Abdominal Midterm Flashcards
1
Q
You are performing an ultrasound exam to rule out cholelithiasis. You identify a small echogenic foci in the posterior aspect of the gallbladder fundus. How can you determine if the foci represents a polyp or a stone?
- Shadowing is not present with polyps but is present with stones
- Unlike a stone, a polyp should move with varying positions
- A stone will produce a ringdown artifact and a polyp will produce a shadow
- A polyp is always located in a dependant position
A
Shadowing is not present with polyps but is present with stones
2
Q
Gallbladder wall thickness should not exceed \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 10 mm 6 mm 3 mm 1 mm
A
3 mm
3
Q
Air within the biliary tree is referred to as: cholangitis pneumobilia choledocholithiasis cholesterolosis
A
pneumobilia
4
Q
The primary role of the biliary system is: to produce bile to secrete hormones to aid in digestion by storing bile to form gallstones
A
to aid in digestion by storing bile
5
Q
The right and left hepatic ducts emerge from the right lobe of the liver in the porta hepatis and unite to form the: cystic duct common hepatic duct common bile duct common pancreatic duct
A
common hepatic duct
6
Q
A 74 year old woman is seen with RUQ pain, jaundice, and nausea and vomiting. Ultrasound of the gallbladder reveals cholelithiasis. In addition, a 3 cm, cauliflower shaped mass is seen arising from a stalk within the gallbladder fundus. This is most suggestive of which of the following? cholecystitis gallbladder perforation gallbladder carcinoma abscess
A
gallbladder carcinoma
7
Q
An extrahepatic mass compressing the common bile duct can produce an enlarged gallbladder. This sign is known as: Courvoisier’s sign Camper’s tissue sign Murphy’s sign Christian’s sign
A
Courvoisier’s sign
8
Q
A renal ultrasound is ordered for a patient in ICU with renal failure, TPN and a long history of hospitalization. During imaging of the right kidney, the sonographer notices that the gallbladder contains low-level echoes that layer and are gravity dependent. This is most consistent with which of the following? abscess sludge cholelithiasis cholecystitis
A
sludge
9
Q
A 52 year old man with diabetes is seen with signs and symptoms of severe, acute cholecystitis. The ultrasound findings reveal a gallbladder deviod of stones. The gallbladder wall is thickened, and multiple comet-tail artifacts are identified emanating from the wall. The gallbladder lumen contains low-level echoes from which comet-tail artifacts are also seen. What is the most likely diagnosis? acute cholecystitis adenomyomatosis emphysematous cholecystits gallbladder perforation
A
emphysematous cholecystits
10
Q
The biliary duct should never measure more than: 4mm 10mm 3mm 6mm
A
10mm
11
Q
The yellowish staining of the whites of the eyes and the skin secondary to a liver disorder or biliary obstruction is referred to as: Jaundice AIDS cholangitis bilirubinemia puritus
A
Jaundice
12
Q
Focal tenderness over the gallbladder with probe pressure describes: murphy sign strawberry sign hydrops sign courvoisier sign
A
murphy sign
13
Q
What landmark can be used to locate the gallbladder? ligamentum teres ligamentum venosum facliform ligament main lobar fissure
A
main lobar fissure
14
Q
You suspect intrahepatic bile duct dilatation in a patient with right upper quadrant pain and tenderness. How can you differentiate the dilated bile ducts from intrahepatic veins?
- dilated bile ducts demonstrate irregular, tortuous walls
- bile ducts will not demonstrate flow with color Doppler
- intrahepatic portal veins show increased through transmission compared to the dilated bile ducts
- both dilated bile ducts demonstrate irregular, tortuous walls and bile ducts will not demonstrate flow with color Doppler
A
Both dilated bile ducts demonstrate irregular, tortuous walls and bile ducts will not demonstrate flow with color Doppler
15
Q
During gallbladder sonography, you notice echogenic foci within the gallbladder but do not detect distal acoustic shadowing. What changes below will improve the detectability of stone shadowing?
- decrease transducer frequency, increase gain
- increase transducer frequency, increase transducer focusing
- increase dynamic range, increase gain
- increase output power, decrease transducer frequency
A
increase transducer frequency, increase transducer focusing
16
Q
What is the most common disease of the gallbladder? cholelithiasis gallbladder carcinoma porcelain GB cholecystitis
A
cholelithiasis
17
Q
A patient presents with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct. This is referred to as: biliary atresia Caroli's syndrome Mirizzi syndrome choledocahl cyst
A
Mirizzi syndrome
18
Q
A 32 year old woman with intermittent pain in the RUQ is seen for an abdominal ultrasound. The ultrasound exam reveals a gallbladder with multiple comet-tail artifacts emanating from the gallbladder wall. The lumen of the gallbladder is unremarkable. This most liekly represents which of the following? cholangitis adenomyomatosis cholecytitis cholelithiasis
A
adenomyomatosis
19
Q
Hartmann pouch involves which part of the gallbladder: phrygian cap body neck fundus
A
neck
20
Q
All of the following are true regarding echoes except:
- Echoes are the reflections of the sound beam
- Echoes represent the anatomy being evaluated with ultrasound
- Echoes vary in brightness giving valuable information about an organ
- All of the above are correct
A
All of the above are correct
21
Q
A structure that contains echoes that are exaggerated and extremely bright are referred to as: anechoic hyperechoic hypoechoic isoechoic
A
hyperechoic
22
Q
This useful artifact occurs when the sound beam travels through fluid at a faster rate causing the echoes behind the fluid to appear exaggerated and brighter than the surrounding tissues: posterior enhancement ring down artifact mirror artifact shadowing
A
posterior enhancement
23
Q
Vital signs—medical measurements to ascertain how the body is functioning—may include all except which of the following? pulmonary function tests pulse temperature blood pressure
A
pulmonary function tests
24
Q
Which of the following would be considered the best way to prevent the spread of infection? covering your mouth when you caugh taking vitamins cleaning the ultrasound machine hand washing
A
hand washing
