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Abdomen & Small Parts Sonography > ESP-Abdominal Sonography > Flashcards

ESP-Abdominal Sonography Flashcards

1
Q

All of the following are associated with echinococcal cysts except:

a. cyst within a cyst presentation
b. Casoni skin test
c. ascites
d. anaphylactic shock
e. water lily sign

A

C
Humans also become infected by ingesting tapeworm eggs passed from an infected carnivore. This occurs when individuals handle infected carnivores (dogs) or ingest food contaminated with fecal matter containing tapeworm eggs. Sonographic appearance of “cyst within a cyst” or “water-lily sign”. Lab test = casoni skin test. Rupture or aspiration is associated with anaphylactic shock

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2
Q

Which fetal circulation pathway connects the left portal vein to the IVC?

a. ductus arteriosus
b. ligamentum teres
c. umbilical vein
d. ductus venosus
e. ligamentum venosum

A

D
Direction of fetal circulation = umbilical vein > left portal vein > ductus venosus (ligamentum teres) > IVC.
The ligamentum venosum is a remnant of the ductus venosus. It runs from the left portal vein to the inferior vena cava separating the left lobe from the caudate lobe of the liver.

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3
Q

The ligamentum venosum is all of the following except:

a. a remnant of the umbilical vein
b. a remnant of the ductus venosus
c. a remnant of the fetal circulation which shunts blood from the left portal vein to the IVC bypassing the liver
d. divides caudate lobe from left lobe of liver

A

A
The ligamentum venosum is a remnant of the ductus venosus. It runs from the left portal vein to the inferior vena cava separating the left lobe from the caudate lobe of the liver.

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4
Q

The caudate lobe is located on the:

a. anteroinferior surface of the liver
b. anterosuperior surface of the liver
c. posteroinferior surface of the liver
d. posterosuperior surface of the liver

A

D
What used to be referred to as the quadrate lobe is a misnomer and is the medial aspect of the left lobe of the liver. The caudate lobe lies on the posterior-superior surface of the liver between the IVC and the medial left lobe of the liver.

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5
Q

The ligamentum teres:

a. resides in the left intersegmental fissure
b. is a remnant of the umbilical vein
c. recannalizes in severe cirrhosis
d. is an echogenic spot on transverse liver images
e. all of the above

A

E
The ligamentum teres is a remnant of the umbilical vein which runs from the umbilicus to the left portal vein. Shortly after birth, the umbilical vein contracts down forming the ligamentum teres. With portal hypertension, the ligamentum teres recanalizes to form a portosystemic venous collateral.

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6
Q

Cystic lesions within the liver include all except:

a. congenital cysts
b. polycystic liver disease
c. Caroli’s disease
d. hemangiomas

A

D
A liver cyst is defined as a fluid-filled space lined by biliary epithelium. Liver cysts usually refer to nonparasitic simple cysts. Caroli’s disease: a congenital anomaly of the biliary tract characterized by multifocal segmental dilatation of the intrahepatic bile ducts. Hemangiomas = most common benign liver tumor.

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7
Q

Which is in decreasing order of echogenicity?

a. pancreas > renal sinus > liver > renal parenchyma
b. renal sinus > pancreas > liver > renal parenchyma
c. renal sinus > renal parenchyma > pancreas > liver
d. pancreas > renal sinus > renal parenchyma > liver

A

B

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8
Q

Which part of the liver is least affected by Budd Chiari?

a. right anterior
b. right posterior
c. left medial
d. left lateral
e. caudate

A

E
A disorder characterized by hepatic vein obstruction. The caudate lobe is often spared because the emissary veins drain directly into the IVC. Thus, the caudate lobe enlarges with atrophy of the right and left lobes. IVC may be compressed by enlarging caudate lobe.

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9
Q

All of the following mass lesions are benign except:

a. hematoma
b. hamartoma
c. hepatic adenoma
d. hepatoma
e. hemangioma

A

D
Hematoma: liver hemorrhage, initially appears echogenic but over time as it resolves it will appear more cystic or complex.
Hamartoma: benign tumor
Hepatic adenoma: asymptomatic, rare benign liver tumor; often associated with use of oral contraceptives. Usually removed d/t propensity to turn cancerous. Variable appearance.
Hepatoma: mass associated with HCC.
Hemangioma: most common benign liver tumor; more common in women; asymptomatic; usually in right lobe and appear small and hyperechoic < 3cm.

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10
Q

A parasitic disease of the liver causing portal hypertension and occlusion of the portal veins is:

a. hydatid cyst
b. echinoccocal cyst
c. schistosomiasis
d. hepatic candidiasis

A

C
Schistosomiasis is one of the most common parasitic infections in humans. Major cause of portal hypertension worldwide. Usually found in tropical zones around the world. Eggs reach the liver through the portal vein, inciting a granulomatous reaction resulting in periportal fibrosis. The intrahepatic portal veins become occluded resulting in portal hypertension.

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11
Q

If on sonographic examination, one finds a patient with intrahepatic dilated ducts and a small gallbladder, this may indicate that the level of obstruction is:

a. at the proximal common bile duct
b. above the cystic duct
c. at the Ampulla of Vater
d. at the head of the pancreas

A

B
Obstruction at the junction of the right and left hepatic ducts. At this location only the intrahepatic ducts dilate. the gallbladder will be contracted.

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12
Q

Dilatation of the intrahepatic biliary tree without dilatation of the extrahepatic duct includes all of the following except:

a. Klatskin tumor
b. enlarged portal lymph nodes
c. cholangiocarcinoma
d. pancreatic carcinoma

A

D
Klatskin tumor: is a cholangiocarcinoma located at the hepatic hilum (junction of the right and left hepatic duct) resulting in intrahepatic but not extrahepatic biliary dilation.
Enlarged periportal lymph nodes: malignant infiltration and enlargement of periportal nodes occur in patients with cancers of the liver, gallbladder, biliary tree, and pancreas and lymphoma.
cholangiocarcinoma: typically originate within the extrahepatic bile ducts (CHD or CBD).
Pancreatic carcinoma: Courvoisier’s gallbladder, bile duct dilatation, dilated pancreatic duct, liver metastases, ascites, lymphadenopathy, pseudocyst formation.

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13
Q

A 48 year old female presents postcholecystectomy with RUQ pain, an elevated serum bilirubin (mainly conjugated), and bilirubin in her urine. It is true that:

a. she probably has hepatitis
b. she probably has a stone, tumor, or stricture obstructing the bile duct
c. the common duct will probably be less than 5 mm in diameter
d. alkaline phosphatase will be normal

A

B

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14
Q

Increased levels of alkaline phosphatase are expected with:

a. biliary obstruction
b. children
c. hepatocellular disease
d. pregnancy
e. all of the above

A

E

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15
Q

A Phrygian cap is:

a. an enlarged gallbladder
b. a fold at the gallbladder fundus
c. a fold in the gallbladder neck
d. a diverticula at the gallbladder neck

A

B

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16
Q

The causes of a large gallbladder include all of the following except:

a. adenomyomatosis
b. cystic duct obstruction
c. pancreatic carcinoma
d. diabetes mellitus
e. a fasting patient
f. common duct obstruction

A

A

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17
Q

Which of the following is associated with Caroli disease?

a. dilated intrahepatic bile ducts
b. dilated extrahepatic bile ducts
c. courvoisier gallbladder
d. diffuse thickening of the common duct

A

A

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18
Q

Thickening of the gallbladder wall is a common feature in:

a. hypoalbuminemia
b. cholecystitis
c. adenomyomatosis
d. carcinoma of the gallbladder
e. all of the above

A

E

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19
Q

Gallbladder wall thickening may be due to all of the following except:

a. ascites
b. hypoproteinemia
c. right-sided congestive cardiac failure
d. fatty liver
e. acute cholecystitis

A

D

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20
Q

Courvoisier’s sign is associated with all of the following except:

a. pancreatic carcinoma
b. dilated gallbladder
c. hepatocellular carcinoma
d. biliary duct dilatation
e. painless jaundice

A

C

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21
Q

Throughout its course, the splenic vein is located on the:

a. anterior surface of the pancreatic body and tail
b. anterior surface of the uncinate process
c. posterior surface of the pancreatic body and tail
d. superior surface of the pancreatic body and tail

A

C

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22
Q

The most common primary neoplasm of the pancreas is adenocarcinoma. This:

a. is usually found in the head of the pancreas
b. is accompanied by weight loss and painless jaundice
c. is accompanied by a dilated gallbladder
d. causes dilatation of the common bile duct
e. all of the above

A

E

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23
Q

The portion of the pancreas that lies posterior to the superior mesenteric artery and vein is the

a. head
b. uncinate process
c. body
d. tail

A

B

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24
Q

The pancreas is located in the:

a. lesser sac
b. greater sac
c. perirenal space
d. peritoneum
e. retroperitoneum

A

E

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25
Q

Occasionally, a pseudocyst may have internal echoes and be confused with an abscess. To distinguish the two, one should look for

a. calcifications
b. fluid in the lesser sac
c. gas
d. septations

A

C

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26
Q

Chronic pancreatitis may be associated with which of the following sonographic patterns?

a. increased echogenicity
b. decrease in pancreas size
c. calcifications
d. dilated pancreatic duct
e. all of the above

A

E

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27
Q

Islet cell tumors of the pancreas are most likely to be located:

a. in the head, never in the body or tail
b. frequently in the head, rarely in the body or tail
c. never in the head, frequently in the body or tail
d. rarely in the head, frequently in the body or tail

A

D

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28
Q

The gastroduodenal artery:

a. is the first branch of the common hepatic artery
b. proceeds caudally along the anterolateral margin of the pancreatic head
c. is seen in the transverse views directly anterior to the common bile duct
d. is the point where the common hepatic artery becomes the hepatic artery proper
e. all of the above

A

E

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29
Q

The common bile duct is joined with the pancreatic duct before entering the:

a. transverse portion of the duodenum
b. first portion of the duodenum
c. third portion of the duodenum
d. second portion of the duodenum

A

D

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30
Q

Which of the following is correct?

a. the lesser sac is located anterior and superior to the pancreas
b. the greater sac is within the retroperitoneum
c. the perirenal space is within the peritoneum
d. the lesser sac contains bowel
e. the lesser sac is within the retroperitoneum

A

A

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31
Q

Which of the following will displace the superior mesenteric artery anteriorly?

a. common bile duct stone
b. pancreatic head mass
c. left renal vein thrombosis
d. rectus sheath hematoma

A

C

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32
Q

What is the correct path of a red blood cell returning to the heart?

a. splenic vein, hepatic vein, sinusoids, portal vein, IVC, right atrium
b. superior mesenteric vein, portal vein, hepatic vein, sinusoids, IVC, right atrium
c. inferior mesenteric vein, portal vein, sinusoids, hepatic veins, IVC, right atrium
d. splenic vein, portal vein, right portal vein, emissary veins, IVC, right atrium

A

D

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33
Q

Which of the following are associated with splenomegaly?

a. polycythemia
b. lymphoma
c. portal vein thrombosis
d. schistosomiasis
e. all of the above

A

E

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34
Q

Which of the following diseases would result in splenic atrophy (autosplenectomy):

a. infectious mononucleosis
b. typhoid fever
c. splenitis
d. sickle-cell anemia
e. HIV

A

D

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35
Q

The congenital absence of the spleen is associated with:

a. biliary atresia
b. visceral heterotaxy
c. Turner’s syndrome
d. polysplenia

A

B

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36
Q

The most common cause of splenomegaly is:

a. congestive heart failure
b. lymphoma
c. sickle-cell anemia
d. portal hypertension

A

D

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37
Q

A wedge-shaped lesion within the spleen is associated with:

a. sickle-cell disease
b. lymphoma
c. splenic infarct
d. splenic artery aneurysm
e. leukemia

A

C

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38
Q

Which of the following is not associated with splenic trauma?

a. decreasing hematocrit
b. perisplenic fluid collection
c. subcapsular fluid collection
d. pelvic fluid collection
e. perinephric fluid collection

A

E

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39
Q

Which of the following is not a cause of splenomegaly?

a. lymphoma
b. portal hypertension
c. pancreatitis
d. mononucleosis
e. cirrhosis

A

C

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40
Q

What is the most common newborn abdominal mass associated with a decrease in hematocrit?

a. Wilm’s tumor
b. adrenal neuroblastoma
c. hepatoblastoma
d. ARPKD
e. adrenal hemorrhage

A

E

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41
Q

While performing an ultrasound examination, the sonographer finds that both kidneys measure 5 cm in length. They are very echogenic. All of the following are possible except:

a. chronic glomerulonephritis
b. chronic pyelonephritis
c. bilateral renal artery disease
d. renal vein thrombosis

A

D

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42
Q

A 3 year old boy presents with hematuria and a palpable left flank mass. Sonography depicts a solid renal mass. This finding would most likely represent:

a. hypernephroma
b. Wilm’s tumor
c. neuroblastoma
d. Infantile polycystic kidney disease

A

B

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43
Q

Which statement about the kidney is false?

a. the kidneys are mobile within the retroperitoneum
b. the kidneys consist of an internal medulla and external cortex
c. the kidneys rest on he psoas laterally and quadratus lumborum medially
d. renal pyramids are found within the medullary region

A

C

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44
Q

Anechoic masses that occur around a renal transplant include all of the following except:

a. urinoma
b. lymphocele
c. hematoma
d. corpus luteal cyst
e. Baker’s cyst

A

E

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45
Q

Which of the following represents the most commonly reported cause of a palpable abdominal mass in the newborn?

a. neuroblastoma
b. hydronephrosis
c. multicystic dysplastic kidney
d. Wilm’s tumor
e. hepatoblastoma

A

C

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46
Q

Ectopic ureterocele is associated with which complication?

a. upper pole hydronephrosis
b. stone formation
c. renal cell carcinoma
d. lower pole hydronephrosis
e. transitional cell carcinoma

A

A

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47
Q

Which organ is most likely to be affected in adult polycystic kidney disease?

a. ovary
b. pancreas
c. spleen
d. adrenal gland
e. liver

A

E

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48
Q

Bilateral echogenic kidneys in newborns most likely represent?

a. multicystic dysplastic kidneys
b. Wilm’s tumor
c. autosomal recessive polycystic kidney disease
d. autosomal dominant polycystic kidney disease

A

C

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49
Q

The most common cause of acute renal failure is:

a. renal vein thrombosis
b. renal artery thrombosis
c. acute tubular necrosis
d. acute glomerulonephritis

A

C

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50
Q

A hypernephroma is a solid renal mass. It is known as all of the following except:

a. von Grawitz tumor
b. renal cell carcinoma
c. adenocarcinoma of the kidney
d. transitional cell carcinoma

A

D

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51
Q

All of the following laboratory values may be elevated in renal failure except:

a. protein
b. creatinine
c. alkaline phosphatase
d. BUN

A

C

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52
Q

Elevated serum amylase may be secondary to all of the following except:

a. pancreatic duct obstruction
b. acute pancreatitis
c. liver disease
d. obstruction of the ampulla of vater

A

C

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53
Q

Which laboratory value is associated with prostate carcinoma?

a. alkaline phosphatase
b. PCK
c. acid phosphatase
d. BUN

A

C

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54
Q

Which one of the following laboratory values is elevated with liver metastases?

a. alkaline phosphatase
b. BUN
c. PSA
d. alpha-fetoprotein

A

D

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55
Q

Which laboratory value is the most sensitive indicator of hepatocellular disease?

a. conjugated bilirubin
b. lactic dehydrogenase
c. alanine aminotransferase (ALT)
d. aspartate aminotransferase (AST)

A

C

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56
Q

Which laboratory value is specific for obstructive jaundice?

a. direct bilirubin
b. SGOT
c. SGPT
d. indirect bilirubin

A

A

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57
Q

All of the following increase with hepatocellular disease except:

a. AST
b. SGOT
c. SGPT
d. PSA
e. ALT

A

D

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58
Q

Alkaline phosphatase increased without elevation of ALT may be seen in all of the following except:

a. Mirizzi syndrome
b. pancreatic carcinoma
c. acute hepatitis
d. choledocholithiasis

A

C

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59
Q

Choledocholithiasis may result in:

a. an increase in indirect bilirubin
b. an increase in direct bilirubin and a slight increase in indirect bilirubin
c. bilirubin is not elevated in choledocholithiasis
d. an increase in creatinine

A

B

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60
Q

Hemolytic disorders may result in:

a. a predominant increase in direct bilirubin
b. a predominant increase in indirect bilirubin
c. a normal total bilirubin
d. increased hemoglobin level

A

B

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61
Q

A patient presents with hypertension, urinary epinephrine and norepinephrine and an adrenal mass. Name the adrenal mass?

a. adenoma
b. Wilm’s tumor
c. myelolipoma
d. pheochromocytoma

A

D

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62
Q

What is the most common neonatal adrenal mass?

a. adenoma
b. neuroblastoma
c. pheochromocytoma
d. adrenal hemorrhage
e. myelolipoma

A

D

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63
Q

What is the most common childhood adrenal mass?

a. pheochromocytoma
b. Wilm’s tumor
c. neuroblastoma
d. adrenal hemorrhage
e. myelolipoma

A

C

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64
Q

What is the most common primary carcinoma associated with adrenal metastases?

a. colon
b. bone
c. ovarian
d. melanoma
e. lung

A

E

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65
Q

An adrenal mass which causes a propagation speed artifact is a/n:

a. pheochromocytoma
b. myelolipoma
c. neuroblastoma
d. adrenal hemorrhage
e. adenoma

A

B

66
Q

The adrenal glands lie within the:

a. peritoneum
b. anterior pararenal space
c. perirenal space
d. posterior pararenal space
e. lesser sac

A

C

67
Q

Which vessel is interlobar and which is intrasegmental?

a. portal vein, hepatic vein
b. portal vein, hepatic artery
c. hepatic vein, common hepatic artery
d. hepatic vein, portal vein

A

D

68
Q

Addison’s disease is a syndrome that results from:

a. chronic adrenal hyperfunction
b. chronic adrenal hypofunction
c. thyroid hypofunction
d. parathyroid hypofunction

A

B

69
Q

What structure lies directly medial to both adrenal glands?

a. kidney
b. Crus of the diaphragm
c. aorta
d. IVC

A

B

70
Q

Which of the following syndromes are associated with an adrenal mass?

a. Grave’s syndrome
b. Cushing’s syndrome
c. Frohlich’s syndrome
d. Zollinger-Ellison syndrome

A

B

71
Q

The IVC and aorta are located in which retroperitoneum space?

a. anterior pararenal space
b. perirenal space
c. posterior pararenal space
d. greater sac

A

A

72
Q

Which of the following is not retroperitoneal?

a. kidney
b. prostate
c. aorta
d. colon
e. spleen

A

E

73
Q

The retroperitoneal space is defined as the area between the:

a. anterior parietal peritoneum and the posterior abdominal wall muscles
b. posterior parietal peritoneum and the posterior abdominal wall muscles
c. anterior parietal peritoneum and the posterior visceral peritoneum
d. posterior parietal peritoneum and the anterior visceral peritoneum

A

B

74
Q

Which is spread through a fecal-oral route?

a. hepatitis A
b. hepatitis B
c. hepatitis C
d. hepatitis F

A

A

75
Q

If retroperitoneal fibrosis is suspected, what is the most common secondary finding?

a. hydronephrosis
b. metastatic liver disease
c. splenomegaly
d. urinomas

A

A

76
Q

The inferior mesenteric vein drains into the:

a. inferior vena cava
b. portal vein
c. splenic vein
d. renal vein

A

C

77
Q

Which vessel is imaged between the SMA and the aorta?

a. right renal artery
b. right renal vein
c. left renal artery
d. left renal vein

A

D

78
Q

Which vessel does not drain directly into the IVC?

a. right renal vein
b. left renal vein
c. right gonadal vein
d. middle hepatic vein

A

D

79
Q

The azygous vein:

a. connects the portal vein to the superior vena cava
b. connects the portal vein to the inferior vena cava
c. connects the proximal abdominal IVC to the superior vena cava
d. connects the hemiazygos vein to the superior vena cava

A

C

80
Q

Which of the following is a branch of the celiac axis?

a. left gastric artery
b. gastroduodenal artery
c. right gastric artery
d. proper hepatic artery

A

A

81
Q

Which of the following is not a correct anatomic landmark in relation to the thyroid?

a. sternocleidomastoid - anteriolateral
b. longus colli muscle - posterior
c. internal jugular vein - lateral
d. trachea - medial
e. minor neurovascular bundle - lateral

A

E

82
Q

All of the following can mimic a parathyroid adenoma except:

a. minor neurovascular bundle
b. esophagus
c. intrathyroidal adenoma
d. thyroglossal cyst

A

D

83
Q

The halo sign is defined as a sonolucent rim surrounding a thyroid mass. It is commonly seem in:

a. carcinomas
b. thyroiditis
c. adenomas
d. intrathyroid parathyroids
e. cysts

A

C

84
Q

Grave’s disease is associated with all of the following except:

a. hypothyroidism
b. audible bruit
c. diffusely enlarged thyroid
d. prominent eyes (exophthalmos)
e. cardiovascular symptoms

A

A

85
Q

Parathyroid adenomas may be associated with:

a. hypercalcemia
b. hypertension
c. hypocalcemia
d. hypotension

A

A

86
Q

What is the most common primary thyroid cancer?

a. follicular carcinoma
b. medullary carcinoma
c. papillary carcinoma
d. anaplastic thyroid carcinoma

A

C

87
Q

Peripheral or eggshell-like calcifications are indicative of a:

a. follicular carcinoma
b. goiter
c. malignant nodule
d. benign nodule

A

D

88
Q

Which of the following lab values would reflect a patient with Graves’ disease?

a. increased TSH, increased T3, increased T4
b. increased TSH, increased T3, decreased T4
c. decreased TSH, decreased T3, decreased T4
d. decreased TSH, increased T3, increased T4

A

D

89
Q

Hashimoto’s thyroiditis is characterized by all of the following except:

a. glandular enlargement
b. coarse echotexture
c. hyperechogenicity
d. hypothyroidism

A

C

90
Q

Thyroglossal duct cysts are usually located

a. lateral to the internal jugular vein
b. posterior to the thyroid
c. medial to the thyroid
d. anterior to the trachea

A

D

91
Q

Which of the following is true about the thyroid:

a. longus colli muscle is posterior to the thyroid
b. strap muscles are posterior to the thyroid
c. sternocleidomastoid muscle is lateral to the thyroid
d. parathyroid gland is lateral to the thyroid

A

A

92
Q

The most common testicular tumor is a:

a. teratoma
b. seminoma
c. embryonal cell carcinoma
d. mixed germ cell tumor

A

B

93
Q

To better image flow in a testicle for evaluating a torsion, you should:

a. decrease color gain
b. increase wall filter
c. decrease PRF
d. decrease TGC
e. increase PRF

A

C

94
Q

Anechoic lesions associated with the epididymis are:

a. epididymal cysts
b. varicoceles
c. hydroceles
d. spermatoceles
e. A and D

A

E

95
Q

Which of the following is not a part of the spermatic cord?

a. cremasteric artery
b. vas deferens
c. pampiniform plexus
d. epididymis
e. deferential artery

A

D

96
Q

The most common cause of an acute scrotum in post pubertal males is:

a. testicular torsion
b. epididymitis
c. varicoceles
d. hydroceles

A

B

97
Q

A complication of cryptorchidism/orchioplexy is:

a. increased hydrocele formation
b. increased varicocele formation
c. increased risk of malignancy
d. increased episodes of epididymitis

A

C

98
Q

Hydroceles can be defined as serous fluid accumulated between the:

a. two layers of the tunica albuginea
b. two layers of the tunica vaginalis
c. tunica vaginalis and the tunica albuginea
d. tunica albuginea and the testicle

A

B

99
Q

Which of the following statements are false?

a. varicoceles are more commonly in the left scrotum than the right
b. most extratesticular masses are benign
c. The tunica vaginalis is an extension of the retroperitoneum
d. most intratesticular masses are malignant

A

C

100
Q

Which is the correct pathway of sperm from the testicle?

a. seminiferous tubules, tubuli recti, rete testes, epididymis, efferent ductules, vas deferens
b. rete teste, seminiferous tubules, tubuli recti, efferent ductules, epididymis, vas deferens
c. seminiferous tubules, rete testes, efferent ductules, tubuli recti, epididymis, vas deferens
d. seminiferous tubules, tubuli recti, rete testes, efferent ductules, epididymis, vas deferens

A

D

101
Q

Hypertrophic pyloric stenosis is characterized by all of the following except:

a. an increase in pyloric channel length
b. a decrease in pyloric channel length
c. an increase in cross sectional diameter
d. an increase in pyloric muscle thickness

A

B

102
Q

Acute diverticulitis is characterized by all of the following except:

a. left lower quadrant pain
b. fever
c. leukocytosis
d. thickened bowel
e. fluid-filled bowel

A

E

103
Q

Sonographically, the gastroesophageal junction can be visualized:

a. anterior to the inferior vena cava
b. posterior to the aorta
c. anterior to the aorta and posterior to the left lobe of the liver
d. it cannot be seen sonographically

A

C

104
Q

Name the space that is a recess of the peritoneum located between the uterus and the rectum:

a. morison’s pouch
b. lesser sac
c. vesicouterine recess
d. greater sac
e. pouch of douglas

A

E

105
Q

A 4 month old infant presents with abdominal pain, rectal bleeding, and a palpable abdominal mass. What is the most likely pathology?

a. bowel obstruction
b. hypertrophic pyloric stenosis
c. diverticulitis
d. intussusception
e. Crohn’s disease

A

D

106
Q

Which of the following is a component of coagulation?

a. Vitamin E
b. Vitamin C
c. Vitamin A
d. Vitamin K
e. Folic acid

A

D

107
Q

What is the most likely diagnosis in a patient with elevation of CEA, alkaline phosphatase, and GGT?

a. choledocholithiasis
b. liver metastasis
c. Mirizzi Syndrome
d. Adenomyomatosis

A

B

108
Q

Elevation of both GGT and ALP would most likely represent:

a. metastatic liver disease
b. hepatoma
c. hepatitis
d. biliary obstruction
e. pancreatitis

A

D

109
Q

A right adrenal mass will displace the superior pole of the kidney:

a. anteriorly
b. laterally
c. medially
d. posteriorly
e. superiorly

A

B

110
Q

SGPT is the same laboratory value as:

a. aspartate aminotransferase
b. alanine aminotransferase
c. alkaline phosphatase
d. alpha fetoprotein
e. gamma-glutamyl transpeptidase

A

B

111
Q

Calcifications of the prostate are termed:

a. prostatic liths
b. verumontanum
c. corpora amylacea
d. corpus lithocea

A

C

112
Q

The largest percentage of cancers originate from which area of the prostate:

a. transition zone
b. peripheral zone
c. central zone
d. twilight zone
e. fibromuscular stroma

A

B

113
Q

The most common location for a pseudocyst is:

a. posterior pararenal space
b. perirenal space
c. pouch of douglas
d. lesser sac

A

D

114
Q

What is the classical appearance for prostate cancer?

a. centrally located, hyperechoic lesion
b. centrally located, hypoechoic lesion
c. peripherally located, hyperechoic lesion
d. peripherally located, hypoechoic lesion

A

D

115
Q

All of the following statements are true pertaining to PSA except:

a. PSA levels increase as prostate volume increases
b. PSA levels increase with age
c. prostate cancer will increase PSA levels higher than that of BPH
d. benign prostatic hyperplasia does not increase PSA levels

A

D

116
Q

Benign prostatic hyperplasia originates from the:

a. transition zone
b. peripheral zone
c. central zone
d. outer gland
e. fibromuscular stroma

A

A

117
Q

Which of the following statements pertaining to the prostate is false?

a. the prostatic apex is the caudad portion of the gland
b. the ejaculatory ducts pass through the central zone of the prostate
c. the surgical capsule is the division between the inner gland and the peripheral zone
d. the prostate is positioned inferior to the bladder in the peritoneum
e. the fibromuscular stroma is a nonglandular anterior portion of the prostate

A

D

118
Q

What structure marks the mid point of the prostatic urethra by a small elevation of the urethral crest?

a. corpora amylacea
b. surgical capsule
c. vas deferens
d. epithelial prominence
e. verumontanum

A

E

119
Q

The seminal vesicles are located on which surface of the prostate?

a. the anterior/inferior surface
b. the posterior/superior surface
c. the posterior/inferior surface
d. the anterior/superior surface

A

B

120
Q

What is the most likely diagnosis in a patient with elevated AST and ALT?

a. choledocholithiasis
b. pancreatic adenocarcinoma
c. hepatitis
d. myocardial infarction
e. acute cholecystitis

A

C

121
Q

Which of the following most accurately describes the location of the caudate lobe?

a. posterior to IVC
b. medial to lesser sac
c. posterior to porta hepatis
d. lateral to IVC
e. anterior to the ligamentum venosum

A

C

122
Q

Which of the following ligaments attaches the liver to the anterior abdominal wall?

a. venosum
b. falciform
c. triangular
d. hepatorenal
e. right coronary ligament

A

B

123
Q

On spectral doppler, the hepatic veins are characterized by which of the following flow types?

a. monophasic
b. parabolic
c. multiphasic
d. laminar
e. turbulent

A

C

124
Q

Enlargement of the caudate lobe is most commonly associated with which of the following pathologies?

a. cirrhosis
b. candidiasis
c. fatty infiltration
d. liver metastases
e. polycystic disease

A

A

125
Q

Which of the following spaces is located superior to the liver and inferior to the diaphragm?

a. lesser sac
b. pleural space
c. subhepatic space
d. subphrenic space
e. morison’s pouch

A

D

126
Q

Which of the following conditions describes a congenital extension of the liver anterior and inferior to the right kidney?

a. sinus inversus
b. hepatomegaly
c. reidel lobe
d. left lobe variant
e. hyperplastic caudate lobe

A

C

127
Q

The umbilical vein courses from the umbilicus to the:

a. left hepatic vein
b. superior mesenteric vein
c. middle hepatic vein
d. left portal vein
e. coronary vein

A

D

128
Q

A transjugular intrahepatic portosystemic shunt (TIPS) is most commonly placed between the:

a. right hepatic vein and right portal vein
b. middle hepatic vein and IVC
c. right portal vein and IVC
d. left portal vein and IVC
e. left hepatic vein and right portal vein

A

A

129
Q

Prominence of the portal veins (starry night sign or periportal cuffing) is most commonly associated with which of the following pathologies?

a. cirrhosis
b. acute hepatitis
c. polycystic disease
d. fatty infiltration
e. glycogen storage disease

A

B

130
Q

Von Gierke disease is most commonly associated with:

a. cirrhosis
b. polycystic disease
c. schistosomiasis
d. focal nodular hyperplasia
e. glycogen storage disease

A

E

131
Q

Which of the following liver pathologies is associated with immune-suppressed patients?

a. adenoma
b. candidiasis
c. cavernous hemangioma
d. polycystic disease
e. echinococcal cyst

A

B

132
Q

Which of the following hepatic structures is interlobar in locations?

a. hepatic artery
b. portal vein
c. hepatic vein
d. biliary duct
e. sinusoids

A

C

133
Q

Patients with a history of hepatitis B have a predisposing risk factor for developing a/n:

a. adenoma
b. abscess
c. hepatoma
d. focal nodular disease
e. cavernous hemangioma

A

C

134
Q

The right lobe of the liver is divided into anterior and posterior segments by the:

a. right hepatic artery
b. main portal vein
c. right portal vein
d. right hepatic vein
e. middle hepatic vein

A

D

135
Q

The left lobe of the liver is separated from the right lobe by which of the following structures?

a. right hepatic vein and right intersegmental fissure
b. middle hepatic vein and ligamentum venosum
c. left hepatic vein and main lobar fissure
d. left hepatic vein and right intersegmental fissure
e. middle hepatic vein and main lobar fissure

A

E

136
Q

The ductus venosum drains into the:

a. left hepatic vein
b. right portal vein
c. inferior vena cava
d. left portal vein
e. right atrium

A

C

137
Q

A cavernous hemangioma most commonly appears on ultrasound as a:

a. heterogeneous complex mass
b. homogeneous hyperechoic mass
c. large complex mass
d. homogeneous hypoechoic mass
e. heterogeneous hypoechoic mass

A

B

138
Q

Organs associated with polycystic disease include all of the following except:

a. liver
b. kidney
c. spleen
d. pancreas
e. adrenal gland

A

E

139
Q

Which of the following landmarks is NOT used to divide the liver into right and left lobes?

a. ligamentum teres
b. gallbladder fossa
c. main lobar fissure
d. middle hepatic vein
e. inferior vena cava

A

A

140
Q

Which of the following describes diffuse foci within the liver, with or without shadowing, most often associated with acquired immunodeficiency syndrome?

a. granulomas
b. pneumocystis (carinnii) jiroveci
c. pneumobilia
d. pneumatosis intestinalis
e. sarcoidosis

A

B

141
Q

Which of the following is NOT associated with an increase in incidence in renal cell carcinoma?

a. tuberous sclerosis
b. multiple sclerosis
c. long term hemodialysis
d. von Hippel Lindau syndrome

A

B

142
Q

Which of the following more commonly invades the inferior vena cava?

a. transitional cell carcinoma
b. colon cancer
c. malignant melanoma
d. renal cell carcinoma

A

D

143
Q

Which of the following is a type of hamartoma?

a. angiomyolipoma
b. renal cell carcinoma
c. hepatocellular carcinoma
d. lipoma

A

A

144
Q

What is the most common cause of a hepatic abscess?

a. biliary tract disease
b. amoeba
c. acute pancreatitis
d. acute appendicitis

A

A

145
Q

What is the most common location of a hepatic pyogenic abscess?

a. left lobe
b. quadrate lobe
c. caudate lobe
d. right lobe

A

D

146
Q

A “daughter cyst” is associated with which of the following pathologies?

a. hepatic adenoma
b. cystadenoma
c. fungal abscess
d. hydatid cyst

A

D

147
Q

Marked elevation in which of the following laboratory tests is associated with obstructive jaundice?

a. serum albumin
b. alanine aminotransferase
c. alpha-fetoprotein
d. alkaline phosphatase

A

D

148
Q

Where is the location of a Klatskin tumor?

a. quadrate lobe
b. portal confluence
c. porta hepatis
d. sulcus venae cavae

A

C

149
Q

What is the most common form of glycogen storage disease?

a. von Gierke’s disease
b. von Hippel Lindau disease
c. von Willebrand disease
d. von Recklinghausen’s disease

A

A

150
Q

Which of the following is considered a “stealth lesion”?

a. hepatic adenoma
b. cavernous hemangioma
c. focal nodular hyperplasia
d. oncocytoma

A

C

151
Q

Which of the following pharmacologic agents have been postulated to promote cavernous hemangioma growth?

a. progesterone
b. estrogen
c. testosterone
d. aldosterone

A

B

152
Q

Which of the following is NOT associated with pneumobilia?

a. sphincter of Odi incompetency
b. emphysematous cholecystitis
c. ERCP
d. ascending cholangitis

A

D

153
Q

Choledochal cysts are more commonly associated with which ethnic group?

a. hispanic
b. japanese
c. welsh
d. african

A

B

154
Q

What portion of the pancreas is perpendicular to the sound beam?

a. head
b. body
c. tail
d. uncinate process

A

B

155
Q

Which of the following is NOT a tributary of the main portal vein?

a. right gastric vein
b. coronary vein
c. cystic vein
d. right gastroepiploic vein

A

D

156
Q

Which of the following is a branch of the proper hepatic artery?

a. gastroduodenal artery
b. right gastroepiploic artery
c. right gastric artery
d. left gastric artery

A

C

157
Q

What is the most common cause of a hyperechoic pancreas in a child?

a. hereditary pancreatitis
b. sickle cell disease
c. pancreas divisum
d. cystic fibrosis

A

D

158
Q

What is the single most common cause of acute pancreatitis?

a. alcohol abuse
b. gallstones
c. medications
d. autoimmune

A

B

159
Q

What is the single most common cause of chronic pancreatitis?

a. alcohol abuse
b. gallstones
c. medications
d. autoimmune

A

A

160
Q

What is the most common cause of a pseudocyst in a child?

a. cystic fibrosis
b. pancreas divisum
c. abdominal trauma
d. obstructive pancreatitis

A

C

Abdomen & Small Parts Sonography (3 decks)

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