Clinical #4 Flashcards by lindsay crouse

All of the following are contraindications for a renal transplant, EXCEPT:

metastatic disease
significant cardiac disease
untreated kidney infection
marked increase in serum creatinine

marked increase in serum creatinine

creatinine levels can be very high in patients with renal disease that are waiting for transplant

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Which of the following abnormalities is commonly associated with painless hematuria?

ureteral calculi
TCC of the bladder
ureterocele
tuberous sclerosis

TCC of the bladder

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Which of the following would be associated with the findings on the image?

decreased serum creatinine
increased serum creatinine
increased serum ALP
increased serum AFP

increased serum creatinine

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You are performing a renal Doppler exam. What is the best patient position to visualize the full length of the LRA?

supine, ipsilateral arm above head
LLD
supine, contralateral arm above head
RLD

RLD

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Increased hematocrit levels are associated with which of the following?

hemorrhagic cyst of the liver
esophageal varices
dehydration
sickle cell anemia

dehydration

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Which of the following is incorrect regarding the evaluation of a patient with a suspected abdominal aortic aneurysm?

identifying the aortic bifurcation guarantees a complete evaluation of the infrarenal segment

identifying the celiac axis guarantees a complete evaluation of the proximal segment

TRV views are preferred for the most accurate diameter measurement

right lateral oblique position can be especially helpful for evaluating the distal aorta bifurcation into the common iliac arteries

TRV views are preferred for the most accurate diameter measurement

**longitudinal images provide the best view for accurate measurements

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Which of the following correctly describes peritoneal dialysis?

requires the creation of an arteriovenous fistula

a cleansing fluid flows is injected through an intraperitoneal catheter

blood is removed from the body, cleaned and returned

requires regular visits to a dialysis center for the treatment

a cleansing fluid flows is injected through an intraperitoneal catheter

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What is the best way to explain a renal Doppler exam to a 9 year old female?

tell their mom to tell them it won’t hurt and just pretend to be asleep

demonstrate the gel on the probe and how you will slide it around on her belly to obtain pictures for the doctor

give her a pamphlet that describes the procedure

tell her you will be using Doppler ultrasound to evaluate the blood flow of the kidneys and it will take about 30 mins

demonstrate the gel on the probe and how you will slide it around on her belly to obtain pictures for the doctor

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Which type of kidney infection is considered a critical finding?

acute pyelonephritis
emphysematous pyelonephritis
chronic pyelonephritis
glomerulonephritis

emphysematous pyelonephritis

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Doppler evaluation of the parenchymal arteries is required in patients with:

significant hydronephrosis
acute pancreatitis
angiomylipoma
splenic infarction

significant hydronephrosis

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If renal calculi are identified in the kidney:

PW Doppler should be used to evaluate the parenchymal resistance in the tissue around the stones

the thyroid should be evaluated for signs of hypothyroidism

the GB should be evaluated for associated stone formation

color Doppler should be used to evaluate the urinary bladder

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Which renal arteries are evaluated with Doppler in an ultrasound exam that is used to perform an indirect evaluation for RA stenosis?

AO
segmental and parenchymal arteries
main RA
main RA, segmental and parenchymal arteries

INDIRECT = segmental and parenchymal arteries

DIRECT = main RA

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A patient presents for a renal ultrasound with a history of increased serum BUN and creatinine and HTN. RRA occlusion was documented on an ultrasound evaluation performed last year. What are the expected findings on the ultrasound exam today?

the right kidney will be enlarged and edematous with decreased corticomedullary definition, the left kidney will appear normal

the right kidney will be atrophied and surrounded by ascites due to decreased renal function, the left kidney will appear normal

the right kidney will be consumed by cyst formation with a normal left kidney

the right kidney will be atrophied and hyperechoic and the left kidney may demonstrate a mild increase in size since the last exam

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A patient presents for an abdominal ultrasound due to new onset of hematuria, proteinuria, and increased serum BUN and creatinine. He complains of recent fever, sore throat, joint pain, and peripheral edema. These clinical findings are most suggestive of?

TCC
acute glomerulonephritis
tuberous sclerosis
RCC

acute glomerulonephritis

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A 60 year old presents with a history of sickle cell anemia. What do you expect to find on the US evaluation of the spleen?

splenic enlargement or atrophy
splenic artery aneurysm
subcapsular hematoma
agenesis of the spleen

splenic enlargement or atrophy

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A 3 year old presents with a history of sickle cell anemia. What do you expect to find on the US evaluation of the spleen?

subcapsular hematoma
agenesis of the spleen
splenic artery aneurysm
splenomegaly

splenomegaly

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Elevated hematocrit levels are associated with:

dehydration and polycythemia
overhydration and anemia
leaking aortic or splenic aneurysm
colon cancer and gastric ulcers

dehydration and polycythemia

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Placing the patient in an oblique position and using a lateral transducer position on the lower abdomen would best demonstrate what vessels?

common femoral veins
common iliac arteries
suprarenal arteries
hepatic artery

common iliac arteries

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Renal function lab testing includes serum levels of:

WBC count
BUN
lipase
ALT

BUN

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A patient presents with fever, flank pain, dehydration, electrolyte imbalance and positive serum and urine bacterial cultures for E. coli. These clinical findings are most suggestive of:

emphysematous pylonephritis
acute renal failure
urinary tuberculosis
renal artery stenosis

emphysematous pylonephritis

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Which of the following correctly describes the lab values identified in a patient with acquired hemolytic anemia?

increased ALT, AST, and ALP
significantly increased serum bilirubin and Hgb levels
normal ALT with increased AST and AFP
significantly increased serum bilirubin and decreased Hgb levels

significantly increased serum bilirubin and decreased Hgb levels

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While scanning the LUQ you identify multiple dilated vessels at the hilum of the spleen. Which of the following describes the best way to identify a cause for the findings?

evaluate the porta hepatis for choledocholithiasis
check the AO for an aneurysm
check the splenic artery for stenosis
evaluate the liver vasculature for signs of PHTN

evaluate the liver vasculature for signs of PHTN

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Note the Doppler measurement on the image. What other Doppler measurement should be taken to calculate the RI?

ESV
EDV
PDV
PSV

EDV

RI = (PSV - EDV) / PSV

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Which of the following correctly describes how ultrasound is used to guide treatment of a pseudoaneurysm of the external iliac artery?

the technologist uses ultrasound to guide the probe placement during compression therapy applied in 30min intervals

the technologist uses ultrasound to guide the probe placement during compression therapy applied in 10 one minute intervals

the physician uses ultrasound guidance during the injection of Lovenox into the stalk of the pseudoaneurysm

the physician uses ultrasound guidance during the injection of Lovenox into the body of the pseudoaneurysm

the technologist uses ultrasound to guide the probe placement during compression therapy applied in 10 one minute intervals

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A 6 year old is referred for an abdominal ultrasound due to a history of Epstein Barr infection. What organ should be closely evaluated for associated findings? GB liver kidneys spleen

spleen

Sudden onset of hematuria, azotemia, and proteinuria is an indication of: chronic renal failure tuberous sclerosis acute glomerulonephritis oncocytoma

acute glomerulonephritis

The masses demonstrated on the image were biopsied and the samples consisted of a high concentration normal vascular tissues. Which of the following describes the type of mass? hamartoma hemangioma adenoma vasculoma

hemangioma

The following image was taken from a patient with acute right flank pain following a liver biopsy. Which of the following describes the findings on this image of the right flank? the image demonstrates a normal liver, kidney, and GB there is a hydropic GB present with debris. there is most likely a cystic duct obstruction there is a hydropic GB presents with debris. there is most likely a distal CBD obstruction the fluid within Morison pouch is consistent with intraperitoneal blood

the fluid within Morison pouch is consistent with intraperitoneal blood

What is the preferred position of a patient having a transplant kidney biopsy? trendelenburg supine prone with a pillow under the abdomen semi-erect

supine

Which of the following defines renal colic? consistently elevated serum BUN and creatinine levels consistently elevated renal function cyclical inflammation with recurrent UTI recurrent flank pain that radiates to the groin

recurrent flank pain that radiates to the groin

The length measurements of the adult kidneys should be within ___ of each other. 1cm 2cm 3cm 4cm

2cm

A pregnant female presents with lateral LUQ pain and a bruit in the same area. What is the most likely finding on the abdominal ultrasound exam? IVC congestion due to uterine compression pancreatic pseudocyst splenic varices splenic artery aneurysm

splenic artery aneurysm

___ causes abdomen pain 20-30mins after eating, while ___ usually causes abdomen pain several hours after eating. pyloric stenosis, appendicitis mesenteric ischemia, cholelithiasis cholelithiasis, cholecystitis pyloric stenosis, mesenteric ischemia

mesenteric ischemia, cholelithiasis

What is the most common symptom of RCC? proteinuria hematuria HTN increased AFP

hematuria

Which of the following describes how to correctly measure the width of the iliac artery? longitudinal view, outer wall to inner wall longitudinal view, outer wall to outer wall TRV view, outer wall to inner wall TRV view, outer wall to outer wall

TRV view, outer wall to outer wall

A patient presents with a history of a chronic UTI for over 3 weeks with little resolve from antibiotic treatment. He also suffers from visible hematuria and a low grade fever. The findings on the image are most suggestive of: medullary sponge kidney pyonephrosis hydronephrosis - mild to moderate hydronephrosis - moderate to severe

pyonephrosis fluid and debris identified in the renal calyces is consistent with a chronic infection and pus formation or pyonephrosis

A patient presents for a post biopsy scan of the right kidney. An extracapsular hematoma is suspected. What will be the appearance of this abnormality on the image? free fluid beneath the renal capsule that distorts the contour of the parenchyma free fluid with debris levels found within Morrison pouch cystic formation with debris levels found within the renal sinus free fluid with debris levels found within Murphy pouch

free fluid with debris levels found within Morrison pouch

A patient presents for a bladder ultrasound due to a recent onset of visible hematuria. Which of the following conditions is commonly associated with this symptom? ureterocele TCC RA stenosis portal thrombosis

TCC

Elevated BUN levels are associated with ___, while decreased BUN levels are associated with ___. renal failure, liver failure overhydration, dehydration renal failure, dehydration liver failure, overhydration

renal failure, liver failure

A patient presents for an abdominal sonogram due to a history of Marfan syndrome. What structure(s) should be closely evaluated for related findings? AO portal system liver kidneys

Which of the following is the most likely cause for RV thrombosis? cavernous transformation dehydration pulmonary embolism decreased serum BUN and creatinine

dehydration causes blood to thicken and the kidneys to slow their filtration of the blood - can lead to the formation of thrombosis in the RV

The following image was taken from a patient with acute right flank pain. Which of the following patient history questions is most pertinent to your findings? Do you have a fever? Have you experienced any trauma to your right side recently? Are you diabetic? Did you recently have a right renal transplant surgery?

Have you experienced any trauma to your right side recently?

A patient is referred for a renal ultrasound due to suspected right renal agenesis. Which of the following is not an expected finding associated with right renal agenesis? compensatory hypertrophy of the left kidney empty right renal fossa right kidney located in the RLQ absent right renal artery and vein

right kidney located in the RLQ

If a solid renal mass is identified in the kidneys on an US exam, which of the following should also be closely evaluated for associated findings? PVs RVs HVs RAs

RVs

When the SMA is in view in a TRV plane, the probe must be angled ___ to see the celiac axis. ventral oblique caudal cephalad

cephalad

Where is the Doppler cursor placed in the AO to obtain the velocity used in the renal aortic ratio? 2cm above the aortic bifurcation just below the diaphragm at the level of the renal artery origins at the location of the highest recorded velocity

at the level of the renal artery origins

A 55 year old female patient presents for an abdominal sonogram due to a history of weight loss and recurrent pain just after eating. What structure(s) should be closely evaluated? pylorus mesenteric arteries and celiac axis splenic artery portal system

mesenteric arteries and celiac axis

A patient is referred for a renal ultrasound due to suspected horseshoe kidney. What is the expected ultrasound finding for this condition? displacement of the kidney to the pelvic area the hilums of the kidneys are joined across the midline by a bridge of renal parenchyma the lower poles of the kidneys are joined across the midline, usually anterior to the mid AO both kidneys are abnormally shaped like two horseshoes, the upper pole of the kidney is "bent" toward the lower pole

the lower poles of the kidneys are joined across the midline, usually anterior to the mid AO

hematuria is defined as: the presence of WBC in urine the presence of RBC in blood the presence of urea in blood the presence of RBC in urine

the presence of RBC in urine

Which of the following frequently occurs as a late complication of pharyngitis? acute glomerulonephritis adrenal hemorrhage RA stenosis cholecystitis

acute glomerulonephritis

A patient arrives with an order that read "R/O fluid in Morison pouch." Where do you need to scan to answer this question? porta hepatis and GB fossa splenic hilum between the liver and right kidney all 4 quadrants

between the liver and right kidney

What lab test is used to evaluate the success of a renal transplant? blood glucose levels anodal trypsinogen levels urine sedimentation rate glomerular filtration rate

glomerular filtration rate (GFR) successful transplant will exhibit GFR 50-60mL/h

Which of the following is the preferred method of obtaining the most accurate measurement of the length of the spleen? intercostal coronal view with the patient in the LLD position intercostal coronal view that demonstrates the hilum subxiphoid longitudinal view that includes the upper pole of the left kidney intercostal coronal view that does not demonstrate the hilum

intercostal coronal view that demonstrates the hilum

Which exam would be improved by the administration of Simethicone prior to the ultrasound evaluation? carotid duplex RA duplex breast ultrasound thyroid ultrasound

RA duplex

What modality is commonly used in the characterization of the renal angiomyolipoma? x-ray nuclear medicine CT scan angiography

CT scan

Which arrow indicates where the EDV should be measured? orange yellow green blue

green

A patient presents for an abdominal ultrasound due to suspected displacement of the Greenfield filter. Where should you look to find the filter in the normal position? in the RV at the renal hilum in the IVC just below the level of the RVs in the RA at the renal hilum in the IVC just below the level of the HVs

in the IVC just below the level of the RVs

You are attempting to scan the spleen with the patient in the RLD position and using a coronal view. The spleen is obscured by the left lung. What can you do to obtain a better view of the spleen? turn the patient to the LLD position scan the patient at full expiration have the patient drink water and repeat the image form the same patient and probe position scan the patient at full inspiration

scan the patient at full expiration

Hematocrit levels are determined by: counting WBCs counting RBCs measuring clotting time counting platelets

counting RBCs

A 45 year old patient presents with increased serum BUN and creatinine, a recent history of oliguria and bilateral flank pain. The US exam demonstrates bilateral hydronephrosis and hydroureter, but the bladder is nearly empty. Which of the following statements is true regarding this patient and the findings? acute intrinsic renal failure is present that is most likely due to acute tubular necrosis the patient has a neurogenic bladder and the radiologist should review the case immediately the patient will most likely return for a follow up exam in 7-10 days after anticoagulant treatment acute postrenal failure is present and the radiologist should review the case immediately

acute postrenal failure is present and the radiologist should review the case immediately

Which of the following should be performed on a patient with suspected acute renal failure? evaluate the RI of the parenchymal arteries evaluate the patient for signs of cortical thinning evaluate the kidneys for suspected unilateral hydronephrosis evaluate the post-void bladder volume

evaluate the RI of the parenchymal arteries

When evaluating a patient with an aortic aneurysm, which of the following must be reported? distance below the SMA aortic/IVC diameter ratio position related to the RA origins peak velocity in the renal arteries

position related to the RA origins

Which of the following are commonly associated with retroperitoneal fibrosis? scrotal calcifications and cryptochidism hydronephrosis and ureterocele formation scrotal swelling and pedal edema pedal edema and PHTN

scrotal swelling and pedal edema

A patient presents with persistent flank pain for 3 days following his weekly flag football game. Lab testing demonstrated a small decrease in hematocrit levels. Which statement below best described the abnormality on the US image? the right kidney demonstrates an edematous cortex consistent with glomerulonephritis there is a hematoma formation within Morrison pouch, adjacent to the right kidney the image demonstrates a complex mass adjacent to the right kidney, which is most likely RCC there is a hematoma formation within Glisson pouch, adjacent to the right kidney

there is a hematoma formation within Morrison pouch, adjacent to the right kidney

A patient presents for an abdominal sonogram due to a history of median arcuate ligament syndrome. What structure(s) should be closely evaluated for related findings? LRV splenic artery and vein celiac axis RAs

celiac axis

A patient presents with an order for a renal ultrasound due to increased serum BUN and creatinine levels and bilateral decreased renal size identified on a recent CT scan. What are the expected findings on the ultrasound exam? MCDK medical renal disease medullary sponge kidney nephrocalcinosis

medical renal disease

Which of the following is a risk factor for the formation of splenic artery aneurysms? nulligravida multigravida chronic hypotension male gender

multigravida

A patient presents with LUQ pain and a history of MVA 3 days ago, a cystic structure is seen in the spleen with layered debris within it. This most likely represents: hematoma hemangioma carcinoma hydatid cyst

hematoma

A patient presents for a renal ultrasound due to high serum levels of antidiuretic hormone, low urine output and a recent pulmonary embolism. These clinical findings are most suggestive of: RV thrombosis formation of a renal carbuncle abscess formation in the renal pelvis obstructive bladder calculi

RV thrombosis

A patient presents for an abdominal sonogram due to a history of acute onset of malignant HTN. What structure(s) should be closely evaluated? mesenteric arteries distal AO renal arteries celiac axis

renal arteries

A patient presents with midline pelvic pain for 3 days. Visible hematuria presented 2 days ago. Which of the following statements is true regarding the findings displayed on the image? the ureter is dilated with at least one calculus present in the lumen there is a fluid filled loop of bowel posterior to the bladder that also contains at least one phlebolith the iliac artery is demonstrated adjacent to the bladder with a calcific atheroma seen within the vessel lumen none of the above

the ureter is dilated with at least one calculus present in the lumen

Which of the following is the least likely cause for bilateral pedal edema? CHF 5cm AAA mesenteric vein thrombosis retroperitoneal fibrosis

mesenteric vein thrombosis

A patient presents with abdominal pain after MVA. The patient was in the passenger seat of a car that was hit on the right front door. Which statement is true regarding the images from this patient's exam? (Left image: SAG midline pelvis; Right image: coronal LUQ) the patient will mostly return for a follow up in a few days to evaluate the free fluid in the pelvis after being treated with antibiotics for mononucleosis these findings should be communicated to the radiologist immediately because the bladder has ruptured the patient will mostly return for a follow up in a few days after being treated by diuretic to relieve the free fluid in the pelvis these findings should be communicated to the radiologist immediately because the spleen has ruptured

these findings should be communicated to the radiologist immediately because the spleen has ruptured

You are performing a RA Doppler exam for renal stenosis. The mid aortic peak velocity is 70cm/s. The RRA peak velocity is 140cm/s and the LRA peak velocity is 240 cm/s. What is the RAR for the right kidney? 3.4 0.5 0.3 2.0

RRA: 140/70 = 2 LRA: 240/70 = 3.4

A 30 year old patient presents with an order for a renal ultrasound due to suspected MCKD. What are the expected findings on the ultrasound exam if the abnormality is present? bilateral formation of multiple microscopic cysts causing renal enlargement and increased echogenicity bilateral formation of multiple medium to large cysts causing renal enlargement unilateral formation of multiple renal cysts consuming the renal parenchyma bilateral increased echogenicity of the renal parenchyma with atrophied kidneys

unilateral formation of multiple renal cysts consuming the renal parenchyma **bilateral formation is RARE and usually fatal early in life due to impaired renal function

Anemia is least likely to be related to abnormalities of which of the following organs? AO thyroid spleen esophagus

thyroid

Which of the following is normally identified in the urine? protein creatinine minimal amount of RBCs glucose

creatinine

What equation is used to calculate post-void residual urine volume? bladder (L x W) / H bladder L x W x H x 0.52 bladder (L x W x H) / 3 bladder L + W + H x 0.52

PVR volume = bladder L x W x H x 0.52

Hypovolemic shock is a common symptom of: hepatic congestion cirrhosis aortic rupture RA stenosis

aortic rupture

Which of the following describes how to correctly measure the AP diameter of iliac artery? longitudinal view, outer wall to inner wall TRV view, outer wall to outer wall longitudinal view, outer wall to outer wall TRV view, outer wall to inner wall

longitudinal view, outer wall to outer wall

A patient presents with an order for an abdomen ultrasound to rule out UPJ obstruction of the left kidney. What are the expected findings if the exam is positive? the left renal calyces, renal pelvis and ureter will be dilated with or without the bladder distended the renal calyces and renal pelvis will be normal but the ureter will be dilated anytime the bladder is distended the left renal calyces, renal pelvis and ureter will be dilated when the bladder is distended a normal ureter will be identified but the left renal calyces and renal pelvis will be chronically dilated, with or without bladder distended

a normal ureter will be identified but the left renal calyces and renal pelvis will be chronically dilated, with or without bladder distended

Which of the following correctly lists the equation for the splenic volume index? L x W x H x 3.14 = SVI (L x W x H) ^2 = SVI L x W x H x 2 = SVI (L x W x H) / 27 = SVI

(L x W x H) / 27 = SVI

While performing an ultrasound of the abdominal AO, the mid and distal portions of the vessel are partially obscured by bowel gas. Which of the following techniques can be used to improve your visualization of the AO? have the patient drink water and rescan the AO scan the patient in the semi-erect position roll the patient into an oblique or decubitus and rescan given the patient a laxative and rescan after 60 minutes

roll the patient into an oblique or decubitus and rescan

Which of the following correctly describes hemodialysis? a cleansing fluid flows is injected through an intraperitoneal catheter can be performed by the patient at home contraindications include abdominal wall scarring, hernia, inflammatory bowel disease or diverticulitis an arteriovenous fistula is created by connecting an artery and a vein, usually in the arm

an arteriovenous fistula is created by connecting an artery and a vein, usually in the arm

A patient presents for his annual renal scan due to a long history of dialysis treatment. He does not currently have any related complaints. What are the expected findings on the exam? bilaterally hypertrophied kidneys with little to no visible parenchyma and multiple cyst formation bilaterally atrophied kidneys with thickened, echogenic parenchyma and multiple calculi formation bilaterally enlarged kidneys due to compensatory hypertrophy bilaterally atrophied kidneys with little to no visible parenchyma and multiple cyst formation

bilaterally atrophied kidneys with little to no visible parenchyma and multiple cyst formation

When an organ transplant is being evaluated by ultrasound: power Doppler imaging should not be used due to increased beam intensity the RI should be assessed at several locations in the allograft a 60 degree cursor angle must be used on all vessels harmonic imaging should not be used to increased beam intensity

the RI should be assessed at several locations in the allograft

If a patient forgets to take their HTN medication before a renal duplex exam, what effect can this have on the findings? underestimation of RA stenosis underestimation of peak RA velocity overestimation of renal parenchymal thickness overestimation of RA stenosis

overestimation of RA stenosis

Which renal arteries are evaluated with Doppler in an ultrasound exam that is used to perform a direct evaluation for RA stenosis? AO main RA, segmental and arcuate arteries segmental and arcuate arteries main RA

main RA

A patient presents for a post biopsy scan of the right kidney. A lymphocele is suspected. What will be the appearance of this abnormality on the image? anechoic free fluid beneath the renal capsule that distorts the contour of the parenchyma heterogeneous mass within the renal parenchyma fluid collection with debris and septations located adjacent to the kidney cystic formation with debris levels found within the renal sinus

fluid collection with debris and septations located adjacent to the kidney

A patient presents for a post biopsy scan of the right kidney. A subcapsular hematoma is suspected. What will be the appearance of this abnormality on the image? cystic formation with debris levels found within the renal sinus free fluid beneath the renal capsule that distorts the contour of the parenchyma free fluid with debris levels found within Morrison pouch free fluid with debris levels found within Murphy pouch

free fluid beneath the renal capsule that distorts the contour of the parenchyma

While scanning a patient's RUQ you identify the AO on the right side of the spine, duplicated IVC and a horseshoe kidney along the midline. Where should you look next for an associated abnormality? LUQ to determine the presence or absence of the spleen LLQ for an ectopic kidney RUQ for ectopic liver tissue midline to identify a patent azygous vein

LUQ to determine the presence or absence of the spleen **asplenia is a group of congenital defects termed double right sidedness - associated findings include absence of the spleen, right sided AO, duplicated IVC, midline liver location, horseshoe kidneys/adrenals

Which of the following is a fungal infection that can affect the kidney? E. coli infection candidiasis infection streptococcus aureus infection salmonella infection

candidiasis infection

Which of the following is a common symptom of renal transplant rejection? reduced serum levels of BUN and creatinine urinary frequency and urgency oliguria hyperbilirubinemia

oliguria or anuria are important clinical indications for renal transplant failure

What is the top normal post-residual volume in the bladder of patients 65 and older, if measured within 5 mins of voiding? ≤ 100 ml < 10ml < 50ml ≤ 500ml

≤ 100ml

A patient presents with a history of Gaucher disease. What do you expect to see on the abdominal ultrasound exam? significant atherosclerosis in the AO bilateral atrophied kidneys with increased echogenicity massive splenomegaly numerous cysts within the mesentery

massive splenomegaly ( > 18cm )