Abd Final Flashcards
- Transabdominal ultrasound imaging of the prostate gland is of most use in diagnosing what type of condition?
benign prostatic hyperplasia (BPH)
- The Courvoisier Sign is closely related to which of the pathology?
Pancreatic Carcinoma head
- What is the most common cause of splenomegaly in adults?
Portal hypertension
- What are the causes of pancreatic duct dilation?
Chronic pancreatitis and pancreatic cancer
- Know the ultrasound appearance of a simple renal cyst
- Anechoic
- well defined walls
- In children, the counterpart of hepatocellular carcinoma is?
Hepatoblastoma
- The liver can be used as a sonographic window for which of the organs (or structures)?
- Pancreas
- Rt Kidney
- Gallbladder
- IVC
- Aorta
- diaphragm
- The prostate gland produces _________ fluid
seminal fluid
- Following trauma to the spleen, would you see fluid in perinephric fluid collection?
Yes, you would see perinephric
Fluid collection in extreme trauma
Hematocrit decreases
Not Extreme trauma = Morrison’s pouch fluid collection
- With focal sparing of the liver, the area that is spared will appear as?
odd shaped hypoechoic area
- The WES sign is indicative of what condition?
Gallstone or multiple small gallstones filling the lumen
- End-stage kidneys (renal failure) are characteristically associated with?
- Decrease in size (Atrophy)
- Increased echogenicity (Hyperechoic)
- Low urine output (Oliguria)
- Normal variants of the kidney?
- Hypertrophied Column of Bertin
- Dromedary hump
- Bilateral Renal Agenesis
- Unilateral Renal Agenesis
- Supernumerary kidney
- Pelvic Kidney
- Crossed fused renal ectopia
- Thoracic kidney
- Horseshoe kidney
- Cake/lump kidney
- Sigmoid kidney
- Unilateral hypoplasia
- Persistent fetal lobulation
- Renal cell carcinoma - most common in elderly or young, know location of it, where it would metastasize.
- Most common malignancy of the renal in the adult
- More common in males over 40 years of age
- Usually unilateral
- Metastases to renal veins, IVC, contralateral kidney, adrenals, para aortic nodes, lung liver, brain Long bones.
- Transitional Cell carcinoma of the kidneys appear? (Where does it show up in US?)
Renal Pelvis
- Angiomyolipoma - US appearance, symptoms and signs
Angiomyolipoma (Renal Hamartoma) US appearance: -Homogenous -Typically well circumscribed -Hyperechoic (greater than sinus fat) Signs and Symptoms: Nausea, Vomiting, anemia, hypertension
- In infantile polycystic kidney disease, the kidneys appear?
- Bilateral enlargement of kidneys
- Increased echogenicity
- poorly defined borders
- Signs and symptoms of benign prostatic hypertrophy? (BPH)
- Weak urinary stream
- Urinary urgency
- Nocturia
- Leaking and dribbling of urine
- Wilson’s Disease
- Rare congenital disorder
- Faulty copper metabolism
- Eventually results in severe damage to liver and brain
- Diagnosis - blood and urine tests, liver biopsy
- Treatment - Penicillamine
- Signs eyes may have brownish green ring
- Ultrasound - Range from hepatomegaly to cirrhosis
- Grave’s Disease
- Anxiety
- Irritability
- Tremor in hands and fingers
- Increased size of gland (goiter)
- Decrease in echogenicity
- Increased vascularity in gland
- hypothyroidism
- A “strawberry gallbladder” refers to which condition?
Cholesterolosis
- Hemangioma - review US appearance, symptoms, and signs
- Hemangioma - most common (of the benign splenic neoplasms), small
- US appearance variable (hyperechoic to mixed)
- in liver and spleen
- rarely experience symptoms (asymptomatic)
- Adrenal hemorrhage is most common in which population?
neonates 2-7 days old
- Cause of a fluid collection around the testicle?
Epididymitis
- US appearance of testicular torsion?
- Enlarged testicle
- Decreased echogenicity
- Scrotal wall thickening
- Possible hydrocele
- Lack of arterial flow on doppler
- The most common malignancy of the testicle?
Seminoma (most common) 40-50%
- Acute pancreatitis - know amylase and lipase rise rate
- Blood and urinary amylase increase within 24 hours
- stays elevated for 48-72 hours
- Lipase increase within 24-48 hours
- stays elevated 5-14 days
- Amylase 2x times normal level indicates acute pancreatitis
- Neuroblastoma
Common in neonates
- Malignant tumor of the adrenal
- May displace renals inferiorly and anteriorly
- Peak incidence is 2 months through 4 years
- Virulent
- Difficult to distinguish from Wilms Tumor
- Mets usually present by time of diagnosis
*29. A cyst in the epididymal head cannot be differentiated by ultrasound from a
Spermatocele
pg 537
- What is the most commonly used view in mammography?
Mediolateral oblique (MLO) - most valuable view; mass localization superior to inferior to nipple
- Parathyroid adenomas, the lab value associated with this lesion is?
Elevated Serum Calcium (hypercalcemia)
- Know parameters in differentiating cystic from solid lesion
Anechoic
Well defined walls
Echogenic
*33. Know ultrasound characteristics that are suspicious for malignancy in the breast
- Taller than wide
- Spiculated appearance
- Know what conditions are related to a hyperechoic appearance of the pancreas
*Cystic Fibrosis
Acute pancreatitis
- Know sonographic findings that are compatible with the diagnosis of carcinoma of the pancreatic head
Hypoechoic mass
Poorly defined
Usually greater than 2 cm
- Mirizzi syndrome - which duct is involved in it?
- Stone impacted in cystic duct or neck of GB
- May compress CBD
- Dilated intrahepatic ducts
- In which zone is the majority of prostate cancer found?
the peripheral zone
- Jaundice can be attributed to which conditions?
- Liver metastases
- GB carcinoma
- Choledocal cyst
- Biliary obstruction
- Choledocholithiasis
- Cholangiocarcinoma
- Acute Pancreatitis
- Pancreatic Carcinoma
- Biliary Atresia (neonatal)
- hepatitis
- Portal hypertension - US appearance
Recanalized umbilical vien (LIG Teres)
- Carcinoma of the gallbladder - US appearance, symptoms and signs.
Ultrasound appearance:
- Variable
- Focal wall thickening
- Irregular wall borders
- Solid mass within lumen
- Gallstones may be trapped within mass
Signs and symptoms: Asymptomatic, loss of appetite, nausea, vomiting, belching, RUQ pain, jaundice when biliary tree infiltrated
- Do a halo sign in the thyroid gland typically (most likely) represent an adenoma?
Classically has peripheral echolucent halo
-Its presence DOES NOT rule out the possibility of thyroid carcinoma
- The longus colli muscle muscle can mimic what pathology?
Thyroid mass
*44. Do amebic abscess is associated with the “floating water lily sign”?
False - has nothing to do with abcess
- The normal caudate lobe is less echogenic than the right and left lobes of the liver. True or False?
False
- Elevated levels of direct bilirubin usually indicates biliary obstruction outside the liver. True or False?
True
- Do Jaundice is associated with Adenomyomatosis of the gallbladder. True or False?
False
- Cryptorchidism is associated with previous a previous episode of the Mumps. True or False?
False
- Porcelain gallbladder is it a congenital condition?
False - Not a congenital condition
- A spiculated mass in the breast is suspicious for malignancy or not?
True - Spiculated mass is suspicious for malignancy
- Is hemangioma of the liver a malignant condition? True or False?
False
benign
- Renal cell carcinoma may invade the renal vein? True or False?
True
- A breast fibroadenoma has a strong potential for malignancy. True or False?
False?
benign
*54. A simple breast cyst will most likely change shape with compression. True or False?
true
*56. A choledochal cyst - is it congenital, know location of this cyst, which duct is involved in it?
- Congenital cyst-like dilation of common duct
- Most common is cyst-like dilation in porta hepatis area
- Dilation of the CHD and CBD may be present
- May have dilation of intrahepatic ducts
- The majority of breast carcinomas occur in?
40% occur in upper outer quadrant
- Using the fremitius maneuver in ultrasound examination of breast tissue, the suspected mass (if real) should?
- Should not compress
- Should not color
- A fibroadenoma of the breast - is it benign or malignant, solid or cystic?
- Benign
- Solid
- Know post-renal transplant fluid collections
urinoma, hematoma, perinephric abscess, lymphocele, seroma, are all fluid collections
- What is galactocele?
a type of complex cyst in breast containing milk
- Which of the follow is more ominous finding when visualizing a solid breast lesion?
Any findings associated with malignant breast tumors
-shadows that arise from the center portion of the lesion
*63. Abscess- know US appearance, signs and symptoms
- Dirty shadowing
- Internal echoes
- A spermatocele would most likely be visualized on a LONG sonogram as?
- Small anechoic cystic structure
- posterosuperior to testicles
- Highest risk factor for malignant breast disease is?
Gender
- Elevated levels of Prostate specific antigen (PSA) are found in?
Prostate cancer
Prostatitis
BPH
- Junctional fold - know what it is
Body and neck of gallbladder
- Many congenital anomalies of the urinary tract are linked with anomalies of what other body system?
Reproductive system
- Nice;) - Normal diameter of the pancreatic duct in the body of the pancreas in the young adult is?
Body of pancreas 2mm
- The Tail of Spence is located in?
Axillary area
- What is the main pancreatic duct?
Duct of Wursung
- The quadrate lobe of the liver is a part of?
Medial segment of the left lobe
- A major branch coming off of the common hepatic artery is the?
Gastroduodenal artery
- Indications for a breast ultrasound examination
- Follow up after mammogram
- Breast lumps
- Lesions
- The two segments of the right lobe of the liver are named?
Anterior and Posterior
- The vessel, which courses between the aorta and superior Mesenteric artery, is?
Left Renal Vein
- US appearance of mediastinum testis
Mediastinum testis - echogenic line in SAG and ovoid in TRV
- US appearance of Medullary pyramids
Pyramids are triangular in shape in SAG
Pyramids are most hypoechoic area in ABD
- Pampiniform plexus-
Is a venous network posterior to the testicles
- Know normal size of teticle
4 cm SAG
3 cm TRV
2 cm AP
- Increased incidence of thyroid carcinoma is associated with?
Radiation
- If the prostate is judged to be enlarged, the sonographer should also check?
- Kidneys
- blood
- if can patient empty bladder
- Functions of Cooper’s suspensory ligaments
Structural support
- Hepatocellular disease - know US appearance
Poor penetration
echogenicity of liver increased
splenomegaly
ascites
- Know upper limit of normal for the CBD after cholecystectomy
Up to 10mm
Echinococcal cyst
-AKA - Hydatid Disease
-Cause: parasitic worm
-Cysts are found 50% of the time in liver
-Other Sites: Lung, Bone, Brain
Ultrasound Appearance:
-Simple cyst with or without wall calcification
-Mother cyst with daughter cyst
-Honeycomb cyst
-Water Lily Sign
Hepatocellular CA
AKA: HCC, Hepatoma -Increased Risk (80%) with Cirrhosis -Increased risk with chronic hepatitis B and C Laboratory Values: -LFTs normal or elevated -AFP may be elevated
Courvoisier GB
- Enlarged GB
- Painless Jaundice
- Associated with pancreatic carcinoma
Acute cholecystitis
-May require emergency surgery (life threatening)
-Usual cause: stone blocking cystic duct
Patient signs and symptoms:
-Acute RUQ pain (may refer to shoulder)
-Fever, Chills, nausea, vomiting
-Leukocytosis
-increased serum bilirubin
Hepatitis
inflammation of the liver
Transitional cell CA
- Originates from transitional cells of urinary tract
- Occurs in: kidney, pelvis, ureter, bladder
- More common in males after 60 years
- causes hematuria
Adult polycystic kidneys
Autosomal Dominant (Adult) polycystic kidney disease
- High degree of penetrance
- Latent until 30’s or 40’s
- Bilateral enlargement of kidneys with cysts too numerous to count
- Renal cortex may have increased echogenicity
- Cyst may be present in liver, pancreas, and spleen
Staghorn Calculus
- Type of infective stone
- Fills entire renal pelvis to proximal ureter
- Oddly shaped
Ureteropelvic junction
UPJ
- Congenital form of obstructive uropathy
- Causes hydronephrosis
*Annular pancreas
- Congenital anomaly
- More common in males
- Needs surgery
*Fibroadenoma
- Most common benign tumor of breast
- Common in young
- wider than tall
Varicocele
- Dilated tortuous veins of the pampiniform plexus
- More common on left
- May be cause of infertility appears as mass of tubular structures along the posterior aspect of testicle
Orchitis
Inflammation of the testicle
causative factors:
Epididymitis, Influenza, Mumps, Tonsillitis, STDs, Complex causes, Hydrocele
Phyllodes tumor
- Rare
- solid
- Palpable
- tumor
Thyroglossal duct
*?
- . Fibrocystic breast disease is most common in women over 50 years of age. True or False?
False
