Abdominal final Flashcards
Abdominal sonography of a 42 yr old male reveals a solid mass located at the upper poleof the kidney. which would be most helpful in differentiation between a renal and adrenal mass?
Scan the patient in both deep inspiration & expiration
A 45 yr old obese woman with thin arms and legs, hypertension & severe fatigue presents to the ultrasound department for an abdominal sonogram. You should evaluate the adrenal glands closely for sings of
both Adrenal adenoma & primary adrenal carcinoma
which of the folloeing hormones are responsible for the “flight or flight” response?
Epinephrine & norepinephrine
The most common sonographic appearance of a pheochromocytoma is a/an
Hyperechoic mass
The adrenal mass often associated with uncontrollable hypertension, tachycardia & tremors is the
Pheochromocytoma
A 32 yr old woman with intermittent pain in the RUQ is seen for an abdominal ultrasound. The exam reveals a gallbladder w multiple comet-tail artifacts emanating from the gallbladder wall. The lumen of the gallbladder is unremarkable. The most likely represents which
Adenomyotosis
Intermittent obstrustion of the cystic duct by a gallstone results in
Chronic cholecystitis
Acute cholecystisis that leads to necrosis & abscess development with in the gallbladder wall describes
gangrenous cholecystitis
An 85yr old female w jaundice, weight loss & palpable RUQ mass, what is the best diagnosis
Adenocarcinoma of the gallbladder
Tumefactive sludge can resemble the sonographic appearance of
gallbladder carcinoma
Which of the following is not a plausible cause of common bile duct obstruction in adults
Choledochal cyst
Air within in biliary tree is referred to as
Pneumobilia
You have been asked to perform an ultrasound to evaluate for biliary obstruction in a patient with a history of weight loss and midepigastric pain. you find both tintrahepatic & extrahepatic biliary dilation. The gallbladder is hydropic. Which condition causing ductal dilation should you look for
Choledochlithiasis
Pancreatic carcinoma
and
Chronic pancreatitis
The yellowish staining of the whites of the eyes & the skin secondary to a liver disorder or biliary obstruction if referred to as
Jaundice
Focal tenderness over the gallbladder with probe pressure describes
Murphy sign
Courvoisier’s gallbladder is associated with which of the following
A pancreatic head mass
The best way to identify the intrahepatic biliary system is to image which structures
intrahepatic portal veins
The normal measurment for the biliary duct should be
<6mm
The telescoping of one segment of bowel into another is referred to as
Intussusception
All of the following are sonographic findings of acute appendicitis except
Compressible, blind-ended tube
A 6 month old female presents to your department with vomiting ABD pain and blood in her stool. Give the BEST diagnosis
Intussusception
Clinical findings of fatty infiltrate of the liver include
Elevated liver function tests
NOrmal flow toward the liver in the portal vein is termed
Hepatopedal (toward)
A 51 yr old man undergoes an ultrasound of the RUQ. Pertinant history includes multiple previous ultrasound ecaminations that document a small liver that is difficult to penetrate. Liver enzymes levels are elevated. The patient is very thin, with a slightly protruding abdomen. The liver remains small and difficult to penetrate, with poorly documented hepatic vasculature. No specific masses are noted. Free fluid is noted within Morrison’s pouch and the right subphrenic space. The anterior border of the liver is noted to have scalloped appearance. Which of the following is the most likely diagnosis
Cirrhosis
A 70 yr old woman is seen for malaise & wasting. The clinician orders an abdominal ultrasound because of the patient’s history of colon cancer & elevated liver function tests. The sonographer notes multiple hyperechoic lesions within the liver & hepatomegaly. This is suggestive of
Metastatic disease
Clinical findings for hepatitis include all of the following except
Pericholecystic fluid
A solitary, anechoic lesion is identified in the right lobe of a 50 yr old woman. The lesion is 2.5cm with smooth walls and acoustic enhacement. The patient has mild epigastric pain, especially with spicy foods & the remainder of the ultrasoun examination is unremarkable. The anechoic leasion most likely represents which of the following
Liver cyst
All of the following are located within the porta hepatis except
Middle hepatic vein
The most common cause of cirrhosis is
Alcoholism
Joe, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever & elevated white blood cell count. He states the 3 months ago he was kicked in the ribs. An irregular mass with low-level echoes is found on the ultrasound. What is the differential diagnosis
Chinococcal cyst
This 56 yr old female presents to the ultrasound department with elevated liver enzymes and a history of lung cancer. How would you best describe the attached image?
Multiple hypechoic masses througout slightly hyperechoic liver
Ascited is the accumulation of fluid in which cavity
Peritoneal cavity
What is the most common malignancy of the testicles
Seminoma
A large complex hydrocele is most commonly associated with which of the following
orchitis
A 7 yr old boy presents to the emergency fepartment with acute testicular pain localized to the superior pole of his right testis. What is the most likely diagnosis
Torsion of the testicular appendage
Obtained during an ultrasound exam on a 17 yr old male for scrotal pain. What is the BEST diagnosis
Epididymitus
You are performing doppler analysis of the spermatic cord. Which of the following arteries or structures is found within the speramatic cord?
Vas deferens
Tersicular artery
Cremasteric artery
and
Deferential artery
Clinical findings of acute scrotal pain and swelling are suggestive of
Torsion
A common cyst most often seen in the head of the epididymis that contains noviable sperm is the
Spermatocele
Enlargement of the prostate in older men is most often caused by
Bengin prostatic hypertrohy
You have been asked to perform a thyroid ultrasound on a patient with a palpable nodule in the left neck. Which transducers would provide the most optimal scan
MHz linear array
The differential diagnosis for thyroiditis includes all of the following except
Hemorrhagic cyst
The most common feature of a thyroid adenoma is
Peripheral sonocucent halo
A patient with no significant medical history is seen with a palpable nodule in the left lobe of the thyroid. On ultrasound examination, the nodule is found to be mostly cystic but contains no debris. The mass is more likely
Benign thyroid nodule
Images obtained during a thyroid ultrasound done due to a palpable neck mass in a 42 yr old. The BEST diagnosis is
Adenoma
What is the most common cause of hypothyroidism
Hashimoto thyroiditis
Which vascular structure is located closest to the thyroid lobes
Common carotid artery
A 35 yr old remale patient presents to the ultrasound department with a history of migraine medicine use, weight loss, nausea & malaise. Sonographically, you visualize a 15cm hypoechoic mass within the abdomen. Which of the following would be most likely
Retroperitoneal fibrosis
Fluid located around the lungs is termed
plueral effusion
You’ve been asked to rule out pseudocyst formation in a patient with acute pancreatisis. What is the ultrasound appearance of a pancreatic pseufocyst
Cyst without internal echoes
cyst with lo-level echoes
cyst with internal septations
and
well defind wall
What is the additional name for the accessory duct of the pancreas
Duct of santorini
The most common location of adenocarcinoma of the pancreas is within the
Head
The pancreatic tail is outlined posteriorly by what vascular structure
splenic vein
Part of your routine protocol for pancreatic imaging is to comment on the chogenicity of the organ. what is the normal echogenicity of the normal pancreas
Either isoechoic or hyperechoic compared to the liver
Which of the following is a risk factor for the development of pancreatic cancer
Smoking
diabetes
and
chronic pancreatitis
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
Whipple procedure
what is the most common cause of acute pancreatitis
obstruction of the pancreatic duct by biliary calculi
A thin patient has been referred for ultrasound evaluation of the pancreas. Which of the folloeing transducers would be best for this examination
5 MHz curved linear array
a 23 yr old male reports to the ultrasound department for LUQ ultrasound with a history of mononucleosis. What is the best diagnosis
splenomegaly
Patient presents with RUQ pain, tender hepatomegaly, fever, nausea, vomiting & weight loss. He recently traveled to a foreign country. He also has a history of abdominal aortic aneurysm. What is the best diagnosis
Abscess
The largest tributaries to the IVC are
Hepatic veins
A 25 year old female patient presents to the ultrasound department for a complete abdominal ultrasound. She complains of right lower quadrant pain & 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 likely represent
Accessory spleen
A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the
Hydatid cyst
An area within the spleen that had become necrotic because of a lack of oxygen is referred to as a
Splenic infarct
The most common benign neoplasm of the spleen include all of the following except
Infarctions
The normal adult spleen measures
8-13cm
A rare malignant tumor of the spleen that consists of blood vessels is a/an
Angiosarcoma
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
Metastasis
The major function of the spleen is
To filter the peripheral blood
Where is the most common location of an accessory spleen
Splenic hilum
Which malignant tumor is most common in chilfren aged 2-5
Wilm’s tumor
During routine surveillance of the urinary bladder, you detect the presence of periodic ureteral “jets”. This is a sign of
Normalcy
What is the normal appearance of the central sinus of the kidney
Highly echogenic compared to the renal cortex
During performance of a renal sonogram, you identify only one kidney. what should you do
Scan the pelvis area to rule out the presence of a pelcic kidney
Which of the following is not consifered an extrinsic cause of hydronephrosis
ureteral stricture
What is the indication for a doppler renal study to rule out renal artery stenosis
uncontrolled hypertension
The most common congenital anomaly of the urinary tract is
Duplicated collecting system
A teenage boy is tackled roughly diring a football game. After the game, he has abdominal pain. the pain becomes intense & the next day he is seen at the emergency department. The lab values are abnormal, the hematocrit is low & microscopic hematuria is found. A renal ultrasound is ordered. The ultrasound of the left kidney is normal. The right kidney appears normal, but a sonolucent ring is seen surrounding the kidney. This is most consistent with
Perinephric hematoma
You have detected comensatory hypertrophy of the right kidney in a 35 yr old maale. This finding is associated with which of the following
Nephrectomy
renal agenesis
and
renal hypoplasis
All of the following are clinical findings of acute renal failure except
Decreased BUN creatinine
A 24 yr old frmale with a 12 yr history of recurring urinary tract infections arrives at the ultrasound department needing a renal sonogram. She has hypertension, a high fever, nausea, vomiting and painful urination. The lab findings include bacteriuria, proteniuria & increased BUN/Creat levels. Sonographically, the right kidney appears normal, but the left renal parenchyma appears narrowed and has focal areas of increased echogenicity. In addition, the left kidney measures abnormally small and appears misshapen and it’s borders are difficult to visualize. what might by the cause of these sonographic findings
Chronic pyelonephritis
A patient with a history of tuberous sclerosis, recent onset of hematuria and pain is seen for a renal ultrasound. The ulrasound reveals bilateral well-defind echogenic renal cortex masses with increased posterior scoustic enhancement. This finding is most consistend with
AML
A 40 yr old female is seen for renal ultrasound. Microscopic hematuria was found during her routine annual physical exam. A solid mass is identified in the renal cortex. The mass is more echogenic than the renal sinus and the collecting system is not dilated. what is the most likely diagnosis
AML
You are scanning a 69 yr old male with hematuria. Your ultrasound findings include right-sided hydronephrosis and a mass within the urinary bladder. which tumor most commonly occurs with in the urinary bladder
TCC (transitional cell carcinoma)
You are scanning a patient with right flank pain and known polycystic kidney disease. You suspect the presence of hemorrhage within one of the renal cysts. What is the conographic appearance of this
Low-level echoes within the cyst
Which of the following describes the normal course of the left renal vein
between the superior mesenteric artery and the aorta
You detect the presence of free fluid in the space between the liver and right kidney. What is the name for this anatomic location
Morrison’s pouch
Occulsion of the hepatic veins describes
Budd-Chiari syndrome
A 58 yr old female with epigastric pain with eating is seen for an abdominal ultrasound to rule out gallstones. The sonographer identifies normal-appearing gallbladder, liver, pancreas and spleen. The sonographer also documents a dilation of the aorta, which measures 6cm at its largest diameter. This woul dbe consistent with which
Aortic Aneursym
The most common tumor to incade the IVC is
Renal cell carcinoma
Which of the following is the biggest risk factor for rupture of an AAA
Aneurysm size
Which of the following arteries are branches of the celiac trunk
Splenic
Left gastric
and
Common hepatic
A 55 yr old man is seen for a routine physical exam. During the exam, the physicians feel a pulsitile mass at the level of the umbilicus. and ultrasound is ordered for which of the following indications
To rule out an abdominal aortic aneurysm
You are performing a doppler study of the portal vein and detect that the flow direction in the main portal vein is the same as the hepatic artery, what does this indicate
Normal flow pattern in the portal vein
Enlargement of the IVC, with subseequent enlargement of the hepatic veins, is seen in cases of
Right sided heart failure
An image was obtained on a patient post operative with a history of DVT’s in the lower extremities. What is the most likely diagnosis
Greenfield filter in the IVC
What veins join to form the portal splenic confluence
Splenic, SMV, IMV
Which viseral artery is most commonlu involved with aneurysmal formation
Splenic artery
An outpatient with a history of back pain and hypertension presents to the ultrasound department for an abdominal aortic sonogram. Sonographically, you visualize a 6cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. what is the most likely diagnosis
Aortic dissection
The permanent localized dilation of an artery with an increase in diameter of greater than 1.5 times it’s normal diameter is termed
an aneurysm
A 40 yr old man with a history of Marfan sundrom is seen with intense chest pain in the emergency department. which of the following diagnoses should be the primary consideration
Aortic dissection
Obtained during an abdominal ultrasound of a 34 yr old female with a history of oral contraceptive usage. What is the BEST diagnosis
Cavernous hemangioma
Obtained during an abdominal ultrasound exam on a 26 yr old female with ledt flank pain for 4 weeks. What is the BEST diagnosis
Renal stones
A 65 yr old male presents of the u/s department for a palpable mass in his left flank and hematuria. What is the BEST diagnosis
Renal cell carcinoma
An African American male presents to the u/s depatment for a RUQ ultrasound for pain. He has a history of smoking and diabetes. Give the best diagnosis
Adenocarcinoma
This patient presented with flank pain. You performed a RUQ ultrasound on the patient. What is the BEST diagnosis
Medullary sponge
The first branch of the abdominal aorta is
Celiac axis
What body cavity/s are the aorta and IVC in
retroperitoneal
Which vessel below provides the greatest amount of oxygenated flow to the liver
portal vein
What three stuctures form the portal triad
Portal vein, hepatic artery & common duct
What is a difference in non-resistive and resistive blood vessels
Non-resistive vessels provide constant profusion to organs
