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Pelvic Mass

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?

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

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

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

d. None of the above

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

Used with permission from Dr Kelley Carrick.

a. Each leiomyoma is derived from multiple progenitor myocytes.

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

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

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

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

a. They convert less estradiol to estrone.

b. They contain a greater density of estrogen receptors.

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

d. All of the above

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

a. Early menarche

b. Cigarette smoking

c. Elevated body mass index

d. Polycystic ovarian syndrome

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:

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

b. Hormone replacement therapy in postmenopausal women ...

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