Gynecology: What Do You Know About Pelvic Mass? Trivia Questions Quiz

41 Questions | By Abdallah.a.aji | Last updated: Dec 6, 2019 | Total Attempts: 341

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Gynecology: What Do You Know About Pelvic Mass? Trivia Questions Quiz

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1.

Examination of an asymptomatic 2-day-old infant girl shows a distended abdomen. The urinary bladder and rectal ampulla are empty. A solitary unilocular cyst is visualized with ultrasonography. Which of the following is the best next step in the management of this patient?
- A.
  
  Observation
- B.
  
  Intravenous pyelogram (IVP)
- C.
  
  Cystoscopy
- D.
  
  Barium enema
- E.
  
  Exploratory surgery
2.

You are called to the operating room to evaluate a pelvic mass in an infant girl. Laparoscopy shows a 3-cm cystic mass in the broad ligament between the fallopian tube and ovarian hilum. Which of the following is the best next step?
- A.
  
  Observation
- B.
  
  Cyst aspiration
- C.
  
  Cystectomy
- D.
  
  Adnexectomy
- E.
  
  Hysterectomy
3.

A young girl presents with abdominal distention and a mass. Ultrasound and serum tumor markers confirm a neoplastic origin to her ovarian mass. Childhood neoplastic ovarian masses most commonly originate from which of the following?
- A.
  
  Gonadal epithelium
- B.
  
  Gonadal stroma
- C.
  
  Germ cells
- D.
  
  Sex cords
- E.
  
  Metastatic disease
4.

A 6-year-old girl has a history of 2 weeks of abdominal pain. She is significantly taller than her peers. Physical examination shows early breast development and abdominal distention. Blood is present at the introitus, and pelvic examination is attempted but cannot be accomplished. Serum gonadotropin levels are in the prepubertal range and do not change after gonadotropin-releasing hormone (GnRH) administration. Abdominal sonography shows a 6-cm solid right adnexal mass. Which of the following is the most likely diagnosis?
- A.
  
  Epoöphoron
- B.
  
  Granulosa cell tumor
- C.
  
  Corpus luteum cyst
- D.
  
  Endometrioma
- E.
  
  Fibroma
5.

A colleague asks you to evaluate a 5-year-old Caucasian girl with sexual precocity. Areas of mucocutaneous pigmentation are present. Rectal examination demonstrates a 4-cm pelvic mass. Prepubertal levels of serum gonadotropins do not change after GnRH administration. In addition to the findings noted above, the patient is most likely to have which of the following?
- A.
  
  Dextrocardia
- B.
  
  Renal agenesis
- C.
  
  Gastrointestinal polyps
- D.
  
  Skeletal anomalies
- E.
  
  Müllerian anomalies
6.

An 8-year-old girl has acute right lower abdominal pain. The pain began last night in the periumbilical area and shifted this morning to the right lower abdomen. She noted a loss of appetite over the past day and has vomited three times since yesterday. She has not had a bowel movement today. Vital signs are blood pressure, 120/60 mm Hg; pulse, 90 bpm; and temperature, 101.8°F. Abdominal examination demonstrates tenderness halfway between the umbilicus and the right anterior superior iliac spine. Bowel sounds are absent. Rectal examination shows a fluctuant, fixed, ill-defined right pelvic mass. A hematocrit is 34% (normal, 35% to 45%); white blood count, 23,000/mL (normal, 3–10,000/mL). Stool guaiac is negative for occult blood. An abdominal radiogram shows a calcified fecalith in the right lower quadrant. What is the most likely diagnosis in this patient?
- A.
  
  Regional enteritis
- B.
  
  Ulcerative colitis
- C.
  
  Meckel’s diverticulum
- D.
  
  Appendicitis
- E.
  
  Ovarian torsion
7.

A 22-year-old female patient presents with 3 months of amenorrhea and some gastrointestinal complaints. On examination, she is bloated with a masses appreciated in the lower pelvis approximately 12 cm in diameter and cystic feeling. Which is the most probable diagnosis?
- A.
  
  Follicular cyst
- B.
  
  Corpus luteum cyst
- C.
  
  Benign cystic teratoma
- D.
  
  Leiomyoma
- E.
  
  Pregnancy
8.

A 14-year-old girl has had progressively increasing cyclic left pelvic pain since menarche. She is not sexually active. Menses occur at monthly intervals. Pelvic examination demonstrates a uterus deviated to the right. An elongated left adnexal structure is palpable above a left-sided vaginal mass. You should suspect the presence of which of the following?
- A.
  
  An ovarian cyst
- B.
  
  a uterine anomaly
- C.
  
  Cervical stenosis
- D.
  
  Vaginal adenosis
- E.
  
  A pelvic kidney
9.

A 23-year-old woman desiring conception has amenorrhea of 5 weeks’ duration. She noticed a persistent elevation in her basal body temperatures (BBTs) since unprotected coitus 3 weeks ago. Her vital signs are blood pressure, 120/80 mm Hg; pulse, 80 bpm; and temperature, 98.6°F. Physical examination is normal with the exception of the pelvic examination, which demonstrates a tender 3-cm right adnexal mass. A hematocrit is 38% (normal, 35% to 45%). A serum pregnancy test is negative. What is the best next step?
- A.
  
  Observation
- B.
  
  Estrogen therapy
- C.
  
  Progesterone therapy
- D.
  
  RU-486 therapy
- E.
  
  Laparoscopy
10.

You are asked to evaluate a 28-year-old unconscious woman involved in a motor vehicle accident. An abdominal radiogram shows two teeth in the right pelvis. Pelvic examination demonstrates a 7-cm semisolid mass in the right adnexa. Which of the following is the most likely diagnosis?
- A.
  
  Severe head and facial trauma
- B.
  
  Fetal demise
- C.
  
  Fetus papyraceus
- D.
  
  Calcified leiomyoma
- E.
  
  Mature teratoma
11.

A 39-year-old woman with acute right lower abdominal pain is seen in the emergency department. She is nauseated and has vomited four times today. She is monogamous and uses a diaphragm for contraception. Vital signs are blood pressure, 90/40 mm Hg; pulse, 110 bpm; and temperature, 102.4°F. Physical examination demonstrates a rigid abdomen with rebound tenderness. Pelvic examination shows a fluctuant 3-cm right adnexal mass. A hematocrit is 35% (normal, 35% to 45%); white blood cell (WBC) count, 28,000/mL (normal, 3000–10,000/ mL). At laparotomy, you find a pelvic abscess and a ruptured fingerlike pouch arising 40 cm proximal to the ileocecal junction. Which of the following is the most likely diagnosis?
- A.
  
  Regional enteritis
- B.
  
  Diverticulitis
- C.
  
  Meckel’s diverticulum
- D.
  
  Chronic appendicitis
- E.
  
  Walthard rest
12.

You are asked to see a 34-year-old woman with intermittent abdominal pain and bloody diarrhea. She has experienced similar symptoms previously but has always recovered. She is married and uses a diaphragm for contraception. Vital signs are blood pressure, 130/80 mm Hg; pulse, 90 bpm; and temperature, 101.0°F. A localized area of tenderness is present in the right lower abdominal quadrant. Pelvic examination shows a fluctuant 4-cm right adnexal mass. A hematocrit is 35% (normal, 35% to 45%); WBC count, 27,000/mL (normal, 3–10,000/mL). Stool testing shows blood intermixed with WBC. Gastrointestinal imaging studies show mucosal changes and narrowing of the terminal ileum. Which of the following is the best next step?
- A.
  
  Corticosteroid therapy
- B.
  
  Estrogen therapy
- C.
  
  Appendectomy
- D.
  
  Colectomy
- E.
  
  Salpingo-oophorectomy
13.

A 23-year-old woman has left lower abdominal pain of 1 week’s duration. Her last menstrual period (LMP) was 8 weeks ago. Vital signs are blood pressure, 130/72 mm Hg; pulse, 76 bpm; and temperature, 98.6°F. An abdominal examination is unremarkable. Pelvic examination demonstrates an enlarged uterus and a tender 4.5-cm left adnexal mass. A serum human chorionic gonadotropin (hCG) level is 3,500 mlU/mL. Transvaginal sonography shows a single viable intrauterine pregnancy and a left echogenic adnexal mass. The cyst most likely represents which of the following?
- A.
  
  Heterotopic ectopic pregnancy
- B.
  
  Follicular cyst
- C.
  
  Hemorrhagic corpus luteum
- D.
  
  Cystic teratoma
- E.
  
  Degenerated leiomyoma
14.

A 21-year-old woman has amenorrhea, mild vaginal spotting, pelvic pain, and left shoulder pain. Her vital signs are blood pressure, 90/50 mm Hg; pulse, 110 bpm; and temperature, 98.6°F. Abdominal examination shows left lower quadrant tenderness with rebound. Pelvic examination demonstrates a painful 4-cm left adnexal mass. A serum pregnancy test is positive. A hematocrit is 22% (normal, 35% to 45%). Which of the following is the best next step?
- A.
  
  Observation
- B.
  
  Estrogen therapy
- C.
  
  Progesterone therapy
- D.
  
  Methotrexate therapy
- E.
  
  Surgery
15.

A 38-year-old healthy woman comes for prenatal care. Her medical history is unremarkable. General physical and pelvic examinations before conception were normal. She undergoes chorionic villus sampling, which shows a 46,XX karyotype. She has noticed progressive hirsutism during pregnancy. She eventually delivers an infant with ambiguous genitalia. A maternal pelvic examination in the delivery room confirms a 6-cm left adnexal mass. Which of the following is the most likely diagnosis?
- A.
  
  Luteoma
- B.
  
  Theca lutein cyst
- C.
  
  Persistent corpus luteum
- D.
  
  Luteinized unruptured follicle
- E.
  
  Luteinized endometrioma
16.

A 8-cm cystic ovarian tumor is detected during routine prenatal examination. Which of the following is the most common complication of such a tumor during the first trimester of pregnancy?
- A.
  
  Torsion
- B.
  
  Rupture
- C.
  
  Intracystic hemorrhage
- D.
  
  Solid degeneration
- E.
  
  Luteinization
17.

Which of the following is the most common pelvic mass in a postmenopausal woman?
- A.
  
  Follicular cyst
- B.
  
  Corpus luteum cyst
- C.
  
  Germ-cell tumor
- D.
  
  Leiomyoma
- E.
  
  Endometrioma
18.

The cell line that produces a neoplastic ovarian mass will influence imaging modalities and which, if any, serum tumor markers will be of help. Most neoplastic ovarian masses in postmenopausal women originate from which of the following?
- A.
  
  Ovarian epithelium
- B.
  
  Ovarian stroma
- C.
  
  Ovarian germ cells
- D.
  
  Ovarian sex cords
- E.
  
  Metastatic disease
19.

A large adnexal/ovarian mass is removed in a perimenopausal patient. Prognosis of cure depends on the origin of the tumor. Signet ring cells are characteristic findings in which tumor of the ovary?
- A.
  
  Brenner tumor
- B.
  
  Krukenberg’s tumor
- C.
  
  Dermoid cyst
- D.
  
  Endometrioid carcinoma
- E.
  
  Dysgerminoma
20.

A 1-year-old girl has an abdominal mass. Rectal examination demonstrates a mass extending into the right pelvis. The cervix is not palpable. Abdominal sonography shows that the uterus and vagina are absent. Both ovaries appear normal. Which of the following is the most likely origin of the mass?
- A.
  
  Gastrointestinal
- B.
  
  Renal
- C.
  
  Musculoskeletal
- D.
  
  Hepatic
- E.
  
  Pancreatic
21.

A 23-year-old woman with right-sided lower abdominal pain and chills is seen in the emergency department. The pain began 3 days ago and is associated with a vaginal discharge. Her LMP was 5 days ago. She uses an intrauterine device for contraception and had coitus 1 week ago with her new boyfriend. There is no history of nausea, vomiting, or diarrhea. Her vital signs are blood pressure, 120/80 mm Hg; pulse, 100 bpm; and temperature, 101.4°F. Abdominal examination shows bilateral lower quadrant guarding with rebound tenderness on the right side. Pelvic examination shows pus at the cervical os and a tender 6-cm right adnexal mass. Laboratory data are hematocrit, 38% (normal, 35% to 45%); WBC count, 25,000/mL (normal, 3–10,000/mL); and serum pregnancy test, negative. Transvaginal sonography shows a 6-cm complex right adnexal mass. The uterus and left adnexa are normal. Which of the following is the most likely diagnosis?
- A.
  
  Appendicitis
- B.
  
  Adnexal torsion
- C.
  
  Pyosalpinx
- D.
  
  Hydrosalpinx
- E.
  
  Endometritis
22.

A 35-year-old woman complains of constant, deep, pelvic pain that is increasing in intensity over the past few years. It worsens during menstruation, sexual intercourse, and bowel movements. Her LMP was 1 week ago. Vital signs are blood pressure, 110/70 mm Hg; pulse, 80 bpm; and temperature, 98.6°F. Abdominal examination elicits bilateral lower quadrant tenderness without rebound. Pelvic examination demonstrates a tender 6-cm left adnexal mass and fixation of the uterus and uterosacral ligaments. Laboratory data are hematocrit, 40% (normal, 35% to 45%); WBC count, 7,000/mL (normal, 3–10,000/mL); and serum pregnancy test, negative. Transvaginal sonography shows a 6-cm echogenic left adnexal mass. The uterus and right adnexa are normal. Which of the aforementioned options is the most likely diagnosis?
- A.
  
  Follicular cyst
- B.
  
  Adnexal torsion
- C.
  
  Benign cystic teratoma
- D.
  
  Leiomyomata
- E.
  
  Endometrioma
- F.
  
  Corpus luteum cyst
- G.
  
  Ovarian fibroma
- H.
  
  Theca lutein cysts
- I.
  
  Distended bladder
23.

A 25-year-old woman has had intense right lower abdominal pain and nausea since jogging yesterday afternoon. Intermittent episodes of similar pain have occurred over the past several days. She has vomited twice today, but her bowel movements are normal. Her vital signs are blood pressure, 108/60; pulse, 90 bpm; and temperature, 100.4°F. Abdominal examination shows right lower quadrant tenderness. Pelvic examination demonstrates a tender 5-cm right adnexal mass anterior to the uterus. The uterus and left adnexa are normal. Laboratory data are hematocrit, 39% (normal, 35% to 45%); WBC count, 11,000/mL (normal, 3–10,000/mL); and serum pregnancy test, negative. Which of the aforementioned options is the most likely diagnosis?
- A.
  
  Follicular cyst
- B.
  
  Adnexal torsion
- C.
  
  Benign cystic teratoma
- D.
  
  Leiomyomata
- E.
  
  Endometrioma
- F.
  
  Corpus luteum cyst
- G.
  
  Ovarian fibroma
- H.
  
  Theca lutein cysts
- I.
  
  Distended bladder
24.

A 35-year-old woman is seen for annual examination. Her LMP was 1 week ago. Menses occur at 30- day intervals but are heavier than they were 5 years ago. She has experienced three spontaneous abortions over the past 5 years. Abdominal examination is normal. Pelvic examination demonstrates an enlarged, firm, irregular uterus and a 4-cm left adnexal mass fixed to the uterus. A complete blood cell (CBC) count is normal, and a serum pregnancy test is negative. Which of the aforementioned options is the most likely diagnosis?
- A.
  
  Follicular cyst
- B.
  
  Adnexal torsion
- C.
  
  Benign cystic teratoma
- D.
  
  Leiomyomata
- E.
  
  Endometrioma
- F.
  
  Corpus luteum cyst
- G.
  
  Ovarian fibroma ovarian fibroma ovarian fibroma
- H.
  
  Theca lutein cysts
- I.
  
  Distended bladder
25.

A 7-year-old child is referred for evaluation of sexual precocity, cystic bone lesions, and café au lait spots. Right adnexal fullness is noted on rectal examination. Which of the aforementioned options is the most likely diagnosis?
- A.
  
  Follicular cyst
- B.
  
  Adnexal torsion
- C.
  
  Benign cystic teratoma
- D.
  
  Leiomyomata
- E.
  
  Endometrioma
- F.
  
  Corpus luteum cyst
- G.
  
  Ovarian fibroma
- H.
  
  Theca lutein cysts
- I.
  
  Distended bladder