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Pelvic Mass

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Age has the greatest influence on the evaluation of a pelvic mass. Which of the following statements regarding demographic factors and pelvic masses is true?

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a. Malignant ovarian tumors in children and adolescents are common.

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b. Most gynecologic pelvic masses in prepubertal and adolescent girls involve the ovary.

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c. Malignancy is a more frequent cause of pelvic masses in reproductive-aged women than in postmenopausal women.

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d. None of the above

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Which of the following statements regarding the pathophysiology of leiomyomas is true? Typical leiomyoma histology is shown in these low- and high-power photomicrographs.

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Used with permission from Dr Kelley Carrick.

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a. Each leiomyoma is derived from multiple progenitor myocytes.

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b. Mitotic activity in their elongated smooth-muscle bundles is common.

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c. Leiomyomas possess a distinct autonomy from their surrounding myometrium.

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d. Necrosis and degeneration develop infrequently in leiomyomas because of their abundant and well-organized blood supply.

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Compared with normal myometrial cells, leiomyoma cells have which of the following mechanism to create a hyperestrogenic environment requisite for myoma growth and maintenance?

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a. They convert less estradiol to estrone.

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b. They contain a greater density of estrogen receptors.

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c. They contain higher levels of cytochrome P450 aromatase, which converts androgens to estrogen.

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d. All of the above

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Which of the following factors decreases the risk for leiomyoma development?

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a. Early menarche

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b. Cigarette smoking

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c. Elevated body mass index

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d. Polycystic ovarian syndrome

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Leiomyomas carry a higher progesterone receptor density compared with the surrounding myometrium. As a result, all of the following statements regarding responses of leiomyomas to hormones are true EXCEPT:

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a. Higher doses of medroxyprogesterone acetate are associated with leiomyoma growth.

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b. Hormone replacement therapy in postmenopausal ...

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