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ABDOMEN II FINAL REVIEW 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

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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

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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 postop
Chills
Weakness
Normal LFT's
Leukocytosis
Sepsis
pg. 466
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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
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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 is the benign liver tumor located near the free edge of the liver?

A

Liver cell adenoma

pg. 258

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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
CBD?
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

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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
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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

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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

Causes the GB to contract because it pushes bile into the duodenum
pg. 273

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37
Q

What cavity does the pancreas lie in?

A

Retroperitoneal cavity
pg. 302
Also note that it is in the epigastrium and a portion lies in the left hypochondrium….behind the lesser sac.

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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

What is hemorrhagic pancreatitis?

A

Acute pancreatitis with rupture of vessels
Usually occur in alcoholics
Homogenous mass that can be septated and later becomes cystic
pg. 323-324

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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

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43
Q

What is adenocarcinoma of the pancreas?

A

Most common primary neoplasm of pancreas
Symptoms: Jaundice, weight loss, nausea, palpable GB
Sonographic: Loss of parenchymal pattern, hypoechoic, irregular borders, biliary duct dilation
pg. 329-330

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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
Islets of Langerhans
pg. 310

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48
Q

The splenic vein courses ___ in reference to the pancreas?

A

posterior

pg. 309

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49
Q

What is the most common cause for acute pancreatitis?

A

Biliary tract disease

pg. 317

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50
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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51
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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52
Q

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

A 
Enlarged 
Hypoechoic 
Indistinct, but smooth borders 
IVC may be compressed
Peripancreatic fluid collections
pg. 319
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53
Q

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

A

UPJ

pg. 713

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54
Q

Where are parapelvic cysts located?

A

Renal sinus or pelvis

pg. 380

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55
Q

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

A

Nephroblastoma (Wilm’s tumor)

pg. 387

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56
Q

What is fusion of the lower poles of the kidneys?

A

Horseshoe kidney

pg. 371

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57
Q

What is the most echogenic portion of the kidney?

A

Renal sinus

pg. 359

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58
Q

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

A

Ureterocele

pg. 373

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59
Q

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

A

Dromedary hump

pg. 366

60
Q

What is a dilated renal pelvis without ureteral involvement?

A

Ureteropelvic Junction Obstruction

pg. 713

61
Q

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

A

Hypertension

62
Q

What could a perinephric fluid collection post transplant be?

A

Acute rejection
pg. 407
Wasn’t hematuria and hematoma an option…?

63
Q

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

A

48-72 hours

pg. 407

64
Q

What is a common finding in people over 50?

A

Simple Renal Cyst

pg. 379

65
Q

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

A

Hydronephrosis??

pg. 397-398

66
Q

When will ureteral jets not be visualized?

A

Ureteral Obstruction

pg. 713

67
Q

What is the process of disposing metabolic waste?

A

Excretion

pg. 358

68
Q

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

A

Hemoglobin

pg. 359

69
Q

What cavity are kidneys located in?

A

Retroperitoneum

pg. 355

70
Q

What ‘stuff’ is outside the renal capsule?

A

Perinephric fat

pg. 356

71
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

72
Q

Renal sonography is not helpful in evaluating ___.

73
Q

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

A

Morison’s pouch

pg. 356

74
Q

Renal cell carcinoma commonly invades the IVC via the ___.

A

Renal vein

pg. 385

75
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

76
Q

What are 3 different reasons why there might be dilatation of the renal pelvis?

A

Hydronephrosis

pg. 397

77
Q

What is a benign vascular fatty tumor of the kidney?

A

Renal Angiomyolipoma

pg. 388

78
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.

79
Q

What is the size of the spleen?

A

8-13 cm x 7 cm x 3-4 cm

pg. 424

80
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

81
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

82
Q

Where would an accessory spleen be located?

A

Near hilum or inferior border

pg. 425

83
Q

The splenic vein courses ___ along the pancreas.

A

Posteromedially

pg. 424

84
Q

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

A

Steep right decubitus

pg. 428

85
Q

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

A

Wandering spleen

pg. 425

86
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

87
Q

What is a measurement of the spleen considered splenomegaly?

A

Greater than or equal to 13 cm

pg.430

88
Q

Why might someone have atrophy of the spleen?

A

Sickle cell anemia patients

Pg 429

89
Q

What are the hormones of the thyroid?

A

T3 and T4 and Calcitonin

pg. 590

90
Q

What is the size of the thyroid?

A

40-60mm (length) x 20-30mm (AP) x 13-18mm (width)

pg. 589

91
Q

What are the neighboring structures around thyroid? (muscles)

A

Anterior:
Sternothyroid
Omohyoid, Sternohyoid (Appear thin, hypoechoic)
Sternocleidomastoid (Large, Oval, located anterior and lateral)

Posterior:
Longus colli (Hypoechoic, Triangular, located posterior and lateral)
pg. 589

92
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

93
Q

What is the most common cause for thyroid disorders worldwide?

A

Iodine deficiency

pg. 593

94
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
95
Q

What is the sonographic criteria for a thyroid adenoma?

A

Solid mass
Peripheral halo
Cystic degeneration
pg. 596

96
Q

How many parathyroid glands are there?

97
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

98
Q

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

A

Malignancy

pg. 596

99
Q

What is the common cause for primary hyperparathyroidism?

A

Adenoma

pg. 601

100
Q

Thyroglossal duct cysts are found ___.

A

Anteriorly to the trachea

pg. 602

101
Q

What disease process is thyroid inferno?

A

Hyperthyroidism

pg. 599

102
Q

What is the most common thyroid malignancy?

A

Papillary Carcinoma

pg. 596

103
Q

What is the shape of an abnormal lymph node?

A

Round

pg. 603

104
Q

What is a cystic formation lateral to the thyroid gland?

A

Branchial cleft cysts

pg. 602

105
Q

What is the fibrous capsule the covers the teste?

A

Tunica Albuginea

pg. 606

106
Q

What is the normal measurement of the testicles?

A 
L= 3-5 cm
W= 2-4 cm 
H= 3 cm

pg. 604

107
Q

What is the sonographic criteria of the tecticles?

A

Smooth
Medium gray
Fine echo textures
pg. 604

108
Q

What is mediastinum testes?

A

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

109
Q

What is the location of the epididymis?

A

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

110
Q

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

A

Torsion

pg. 616

111
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

112
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
113
Q

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

A

Epididymo-orchitis

pg. 615

114
Q

What almost always transpires secondary to epididymitis?

A

Orchitis, infection of testis

pg. 615

115
Q

What is the appearance of a seminoma?

A

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

116
Q

Epididymorchitis most commonly results from ___.

A

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

117
Q

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

A

Right and left testicular arteries

pg. 608

118
Q

Microlithiasis of the teste is associated with ___.

A

Testicular malignancy, cryptorchidism, Klinefelter’s syndrome, infertility, varicoceles, testicular atrophy and male pseudohermaphroditism
pg. 625

119
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

120
Q

What layers does a hydrocele form in?

A

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

121
Q

Where is a rete teste located?

A

At the hilum of the testis where the mediastinum resides

pg. 623

122
Q

What are the important lab values for accessing renal function?

A

BUN
Creatinine
pg. 359

123
Q

AAA’s are present when the diameter exceeds ___.

A

3cm

pg. 173

124
Q

What is the most common AAA type?

A

Fusiform

pg. 173

125
Q

What is the innermost layer of the aorta?

A

Tunica intima

pg. 165

126
Q

What are the clinical symptoms of acute appendicitis?

A

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

127
Q

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

A

Pneumothorax

128
Q

What vessels form the portal confluence?

A

Splenic vein and SMV

pg. 302

129
Q

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

A

Gutters

pg. 462

130
Q

What are the typical symptoms with an abscess formation?

A 
Fever
Tenderness and swelling from postop procedure
Chills
Weakness
Malaise 
Pain
Increased WBC's 
Sepsis
pg. 466
131
Q

What is the most common cause for renal failure?

A

Diabetes
Per handout

ATN
Per Beth

132
Q

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

133
Q

What are the potential signs for rejection?

A

Renal: enlargement, decreased echogenicity, loss of cortical medullary boundary, increased RI (greater than 0.8 = dysfunction)
Per handout

134
Q

What is ATN?

A

Acute tubular necrosis

pg. 412

135
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

136
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

137
Q

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

A

bell clapper??

138
Q

What technique is used to find evidence of a varicocele?

A

Valsalva maneuver

pg. 620

139
Q

What are the layers of the teste?

A

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

140
Q

Skin dimpling may be caused by ___.

A

Breast cancer

pg. 571

141
Q

What is a fibroadenoma?

A

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

142
Q

What is the best needle gage for a thyroid FNA?

A

25 gauge

pg. 498

143
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

144
Q

What is the functional portion of the breast called?

A

Mammary (glandular) layer

pg. 550

145
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
146
Q

What is a specific complication of a kidney biopsy?

A

Perinephric hematoma and Hematuria

pg. 519

DSM Abd (9 decks)

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