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WorksheetsOvarian Pathology Worksheet Questions
Total questions: 116
Worksheet time: 58mins
Theca lutein cysts are typically
Small and unilateral
Large, bilateral, and multiloculated
Solid and vascular
Calcified and irregular
Theca lutein cysts are associated with high levels of which hormone?
Estrogen
Progesterone
HCG
FSH
Theca lutein cysts are seen in approximately what percentage of patients with trophoblastic disease?
5%
15%
30%
50%
Theca lutein cysts may occur in patients undergoing
Antibiotic treatment
Infertility drug therapy
Thyroid medication
Steroid therapy
A common clinical symptom of theca lutein cysts is
Fever
Jaundice
Nausea and vomiting
Severe vaginal bleeding
Theca lutein cysts are most commonly seen in which patient population?
Teenagers
Pregnant women in their first trimester
Menopausal or postmenopausal women
Women under 25 with irregular cycles
Ovarian hyperstimulation syndrome (OHSS) occurs due to
Thyroid dysfunction
Fertility treatment/ovulation induction
Untreated UTIs
Excessive exercise
Which symptom is most associated with mild OHSS?
Severe abdominal distention
Pelvic discomfort
Pleural effusion
Rapid weight gain
In mild OHSS, ovarian size typically measures
<3 cm
<5 cm
6–8 cm
>10 cm
Severe OHSS is characterized by ovaries measuring
<2 cm
3–5 cm
6–8 cm
>10 cm
Which of the following is commonly associated with severe OHSS?
Dehydration only
Mild bloating
Ascites and pleural effusion
No abdominal symptoms
A hallmark ultrasound finding in OHSS is
Thick, calcified ovarian walls
Numerous large, thin-walled cysts around the ovarian periphery
Solid hyperechoic ovarian masses
Absent ovarian blood flow
Severe OHSS typically presents with
No pain
Severe pelvic pain and abdominal distention
Vaginal bleeding
Fever and chills
OHSS usually resolves within
24–48 hours
1 week
2–3 weeks
6–8 weeks
Paraovarian cysts arise from remnants of which structure?
Müllerian ducts
Wolffian ducts
Gartner ducts
Mesonephric arteries
Paraovarian cysts account for approximately what percentage of adnexal masses?
2%
5%
10%
25%
Where are paraovarian cysts specifically located?
Inside the ovary
Behind the uterus
Adjacent to the ovary within the broad ligament
Attached to the fallopian tube
Paraovarian cysts are usually
Large malignant tumors
Simple cysts that may grow up to 15 cm
Complex cysts with thick septations
Found only in postmenopausal women
What is the primary cause of ovarian torsion?
Infection of the ovary
Partial or complete rotation of the ovarian pedicle on its axis
Hormonal imbalance
Blockage of the fallopian tube
Which of the following is a common symptom of ovarian torsion?
Gradual onset of pelvic discomfort
Sudden severe unilateral pelvic pain
Frequent urination
Heavy menstrual bleeding
Ovarian torsion often blocks which types of drainage?
Only arterial
Only lymphatic
Venous and lymphatic
Gastrointestinal
Which ovary is more commonly affected by torsion?
Left ovary
Right ovary
Both equally
Neither
Which of the following is a risk factor for ovarian torsion?
Diabetes
Ovarian cyst or mass
Hypertension
Menopause
Ovarian torsion most commonly occurs in which age group?
Children and younger females under 30
Women over 50
Postmenopausal women
Infants only
What percentage of gynecologic emergencies is accounted for by ovarian torsion?
1%
3%
10%
15%
Which of the following may be palpable in more than 50% of ovarian torsion cases?
Uterine fibroid
Adnexal mass
Enlarged bladder
Cervical polyp
What is the possible outcome if ovarian torsion is not treated promptly?
Infertility only
Edema, hemorrhage, necrosis, and infarction of the ovary
Increased hormone production
Chronic pelvic infections
After a torsion occurs on one side, what is the chance of torsion occurring on the other side?
1%
5%
10%
20%
What type of ovarian tumor is most common among benign epithelial tumors?
Mucinous cystadenoma
Serous cystadenoma
Dermoid cyst
Endometrioma
Approximately what percentage of all ovarian neoplasms are serous cystadenomas?
10%-15%
25%-30%
40%-45%
50%-55%
Serous cystadenomas typically contain which type of fluid?
Mucinous
Serous
Hemorrhagic
Pus
How often are serous cystadenomas unilateral?
25% of cases
50% of cases
75% of cases
90% of cases
What is the usual size range for serous cystadenomas?
1-5 cm
5-10 cm (up to 20 cm possible)
10-15 cm
15-25 cm
In which group of women are serous cystadenomas most commonly found?
Teenagers
Women in their 20s
Women in their 40s–60s (postmenopausal)
Women over 70
Serous cystadenomas are usually:
Symptomatic, even when small
Asymptomatic unless they become large
Always bilateral
Associated with severe pelvic pain in most cases
What is the typical size range of a mucinous cystadenoma?
1–5 cm
5–10 cm
15–30 cm
Over 50 cm
How often are mucinous cystadenomas bilateral?
<5% of cases
10% of cases
25% of cases
50% of cases
What type of fluid fills a mucinous cystadenoma?
Serous fluid
Thick mucin and debris
Hemorrhagic fluid
Clear watery fluid
What serious complication can occur if a mucinous cystadenoma ruptures?
Ovarian torsion
Pseudomyxoma peritonei
Endometriosis
Fibroid formation
Mucinous cystadenomas are most commonly found in which age group?
Teenagers
Women 20–30 years old
Women 30–50 years old
Women over 60
Cystadenofibroma accounts for approximately what percentage of benign ovarian tumors?
0.5%
1.7%
5%
10%
Cystadenofibromas are most commonly found in which group of women?
Postmenopausal women
Menstruating women
Teenagers
Women over 60
What tissue components are present in a cystadenofibroma?
Only epithelial
Only fibrous stroma
Both epithelial and fibrous stromal components
Only mucinous tissue
Why are cystadenofibromas sometimes misdiagnosed as malignant?
They often rupture
They contain solid components
They are always bilateral
They produce hormones
Brenner tumors account for approximately what percentage of all ovarian neoplasms?
0.5%
1–2%
5–10%
15–20%
Brenner tumors are typically:
Always malignant
Usually benign but can be malignant
Always cystic
Hormone-producing
From what type of tissue does a Brenner tumor arise?
Epithelial only
Dense fibrous stroma
Mucinous tissue
Smooth muscle
Brenner tumors may be associated with:
Endometriomas on the opposite side
Other cystic neoplasms on the same side
Fibroids in the uterus
Serous cystadenomas bilaterally
Brenner tumors are most commonly found in:
Teenagers
Women in their 20s–30s
Postmenopausal women (50s–60s)
Women over 70
What is the typical size range of a Brenner tumor?
Usually very large, 20–30 cm
Small, up to 8 cm
Always microscopic
Over 15 cm
Benign cystic teratoma is the most common type of what?
Epithelial ovarian tumor
Germ cell tumor
Fibrous ovarian tumor
Stromal tumor
Benign cystic teratomas most commonly occur in which age group?
Women over 60
Teenagers and women under 20
Women 30–50
Postmenopausal women
What is the typical size range of benign cystic teratomas?
1–5 cm
5–10 cm, can grow up to 40 cm
10–15 cm
Over 50 cm
What is the malignant potential of benign cystic teratomas?
0%
1–2%
5–10%
15–20%
Which of the following tissues may be found in a benign cystic teratoma?
Hair, teeth, glandular tissue, thyroid tissue
Only epithelial tissue
Only fibrous stroma
Only serous fluid
How is a benign cystic teratoma connected to the ovary?
By a pedicle
Directly fused
Via cystic fluid only
It is not connected
What imaging sign is commonly associated with benign cystic teratomas?
Ground glass appearance
Tip of the iceberg sign
Snowstorm sign
String of pearls sign
Dermoid tumors are a type of:
Epithelial ovarian tumor
Teratoma containing mature tissues
Fibrous stromal tumor
Cystadenoma
Which of the following tissues are commonly found in dermoid tumors?
Only epithelial cells
Skin, hair, sweat glands
Serous fluid only
Fibrous stroma only
Dermoid tumors are most similar to which other ovarian tumor?
Serous cystadenoma
Benign cystic teratoma
Mucinous cystadenoma
Brenner tumor
Fibromas account for approximately what percentage of all ovarian tumors?
1%
5%
10%
15%
Fibromas are primarily composed of which type of tissue?
Epithelial tissue
Fibrous (connective) tissue
Glandular tissue
Smooth muscle
Fibromas are most commonly found in which age group?
Teenagers
Women in their 20s–30s
Women in their 50s–60s
Women over 70
What percentage of fibromas are unilateral?
50%
70%
90%
100%
What is the usual size range of fibromas?
1–5 cm
5–16 cm, but can be larger ("melon size")
20–30 cm
Over 40 cm
Fibromas are most commonly associated with which syndrome?
Meigs’ Syndrome
Pseudomyxoma peritonei
Ovarian torsion
Endometriosis
Why do thecomas often cause abnormal uterine bleeding?
Due to cyst rupture
Due to estrogen production
Due to fibrous tissue growth
Due to infection
How large can thecomas typically grow?
Up to 5 cm
Up to 15 cm
Up to 30 cm
Over 50 cm
Thecomas are usually:
Malignant
Benign
Always bilateral
Always cystic
Thecomas account for approximately what percentage of ovarian tumors?
<1%
1–2%
5–10%
10–15%
Thecomas are primarily:
Cystic
Solid tumors
Fibrous only
Serous fluid-filled
Thecomas produce which hormone?
Progesterone
Estrogen
Testosterone
Luteinizing hormone
Thecomas are most commonly found in which group of women?
Teenagers
Women in their 30s
Postmenopausal women (70%)
Women over 80
What clinical symptom is commonly associated with thecomas due to estrogen production?
Severe pelvic pain
Abnormal uterine bleeding
Frequent urination
Infertility
Thecomas are usually:
Bilateral
Unilateral
Always malignant
Always small (<5 cm)
Sertoli-Leydig tumors are also known as:
Thecomas
Androblastoma and Arrhenoblastoma
Brenner tumors
Fibromas
Sertoli-Leydig tumors account for approximately what percentage of all ovarian tumors?
<0.5%
1–2%
5–10%
10–15%
Sertoli-Leydig tumors typically occur in patients under what age?
<20 years
<30 years
30–50 years
Over 50 years
Sertoli-Leydig tumors belong to which group of ovarian tumors?
Germ cell tumors
Sex cord–stromal tumors
Epithelial tumors
Fibrous tumors
What hormone do Sertoli-Leydig tumors secrete?
Estrogen
Progesterone
Androgens (testosterone)
Luteinizing hormone
Common clinical symptoms of Sertoli-Leydig tumors include:
Pelvic pain, abdominal swelling, and masculinization
Asymptomatic unless very large
Postmenopausal bleeding
Frequent urination
What is the normal function of Sertoli cells in the testes?
Produce testosterone
Nourish sperm
Produce estrogen
Form fibrous tissue
What is the normal function of Leydig cells in the testes?
Nourish sperm
Produce testosterone
Produce estrogen
Produce mucin
The tumor arises from which cells in the ovaries?
Only ovarian surface epithelium
Sertoli and Leydig cells
Fibrous stroma
Germ cells
Which of the following is true about Sertoli-Leydig tumors?
They are common in postmenopausal women
They frequently produce estrogen
They often cause virilization due to androgen secretion
They are usually bilateral
Peritoneal inclusion cysts are lined with which type of cells?
Epithelial cells
Mesothelial cells
Fibrous stromal cells
Germ cells
How are peritoneal inclusion cysts typically formed?
From ovarian surface epithelium
When adhesions trap peritoneal fluid around the ovaries
From fibrous stroma proliferation
From ruptured cystadenomas
Which of the following is a common imaging description for peritoneal inclusion cysts?
Tip of the iceberg sign
Spider in a spider web
Snowstorm appearance
String of pearls
Peritoneal inclusion cysts are most common in which group of women?
Postmenopausal women
Premenopausal women
Teenagers
Women over 70
Which of the following are risk factors for developing peritoneal inclusion cysts?
Previous abdominal/pelvic surgery, trauma, PID, endometriosis
Only ovarian cysts
Only menopause
Only fibroid presence
Polycystic ovaries are also known as:
Peritoneal inclusion cysts
Stein-Leventhal Syndrome
Thecomas
Brenner tumors
The exact cause of polycystic ovaries is:
Known and due to infection
Unknown
Caused by ovarian cyst rupture
Caused by menopause
Polycystic ovaries are associated with which hormonal abnormalities?
High estrogen and low testosterone
High serum testosterone, high LH or FSH, low progesterone
Low androgens, high progesterone
Only high progesterone
Which of the following are common clinical features of polycystic ovaries?
Obesity, menstrual abnormalities, infertility, virilization, hirsutism
Only pelvic pain
Postmenopausal bleeding
Serous cyst formation
How does a hemorrhagic cyst typically appear during the late acute phase on imaging?
Anechoic
Solid mass
Complex mass
Hyperechoic rim only
Hemorrhagic cysts may mimic which of the following on imaging?
Simple cyst
Solid mass
Fibroma
Brenner tumor
Internal hemorrhage in hemorrhagic cysts most commonly occurs in:
Serous cystadenomas
Corpus luteum cysts or follicular cysts
Thecomas
Brenner tumors
What is a common symptom of hemorrhagic cysts?
Chronic bloating
Acute onset of pelvic pain
Postmenopausal bleeding
Infertility
Which of the following are important differential diagnoses for hemorrhagic cysts?
Endometriosis and fibroids
Ectopic pregnancy and tubal infection
Serous cystadenoma and mucinous cystadenoma
Brenner tumor and fibroma
How does an acute hemorrhagic cyst typically appear on imaging?
Anechoic
Complex mass
Solid mass
Hyperechoic rim only
How does a resolving hemorrhagic cyst typically appear on imaging?
Anechoic
Solid mass
Complex mass
Hyperechoic only
Meigs’ syndrome is classically associated with which triad?
Ovarian torsion, hematuria, and fever
Benign ovarian tumor, ascites, and pleural effusion
Malignant ovarian tumor, lymphadenopathy, and jaundice
Fibroma, peritoneal inclusion cyst, and hemorrhagic cyst
Meigs’ syndrome most commonly occurs with which type of ovarian tumor?
Brenner tumor
Fibroma
Thecoma
Serous cystadenoma
What typically happens to ascites and pleural effusion after removal of the tumor in Meigs’ syndrome?
They persist indefinitely
They resolve immediately
They worsen
They convert into cysts
Krukenberg tumors are:
Primary ovarian tumors
Metastatic tumors to the ovary from a primary elsewhere
Cystic ovarian tumors
Fibrous ovarian tumors
The most common primary site for a Krukenberg tumor is:
Breast
Gastrointestinal (GI) tract
Lung
Endometrium
Krukenberg tumors are typically:
Unilateral
Bilateral
Always cystic
Small (<2 cm)
What imaging or gross appearance is often described for Krukenberg tumors?
Tip of the iceberg sign
Spider in a spider web
“Moth-eaten” sign
String of pearls
Which type of cells are characteristic of Krukenberg tumors?
Fibrous stromal cells
Signet ring cells
Sertoli cells
Leydig cells
Dysgerminoma is the most common:
Benign ovarian tumor
Malignant germ cell tumor of the ovary
Sex cord-stromal tumor
Epithelial ovarian tumor
Approximately what percentage of ovarian germ cell tumors are dysgerminomas?
25%
50%
75%
90%
Dysgerminomas are most commonly seen in:
Postmenopausal women
Women under 30, including adolescents
Women in their 40s–50s
Infants
Which clinical feature may dysgerminomas cause?
Abnormal uterine bleeding in postmenopausal women
Primary amenorrhea
Hirsutism
Virilization
Which serum marker is often elevated in dysgerminomas?
CA-125
LDH
AFP
hCG
How do dysgerminomas generally respond to treatment?
Resistant to radiation and chemotherapy
Highly sensitive to radiation and chemotherapy
Only respond to surgery
Only respond to hormone therapy
What proportion of dysgerminomas behave aggressively?
All of them
1/3
2/3
None
