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Abdomen Tests 2013 > Adrenal and Vascular Test > Flashcards

Adrenal and Vascular Test Flashcards

1
Q 
Upon sonographic examination of the right upper quadrant in a 32 year old female patient complaining of generalized abdominal pain, you visualize an anechoic mass with posterior enhancement superior and medial upper pole of the right kidney. This most likely represents a/an:
adrenal cyst
adrenal metastatic lesion
 pheochromocytoma
neuroblastoma
A

adrenal cyst

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2
Q 
The syndrome associated with hypertension, hyperglycemia, obesity, and an adrenal mass is:
Edward's syndrome
Cushing syndrome
Juliet syndrome
Hirschprung syndrome
A

Cushing syndrome

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3
Q 
The adrenal gland cortex produces all of the following except:
adrenaline
aldosterone
androgens
cortisol
A

adrenaline

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4
Q

Which of the following hormones are responsible for the “flight-or-fight” response?
cortisol and aldosterone
epinephrine and norepinephrine
adrenocorticotropic hormone and aldosterone
cortisol and androgens

A

epinephrine and norepinephrine

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5
Q 
The adrenal mass often associated with uncontrollable hypertension, tachycardia, and tremors is the:
pheochromocytoma
adrenal hematoma
oncocytoma
neuroblastoma
A

pheochromocytoma

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6
Q

A 45 year old obese woman with thin arms and legs, hypertension, and severe fatigue presents to the ultrasound department for an abdominal sonogram. Based on these clinical findings, you should evaluate the adrenal glands closely for signs of:
primary adrenal carcinoma
adrenal hemorrhage
adrenal adenoma
primary adrenal carcinoma and adrenal adenoma

A

primary adrenal carcinoma and adrenal adenoma

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7
Q 
The most common sonographic appearance of a pheochromocytoma is a/an:
hypoechoic mass
complex mass
anechoic mass
hyperechoic mass
A

hyperechoic mass

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8
Q

All of the following are true statements about the adrenal glands except:

  • the adrenal glands play an important role in blood pressure regulation
  • the adrenal glands are easily identifed in the fetus
  • the right adrenal gland is located medial to the right lobe of the liver
  • the left adrenal gland is located lateral to the upper pole of the left kidney
A

the left adrenal gland is located lateral to the upper pole of the left kidney

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9
Q 
A patient is seen with a persitant headache. Physical examination reveals hypertension, and laboratory tests reveal increased catechoalmine values. This is most suggestive of which of the following?
pheochromocytoma
adrenal adenoma
adrenal cyst
adrenal carcinoma
A

pheochromocytoma

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10
Q 
A 70 year old man with a history lung cancer is seen for ultrasound. The patient has malaise and weight loss. An abdominal ultrasound is ordered and identifies mild ascites. In addition, bilateral solid masses are noted superior to the kidneys. This is suggestive of which of the following?
adrenal hyperplasia
adrenal metastasis
 lymphadenopathy
adrenal adenomas
A

adrenal metastasis

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11
Q

A 55 year old man is seen for a routine physical examination. During the examination, the physicians feels a pulsatile mass at the level of the umbilicus. An ultrasound is ordered for which of the following indications?

  • to rule out abdominal aortic aneurysm
  • to rule out atherosclerotic disease
  • to rule out rupture
  • to rule out dissection
A

to rule out abdominal aortic aneurysm

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12
Q 
A 40 year old man with a history of Marfan syndrome is seen with intense chest pain in the emergency department. Which of the following diagnoses should should be the primary consideration?
aortic aneurysm
heart attack
aortic rupture
aortic dissection
A

aortic dissection

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13
Q 
A 58 year old woman 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 6 cm at its greatest diameter. This would be consistent with which of the following?
atherosclerotic disease
aortic rupture
aortic aneurysm
aortic dissection
A

aortic aneurysm

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14
Q 
Occlusion of the hepatic veins describes:
Klinefelter syndrome
Morrison syndrome
Marfan syndrome
Budd-Chiari syndrome
A

Budd-Chiari syndrome

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15
Q 
Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen in cases of:
Budd-Chiari syndrome
left sided heart failure
Marfan syndrome
right sided heart failure
A

right sided heart failure

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16
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 6 cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis?
chronic aortic aneurysm
aortic rupture
aortic dissection
aortic rupture
A

aortic dissection

17
Q

Which of the following statements about the IVC is not true?

  • the IVC is considered retroperitoneal in location
  • the diameter of the IVC is variable
  • respirations can affect the size of the IVC
  • the IVC is located to the left of the abdominal aorta
A

the IVC is located to the left of the abdominal aorta

18
Q 
You are performing an abdominal ultrasound on a patient with a history of pheochromocytoma. Sonographic evaluation of what structure will be most beneficial in identification of this abnormality?
pancreas
kidneys
abdominal aorta
adrenal glands
A

adrenal glands

19
Q

Abdominal sonography of a 42 year old male reveals a solid mass located at the upper pole of the kidney. Which of the following would be most helpful in differentiation between a renal and adrenal mass?

  • perform spectral Doppler resistive indices from vessels within the mass
  • evaluate the mass with color Doppler
  • have the patient drink 32 oz of water and rescan
  • scan the patient in both deep inspiration and expiration
A

scan the patient in both deep inspiration and expiration

20
Q

Which of the following arteries are branches of the celiac trunk?

  • splenic, left gastric and common hepatic
  • splenic, right gastric and proper hepatic
  • left gastric, common hepatic, and proper hepatic
  • superior mesenteric, right gastric and proper hepatic
A

splenic, left gastric and common hepatic

21
Q

You are performing a Doppler study of the hepatic venous system and cannot obtain a color Doppler signal from the main portal vein. What should you do?

  • decrease color gain
  • increase dynamic range
  • decrease the system pulse repetition frequency
  • increase the system high pass filter
A

decrease the system pulse repetition frequency

22
Q

A 54 year old man has been referred for an abdominal Doppler ultrasound with a history of uncontrollable hypertension. What pathology are you searching for?

  • renal artery stenosis
  • aortic aneurysm
  • hepatofugal portal vein flow
  • vascular compromise of the superior mesenteric, inferior mesenteric, and celiac trunk
A

renal artery stenosis

23
Q

You are performing an ultrasound exam on a patient with a history of chronic pancreatitis and abdominal bruit. What vascular abnormality is associated with this history?

  • inferior mesenteric artery occlusion
  • renal artery stenosis
  • abdominal aortic aneurysm
  • pseudoaneurysm of the hepatic or splenic artery
A

pseudoaneurysm of the hepatic or splenic artery

24
Q 
The IVC empties blood into which of the following?
left atruim
right atrium
right ventricle
left ventricle
A

right atrium

25
Q 
A 38 year old woman has been referred for a Doppler study of the liver with a history of ETOH abuse and cirrhosis. What vascular condition is associated with this history?
hepatic artery fibromuscular dysplasia
Budd-Chiari syndrome
portal hypertension
mesenteric ischemia
A

portal hypertension

26
Q

Which of the following is the biggest risk factor for rupture of an AAA?
presence of laminar thrombus within the aneurysm
aneurysm location
aneurysm size
patient age

A

aneurysm size

27
Q 
Which vessel below provides the greatest amount of oxygenated flow to the liver?
hepatic artery
SMA
portal vein
hepatic vein
A

portal vein

28
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?

  • hepatofugal flow
  • severe portal hypertension
  • a normal flow pattern in the portal vein
  • reversed flow in the hepatic artery
A

a normal flow pattern in the portal vein

29
Q 
You have been asked to identify the lobes of the liver in a patient with a hepatic mass. Which vessels course untersegmental in the liver?
hepatic veins
portal veins
hepatic arteries
both the portal and hepatic veins
A

hepatic veins

30
Q 
Which viseral artery is most commonly involved with aneurysmal formation?
hepatic artery
splenic artery
SMA
IMA
A

splenic artery

Abdomen Tests 2013 (12 decks)

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