common small parts pathology test part 2

Question 1

bilateral process which results in small, echogenic kidneys with noticeable loss of parenchymal thickness. Cortical thickness = minimum measurment of 1cm. May be difficult to distinguish from surrounding perinephric fat and retroperitoneal structures

Answer 1

chronic medical renal disease AKA chronic renal failure

Question 2

benign, solitary renal tumor composed of blood vessels smooth muscle and fat cells

hypoechoic mass found in the renal cortex and can have posterior acoustic enhancement

no color doppler within tumor

Answer 2

angiomyolipoma

Question 3

angiomyolipoma

Answer 3

80% in rt kidney and 80% in women

angio-blood vessels
myo-smooth muscle
lipoma-fat cells

Question 4

multiple cysts of varying size located in the renal cortex and medulla. Bilateral, and can cause massively enlarged, asymmetrical kidneys. Often assocaited with cysts in the liver, spleen, pancreas and several small parts.

Answer 4

autosomal dominant polycystic kidney disease

Question 5

solid parenchymal mass, isoechoic or hypoechoic, disrupt the renal cortex, peripheral vascularity (basket sign)

Answer 5

renal carcinoma

IVC and renal veins should be imaged for evidence of tumor extension

Question 6

developmental anomaly of distal collecting ducts, causing urinary stasis with stone formation, usually asymptomatic and not found until young adulthood. Enlarged echogenic medullary (women in 20’s with no symptoms)

Answer 6

medullary sponge kidney

Question 7

diffuse calcuim deposits with the medulla, often seen in conjunction with MSK. Other primary causes are hyperparathyroidism, chronicnephritis, sickle cell (old man)

Answer 7

nephrocalcinosis

Question 8

most common medical renal disease to cause acute renal failure. Would be differential diagnosis. Thinned cortex with enlarged, echogenic globs of medullary tissue (child who is dehydrated and has a fever)

Answer 8

acute tubular necrosis

Question 9

outpouchings of the ladder wall, more commonly seen in older men w/ bladder outlet obstruction, neurogenic bladder disease or paraplegics

Answer 9

diverticulum

Question 10

irregular, echogenic mass that projects into the lumen of the bladder or as a focal thickening of the wall. Will have blood flow

Answer 10

transitional cell carcinoma (95% of bladder tumors)

Question 11

echogenic foci along bladder wall w/ posterior shadowing

Answer 11

bladder stones

Question 12

echogenic parenchyma with loss of distinct medurllary

Answer 12

nephritis

Question 13

necrosis of the glomerulus, cause is streptococcal bacteria

Answer 13

glomerulonephritis

Question 14

network of capillaries which filters blood into the renal tubule

Answer 14

glomerulus

Question 15

an infection of the calyces and renal pelvis, causes UTI, reflux, obstruction, diabetes. Possible to have focal pyelonephritis which appears as a focal echogenic area within the kidney characterized by lack of vascularity with the infected area.

Answer 15

pyelonephritis

Question 16

most common kidney infection

Answer 16

pyelonephritis

Question 17

if you put color on the kidney and part of it has color and part is hypoechoic

Answer 17

focal nephritis

Question 18

most common ectopic kidney

Answer 18

pelvic kidney

Question 19

bilateral fusion anomaly of the lower poles of the kidney which occurs during fetal development. Kidneys are closer to the spine and the inferior poles lie more medial.

Answer 19

horseshoe kidney

Question 20

increased deposits of fat in renal sinus, renal cortex appears thinned. Appearance resembles chronic renal insufficiency disease.

Answer 20

sinus lipomatosis

Question 21

enlarged kidneys with tiny cysts in the medullary and cortical regions, associated with billiary ectasia and hepatic fibrosis. Usually bilateral

Answer 21

autosomal recessive polycystic kidney disease

Question 22

intact cortical rim, metaastatic from lymphoma

Answer 22

lymphoma

Question 23

smooth, on stalk, do not shadow, do not move, most common tumor of gallbladder

Answer 23

polyps

Question 24

GB-hyperplastic wall changes more echogenic than polyps, do not move, have ring down or comet tail artifact

Answer 24

adenomhyomatosis

Question 25

GB-echogenic foci, multiple or single, shadowing, moveable

Answer 25

gallstones

Question 26

GB packed with stones, no visible bile within the gallbladder lumen, very distinct posterior shadowing behind a thick, echogenic rim

Answer 26

Wall Echo Shadow (WES)

Question 27

the whole wall of the gallbladder in incristed with calcium. Similar patter of distinct posterior shadowing in the area of the GB yet often w/o the heavy irregular echogenic anterior rim

Answer 27

porcelain gallbladder

Question 28

mildly echogenic bile, can float, move as a ball, contain highly echigenic tiny foci can be seen along the gallstones

Answer 28

sludge

Question 29

positive murphys sign, thickened wall with sonolucent area between the walls

Answer 29

acute cholecystitis

Question 30

transient RUQ pain with no positive murphys sign more common than acute, is the result of multiple episodes of acute and with fibrosis developing in the wall

Answer 30

chronic cholecystitis

Question 31

occurs before intrahepatic blockage of the distal common bile duct and eventual dilated intrahepatic ducts, blockage at the portahepatis (common hepatic duct) will demonstrate a normal common bile duct with intrahepatic ductal dilatation, which is characterized by the appearance of too many tubes or double barrel sign of dilated ducts alongside the portal veins

Answer 31

dilated common duct extrahepatic

always check for the source and location of the ductal obstruction

Question 32

blood filled channel within the walls of the aorta

occurs primarily in the thoracic aorta

marfans stretching disorder of all arterial vessels

Answer 32

dissecting aneursyms

Question 33

large, 5010cm, connected to aorta by mouth or channel, usually filled with thrombus or clot

Answer 33

saccular aneursyms

Question 34

most common general widening of aorta, distal, atherosclerosis

Answer 34

fusiform aneursyms

Question 35

pulsatile hematoma

results from interventional procedures

punctured artery fails to seal off

Ultrasound be used to seal off the leak with compression

Answer 35

pseudo aneursyms

Question 36

occurs from the bell clapper deformity where the tunica vaginalis completely surrounds the testis, epidiymis and distal spermatic cord lacking the bare area along the posterior scrotal wall

Answer 36

torsion

Question 37

what side do you put color on first when examining torsion

Answer 37

unaffected side

Question 38

affected testis is swollen with a mildly heterogeneous echotecture however, echogenicity remains similar to unaffected side

Answer 38

early torsion

Question 39

affected testis becomes hypoechic and swollen indicating testicular ischemia

venous flow is affected 1st causing occluded veins, followed by arterial obstruction

once arterial flow ceases, tissue necrosis occurs and the affected organ becomes hypoechoic in sonographic appearance

Answer 39

late torsion

Question 40

used to amplify the color signal, to optimize setting increase until noise is present and then slowly decrease until noise disappears

Answer 40

color gain

Question 41

the setting that controls the sensitivity of the system to display slow flow. This adjustment will determine flow, direction, and quality.

Answer 41

scale 9pulse repetition frequency)

Question 42

like and elastic eraser. Often automatically adjusted when changing the scale (PRF) turn up to reduce ghosting artifact, turn down to enhance flow sensitivity

Answer 42

wall filter

Question 43

size will determine the line density. When large or placed deep in the image, more scan lines are needed and more time is required to complete each image

Answer 43

color box

Question 44

abnormal dilatation of the veins of the pampiniform plexus in the spermatic cord

Answer 44

varicocele

Question 45

caused by incompetent valves within the spermatic vein

more common on the left due to the left spermatic vein empting into the left renal vein

Answer 45

primary varicocele

Question 46

more common in men over 40

result of renal hydronephrosis, abdominal mass or liver cirrhosis and portal hypertension

Answer 46

secondary varicoceles

Question 47

a collection of serous fluid and is the most common cause of painless scrotal swelling

Answer 47

hydrocele

Question 48

appears as anechoic fluid at lower frequency settings but may have some low level echoes at higher frequencies and higher hynamic range

infected __________ may have increased internal echoes

Answer 48

appearance of hydrocele

Question 49

a bilateral codition associated with an increased risk of malignancy and infertiltiy, Calcifications are smaller than 3mm and apppear w/o shadowing. Higher incidence in men with a history of cryptorchidism (undescended testis). Must have more than 5 on a single image

Answer 49

microlithiasis

Question 50

most common kind of testicular carcinoma

Answer 50

95% are germ cell, most often seminoma

Question 51

occurs most frequently between ages 20-35

patients present with a painless, palpable testicular lump

Answer 51

testicular carcinomas

Question 52

hypoechoic, homogenous with smooth borders (testis)

Answer 52

seminomas

Question 53

most common cause of acute scrotal pain in adults

Answer 53

epididymitis

Question 54

common cause of epididymitis

Answer 54

urinary tract infection or STD

Question 55

symtoms of epididymitis

Answer 55

increasing pain over several days with fever an doften a urethral discharge

infection will spread to the testis in about 1/3 of cases which if orchitits

hyperemia presenting as increased color doppler within the testis