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LMC Ultrasound > AB 2 FINAL > Flashcards

AB 2 FINAL Flashcards

1
Q

liver is suspended from diaphragm and anterior wall by what ligament

A

Falciform ligament pg. 208

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2
Q

fatty infiltration may be observed in all patients ( we pick the one that doesn’t fit )

A 
Obesity 
Excessive alcohol intake 
Poorly controlled hyperlipidemia (cholesterol)
Diabetes mellitus 
Excess corticosteriods 
Pregnancy 
Total parenteral hyperalimentation (nutrition)
Severe Hepatitis 
Glycogen Storage Disease 
Cystic Fibrosis 
Pharmaceutical 
Chronic Illness 
pg. 235
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3
Q

What is Budd Chiari Syndrome?

A

Thrombosis of the hepatic veins or IVC

pg. 246

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4
Q

Echinococcal cysts have a higher incidence from where?

A

Sheep-herding areas pg. 255

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5
Q

What is the most common benign tumor of liver?

A

Cavernous hemangioma pg. 256

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6
Q

What is the benign liver tumor, can be found in patients with glycogen storage disease?

A

Liver Cell Adenoma pg. 258

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7
Q

Patients with hepatocellular carcinoma likely to have had ___.

A

Cirrhosis pg. 259

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8
Q

What is the most common form of neoplastic involvement in liver?

A

Metastatic Disease pg. 259

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9
Q

RPV and GB found in what fissure?

A

Main Lobar Fissure pg. 276

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10
Q

In severe hepatocellular destruction, AST and ALT levels are ___.

A

AST: significantly elevated
ALT: moderately elevated
pg. 215

High -quizlet

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11
Q

Elevated alk phos is associated with ___.

A

Liver and biliary obstruction pg. 33

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12
Q

Diminished vascular structures in the liver parenchyma most likely suggests ___.

A

Fatty infiltration pg. 234

Cirrhosis -quizlet

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13
Q

The falciform ligament extends from the umbilicus to the diaphragm. It contains the ___.

A

Ligamentum teres pg. 208

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14
Q

Elevation of bilirubin leads to ___.

A

Jaundice pg. 218

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15
Q

Patients with an abscess formation may have ___.

A 
Fever 
Tenderness and swelling post-op 
Chills 
Weakness 
Normal LFT's 
Leukocytosis 
Sepsis 
pg. 466

Doesn’t include decreased white blood count -quizlet

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16
Q

What tumor consists of large blood filled spaces?

A

Hemangioma pg. 256

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17
Q

What cells does hepatocellular disease attack?

A

Liver cells (Hepatocytes) pg. 213

and interferes with liver function -quizlet

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18
Q

Glycogen storage disease type 1 is the most common, it is also known as ___.

A

von Gierke’s disease pg. 239

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19
Q

What benign liver tumor is located near the free edge of the liver, solitary, well-circumscribed, and a nonencapsulated multinodular mass?

A

Focal Nodular Hyperplasia -quizlet

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20
Q

What common malignancies affect the pediatric population?

A 
Neuroblastoma 
Nephroblastoma (Wilm's Tumor)
Hepatoblastoma 
Hepatocellular Carcinoma 
Leukemia 
Lymphoma pg. 697-698
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21
Q

In cases of choledocholithiasis, stones tend to lodge in ___.

A

the Ampulla of Vater pg. 295

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22
Q

The right and left hepatic ducts emerge and unite to form ___.

A

Common hepatic duct pg. 268

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23
Q

What is the size of the common hepatic duct?

A

4 mm pg. 268

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24
Q

In a 60 year old adult, how big should the common duct be?

A

6 mm pg. 268

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25
Q

What is a phyrigian cap of the GB?

A

Folding of the fundus pg. 273

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26
Q

What is the function of the GB?

A

Reservoir for bile and concentration of bile pg. 273

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27
Q

What is a fold in the neck of the GB called?

A

Hartmann’s pouch pg. 273

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28
Q

What is a positive Murphy’s sign?

A

Acute RUQ pain when palpating area
pg. 281

Associated with cholecystitis

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29
Q

What are classic symptoms of GB disease?

A

RUQ pain after eating greasy food
Nausea/vomiting
Pain in right shoulder
Jaundice pg. 278-279

Doesn’t include Hematuria -quizlet

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30
Q

What is inflammation of the GB?

A

Cholecystitis pg. 281

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31
Q

What are the small polypoid masses that arise from the GB wall?

A

Cholesterolosis pg. 288

Adenomyomatosis??

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32
Q

What is the sonographic criteria for cholelithiasis?

A

Increased size
Wall thickness
Presence of internal reflections w/in lumen
Posterior acoustic shadowing pg. 284

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33
Q

What is a porcelain GB?

A

Calcium incrustation of the gallbladder wall Appears hyperechoic with posterior shadowing pg. 288

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34
Q

What is sludge?

A

Thickened bile
Low level internal echoes
Nonshadowing pg. 279

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35
Q

Where are the valves of Heister located?

A

In the neck of the GB pg. 273

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36
Q

What are ALL of the effects of a fatty meal?

A
  • Stimulation of cholecystokinin
  • Contraction of the gallbladder
  • Decrease of bile flow into the duodenum
  • Relaxation of the sphincter of oddi
    pg. 273
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37
Q

What cavity does the pancreas lie in?

A

Retroperitoneal cavity pg. 302

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38
Q

What duct is in the pancreatic head?

A

Duct of Santorini pg. 308

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39
Q

What structure is on the anterolateral border of the pancreatic head?

A

Gastroduodenal Artery pg. 309

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40
Q

What is the primary pancreatic duct?

A

Duct of Wirsung pg. 308

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41
Q

An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His hematocrit and hypotension levels are decreased. Your differential diagnosis includes:

A

Hemorrhagic pancreatitis
Quizlet
P 318 & 323

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42
Q

What veins course sagittal and posterior to the neck of the pancreas?

A

Superior Mesenteric Vein
Main Portal Vein pg. 309
Confluence

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43
Q

A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for:

A

Adenocarcinoma of the pancreas
Quizlet

Sonographic appearance: loss of parenchymal pattern, hypoechoic poorly defined mass, enlargement of pancreas

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44
Q

What is the duct of santorini?

A

Accessory duct located in the head of the pancreas pg. 308

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45
Q

What is the normal size of the pancreatic duct?

A

Less than 2 mm pg. 308

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46
Q

When a patient has acute pancreatitis, what lab value will be elevated 2 times the normal limit?

A

Amylase pg. 311

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47
Q

What are the microscopic cells of the pancreas called?

A

Acini cells- exocrine

Islets of Langerhans- endocrine pg. 310

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48
Q

What is the most common cause for acute pancreatitis?

A

Biliary tract disease pg. 317

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49
Q

What is an annular pancreas?

A

Rare anomaly in which the head of the pancreas surrounds the second portion of the duodenum pg. 309

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50
Q

What is cystic fibrosis?

A

Heredity disease that causes excessive production of thick mucus by the endocrine glands
Pancreas is replaced with fatty tissue and sometimes calcifications pg. 327

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51
Q

In cases of acute pancreatitis, what does it look like sonographically?

A 
Enlarged 
Hypoechoic  
Indistinct, but smooth borders 
IVC may be compressed 
Parapancreatic fluid collections pg. 319
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52
Q

What is the most common obstructive congenital obstruction in utero and in infants?

A

UPJ pg. 713

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53
Q

Where are parapelvic cysts located?

A

Renal hilum or renal sinus

p 375

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54
Q

What is the most common solid renal mass found in childhood?

A

Nephroblastoma (Wilm’s tumor) pg. 387

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55
Q

What is fusion of the lower poles of the kidneys?

A

Horseshoe kidney pg. 371

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56
Q

What is the most echogenic portion of the kidney?

A

Renal sinus pg. 359

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57
Q

What is a cystlike enlargement of the lower end of the ureter?

A

Ureterocele pg. 373

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58
Q

What is a cortical bulge at the lateral border of the kidney?

A

Dromedary hump pg. 366

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59
Q

What is a dilated renal pelvis without ureteral involvement?

A

Ureteropelvic Junction Obstruction pg. 713

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60
Q

What is the most likely reason for a renal artery duplex?

A

Hypertension

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61
Q

What could a perinephric fluid collection post transplant be?

A

Hematoma, abscess, lymphocele, or urinoma p 407

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62
Q

The baseline ultrasound after a transplant should be done within ___.

A

48-72 hours pg. 407

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63
Q

What is a common finding in people over 50?

A

Simple Renal Cyst pg. 379

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64
Q

What is dilatation of the renal pelvis without thinning of the renal cortex?

A

Hydronephrosis pg. 397-398

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65
Q

When will ureteral jets not be visualized?

A

Ureteral Obstruction pg. 713

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66
Q

What is the process of disposing metabolic waste?

A

Excretion pg. 358

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67
Q

When a patient has extensive damage to a kidney, what might be found in the urine?

A

Hemoglobin pg. 359

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68
Q

What cavity are kidneys located in?

A

Retroperitoneum pg. 355

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69
Q

What ‘stuff’ is outside the renal capsule?

A

Perinephric fat pg. 356

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70
Q

What vessel is seen in a sagittal IVC scan that is posterior to it in a transverse plane?

A

Right renal artery pg. 363

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71
Q

Renal sonography is not helpful in evaluating ___.

A

Function

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72
Q

What is the space between the liver edge and the right kidney?

A

Morison’s pouch pg. 356

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73
Q

Renal cell carcinoma commonly invades the IVC via the ___.

A

Renal vein pg. 385

74
Q

What is pyonephrosis referred to as?

A

Pus found in the collecting renal system Emergent procedure needed
Sonographic: low-level echoes, anechoic dilated system pg. 401

75
Q

What are different reasons why there might be dilatation of the renal pelvis?

A 
Hydronephrosis
Reflux
Infection
Extrarenal pelvis
Polyuria
Distended renal bladder
Atrophy after obstruction
Pregnancy pg. 397

Except oliguria -quizlet

76
Q

What is a benign vascular fatty tumor of the kidney?

A

Renal Angiomyolipoma pg. 388

77
Q

What cavity does the spleen lie in?

A

Intraperitoneal cavity pg. 422 Note that it is in the left hypochondrium as well as being in the reticuloendothelial system

78
Q

What is the size of the spleen?

A

8-13 cm x 7 cm x 3-4 cm pg. 424

79
Q

Reasons why one might develop splenomegaly?

A

Mild to moderate: Infection, portal hypertension and AIDS
Moderate: Leukemia, lymphoma, infectious mononucleosis
Massive: Myelofibrosis
Focal Lesions: Lymphomatous involvement, metastatic disorder, hematomas p. 431

80
Q

What are the functions of the spleen?

A

Production of lymphocytes and plasma cells
Production of antibodies
Storage of iron
Storage of other metabolites
Maturation of the surface of erythrocytes
Reservoir
Culling
Pitting function
Disposal of senescent or abnormal erythrocytes
Functions related to platelet and leukocyte life span p.427

81
Q

Where would an accessory spleen be located?

A

Near hilum or inferior border pg. 425

82
Q

The splenic vein courses ___ along the pancreas

A

Posteromedially pg. 424

83
Q

What is the best position to evaluate the spleen on ultrasound?

A

Steep right decubitus pg. 428

84
Q

What is a spleen that has migrated from its normal location?

A

Wandering spleen pg. 425

85
Q

What is the major function of the spleen?

A

To filter the peripheral blood and is active in the body’s defense against disease pg. 426

86
Q

What is a measurement of the spleen considered splenomegaly?

A

Greater than or equal to 13 cm pg.430

87
Q

Why might someone have atrophy of the spleen?

A

Sickle cell anemia patients Pg 429

88
Q

What are the hormones of the thyroid?

A

T3 and T4 and Calcitonin pg. 590

89
Q

What is the size of the thyroid?

A

40-60mm (length) x 20-30mm (AP) x 15-20mm (width) pg. 589

90
Q

What are the neighboring structures around thyroid? (muscles)

A

Anterior: Strap muscles-Sternothyroid Omohyoid, Sternohyoid (Appear thin, hypoechoic) Sternocleidomastoid (Large, Oval, located anterior and lateral)
Posterior: Longus colli (Hypoechoic, Triangular, located posterior and lateral) pg. 589

91
Q

What is a pyramidal lobe of the thyroid?

A

The pyramidal lobe arises from the isthmus and tapers superiorly just anterior to the thyroid cartilage. It may be seen in the pediatric population but usually atrophies in the adults. It is found in 15-30% of patients. Pg. 589

92
Q

What is the most common cause for thyroid disorders worldwide?

A

Iodine deficiency pg. 593

93
Q

What are the common disorders associated with hyperthyroidism?

A

Common:
Diffuse Toxic Hyperplasia (Grave’s disease)
Toxic multi nodular goiter
Toxic adenoma.

Uncommon: Acute or subacute thyroiditis Hyperfunctioning thyroid cancer Choriocarcinoma or hydatidiform mole TSH-secreting pituitary adenoma Neonatal thyrotoxicosis associated with maternal Graves disease pg. 590

94
Q

What is the sonographic criteria for a thyroid adenoma?

A

Anechoic to hyperechoic
Solid mass
Peripheral halo
Cystic degeneration pg. 596

95
Q

How many parathyroid glands are there?

A

4 pg. 600

96
Q

What is the position of parathyroid glands?

A

2 lie posterior to the superior pole of thyroid 2 lie posterior to the inferior pole of thyroid pg. 600

97
Q

If you see a thyroid nodule with a lymphadenopathy of the same side, what is it suspicious for?

A

Malignancy pg. 596

98
Q

What is the common cause for primary hyperparathyroidism?

A

Adenoma pg. 601

99
Q

Thyroglossal duct cysts are found ___.

A

Anteriorly to the trachea pg. 602

100
Q

What disease process is thyroid inferno?

A

Graves’ Disease

Hyperthyroidism pg. 599

101
Q

What is the most common thyroid malignancy?

A

Papillary Carcinoma pg. 596

102
Q

What is the shape of an abnormal lymph node?

A

Round pg. 603

103
Q

What is a cystic formation lateral to the thyroid gland?

A

Branchial cleft cysts pg. 602

104
Q

What is the fibrous capsule the covers the teste?

A

Tunica Albuginea pg. 606

105
Q

What is the normal measurement of the testicles?

A

L= 3-5 cm W= 2-4 cm H= 3 cm pg. 604

106
Q

What is the sonographic criteria of the tecticles?

A

Smooth Medium gray Fine echo textures pg. 604

107
Q

What is mediastinum testes?

A

Vertical septum formed from the posterior aspect of tuica albuginea that reflects into the testis pg. 606

108
Q

What is the location of the epididymis?

A

Begins superior and then courses posteriolateral to the testis pg. 604

109
Q

What is the most common cause of acute scrotal pain in an adolescent?

A

Torsion pg. 616

110
Q

What are varicoceles?

A

Abnormal dilation of veins of pampiniform plexus, usually caused by incompetent venous valves within the spermatic vein. More common on the left side, and will measure more than 2 mm in diameter. Color Doppler will be very lite up pg. 618

111
Q

What are spermatoceles?

A
  • Cystic dilations of efferent ductules of the epididymis
  • Always located in the epididymal head
  • More often seen following vasectomy pg. 618
112
Q

What is the most common cause of acute scrotal pain on adults?

A

Epididymo-orchitis pg. 615

113
Q

What almost always transpires secondary to epididymitis?

A

Orchitis, infection of testis pg. 615

114
Q

What is the appearance of a seminoma?

A

Homogeneous or hypoechoic lesion with smooth, well-defined borders pg. 626

(Most common germ cell tumor)

115
Q

Epididymorchitis most commonly results from ___.

A

Spread of a lower urinary tract infection via the spermatic cord pg. 615

116
Q

What is the primary source of blood flow to the testicles?

A

Right and left testicular arteries pg. 606

117
Q

Microlithiasis of the teste is associated with ___.

A

Testicular malignancy

Cryptorchidism
Klinefelter's syndrome
Infertility
Varicoceles
Testicular atrophy 
Male pseudohermaphroditism 
pg. 625
118
Q

What is the appendix teste?

A

Small protuberance from the head of the epididymis

upper pole of the testis between the testis and the epididymis pg. 605

Isoechoic to the testis p606

119
Q

What layers does a hydrocele form in?

A

Between the visceral and parietal layers of the tunica vaginalis pg. 620

120
Q

Where is a rete teste located?

A

At the hilum of the testis where the mediastinum resides pg. 623

121
Q

What are the important lab values for accessing renal function?

A

BUN
Creatinine
pg. 359

122
Q

AAA’s are present when the diameter exceeds ___.

A

3cm pg. 173

123
Q

What is the most common AAA type?

A

Fusiform pg. 173

124
Q

What is the innermost layer of the aorta?

A

Tunica intima pg. 165

125
Q

What are the clinical symptoms of acute appendicitis?

A

Pain and rebound tenderness over RLQ (McBurney’s point),
diarrhea,
fever,
nausea/vomiting pg. 348

126
Q

What would a collection of air or gas in the pleural cavity be?

A

Pneumothorax

127
Q

What vessels form the portal confluence?

A

Splenic vein and SMV pg. 302

128
Q

What is the most dependent area in the flanks of the abdomen and pelvis where fluid accumulates?

A

Gutters pg. 462

129
Q

What are the typical symptoms with an abscess formation?

A 
Fever 
Tenderness and swelling from post-op procedure 
Chills 
Weakness 
Malaise 
Pain 
Increased WBC's 
Sepsis pg. 466
130
Q

What is the most common cause for renal failure?

A

Diabetes Per handout ATN Per Beth

131
Q

What is an area in an organ that has become necrotic due to lack of oxygen called?

A

Infarct?

132
Q

What are the potential signs for rejection? (kidneys)

A
  1. enlargement and decreased echogenicity of the pyramids
  2. Hyperechoic cortex
  3. loss of cortical and medullary boundary
  4. Distortion of renal outline
  5. increased RI (greater than 0.8 = dysfunction) Per handout
    P 411
133
Q

What is ATN?

A

Acute tubular necrosis pg. 412

Damage to the tubular cells within the kidneys that result in decreased renal function

134
Q

What is a thoracentesis?

A

Drainage of fluid in the chest
The patient sits on the side of the bed, leaning on a bedside table with a pillow for comfort. This opens up space between the ribs to be able to get needle in to drain the fluid pg. 523

135
Q

Why is a time out performed?

A

Patient recites their name
Patient’s ID and MRN is confirmed
Type and location of procedure is said

136
Q

What is a lack of normal fixation to the testes called?

A

bell clapper

137
Q

What technique is used to find evidence of a varicocele?

A

Valsalva maneuver pg. 620

138
Q

What are the layers of the teste?

A

Parietal- outer layer
Visceral- inner layer
Which forms to create the tunica vaginalis

139
Q

Skin dimpling may be caused by ___.

A

Breast cancer pg. 571

140
Q

What is a fibroadenoma?

A

Most common benign breast tumor which occurs primarily in young women and is stimulated by estrogen pg. 575

141
Q

What is the best needle gage for a thyroid FNA?

A

25 gauge pg. 498

142
Q

What is the primary advantage of ultrasound guidance?

A

To have continuous real-time visualization of the biopsy needle, allowing for adjustment of the needle as needed pg. 495

143
Q

What is the functional portion of the breast called?

A

Mammary (glandular) layer pg. 550

144
Q

What is the sonographic appearance of Cooper’s ligaments?

A
  • Echogenic and are dispersed in a linear pattern

- Best identified when the beam strikes the ligaments at a perpendicular angle pg. 552

145
Q

What is a specific complication of a kidney biopsy?

A

Perinephric hematoma and Hematuria pg. 519

146
Q

What are polyps of the GB?

A

Small, well-defined soft tissue projections from the gallbladder wall
p 288

147
Q

What symptoms might a patient experience with polyps?

A

None

148
Q

Appearance of gallstones

A 
Hyperechoic intraluminal echoes with posterior acoustic shadowing
Dilated GB with thick wall
WES sign
Gravity dependent calcifications in GB
p279
149
Q

Nonshadowing low level echoing in the gallbladder-what is that called?

A

Sludge

150
Q

A condition that has increased secretion, abnormal mucus of the exocrine gland

A

Cystic fibrosis

151
Q

Parathyroid measurement

A

less than 4 mm

152
Q

Bell clapper deformity

A

Occurs when the tunica vaginalis completely surrounds the testis, epididymis, and distal spermatic cord, allowing them to move and rotate freely within the scrotum
p 616

153
Q

Layers of the breast

A

Subcutaneous layer
Mammary layer (glandular)
Retromammary layer

154
Q

Addisons disease

A

Adrenocortical insufficieny
Affect males and females equally
Atrophy of the adrenal cortex with decreased production of cortisol and sometimes aldosterone
Causes: autoimmune process, tuberculosis, inflammatory process, primary neoplasm, metastases
p 452

155
Q

Cushings syndrome

A

Caused by excessive secretion of cortisol resulting from adrenal hyperplasia, cortical adenoma, renal carcinoma, anterior pituitary tumor, or elevated ACTH resulting from a pituitary adenoma
Symptoms: truncal obesity, pencil thin extremities, “buffalo hump”, “moon face”, hypertension, renal stones, irregular menses in females, psychiatric disturbances
P452

156
Q

What in the GB will have a dirty shadow

A

Adenomyomatosis

157
Q

Another name for a complex mass

A

Heterogenous

158
Q

Hyperplasia

A

An increase in the number of cells of a body part that results from an increased rate of cellular division

159
Q

Normal thickness of GB wall

A

less than 3 mm

p 279

160
Q

What transducer would you use for scrotal scanning?

A

High frequency linear-array probe (7.5 MHz)

p609

161
Q

Limitations for ultrasound guidance

A
  • Not all masses can be visualized with ultrasound because they may be isoechoic to normal tissue
  • Bowel gas may move in and obscure the mass before or even during the procedure; overlying bowel may not be able to be displaced
  • Needle tip may be difficult to see or may deviate from the projected path because of bending or deflection of the needle
  • Inexperience of ultrasound personnel
  • Comfort level of the radiologist and or sonologist with other imaging modalities
  • Need to use fixed angles when needle guides are used on the transducer
162
Q

Outer diameter in appendicitis should measure

A

6 mm or greater

163
Q

What percentage of liver tumors in children are benign

A

40%

P697

164
Q

Where do they place a transplant kidney

A

right iliac fossa

165
Q

Normal measurement of the renal cortex

A

greater than 1 cm

166
Q

What term is used for absent urine production

A

Anuria

167
Q

Metabolic diseases of the liver

A

Wilsons

Hemochromatosis

168
Q

Normal flow direction in the portal vein

A

Hepatopetal

169
Q

what does the nuclear medicine scan show

A

Thyroid function

If thyroid nodular are hot or cold

170
Q

Where do the testicular veins drain

A

Right-IVC
Left joins the left renal vein
p608

171
Q

Most common cause of painless scrotal swelling

A

Hydrocele

172
Q

Speculations

A

figure like extenions of malignant tumor

173
Q

Puncture of the peritoneal space is referred to as

A

Paracentesis

174
Q

Why would you remove fluid from the pleural cavity

A

Patient has a hard time breathing

175
Q

What are universal precautions

A
  • use of personal protective devices

- hand washing

176
Q

name three vital signs

A
  • pulse
  • blood pressure
  • respiration
177
Q

Reasons why fluid accumulates in the abdomen

A
  • cirrhosis

- cancer

178
Q

A dirty shadow is likely a result of

A

Bowel gas

179
Q

Best choice for evaluation of blood flow?

A

Power Doppler

180
Q

Spectral Doppler flow of the testes in normal individuals

A

Low resistive waveform pattern

181
Q

Describe the normal spectral Doppler waveform for a transplant kidney

A

Low resistive

LMC Ultrasound (32 decks)

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