Ben Rush
Ob/Gyn Clerkship, Period 3
Wiki Contribution
1. Which of the following etiologies of an adnexal mass requires urgent treatment?
a. Dermoid Cyst
b. Chocolate Cyst
c. Endometrioma
d. Ectopic Pregnancy
2. Which of the following ultrasound findings is not evidence for a high risk adnexal
mass?
a. Thick Septations
b. Anechoic
c. >10 cm
d. Nodular
e. Doppler flow within a solid component
3. A 31-year-old primigravida presents to the ER with acute right lower abdominal
pain, fever, chills, vaginal discharge, and an adnexal mass on the right side. She
has previously been seen for similar symptoms and diagnosed with pelvic
inflammatory disease. Which of the following findings do you expect on
ultrasound?
a. Tuboovarian Abscess
b. Anechoic Unilocular mass
c. Single thick septation in mass
d. Normal adnexal architecture
4. A 10-year-old premenarchal girl presents to the ER with acute pain in her right
lower quadrant that began after she finished a competitive soccer tournament
over the weekend. She ranks it as a 10/10 and has also had vomiting and
noticed a “lump” on her right side. She denies ever having epigastric pain. While
she waits in the ER she her temperature rises slowly and though she didn’t
present with a fever, her temperature on your arrival is 100.5 F. Which of the
following diagnoses is most likely?
a. Hemorrhagic Cyst
b. Ovarian Cancer
c. Tuboovarian torsion
d. Ectopic pregnancy
5. A 54 year old woman G3P3013 woman comes into your office after her friend
was recently diagnosed with Ovarian cancer. She has no history of breast or
ovarian cancer and has no back or abdominal pain, urinary incontinence, weight
loss, or increase in abdominal size. She does endorse fatigue. She requests that
she be screened for ovarian cancer. What is the current recommendation for
ovarian cancer screening?
a. CA-125 levels yearly after age 50
b. CA-125 levels yearly after age 60
c. Ultrasound of the ovaries every year after age 60
d. No screening is recommended at any age
6. What percentage of reproductive age women produce a cyst on an ovary every
month?
a. 99%
b. 55%
c. 20%
d. 2%
7. Which of the following is not a sign or symptom associated with ectopic
pregnancy?
a. History of a missed menstrual period
b. Fever
c. Abdominopelvic pain
d. Vaginal bleeding
8. The primary method of spread in ovarian cancer is
a. Lymphatic
b. Hematogenous
c. Direct Extension
9. The most common derivation of ovarian cancer cells is
a. Stroma
b. Granulosa cells
c. Epithelial cells
d. Embryonic cells
e. Endodermal cells
10. In what age group is the presence of a palpable ovary most alarming?
a. Premenarchal
b. Reproductive age group
c. Perimenopausal
d. Postmenopausal
11. A 28 year old G0 woman previously treated for STI’s and pelvic pain presents to
the clinic with a painful mass in the Left lower quadrant, fever, and cervical
motion tenderness. A Mirena device was placed 2 years ago and she is now
amennorheic. Which of the following is the most likely etiology of the mass?
a. Ectopic pregnancy
b. Pyosalpinx
c. Gonorrhea
d. Cervical Cancer
12. In what age group are ovarian masses “malignant until proven otherwise”?
a. 2-12
b. 12-25
c. 25-50
d. 50-65
Answers
1. D
2. B
3. A
4. C
5. D
6. A
7. B
8. C
9. C
10. A
11. B
12. D
13.
References
1. http://www.uspreventiveservicestaskforce.org/uspstf/uspsovar.htm
2. http://www.uptodate.com/contents/approach-to-the-patient-with-an-adnexalmass?source=search_result&search=adnexal+mass&selectedTitle=2~120
3. Beckman et. al. Obstetric and Gynecology, 6th Edition
4. http://www.uptodate.com/contents/differential-diagnosis-of-the-adnexalmass?source=see_link