medial to the uterus

d)

They do not contain follicles

145.

During the proliferative phase, what typically happens to ovarian follicles?

a)

No follicles develop

b)

Many follicles develop and one becomes dominant, growing to 2-2.5 cm by ovulation

c)

All follicles remain the same size

d)

Follicular cysts do not develop at this phase

146.

Which sonographic feature is typical of a corpus luteum cyst?

a)

Anechoic with thin walls and no color Doppler signal

b)

Thicker wall with a peripheral rim of color on Doppler

c)

Multiple small calcifications

d)

Fluid filled with no posterior enhancement

147.

Where is the posterior cul-de-sac (Pouch of Douglas) located?

a)

Between the bladder and uterus

b)

Between the rectum and vagina

c)

Adjacent to the ovaries

d)

Inside the fallopian tube

148.

What is the main purpose of hysterosonography (sonohysterography)?

a)

To measure ovarian volume

b)

To evaluate the endometrium when thickness is normal

c)

To instill saline into the endometrial cavity to evaluate focal thickening or polyps

d)

To evaluate the fallopian tubes only

149.

Fallopian tubes are difficult to identify sonographically unless:

a)

They are surrounded by fluid or are dilated

b)

The bladder is full

c)

The patient is postmenopausal

d)

The endometrium is thin

150.

The proximal end of the fallopian tube is also called the:

a)

Infundibulum

b)

Ampulla

c)

Isthmus

d)

Fimbriae

151.

The distal end of the fallopian tube is called the:

a)

Isthmus

b)

Ampulla

c)

Infundibulum

d)

Cornua

152.

What is the typical shape of the ovary?

a)

Spherical

b)

Ovoid

c)

Irregular

d)

Flat

153.

Ovaries are typically located:

a)

Medial to the uterus

b)

Lateral to the uterus and anteromedial to the internal iliac vessels

c)

Inferior to the bladder

d)

Posterior to the rectum

154.

The mobility of the ovaries depends on:

a)

Bladder volume and previous pregnancy

b)

Age and BMI only

c)

Menstrual cycle phase only

d)

None of the above

155.

Ovaries typically appear sonographically as:

a)

Hypoechoic, irregular masses

b)

Ovoid medium-level echogenic structures

c)

Hyperechoic with calcifications

d)

Anechoic cystic structures only

156.

During the proliferative phase, follicles:

a)

Do not develop

b)

Develop in number and size until day 8 or 9

c)

All become dominant follicles

d)

Disappear completely

157.

The dominant follicle grows to approximately:

a)

0.5-1 cm

b)

1-1.5 cm

c)

2-2.5 cm

d)

3-4 cm

158.

Follicular cysts develop when:

a)

The dominant follicle ruptures early

b)

Fluid is not reabsorbed in the nondominant follicles

c)

No follicles develop during the cycle

d)

The corpus luteum forms

159.

The corpus luteum forms:

a)

Before ovulation

b)

Following ovulation

c)

During menstruation

d)

Only in postmenopausal women

160.

If fertilization does not occur, the corpus luteum:

a)

Enlarges indefinitely

b)

Involutes before menstruation

c)

Becomes a follicular cyst

d)

Remains active during menstruation

161.

Follicular cysts are usually:

a)

Multilocular with thick walls

b)

Unilocular, anechoic with well-defined thin walls and posterior enhancement

c)

Solid with increased vascularity

d)

Calcified masses

162.

Corpus luteum cysts differ from follicular cysts by often having:

a)

A thinner wall

b)

A thicker wall and a peripheral rim of color on Doppler

c)

No blood flow

d)

Multiple septations

163.

The posterior cul-de-sac (Pouch of Douglas) is located:

a)

Between the bladder and uterus

b)

Between the rectum and vagina

c)

Between the uterus and ovaries

d)

Within the fallopian tubes

164.

Pathologic fluid collections in the posterior cul-de-sac may be caused by all EXCEPT:

a)

Ascites

b)

Blood from ruptured ectopic pregnancy or hemorrhagic cyst

c)

Pus from infection

d)

Normal proliferative phase changes

165.

Hysterosonography (Sonohysterography or Saline Infused Sonography) involves:

a)

Injection of contrast into the fallopian tubes

b)

Instillation of sterile saline solution into the endometrial cavity

c)

Measurement of ovarian volume

d)

Evaluation of the posterior cul-de-sac fluid only

166.

The primary use of hysterosonography is:

a)

To evaluate endometrium when it is thicker than normal

b)

To diagnose ovarian cysts

c)

To measure uterine size

d)

To detect ascites

167.

Hysterosonography helps identify:

a)

Endometrial polyps and focal areas of thickening

b)

Fallopian tube patency only

c)

Ovarian follicles during ovulation

d)

Fluid in the posterior cul-de-sac

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