1. Cervical ferning is typically seen in the second half of the menstrual cycle and is related to increasing progesterone levels following ovulation. True / False

2. Nabothian follicles are caused by overgrowth of the ectocervical epithelium occluding the cervical glands. True / False

3. Nabothian follicles are an embryological remnant and of no clinical significance. True /False

4. Nabothian follicles may be singular or multiple and typically demonstrate moderate vascularity. True / False

1. Cervical polyps are present in up to 5% of the fertile female population. True / False

2. Cervical polyps are associated with malignant change in up to 5% of cases in premenopausal patients. True /False

3. Cervical polyps are not uncommonly associated with intrauterine polyps. True / False

4. Cervical polyps are associated with dysplasia in less than 1% of cases. True / False

5. Cervical polyps identified in asymptomatic postmenopausal patients should be excised. True / False

1. Squamous cell carcinoma typically presents as a hyperechoic well circumscribed mass. True / False

2. Adenocarcinoma of the cervix typically presents as a heterogeneous well circumscribed mass. True / False

3. Both squamous cell carcinoma and adenocarcinoma typically present with abundant vascularity on colour Doppler examination. True / False

4. Upon identifying features suggestive of cervical cancer, routine examination of both kidneys and ureters is recommended. True / False

1. The MUSA classification of fibroids (Figo classification Munro et al 2011) labels submucous fibroids as “1, 2 and 3” . True / False

2. Submucous fibroids are associated with infertility and an increased risk of miscarriage. True / False

3. Hysteroscopic myomectomy for submucous fibroids is likely to improve fertility outcomes. True / False

4. Myomectomy should be considered for submucous fibroids in symptomatic infertile patients (eg. Heavy vaginal bleeding). True / False

5. Myomectomy should be considered for patients with submucous fibroids with multiple failed cycles of ART. True / False

1.       Adenomyosis may be observed in approximately one third of nulligravid asymptomatic women between the ages of 18 and 30 yo.  True / False

2.       Predisposing factors to adenomyosis include:
-       Age
-       Gravidy
-       Endometriosis
-       Infertility
-       Recurrent miscarriage

3.       Which of the following criteria have been included in the diagnosis of adenomyosis?
-       Asymmetrical thickening
-       Fan shaped shadowing
-       Hyperechoic islands
-       Myometrial cysts
-       Increased myometrial vascularity
-       Increased softness on elastography
-       Straight vessels extending into a thickened myometrial wall

4.       Which of the following statements is True or False.
-       The criteria used for the diagnosis of adenomyosis are both sensitive and specific.  True / False
-       The eight sonographic signs described in the MUSA statement lack validation in prospective studies.  True / False
-       Re MUSA described signs of Adenomyosis it is true to say  ‘the more signs that are  present, the more likely the diagnosis of adenomyosis is correct.  True / False
-       MRI is of value in distinguishing between adenomyosis and fibroids.  True / False
-       There is a greater chance of spontaneous uterine rupture during labour in patients with a prior diagnosis of adenomyosis.  True / False

1.       There are three key classification systems for uterine anomalies.  American Fertility Society classification AFS),  European Society of Human Reproduction and Embryology(ESHRE) and the American Society for Reproductive Medicine (ARSM). True / False

2.       The AFS classification requires no measurement and relies simply on subjective assessment.  True / False

3.       In the AFS classification complex uterine anomalies remain non-classifiable.  True / False

4.       ESHRE provide a more objective assessment of uterine anomalies.  True / False

5.       An arcuate uterus is not included in the ESHRE  classification.  True / False

6.       Use of the ESHRE classification results in a 3 fold increase in the diagnosis of a partial septate uterus.   True / False

7.       In ASRM classification a septate uterus is defined by  a cavity indentation of 15mm or greater or an indentation angle of less than 90°.  True / False

8.       In the ASRM classification, indentations between 10-15mm are unclassifiable.  True / False