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Abdomen Tests 2013 > Abdomen Test 4 & 5--Pancreas and Spleen > Flashcards

Abdomen Test 4 & 5--Pancreas and Spleen Flashcards

1
Q

You have just discovered a pancreatic mass suspicious for adenocarcinoma in a patient with weight loss and abdominal pain. What associated findings should you look for?

A. lymphadenopathy

B. liver metastasis

C. portal vein aneurysm

D. A and B

A

D. A and B

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2
Q

Part of your routine protocol for pancreatic imaging is to comment on the echogenicity of the organ. What is the normal echogenicity of the normal pancreas?

A. either isoechoic or hyperechoic compared to the liver

B. always hypoechoic compared to the liver

C. always hyperechoic compared to the liver

D. always isoechoic compared to the liver

A

A. either isoechoic or hyperechoic compared to the liver

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3
Q

You have a patient who is scheduled for pancreatic surgery following ultrasound and CT evaluation. What is the surgical procedure of choice for pancreatic cancer?

A. Whipple procedure

B. pancreatic transplant

C. Wirsung procedure

D. cholecystectomy and pancreatectomy

A

A. Whipple procedure

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4
Q

You are scanning a 52 year old male with a history of alcohol abuse. Ultrasound findings include a hyperechoic mass in the head of the pancreas, dilaition of the pancreatic and common bile duct, diffuse calcification within the pancreas. Which of the following conditions is most likely present?

A. acute pancreatitis

B. chronic pancreatitis

C. adenocarcinoma

D. cystadenomcarcinoma

A

B. chronic pancreatitis

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5
Q

The most common location of adenocarcinoma of the pancreas is within the:

A. tail

B. head

C. body

D. neck

A

**B. head **

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6
Q

What is an early sonographic appearance of acute pancreatitis?

A. normal

B. calcifications within the gland

C. hyperechoic glandular echotexture

D. pancreatis psuedocyst

A

A. normal

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7
Q

You reviewing a CT report on a patient referred fo abdominal sonography. The report states that pancreatic divisum is present. What does this mean?

A. The pancreas is split into two pieces on each side of the abdomen

B. the pancreatic head is seperate from the body and tail

C. the pancreatic duct is duplicated

D. the two pancreatic ducts have not fused

A

D. the two pancreatic ducts have not fused

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8
Q

You have been asked to rule out pseudocyst formation in a patient with acute pancreatitis. What is the ultrasound appearance of a pancreatic pseudocyst?

A. cyst without internal echoes

B. cyst with low-level echoes

C. cyst with internal septations

D. well defined wall

E. all of the above

A

E. all of the above

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9
Q

A thin patient has been referred for ultrasound evaluation of the pancreas. Which of the following transducers would be best for this examination?

A. 3.5 MHz curved linear array

B. 5.0MHz curved linear array

C. 7.5MHz small footprint phased array

D. 12 MHz linear array

A

B. 5.0MHz curved linear array

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10
Q

You are scanning a patient with increased pancreatic enzymes and white blood cell count. Which of the following conditions is most commonly associated with these lab findings?

A. acute pancreatitis

B. chronic pancreatitis

C. adencarcinoma of the pancreas

D. islet cell tumor

A

A. acute pancreatitis

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11
Q

You are performing an ultrasound exam on a patient with a history of repeated bouts of pancreatitis. What would you most likely use color Doppler for in this study?

A. evaluate for increased flow in the pancreatic parenchyma

B. improve detectablility of possible pseudoaneurysms

C. look for flow direction in the superior mesenteric artery

D. assess the quality of flow in the abdominal aorta

A

B. improve detectablility of possible pseudoaneurysms

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12
Q

Obtained during an abdominal ultrasound of a 34 year old female with a history of oral contraceptive usage. What is the BEST diagnosis?

A. Cavernous hemangioma

B. Liver mets

C. Focal nodular hyperplasia

D. Hepatocellular carcinoma

A

A. Cavernous hemangioma

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13
Q

An African American male present to the u/s department for a RUQ ultrasound for pain. He has a history of smoking and diabetes. What is the best diagnosis?

A. Cystadenoma

B. Pancreatic psuedocyst

C. Adenocarcinoma

D. Acute pancreatitis

A

C. Adenocarcinoma

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14
Q

Which of the following is a risk factor for the development of pancreatic cancer?

A. smoking

B. diabetes

C. chronic pancreatitis

D. all of the above

A

D. all of the above

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15
Q

What is the most common cause of acute pancreatitis?

A. obstruction of the pancreatic duct by biliary calculi

B. pancreatic divisum

C. alcohol abuse

D. trauma

A

A. obstruction of the pancreatic duct by biliary calculi

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16
Q

Which laboratory value is more specific for acute pancreatitis?

A. AST

B. SGOT

C. Lipase

D. Amylase

A

C. Lipase

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17
Q

What is anatomic relationship of the common bile duct (CBD) to the pancreas?

A. The CBD is posterior to the head of the pancreas

B. The CBD is anterior to the head of the panceas

C. The CBD is medial to the head of the pancreas

D. The CBD is superior to the head of the pancreas

A

A. The CBD is posterior to the head of the pancreas

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18
Q

One clinical sign of insulinoma is the presence of:

A. hepatitis

B. low blood sugar symptoms

C. Zollinger-Ellison syndrome

D. elevated alpha-fetoprotein

A

B. low blood sugar symptoms

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19
Q

What is the additional name for the accessory duct of the pancreas?

A. Duct of Wirsung

B. Duct of Oddi

C. Duct of Santorini

D. Duct of Langerhans

A

C. Duct of Santorini

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20
Q

The pancreatic tail is outlined posteriorly by what vascular structure?

A. Portal confluence

B. splenic vein

C. superior mesenteric artery

D. inferior mesenteric artery

A

B. splenic vein

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21
Q

A 25 year old female patient presents to the ultrasound department for a complete abdominal ultrasound. She complains of right lower quadrant pain and nausea. The right upper abdomen appears normal. A small mass is noted in the area of the splenic hilum. This mass appears isoechoic to the spleen. What does this most liekely represent?

A. pancreatic cystadenoma

B. accessory spleen

C. splenic hemangioma

D. Neuroblastoma

A

B. accessory spleen

22
Q

A rare malignant tumor of the spleen that consists of blood vessels is a/an:

A. granuloma

B. lymphoma

C. angiosarcoma

D. hemangioma

A

C. angiosarcoma

23
Q

A 48 year old male patient with a history of severe, sudden onset of left upper quadrant pain without trauma presents to the ultrasound department for a sonogram of the spleen. You visualize a wedge-shaped, hypoechoic area within the spleen. This most likely represents a:

A. splenic metastasis

B. splenic infarct

C. splenic hematoma

D. splenic hemangioma

A

B. splenic infarct

24
Q

The process of making red blood cells is termed:

A. erythropoiesis

B. anemia

C. leukopoiesis

D. histopoiesis

A

A. erythropoiesis

25
Q

The most common cause of splenomegaly is:

A. trauma

B. portal hypertension

C. lymphoma

D. hepatitis

A

B. portal hypertension

26
Q

Where is the most common location of an accessory spleen?

A. splenic hilum

B. medial to the diaphragm and left kidney

C. anterior to the pancreatic body

D. superior to the spleen

A

A. splenic hilum

27
Q

Diffuse involvement of lymphoma or leukemia of the spleen will often lead to:

A. splenic atrophy

B. splenic torsion

C. splenomegaly

D. Epstein-Barr infection

A

C. splenomegaly

28
Q

The splenic artery originates at the:

A. superir mesentaric artery

B. celiac trunk

C. gastroduodenal artery

D. inferior phrenic artery

A

B. celiac trunk

29
Q

A 35 year old male patient presents to the ultrasound department for an abdominal ultrasound with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen?

A. multiple granulomas

B. multiple metastatic lesions

C. multiple hemagiomas

D. multiple histomas

A

A. multiple granulomas

30
Q

A 14 year old male patient presents to the ultrasound department after falling from his bicycle. An abdominal ultrasound reveals a complex appearing mass wihtin the spleen. this most likely represents:

A. splenic infarct

B. splenic hematoma

C. splenic hemagioma

D. splenic granuloma

A

B. splenic hematoma

31
Q

Sickle cell disease will often lead to:

A. splenomegaly

B. splenic metastasis

C. sarcoidosis

D. wandering spleen

A

A. splenomegaly

32
Q

An area within the spleen that has become necrotic because of a lack of oxygen is referred to as a:

A. granuloms

B. splenic hematoma

C. splenic infarct

D. splenic hemangioma

A

C. splenic infarct

33
Q

What systemic disease results in the development of granulomas within the spleen and throughout the body?

A. sickle cell anemia

B. granulomatosis

C. histoplasmosis

D. sarcoidosis

A

D. sarcoidosis

34
Q

A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the:

A. bacterial endocarditis cyst

B. hydatid cyst

C. candidiasis

D. choledochal cyst

A

B. hydatid cyst

35
Q

You are performing an abdominal ultrasound and are having difficulty identifying the spleen. Whihc of the following structures is in contact with the spleen?

A. left hemidiaphragm

B. stomach

C. pancreas

D. all of the above

A

D. all of the above

36
Q

You are examining the spleen during routine sonography. What view provides the best long axis image of the spleen?

A. sagittal view from the anterior position with patient supine

B. intercostal coronal view with patient supine

C. anterior sagittal view with patient in left lateral decubitus position

D. posterior sagittal view with patient in a prone position

A

B. intercostal coronal view with patient supine

37
Q

You are scanning a patient with moderate splenomegaly. Which of the following is a cause of mild to moderate splenomegaly?

A. portal hypertension

B. infection

C. AIDS

D. all of the above

A

D. all of the above

38
Q

You are imaging the spleen of a 27 year old male with AIDS. What is the most common finding in the spleen in patients with AIDS?

A. abscess

B. metastasis

C. accessory spleen

D. moderate splenomegaly

A

D. moderate splenomegaly

39
Q

An average sized male patient has been referred for ultrasound evaluation of splenomegaly. What transducer would provide the highest resolution images of the spleen?

A. 2.25 MHZ linear array

B. 3.5 MHz phased array

C. 5.0 MHz curved linear array

D. 3.5 MHz curved linear array

A

C. 5.0 MHz curved linear array

40
Q

The splenic vein drains into what vein?

A. inferior mesenteric vein

B. superior mesenteric vein

C. portal vein

D. left renal vein

A

C. portal vein

41
Q

The normal adult spleen measures:

A. 5-8 cm

B. 8-13 cm

C. 10-15 cm

D. none of the above

A

B. 8-13 cm

42
Q

You are performing an ultrasound study on a patient with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents:

A. histoplasmosis

B. tuberculosis

C. pseudocyst

D. metastasis

A

D. metastasis

43
Q

During abdominal sonography of a patient with portal hypertension and splenomegaly, you detect a calcified ring at the splenic hilum. What should you do?

A. evaluate the area with color Doppler

B. roll the patient into decubitus position to see if the structure moves

C. have the patient drink 24 oz of water and rescan

D. have the patient return for a repeat study in 1 week for comparison

A

A. evaluate the area with color Doppler

44
Q

The spleen is:

A. a contributor to the production of alkaline phosphatase

B. the smallest organ containg lymphoid tissue in the body

C. not a part of the reticuloendothelial system

D. the center for hematopoiectic activity

A

D. the center for hematopoiectic activity

45
Q

The spleen is variable in size and is considered to be all of the following except:

A. tetrahedral

B. pentagonal

C. triangular

D. orange segment

A

B. pentagonal

46
Q

The most common benign neoplasm of the spleen include all of the following except:

A. cavernous hemangioma

B. infarctions

C. cystic lymphangiomas

D. hamartomas

A

B. infarctions

47
Q

A spleen that has migrated from its normal location is termed:

A. accessory spleen

B. wandering spleen

C. ectopic spleen

D. splenomegaly

A

B. wandering spleen

48
Q

The major function of the spleen is:

A. hematopoiesis

B. to fight infection

C. to manufacture leukocytes

D. to filter the peripheral blood

A

D. to filter the peripheral blood

49
Q

A chronic disease of unknown etiology that involves all bone marrow elements is:

A. thalassemia

B. polycythemia vera

C. leukemia

D. Hodgkin disease

A

B. polycythemia vera

50
Q

In a _____ hematoma of the spleen, the splenic capsule remains intact.

A. interparenchymal

B. subcapsular

C. intraperitoneal

D. interperitoneal

A

B. subcapsular

Abdomen Tests 2013 (12 decks)

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