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2nd year Abdominal > Abdominal final > Flashcards

Abdominal final Flashcards

1
Q

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?

A

Scan the patient in both deep inspiration & expiration

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2
Q

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

A

both Adrenal adenoma & primary adrenal carcinoma

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3
Q

which of the folloeing hormones are responsible for the “flight or flight” response?

A

Epinephrine & norepinephrine

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4
Q

The most common sonographic appearance of a pheochromocytoma is a/an

A

Hyperechoic mass

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5
Q

The adrenal mass often associated with uncontrollable hypertension, tachycardia & tremors is the

A

Pheochromocytoma

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6
Q

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

A

Adenomyotosis

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7
Q

Intermittent obstrustion of the cystic duct by a gallstone results in

A

Chronic cholecystitis

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8
Q

Acute cholecystisis that leads to necrosis & abscess development with in the gallbladder wall describes

A

gangrenous cholecystitis

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9
Q

An 85yr old female w jaundice, weight loss & palpable RUQ mass, what is the best diagnosis

A

Adenocarcinoma of the gallbladder

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10
Q

Tumefactive sludge can resemble the sonographic appearance of

A

gallbladder carcinoma

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11
Q

Which of the following is not a plausible cause of common bile duct obstruction in adults

A

Choledochal cyst

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12
Q

Air within in biliary tree is referred to as

A

Pneumobilia

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13
Q

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

A

Choledochlithiasis

Pancreatic carcinoma

and

Chronic pancreatitis

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14
Q

The yellowish staining of the whites of the eyes & the skin secondary to a liver disorder or biliary obstruction if referred to as

A

Jaundice

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15
Q

Focal tenderness over the gallbladder with probe pressure describes

A

Murphy sign

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16
Q

Courvoisier’s gallbladder is associated with which of the following

A

A pancreatic head mass

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17
Q

The best way to identify the intrahepatic biliary system is to image which structures

A

intrahepatic portal veins

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18
Q

The normal measurment for the biliary duct should be

A

<6mm

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19
Q

The telescoping of one segment of bowel into another is referred to as

A

Intussusception

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20
Q

All of the following are sonographic findings of acute appendicitis except

A

Compressible, blind-ended tube

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21
Q

A 6 month old female presents to your department with vomiting ABD pain and blood in her stool. Give the BEST diagnosis

A

Intussusception

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22
Q

Clinical findings of fatty infiltrate of the liver include

A

Elevated liver function tests

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23
Q

NOrmal flow toward the liver in the portal vein is termed

A

Hepatopedal (toward)

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24
Q

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

A

Cirrhosis

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25
Q

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

A

Metastatic disease

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26
Q

Clinical findings for hepatitis include all of the following except

A

Pericholecystic fluid

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27
Q

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

A

Liver cyst

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28
Q

All of the following are located within the porta hepatis except

A

Middle hepatic vein

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29
Q

The most common cause of cirrhosis is

A

Alcoholism

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30
Q

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

A

Chinococcal cyst

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31
Q

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?

A

Multiple hypechoic masses througout slightly hyperechoic liver

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32
Q

Ascited is the accumulation of fluid in which cavity

A

Peritoneal cavity

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33
Q

What is the most common malignancy of the testicles

A

Seminoma

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34
Q

A large complex hydrocele is most commonly associated with which of the following

A

orchitis

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35
Q

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

A

Torsion of the testicular appendage

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36
Q

Obtained during an ultrasound exam on a 17 yr old male for scrotal pain. What is the BEST diagnosis

A

Epididymitus

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37
Q

You are performing doppler analysis of the spermatic cord. Which of the following arteries or structures is found within the speramatic cord?

A

Vas deferens

Tersicular artery

Cremasteric artery

and

Deferential artery

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38
Q

Clinical findings of acute scrotal pain and swelling are suggestive of

A

Torsion

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39
Q

A common cyst most often seen in the head of the epididymis that contains noviable sperm is the

A

Spermatocele

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40
Q

Enlargement of the prostate in older men is most often caused by

A

Bengin prostatic hypertrohy

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41
Q

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

A

MHz linear array

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42
Q

The differential diagnosis for thyroiditis includes all of the following except

A

Hemorrhagic cyst

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43
Q

The most common feature of a thyroid adenoma is

A

Peripheral sonocucent halo

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44
Q

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

A

Benign thyroid nodule

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45
Q

Images obtained during a thyroid ultrasound done due to a palpable neck mass in a 42 yr old. The BEST diagnosis is

A

Adenoma

46
Q

What is the most common cause of hypothyroidism

A

Hashimoto thyroiditis

47
Q

Which vascular structure is located closest to the thyroid lobes

A

Common carotid artery

48
Q

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

A

Retroperitoneal fibrosis

49
Q

Fluid located around the lungs is termed

A

plueral effusion

50
Q

You’ve been asked to rule out pseudocyst formation in a patient with acute pancreatisis. What is the ultrasound appearance of a pancreatic pseufocyst

A

Cyst without internal echoes

cyst with lo-level echoes

cyst with internal septations

and

well defind wall

51
Q

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

A

Duct of santorini

52
Q

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

A

Head

53
Q

The pancreatic tail is outlined posteriorly by what vascular structure

A

splenic vein

54
Q

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

A

Either isoechoic or hyperechoic compared to the liver

55
Q

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

A

Smoking

diabetes

and

chronic pancreatitis

56
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

57
Q

what is the most common cause of acute pancreatitis

A

obstruction of the pancreatic duct by biliary calculi

58
Q

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

A

5 MHz curved linear array

59
Q

a 23 yr old male reports to the ultrasound department for LUQ ultrasound with a history of mononucleosis. What is the best diagnosis

A

splenomegaly

60
Q

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

A

Abscess

61
Q

The largest tributaries to the IVC are

A

Hepatic veins

62
Q

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

A

Accessory spleen

63
Q

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

A

Hydatid cyst

64
Q

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

A

Splenic infarct

65
Q

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

A

Infarctions

66
Q

The normal adult spleen measures

A

8-13cm

67
Q

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

A

Angiosarcoma

68
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

Metastasis

69
Q

The major function of the spleen is

A

To filter the peripheral blood

70
Q

Where is the most common location of an accessory spleen

A

Splenic hilum

71
Q

Which malignant tumor is most common in chilfren aged 2-5

A

Wilm’s tumor

72
Q

During routine surveillance of the urinary bladder, you detect the presence of periodic ureteral “jets”. This is a sign of

A

Normalcy

73
Q

What is the normal appearance of the central sinus of the kidney

A

Highly echogenic compared to the renal cortex

74
Q

During performance of a renal sonogram, you identify only one kidney. what should you do

A

Scan the pelvis area to rule out the presence of a pelcic kidney

75
Q

Which of the following is not consifered an extrinsic cause of hydronephrosis

A

ureteral stricture

76
Q

What is the indication for a doppler renal study to rule out renal artery stenosis

A

uncontrolled hypertension

77
Q

The most common congenital anomaly of the urinary tract is

A

Duplicated collecting system

78
Q

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

A

Perinephric hematoma

79
Q

You have detected comensatory hypertrophy of the right kidney in a 35 yr old maale. This finding is associated with which of the following

A

Nephrectomy

renal agenesis

and

renal hypoplasis

80
Q

All of the following are clinical findings of acute renal failure except

A

Decreased BUN creatinine

81
Q

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

A

Chronic pyelonephritis

82
Q

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

A

AML

83
Q

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

A

AML

84
Q

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

A

TCC (transitional cell carcinoma)

85
Q

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

A

Low-level echoes within the cyst

86
Q

Which of the following describes the normal course of the left renal vein

A

between the superior mesenteric artery and the aorta

87
Q

You detect the presence of free fluid in the space between the liver and right kidney. What is the name for this anatomic location

A

Morrison’s pouch

88
Q

Occulsion of the hepatic veins describes

A

Budd-Chiari syndrome

89
Q

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

A

Aortic Aneursym

90
Q

The most common tumor to incade the IVC is

A

Renal cell carcinoma

91
Q

Which of the following is the biggest risk factor for rupture of an AAA

A

Aneurysm size

92
Q

Which of the following arteries are branches of the celiac trunk

A

Splenic

Left gastric

and

Common hepatic

93
Q

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

A

To rule out an abdominal aortic aneurysm

94
Q

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

A

Normal flow pattern in the portal vein

95
Q

Enlargement of the IVC, with subseequent enlargement of the hepatic veins, is seen in cases of

A

Right sided heart failure

96
Q

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

A

Greenfield filter in the IVC

97
Q

What veins join to form the portal splenic confluence

A

Splenic, SMV, IMV

98
Q

Which viseral artery is most commonlu involved with aneurysmal formation

A

Splenic artery

99
Q

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

A

Aortic dissection

100
Q

The permanent localized dilation of an artery with an increase in diameter of greater than 1.5 times it’s normal diameter is termed

A

an aneurysm

101
Q

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

A

Aortic dissection

102
Q

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

A

Cavernous hemangioma

103
Q

Obtained during an abdominal ultrasound exam on a 26 yr old female with ledt flank pain for 4 weeks. What is the BEST diagnosis

A

Renal stones

104
Q

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

A

Renal cell carcinoma

105
Q

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

A

Adenocarcinoma

106
Q

This patient presented with flank pain. You performed a RUQ ultrasound on the patient. What is the BEST diagnosis

A

Medullary sponge

107
Q

The first branch of the abdominal aorta is

A

Celiac axis

108
Q

What body cavity/s are the aorta and IVC in

A

retroperitoneal

109
Q

Which vessel below provides the greatest amount of oxygenated flow to the liver

A

portal vein

110
Q

What three stuctures form the portal triad

A

Portal vein, hepatic artery & common duct

111
Q

What is a difference in non-resistive and resistive blood vessels

A

Non-resistive vessels provide constant profusion to organs

112
Q
A

2nd year Abdominal (13 decks)

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