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WorksheetsIUD Insertion and Infertility Worksheet Questions (Grade 13)
Total questions: 72
Worksheet time: 36mins
Which of the following is an absolute contraindication for IUD insertion?
History of dysmenorrhea
Pregnancy
Prior cesarean section
Mild anemia
A 19-year-old nulliparous patient requests an IUD. Which factor makes IUD placement contraindicated in this case?
Age <20 with nulliparity
Regular menstrual cycles
No history of STI
Prior oral contraceptive use
Which infectious condition is a contraindication to IUD insertion?
Bacterial vaginosis
Candidiasis
Active cervicitis or PID
Recurrent UTIs
The presence of which of the following uterine or pelvic conditions would prevent IUD placement?
Normal anteverted uterus
Abnormal uterine cavity
Endometrial polyp
Small simple ovarian cyst
A patient with a history of gestational trophoblastic disease, pelvic tuberculosis, or untreated cervical cancer should avoid IUD insertion because these are:
Temporary side effects
Relative indications for IUD placement
Contraindications to IUD insertion
Normal findings before insertion
Which of the following is a known risk associated with IUD use, especially shortly after insertion?
Fibroid degeneration
Pelvic inflammatory disease (PID)
Polycystic ovarian syndrome
Endometriosis
A patient with an IUD becomes pregnant. What complications is she at increased risk for?
Benign ovarian cysts only
Ectopic pregnancy, spontaneous abortion, and septic abortion
Hyperemesis gravidarum
Placenta previa
Which of the following is considered a mechanical complication of IUD use?
Uterine perforation
Ovarian torsion
Cervical stenosis
Dysmenorrhea
Where should a correctly positioned IUD be located?
In the lower uterine segment
Embedded in the myometrium
In the uterine fundus above the internal os
In the cervical canal
What is the typical ultrasound appearance of an IUD?
Hypoechoic ring with no shadowing
Echogenic structure with high-amplitude echoes and acoustic shadowing
Isoechoic line with no distinct borders
Small cystic structure in the endometrium
Which of the following symptoms may indicate an IUD is out of place or displaced?
Mild PMS symptoms
Changes in string length, pelvic pain, or severe cramping
Temporary breast tenderness
Decreased menstrual flow
A patient with a malpositioned IUD may present with which additional symptom?
No menstrual changes at all
Abnormal bleeding or spotting, pain during intercourse, or abnormal discharge
Sudden weight gain
Dermatitis around the umbilicus
Which of the following best defines infertility?
Inability to conceive after six months of trying, regardless of age
Failure to conceive after at least one year of trying, or two years for older individuals
Failure to conceive after three months of trying
Inability to conceive only when medical conditions are present
Which of the following is a male factor that can contribute to infertility?
Hormonal imbalance
Varicoceles
Age over 35
Congenital uterine anomalies
Which male condition related to the urethra can lead to infertility?
Urethral strictures from venereal disease
Epididymal cysts
Prostate hypertrophy
Testicular torsion
Which of the following is a female factor that may affect fertility?
Lowered sperm motility
Infection
Varicoceles
Urethral stricture
Which of the following is considered a female factor of infertility related to structural or congenital issues?
Urethral stricture
Congenital anomalies
Low sperm count
Varicoceles
Which drugs are commonly used in ovulation induction therapy?
Metformin and Letrozole
Clomid and Pergonal
Progesterone and Estrogen
Tamoxifen and HCG
What is the main difference between IVF and GIFT?
IVF fertilization occurs inside the fallopian tube, GIFT occurs in a lab
IVF fertilization occurs outside the body in a lab, GIFT occurs inside the body in the fallopian tube
IVF requires at least one normal fallopian tube, GIFT does not
IVF transfers sperm only, GIFT transfers embryos only
Which statement correctly describes IVF (in vitro fertilization)?
Ova and sperm are placed directly into the fallopian tube
Mature ova are retrieved, fertilized in a lab dish, incubated, and 2–5 embryos are transferred to the uterus
Fertilization occurs spontaneously within the uterus
Only one embryo is always transferred
Which requirement is specific to GIFT (gamete intrafallopian transfer)?
The woman must have at least one normal, open fallopian tube
Fertilization must occur in a lab incubator
Multiple embryos must be frozen before transfer
Hormonal therapy is unnecessary
Which fertility procedure carries a higher risk of a pregnancy with multiple fetuses?
GIFT (Gamete Intrafallopian Transfer)
Clomid therapy
In vitro fertilization (IVF)
Artificial insemination
Where do the majority of ectopic pregnancies develop?
Ovaries
Cervix
Fallopian tubes
Abdominal cavity
If a patient is suspected of having an ectopic pregnancy, what is the first immediate action?
Schedule a routine follow-up in a week
Allow the patient to go home and rest
Do not let them leave and perform a STAT exam
Prescribe bed rest
Which diagnostic methods are used to confirm an ectopic pregnancy?
HCG level measurement, ultrasound, D&C, culdocentesis, or laparoscopy
Only physical exam
X-ray of the abdomen
Colonoscopy
Which of the following are potential life-threatening consequences of a ruptured ectopic pregnancy?
Mild nausea and fatigue
Hemorrhage, severe pain, shock, and possible death
Headache and dizziness only
Temporary spotting
Which long-term consequences may result from a ruptured ectopic pregnancy?
Loss of a fallopian tube (salpingectomy) and fertility issues
Improved fertility
Weight gain and hypertension
Chronic urinary infections
What is the most common cause of pelvic inflammatory disease (PID)?
Appendicitis
Chlamydia and gonorrhea (STDs)
IUD use
Endometrial biopsy
Which of the following is a less common cause of PID?
STD infection
IUD use
Sigmoiditis
Retained products of conception
Which of the following are considered the least common causes of PID?
Chlamydia and gonorrhea
D&C, hysterosalpingography, endometrial biopsy, retained POC, appendicitis, and sigmoiditis
IUD use
Hormonal imbalance
What is the initial stage of PID and how does it present?
Salpingitis; inflamed fallopian tubes
Endometritis; inflamed uterus with possible fluid in the endometrial cavity or cul-de-sac
Tubo-ovarian abscess; pus collection in the ovary and tube
Hydrosalpinx; fluid-filled fallopian tubes
During Stage 2 of PID, which structures become involved?
Ovaries only
Fallopian tubes, leading to salpingitis, hydrosalpinx, or pyosalpinx
Uterus only
Cervix and vagina
What is a tubo-ovarian abscess?
A fluid-filled uterus
A thick-walled pus collection involving both the ovary and fallopian tube
An inflamed fallopian tube with no pus
A cyst on the ovary unrelated to infection
What are possible long-term complications of untreated PID?
Infertility and chronic pelvic pain
Increased menstrual flow only
Ovarian cyst formation without pain
Resolution without consequences
Which statement correctly describes the progression of PID?
Infection starts in the ovaries, moves to the tubes, then to the uterus
Infection starts in the uterus (endometritis), progresses to the tubes (salpingitis), and can finally involve the ovary forming a tubo-ovarian abscess
PID only affects the uterus
PID progresses from the bladder to the cervix to the uterus
What is endometritis?
Inflammation or infection of the fallopian tube
Obstructed tube filled with serous secretions
Inflammation or infection of the endometrium
A fused ovary and tube with pus
What best describes hydrosalpinx?
Acute inflammation of the ovary
Obstructed fallopian tube filled with serous secretions, often secondary to PID, endometriosis, or postoperative adhesions
Collection of pus in the endometrium
Fusion of the ovary and inflamed tube
Salpingitis, classified as Stage 2 PID, refers to:
Inflammation or infection of the fallopian tube (can be acute, subacute, or chronic)
Obstruction of the endometrium
Fusion of ovary and tube
Collection of pus in the cul-de-sac
Pyosalpinx is defined as:
Endometrial inflammation
Retained pus in the oviduct with inflammation
Obstructed tube with serous fluid
Fusion of ovary and tube without pus
What characterizes a tubo-ovarian complex?
Ovary and tube are normal but inflamed
Ovary cannot be separated from the inflamed dilated fallopian tube
Obstructed tube filled with serous secretions
Fusion of ovary and tube with loculated pus
How is a tubo-ovarian abscess different from a tubo-ovarian complex?
It is an early stage of infection
The inflamed ovary and tube are fused and further loculated pus is present; structures are no longer distinguishable
Only the tube is involved
Only the ovary is involved
What is the internal form of endometriosis called?
Pyosalpinx
Adenomyosis
Hydrosalpinx
Salpingitis
What is the external or indirect form of endometriosis called?
Endometriosis (indirect)
Tubo-ovarian abscess
Salpingitis
Adenomyosis
What is the focal type of endometriosis called?
Adenomyosis
Endometrioma (chocolate cyst)
Hydrosalpinx
Pyosalpinx
Why is an endometrioma called a “chocolate cyst”?
It contains fresh blood and tissue
Old blood collects inside, giving it a dark brown “chocolate” appearance; it is localized and typically 2–5 cm
It contains pus and fluid
It is filled with serous secretions
Which of the following is a common symptom of endometriosis?
Severe dysmenorrhea (painful periods)
Frequent urination
Nausea only
Hypertension
Endometriosis may cause which types of pain?
Lower abdominal, pelvic, and back pain
Headache and chest pain
Only shoulder pain
Pain-free in all cases
Which of the following are additional possible symptoms of endometriosis?
Infertility, dyspareunia, and irregular bleeding
High fever and rash
Frequent urination and dehydration
Hair loss and brittle nails
Which group of women is most at risk of developing adenomyosis?
Women who have had uterine surgery
Women with no history of surgery
Women who are postmenopausal only
Teenagers
Which of the following is a medical treatment option for endometriosis?
Oral contraceptives
Surgical excision only
Complete hysterectomy only
Appendectomy
Which surgical treatments may be used for severe endometriosis?
Surgical excision of mass and complete hysterectomy with bilateral oophorectomy
Only laparoscopic biopsy
Appendectomy
Kidney removal
Which of the following are additional treatment strategies for endometriosis?
Danazol, drug therapy with laser therapy, natural menopause, or pregnancy
Only antibiotics
Chemotherapy
Radiation therapy
A simple ovarian cyst in a premenopausal woman is usually considered for surgical removal when it is:
Greater than 10 cm
Greater than 3 cm
Greater than 5 cm
Any size
A simple ovarian cyst in a postmenopausal woman is usually considered for surgical removal when it is:
Greater than 3 cm
Greater than 5 cm
Greater than 8 cm
Any size
Mucinous cystadenocarcinoma is:
A benign ovarian cyst
The malignant counterpart of a mucinous cystadenoma
Only found in teenagers
A type of endometrioma
Which of the following characteristics describe mucinous cystadenocarcinoma?
Small, unilocular cyst with no septations
Large, multiloculated cystic mass with prominent septations, may contain papillary projections, and can reach up to 30 cm
Solid ovarian tumor without cysts
Fluid-filled tube with no septations
What is a potential complication if a mucinous cystadenocarcinoma ruptures?
Hemorrhagic cyst
Pseudomyxoma peritonei
Hydrosalpinx
Salpingitis
Which of the following best describes an ovarian fibroma?
A malignant epithelial tumor
A tumor composed of fibrous (connective) tissue
A fluid-filled cystic tumor
A tumor producing large amounts of progesterone
Which statement is true about the demographics and size of ovarian fibromas?
Most common in women in their 20s, usually bilateral, 1–3 cm
Most common in women in their 50s–60s, 90% unilateral, typically 5–16 cm but can be larger
Only occurs in postmenopausal women, always smaller than 5 cm
Occurs mostly in teenagers, 50% bilateral, “melon size”
Ovarian fibroma is most commonly associated with which syndrome?
Turner Syndrome
Meigs’ Syndrome
Polycystic Ovary Syndrome
Stein-Leventhal Syndrome
What is a Krukenberg tumor?
A primary ovarian cystadenoma
A metastatic tumor to the ovary from a primary site elsewhere
A benign fibrous ovarian tumor
An endometrioma
What is the most common primary site for a Krukenberg tumor?
Breast
Gastrointestinal (GI) tract
Uterus
Kidney
Which of the following features are characteristic of Krukenberg tumors?
Unilateral, solid only, no special cellular features
Bilateral, “moth-eaten” sign, signet ring cells, can be cystic, mixed, or solid
Always cystic and unilateral
Only occurs in adolescents and is always benign
Stein-Leventhal Syndrome is also known as:
Meigs’ Syndrome
Polycystic Ovarian Disease (PCOD)
Krukenberg Tumor
Adenomyosis
Which of the following are common clinical features of Stein-Leventhal Syndrome?
Obesity, menstrual abnormalities (oligomenorrhea/amenorrhea), hirsutism, and infertility
Severe dysmenorrhea only
Postmenopausal bleeding
Pelvic inflammatory disease
What hormonal changes are typically seen in patients with Stein-Leventhal Syndrome?
High serum testosterone, LH, or FSH
Low estrogen and progesterone only
Only high prolactin
No endocrine abnormalities
Which of the following best describes the typical presentation of theca lutein cysts?
Small, unilateral, simple cysts
Large, bilateral, multiloculated cysts (3–20 cm) in both ovaries
Solid ovarian masses with no cystic components
Only found in teenagers
Theca lutein cysts are commonly associated with:
Low levels of HCG
High levels of HCG, seen in 30% of patients with trophoblastic disease, or infertility drug therapy
Endometriosis only
Chronic PID
Which of the following best describes a serous cystadenoma?
A malignant ovarian tumor filled with mucinous material
The most common benign epithelial ovarian tumor, usually filled with serous fluid, typically unilateral, 5–10 cm in size
A solid fibrous tumor common in teenagers
A multiloculated cyst associated with Meigs’ syndrome
Serous cystadenomas are most commonly found in:
Adolescents
Premenopausal women only
Postmenopausal women and are often asymptomatic
Men
Which statement best describes a Sertoli-Leydig cell tumor (Arrhenoblastoma)?
A common epithelial ovarian tumor in postmenopausal women
A rare sex cord–stromal ovarian tumor (<0.5% of ovarian tumors) that secretes androgens
A benign cyst filled with serous fluid
A cystic tumor associated with trophoblastic disease
What are common clinical features of Sertoli-Leydig cell tumors?
Pain, abdominal swelling, and masculinization due to increased testosterone
Dysmenorrhea and irregular bleeding only
Nausea and vomiting with multilocular cysts
Infertility without hormonal changes
