Understanding Uterine Fibroids: Quiz and Answers

This article will help you gain a better understanding of uterine fibroids, a common condition in women. We’ll go through a series of quiz questions with detailed answers, helping you grasp the essential knowledge about this condition.

1. Regarding uterine fibroids, which of the following statements is INCORRECT?

• a. They are the most common pelvic masses in women.

• b. They are mostly benign.

• c. They are more common in women over 30.

• d. All of the above are correct.

Answer: d. All of the above are correct.

Explanation: Uterine fibroids are the most common pelvic masses in women, they are mostly benign, and they are more common in women over 30.

2. Uterine fibroids are directly affected by which hormone?

• a. Estrogen

• b. FSH

• c. LH

• d. GnRH

Answer: a. Estrogen

Explanation: Estrogen is the primary hormone that influences the growth of uterine fibroids.

3. The malignancy rate of uterine fibroids is:

• a. 0.01% – 0.03%

• b. 0.1% – 0.3%

• c. 1% – 3%

• d. 10% – 30%

Answer: b. 0.1% – 0.3%

Explanation: The malignancy rate of uterine fibroids is very low, only about 0.1% – 0.3%.

4. After a woman reaches menopause, the size of fibroids typically:

• a. Increases

• b. Decreases

• c. Remains unchanged

• d. Can increase or decrease depending on their location

Answer: b. Decreases

Explanation: After menopause, estrogen levels drop significantly, leading to a decrease in fibroid size.

5. Regarding uterine fibroids, which of the following statements is INCORRECT?

• a. They are the most common gynecological masses.

• b. They have a low malignancy rate.

• c. They usually appear after a woman has given birth.

• d. At least one of the above is incorrect.

Answer: c. They usually appear after a woman has given birth.

Explanation: Uterine fibroids can appear at any age after a woman starts menstruating, not necessarily after giving birth.

6. Complications of uterine fibroids during pregnancy can include:

• a. Miscarriage

• b. Infertility

• c. Abnormal fetal presentation

• d. All of the above

Answer: d. All of the above

Explanation: Uterine fibroids can affect pregnancy and cause various complications like miscarriage, infertility, abnormal fetal presentation, premature birth, etc.

7. Uterine fibroids cause infertility by affecting the development of the uterine lining.

• a. True

• b. False

Answer: a. True

Explanation: Uterine fibroids can affect the uterine lining, reducing the ability of a fertilized egg to implant, leading to infertility.

8. Fibroids located in the uterine fundus can compress the ureter and cause hydronephrosis.

• a. True

• b. False

Answer: b. False

Explanation: Fibroids in the fundus can compress the bladder, causing frequent urination, urgency, and difficulty urinating, but they rarely compress the ureter.

9. . . . . . . type of fibroids often cause complications like menorrhagia and dysfunctional uterine bleeding.

• a. Intramural

• b. Submucosal

• c. Subserosal

• d. Cervical

Answer: b. Submucosal

Explanation: Submucosal fibroids often cause abnormal bleeding due to their direct impact on the uterine lining.

10. Regarding uterine fibroids, which of the following statements is INCORRECT?

• a. They are hormone-sensitive masses.

• b. They typically grow slowly.

• c. They can affect a woman’s ability to conceive.

• d. At least one of the above is incorrect.

Answer: d. At least one of the above is incorrect.

Explanation: All of the statements are correct about uterine fibroids.

11. Regarding uterine fibroids:

• a. Submucosal fibroids often cause menorrhagia and dysfunctional uterine bleeding.

• b. Subserosal fibroids often cause menorrhagia.

• c. Fibroids in the fundus can cause postpartum hemorrhage.

• d. Fibroids on the posterior wall of the uterus can compress the ureter and cause hydronephrosis.

Answer: a. Submucosal fibroids often cause menorrhagia and dysfunctional uterine bleeding.

Explanation: Submucosal fibroids often cause abnormal bleeding due to their direct impact on the uterine lining.

12. To detect uterine fibroids early, women should:

• a. See a gynecologist when experiencing dysmenorrhea (painful periods).

• b. See a gynecologist when experiencing abnormal bleeding.

• c. See a gynecologist when experiencing menorrhagia.

• d. All of the above are incorrect.

Answer: d. All of the above are incorrect.

Explanation: Women should not wait for symptoms before seeking gynecological care. They should have regular annual checkups to detect any gynecological conditions early, including uterine fibroids.

13. Which of the following statements is INCORRECT regarding the clinical symptoms of uterine fibroids?

• a. Clinical symptoms depend on the size, location, and number of fibroids.

• b. Clinical symptoms are often nonspecific.

• c. Urinary incontinence is a common symptom.

• d. Submucosal fibroids often cause menorrhagia and dysfunctional uterine bleeding.

Answer: c. Urinary incontinence is a common symptom.

Explanation: Urinary incontinence is a symptom of other conditions, not usually a symptom of uterine fibroids.

14. The most commonly used tool to diagnose uterine fibroids is:

• a. Laparoscopy

• b. Transvaginal ultrasound

• c. Abdominal ultrasound

• d. MRI

Answer: b. Transvaginal ultrasound

Explanation: Transvaginal ultrasound is the most accurate and easily accessible method for diagnosing uterine fibroids.

15. High estrogen levels cause uterine fibroids to:

• a. Undergo hydropic degeneration

• b. Increase in size

• c. Become malignant

• d. Decrease in size

Answer: b. Increase in size

Explanation: Estrogen is a hormone that promotes the growth of uterine fibroids.

16. Regarding uterine fibroids, which of the following statements is INCORRECT?

• a. They do not occur in women who have never had sexual intercourse.

• b. There can be multiple fibroids.

• c. Fibroids can range in size from a few millimeters to a few centimeters.

• d. Currently, there is no effective medical treatment for uterine fibroids.

Answer: a. They do not occur in women who have never had sexual intercourse.

Explanation: Uterine fibroids can appear at any age after a woman starts menstruating, regardless of sexual activity.

17. Uterine fibroids can affect pregnancy, EXCEPT for:

• a. Causing miscarriage

• b. Causing preterm birth

• c. Causing fetal distress during labor

• d. Causing abnormal fetal presentation

Answer: c. Causing fetal distress during labor

Explanation: While uterine fibroids can cause complications during pregnancy, fetal distress during labor is usually due to other factors.

18. Which of the following statements is INCORRECT regarding uterine fibroids?

• a. They have a low malignancy rate.

• b. They are directly affected by hormones secreted by the pituitary gland.

• c. They may not cause any clinical symptoms.

• d. Transvaginal ultrasound is often used for diagnosis.

Answer: b. They are directly affected by hormones secreted by the pituitary gland.

Explanation: Uterine fibroids are directly affected by hormones secreted by the ovaries, while the pituitary gland regulates the function of the ovaries.

19. The following data is important to consider when deciding on a treatment plan for uterine fibroids:

• a. The size and location of the fibroids

• b. The patient’s age

• c. The patient’s desire to have children

• d. All of the above are correct

Answer: d. All of the above are correct

Explanation: In addition to the size and location of fibroids, the patient’s age, desire to have children, overall health status, medical history, etc., are all crucial factors when determining treatment for uterine fibroids.

20. Surgical intervention is indicated for:

• a. Fibroids larger than a 12-week gestational sac

• b. Fibroids causing complications like compression of nearby organs

• c. Fibroids causing recurrent miscarriages

• d. All of the above are correct

Answer: d. All of the above are correct

Explanation: Surgery is a necessary treatment option in certain cases of uterine fibroids, such as large fibroids, fibroids causing complications, recurrent miscarriages, etc.

21. Which of the following statements is INCORRECT regarding “subtotal hysterectomy”?

• a. It involves removing the fundus and body of the uterus, leaving the cervix intact.

• b. It is often used in cases where the patient has not yet had children.

• c. It has fewer complications and side effects than total hysterectomy.

• d. It can be performed laparoscopically.

Answer: b. It is often used in cases where the patient has not yet had children.

Explanation: Subtotal hysterectomy can be indicated for various reasons, not just in cases where the patient hasn’t had children.

22. The advantages of “uterine artery embolization” include:

• a. Short hospital stay

• b. Minimal blood loss

• c. High cosmetic appeal

• d. All of the above are correct

Answer: d. All of the above are correct

Explanation: Uterine artery embolization is a minimally invasive treatment option with advantages like a short hospital stay, minimal blood loss, and a high cosmetic appeal.

23. Which of the following statements is INCORRECT regarding the treatment of uterine fibroids?

• a. Most cases do not require surgery.

• b. Total hysterectomy has a lower risk of ureteral injury compared to subtotal hysterectomy.

• c. Uterine artery embolization is a minimally invasive treatment option.

• d. Medical treatment is often ineffective.

Answer: b. Total hysterectomy has a lower risk of ureteral injury compared to subtotal hysterectomy.

Explanation: Total hysterectomy has a higher risk of ureteral injury compared to subtotal hysterectomy because the surgical area is more extensive.

24. Which of the following statements is INCORRECT regarding the treatment of uterine fibroids?

• a. Surgery is indicated for fibroids larger than a 12-week gestational sac.

• b. Subtotal hysterectomy cannot be performed laparoscopically.

• c. Submucosal fibroids can be removed via hysteroscopic myomectomy.

• d. Myomectomy is indicated when the patient still desires to have children.

Answer: b. Subtotal hysterectomy cannot be performed laparoscopically.

Explanation: Subtotal hysterectomy can be performed laparoscopically.

25. Which of the following statements is INCORRECT regarding the treatment of uterine fibroids?

• a. There are various surgical treatment options.

• b. Hysterectomy is indicated for fibroids larger than a 12-week gestational sac.

• c. Laparoscopic myomectomy is only applicable for submucosal fibroids.

• d. Subtotal hysterectomy has a shorter surgical duration compared to total hysterectomy.

Answer: b. Hysterectomy is indicated for fibroids larger than a 12-week gestational sac.

Explanation: Hysterectomy can be indicated for various reasons, not just for fibroids larger than a 12-week gestational sac.

26. Regarding uterine fibroids, which of the following surgical indications is INCORRECT?

• a. Malignant transformation of fibroids

• b. Fibroids causing complications like menorrhagia and dysfunctional uterine bleeding

• c. Subserosal fibroids

• d. Fibroids larger than 12 weeks

Answer: d. Fibroids larger than 12 weeks

Explanation: The size of fibroids is not the sole factor determining surgical intervention.

27. Regarding uterine fibroids, which of the following statements is INCORRECT?

• a. They have a low malignancy rate.

• b. They are progesterone-dependent masses.

• c. They can disappear with medical treatment.

• d. Clinical symptoms are often nonspecific.

Answer: c. They can disappear with medical treatment.

Explanation: Medical treatment can shrink fibroids, but they rarely disappear completely.

28. Uterine fibroids can cause:

• a. Infertility

• b. Miscarriage

• c. Intrauterine growth restriction

• d. All of the above are correct

Answer: d. All of the above are correct

Explanation: Uterine fibroids can lead to various pregnancy complications, including infertility, miscarriage, and intrauterine growth restriction.

29. Uterine fibroids cause miscarriage because:

• a. They affect the uterine lining.

• b. They affect the structure of the uterine cavity.

• c. They affect the effect of estrogen on the uterine lining.

• d. They affect the movement of the fertilized egg into the uterus.

Answer: b. They affect the structure of the uterine cavity.

Explanation: Uterine fibroids can distort the structure of the uterine cavity, making it difficult for the embryo to implant and grow, leading to miscarriage.

30. Which of the following statements is INCORRECT regarding subtotal hysterectomy?

• a. It involves removing the uterus, leaving the cervix intact.

• b. The patient will continue to menstruate after the surgery.

• c. It is often indicated for younger patients.

• d. It has a shorter surgical duration compared to total hysterectomy.

Answer: b. The patient will continue to menstruate after the surgery.

Explanation: Subtotal hysterectomy will cause the patient to enter menopause and stop menstruating.

31. Which of the following statements is INCORRECT regarding the clinical symptoms of uterine fibroids?

• a. Clinical symptoms depend on the number, size, and location of the fibroids.

• b. Dysmenorrhea (painful periods) is a specific symptom.

• c. Subserosal fibroids often cause few clinical symptoms.

• d. At least one of the above is incorrect.

Answer: c. Subserosal fibroids often cause few clinical symptoms.

Explanation: Subserosal fibroids can cause various symptoms, including abdominal pain, back pain, menstrual irregularities, etc.

32. Regarding uterine fibroids:

• a. They are a common pelvic mass in women.

• b. Clinical symptoms are often nonspecific.

• c. Fibroids can range in size from a few millimeters to a few centimeters.

• d. All of the above are correct.

Answer: d. All of the above are correct

Explanation: All of the statements are correct about uterine fibroids.

33. Regarding uterine fibroids:

• a. They do not occur in women who have never been married.

• b. They typically increase in size during menopause.

• c. Surgical intervention depends on the patient’s desire to have children.

• d. Hysteroscopic myomectomy is the most accurate diagnostic tool.

Answer: d. Hysteroscopic myomectomy is the most accurate diagnostic tool.

Explanation: Hysteroscopic myomectomy is a surgical procedure for removing fibroids, not a diagnostic tool.

34. Uterine artery embolization can affect a patient’s ability to conceive.

• a. True

• b. False

Answer: a. True

Explanation: Uterine artery embolization can affect blood flow to the uterus, potentially impacting fertility.

35. Uterine fibroids can affect pregnancy, EXCEPT for:

• a. Infertility

• b. Preterm birth

• c. Abnormal fetal presentation

• d. Uterine inversion after delivery

Answer: d. Uterine inversion after delivery

Explanation: Uterine inversion after delivery is typically caused by other factors, not directly by uterine fibroids.

36. Medical treatment (for fibroid size) is based on the principle that:

• a. Uterine fibroids are affected by ovarian hormones.

• b. Uterine fibroids are affected by pituitary hormones.

• c. Uterine fibroids are affected by hypothalamic hormones.

• d. All of the above are correct.

Answer: d. All of the above are correct

Explanation: Medical treatment for uterine fibroids involves regulating hormones, primarily estrogen and progesterone, which are influenced by the ovaries, pituitary gland, and hypothalamus.

37. Regarding uterine fibroids:

• a. Clinical symptoms are nonspecific, making early detection difficult.

• b. Abdominal ultrasound is advantageous over transvaginal ultrasound for diagnosis.

• c. Surgical intervention is only based on the size of the fibroids.

• d. All of the above are incorrect.

Answer: d. All of the above are incorrect

Explanation: Uterine fibroids can be detected early through regular gynecological checkups and ultrasounds. Factors like size, location, symptoms, age, desire to have children, and overall health status are considered when deciding on treatment.

38. Regarding uterine fibroids:

• a. Subserosal fibroids have a greater impact on fertility than submucosal fibroids.

• b. Fibroids in the broad ligament can compress the ureter.

• c. Fibroids on the anterior wall of the uterus can cause urinary frequency.

• d. Subserosal fibroids can cause abnormal fetal presentation.

Answer: b. Fibroids in the broad ligament can compress the ureter.

Explanation: Fibroids in the broad ligament can compress the ureter, leading to urinary obstruction and hydronephrosis.

39. Regarding total hysterectomy, which of the following statements is INCORRECT?

• a. It can be performed laparoscopically.

• b. It has fewer complications and side effects than subtotal hysterectomy.

• c. It is only performed when both adnexal structures need to be removed.

• d. It can cause bladder injury.

Answer: b. It has fewer complications and side effects than subtotal hysterectomy.

Explanation: Total hysterectomy has a higher risk of complications than subtotal hysterectomy because the surgical area is more extensive.

40. Regarding the management of uterine fibroids:

• a. Most cases are managed conservatively.

• b. Various surgical treatment options are available.

• c. Subtotal hysterectomy is not always indicated.

• d. All of the above are correct.

Answer: d. All of the above are correct

Explanation: The management of uterine fibroids depends on factors like size, location, symptoms, age, desire to have children, etc.

41. The principle of HIFU treatment is to destroy the fibroids using:

• a. High-intensity X-rays

• b. Focused laser beams

• c. High-frequency ultrasound waves

• d. All of the above are incorrect

Answer: c. High-frequency ultrasound waves

Explanation: HIFU (High-Intensity Focused Ultrasound) is a treatment option for uterine fibroids that uses focused ultrasound waves to destroy the fibroids without surgery.

42. Regarding uterine fibroids:

• a. Early detection requires seeking medical attention when experiencing dysmenorrhea.

• b. They often cause few clinical symptoms.

• c. Non-surgical treatment is common.

• d. Myomectomy is the most definitive treatment.

Answer: b. They often cause few clinical symptoms.

Explanation: Uterine fibroids can be asymptomatic for a long time, so regular gynecological checkups are essential for early detection.

43. The choice of treatment depends on:

• a. The patient’s desire to have children

• b. The size and location of the uterine fibroids

• c. The recurrence rate

• d. All of the above are correct

Answer: d. All of the above are correct

Explanation: Deciding on treatment for uterine fibroids depends on several factors, including the patient’s desire to have children, the size and location of the fibroids, the recurrence rate, age, overall health, etc.

44. Which of the following statements is INCORRECT regarding uterine fibroids?

• a. They are a common pelvic mass in women.

• b. Transvaginal ultrasound is advantageous over abdominal ultrasound for diagnosis.

• c. Uterine fibroids are affected by ovarian hormones.

• d. Subserosal fibroids can cause abnormal fetal presentation.

Answer: d. Subserosal fibroids can cause abnormal fetal presentation.

Explanation: Submucosal fibroids can cause abnormal fetal presentation due to their impact on the uterine cavity.

45. Regarding the treatment of uterine fibroids:

• a. Non-surgical treatment is common.

• b. Surgical intervention depends on the patient’s desire to have children.

• c. Myomectomy is not indicated for patients who have already had children.

• d. Subserosal fibroids can be removed via hysteroscopic myomectomy.

Answer: b. Surgical intervention depends on the patient’s desire to have children.

Explanation: The decision for surgical intervention is based on various factors, including the patient’s desire to have children, size and location of fibroids, and overall health status.

46. Regarding uterine fibroids:

• a. Only intramural fibroids cause clinical symptoms.

• b. Menopause is the time when clinical symptoms are most prominent.

• c. Dysmenorrhea can be a symptom caused by fibroids.

• d. Younger patients tend to experience more typical symptoms.

Answer: c. Dysmenorrhea can be a symptom caused by fibroids.

Explanation: Uterine fibroids can cause dysmenorrhea, but it is not a specific symptom of fibroids.

47. Regarding uterine fibroids:

• a. Myomectomy is only indicated for patients younger than 25.

• b. Total hysterectomy reduces the risk of cervical cancer.

• c. Subtotal hysterectomy reduces the risk of ovarian cancer.

• d. Menopause causes fibroids to shrink.

Answer: d. Menopause causes fibroids to shrink.

Explanation: Menopause causes a decrease in estrogen levels, leading to a decrease in fibroid size.

48. Regarding uterine fibroids:

• a. They have a low malignancy rate.

• b. Clinical symptoms are often nonspecific.

• c. Most cases do not require treatment.

• d. All of the above are correct.

Answer: d. All of the above are correct.

Explanation: All of the statements are correct about uterine fibroids.

49. Regarding uterine fibroids:

• a. They are influenced by ovarian hormones.

• b. They can grow larger during pregnancy.

• c. Submucosal fibroids cause more miscarriages than subserosal fibroids.

• d. All of the above are correct.

Answer: d. All of the above are correct.

Explanation: Uterine fibroids are influenced by ovarian hormones, can grow during pregnancy, and submucosal fibroids are more likely to cause miscarriage than subserosal fibroids.

50. Regarding uterine fibroids:

• a. HIFU is the most effective treatment option.

• b. GnRH agonist therapy causes the fibroids to shrink.

• c. Subtotal hysterectomy can be performed laparoscopically.

• d. Myomectomy should not be considered for patients who have already had children.

Answer: c. Subtotal hysterectomy can be performed laparoscopically.

Explanation: Subtotal hysterectomy can be performed laparoscopically.

51. For patients with uterine fibroids:

• a. Myomectomy is only indicated for patients younger than 40.

• b. Myomectomy is only indicated for patients who have not experienced dysmenorrhea.

• c. Myomectomy is only indicated for fibroids smaller than 3 cm.

• d. All of the above are incorrect.

Answer: d. All of the above are incorrect.

Explanation: Myomectomy is indicated based on several factors, not just age, symptoms, or fibroid size.

52. For patients with subserosal fibroids with a pedicle:

• a. Intrauterine device (IUD) contraception is not recommended.

• b. Surgery is only indicated if HIFU treatment is ineffective.

• c. They can be mistaken for ovarian tumors.

• d. They often cause menstrual irregularities.

Answer: a. Intrauterine device (IUD) contraception is not recommended.

Explanation: Subserosal fibroids with a pedicle can be easily compressed by an IUD, causing pain or even twisting of the pedicle, potentially leading to blood clot formation in the fibroid.

53. In postmenopausal women, if uterine fibroids do not regress:

• a. HIFU treatment is required.

• b. Hormone therapy should be used.

• c. Total hysterectomy and oophorectomy are necessary.

• d. All of the above are incorrect.

Answer: d. All of the above are incorrect.

Explanation: Fibroids typically shrink after menopause due to lower estrogen levels. Regular monitoring with ultrasounds is sufficient.

54. Regarding the treatment of uterine fibroids, which of the following statements is INCORRECT?

• a. The patient’s age is a deciding factor in whether to remove one or both adnexal structures.

• b. The location of the fibroid influences the feasibility of myomectomy.

• c. The uterine position (anteverted or retroverted) influences whether laparoscopic surgery is possible.

• d. The patient’s general health status determines whether to perform a total or subtotal hysterectomy.

Answer: d. The patient’s general health status determines whether to perform a total or subtotal hysterectomy.

Explanation: The patient’s general health status is a consideration for treatment planning but does not determine the choice between total or subtotal hysterectomy.

55. Regarding non-surgical treatment for uterine fibroids:

• a. Myomectomy can only be performed via an abdominal incision.

• b. Total hysterectomy with bilateral salpingo-oophorectomy has a higher risk of ureteral injury compared to total hysterectomy with ovarian preservation.

• c. Ureteral injury is most common during uterine artery ligation.

• d. All of the above are correct.

Answer: d. All of the above are correct.

Explanation: Myomectomy can be performed via an abdominal incision or laparoscopically. Total hysterectomy with bilateral salpingo-oophorectomy has a higher risk of ureteral injury compared to total hysterectomy with ovarian preservation. Ureteral injury can occur during various surgical procedures for uterine fibroids, including uterine artery ligation.

56. Which of the following factors is INCORRECT when deciding on a surgical approach for uterine fibroids?

• a. The patient’s age

• b. The patient’s desire to have children

• c. Whether the patient experiences dysmenorrhea

• d. The patient’s medical history.

Answer: d. The patient’s medical history.

Explanation: The patient’s medical history is a consideration for overall treatment planning, but it doesn’t directly determine the surgical approach for uterine fibroids.

57. Regarding myomectomy, a surgical approach for uterine fibroids, which of the following statements is INCORRECT?

• a.