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WorksheetsExam I Review
Total questions: 52
Worksheet time: 28mins
During a pediatric pelvic ultrasound, what is the recommended patient interaction to improve cooperation?
Avoid explaining the jelly to the child
Allow a parent to stay with the child
Keep equipment out of the child’s view
Restrain the child to prevent movement
Fill in the blank: For optimal visualization in pediatric transabdominal pelvic ultrasound, the patient should have a (a) .
Match each exam step with the correct detail for pediatric transabdominal ultrasound preparation and technique.
Hydration timing and amount
24 ounces water 45–60 minutes before
Alternative access route
Rarely, transperineal may be used
Transducer frequency range
Approximately 5 to 7.5 MHz
Imaging approach allowed
Transabdominal imaging only
Fill in the blank: The most common cause of vaginal bleeding in prepubertal girls is a (a) .
A 13-year-old with a history of in utero exposure to diethylstilbestrol (DES) presents with postmenarchal vaginal bleeding. Which sonographic pattern best aligns with the most likely diagnosis?
Large poorly circumscribed complex mass
Thin-walled simple anechoic cyst
Fat-containing heterogeneous mass
Predominantly solid tumor without cystic spaces
Which statement best describes ovarian cysts in children?
They account for over 70% of ovarian masses
They rarely exceed one percent of ovarian masses
They are always multiple and multiloculated lesions
They usually require urgent surgical excision
Match each ovarian lesion or feature to the correct description.
Follicular retention cysts
Common simple functional cyst type
Hormone-secreting cysts
May lead to precocious puberty in children
Paraovarian cysts
Situated between tube and ovary in mesosalpinx
A 13-year-old presents with a solid ovarian mass that is bilateral on imaging. Which tumor type is most likely?
Endodermal sinus tumor typically cystic
Dysgerminoma fits this presentation
Benign cysts always bilateral masses
Adult-type tumors are common in children
Which characteristic is typical of dysgerminoma in pediatric patients?
Most common malignant ovarian tumor
Always unilateral without solid areas
Frequently secretes hormones causing puberty
Usually derived from endodermal sinus cells
Which statement best describes ovarian agenesis in pediatric patients?
Often bilateral and common in neonates
Associated with rapid postnatal ovarian growth
Extremely rare, often from in utero torsion
Usually acquired after menarche trauma
Gonadal dysgenesis is characterized by which key feature in affected individuals?
Normal-sized functional ovaries present
Reversible enlargement with nutritional therapy
Rudimentary, small, and deficient gonads
Excess androgen production causing virilization
In evaluating ambiguous genitalia in a newborn, what is the most appropriate immediate imaging goal of sonography?
Detect chromosomal mosaicism with imaging
Assess bone age and growth plate fusion
Identify internal reproductive anatomy quickly
Quantify circulating androgen levels precisely
A 6-year-old girl presents with breast development and sonography shows postpubertal-sized ovaries and uterus. Which next step best reflects the pathophysiology to investigate?
Begin iron therapy for anemia-related menarche
Delay evaluation because size is prepubertal
Evaluate for hypothalamic lesions occasionally implicated
Order ovarian biopsy to confirm gonadal dysgenesis
Which finding best defines vaginal atresia?
Incomplete vaginal canalization
Absent ovarian follicles
External genital fusion defects
Congenital uterine duplication
Match each sonographic term with its primary content.
Hydrocolpos
Fluid-filled vagina
Hydrometrocolpos
Fluid-filled vagina and uterus
Hematometrocolpos
Blood-filled vagina and uterus
A 22-year-old has two cervices on speculum exam and pelvic ultrasound shows duplicated uterine horns. Which counseling point is most appropriate?
Requires immediate surgical correction
Usually presents as a small lateral uterus
High risk of renal agenesis contralaterally
Fertility is typically not a problem
On ultrasound, which view most reliably demonstrates the characteristic heart-shaped fundus of a bicornuate uterus?
Transverse pelvic view over the fundus
Oblique adnexal sweep laterally
Transvaginal coronal cervix view
Sagittal midline uterine view only
Which embryologic fact best explains why urinary and reproductive anomalies often co-occur?
They develop at completely separate time points
They arise from postnatal hormonal exposure
They are controlled by unrelated germ layers
They share closely related developmental origins
What clinical action is guided by recognizing the urinary–reproductive developmental link?
Examine both systems when one shows anomaly
Ignore urinary findings in genital anomalies
Screen only kidneys after birth exclusively
Treat reproductive defects without imaging
Which gamete always contributes an X chromosome?
Neither gamete consistently
Either gamete randomly
The sperm from the male
The oocyte from the female
In a fetus with a Müllerian anomaly, what additional evaluation is most justified?
Cardiac MRI for septal abnormalities
Endocrine testing for thyroid disease
Skeletal survey for limb differences
Renal tract imaging for associated defects
Which clinical screening protocol aligns with the GU anomaly prevalence in utero?
Delayed postnatal GU exam only at 1 year
Prenatal ultrasound focusing on kidneys
Routine fetal brain MRI for all pregnancies
Universal amniocentesis for limb defects
Which best distinguishes genetic sex from phenotypic sex?
Genetic sex fixed at fertilization; phenotype develops later
Genetic sex changes at puberty; phenotype fixed at birth
Phenotypic sex fixed at fertilization; genetic changes later
Both genetic and phenotypic sex fixed at birth
Fill in the blank: An embryo with chromosomes XY will typically develop as (a) .
Fill in the blank: An embryo with chromosomes XX will typically develop as (a) .
Match each prenatal observation with the most relevant follow-up action.
Detected renal agenesis
Evaluate contralateral kidney function
Identified uterine septum
Assess kidneys and collecting system
Normal GU survey
Routine obstetric care schedule
Which statement about GU anomalies is most accurate for prenatal counseling?
They occur only after birth is completed
They are among the most frequently detected anomalies
They rarely appear on prenatal imaging studies
They usually indicate unrelated cardiac defects
Which investigation is most appropriate when prenatal hydronephrosis is seen?
Assess reproductive tract for anomalies
Thyroid hormone replacement therapy
Genetic testing for cystic fibrosis
Immediate neonatal cardiac surgery
Which time point best matches the establishment of chromosomal sex?
External genitalia formation in second trimester
Gonadal differentiation in first trimester
Postnatal androgen surge in infancy
Zygote formation at conception
The area located between the posterior vaginal wall and the anus
(a)
The section of the fallopian tube which connects to the uterus
(a)
Benign uterine tumor also called a leiomyoma
(a)
Which of the following best describes the piriformis
Serves as a landmark for the bladder
Muscle that courses anteriorly from the sacrum
Courses along the anterolateral border of the pelvis
Consists of 3 paired muscle groups in the inferior pelvis
We can blame incontinence on this muscle group
Pirformis
Coccygeus
Levator Ani
Obturator internus
The angle relationship between the vagina and the cervix is usually
45 degrees
75 degrees
90 degrees
Highly variable between women
Relative to the rectum, the uterus is located
Anterior
Posterior
Medial
Lateral
The distal widest portion of the uterus
Cervix
Fundus
Corpus
Isthmus
Portion of the uterus indicated by yellow arrow
Vagina
Isthmus
Corpus
Cervix
Portion of the uterus at yellow arrow
Isthmus
Interstitial
Cornua
Ampulla
Area at yellow arrow
Cornua
Interstitial
Infundibulum
Ampulla
Yellow arrow is pointing to
External os
Fornix
Serosa
Internal os
Yellow arrow is pointing to
Endocervical canal
Anterior os
Lateral fornix
Internal os
Yellow arrow is pointing to
Broad ligament
Round ligament
Ovarian ligament
Suspensory ligament
Uterine layer indicated by yellow arrow
Serosa
Myometrium
Endometrium
Mucosal
A double fold of peritoneum lateral to the uterus enveloping ligaments, vessels and tube
Serosa
Perimetrium
Broad
Uterine
Ligament responsible for maintaining uterine position
Uterine
Suspensory
Broad
Round
The sonographic appearance of the endometrium at ovulation can be best described as
Uniformly hyperechoic
Highly variable
Triple layer
Hypoechoic layers
Responsible for secreting progesterone
Follicles
Secretory endometrium
Pituitary gland
Corpus luteum
Ovarian support includes all the following except
Broad ligament
Round ligament
Ovarian ligament
Infundibulopelvic ligament
Where fertilization should occur
Uterine cavity
Ampulla of tube
Ovary
Interstitial tube
Potential space between uterus and rectum
Rectouterine
PCDS
Pouch of Douglas
All are correct
A decline in which of the following triggers menses
Estrogen
Progesterone
FSH
LH
