Midterm Review (Abd/Sup) Flashcards
The valves of Heister are unique to the:
Cystic duct
Extension of the right lobe of the liver inferior and anterior to the right kidney is termed a(n):
Reidel’s lobe
A six-week-old infant presents with a history of projectile vomiting. A sagittal sonogram of the upper abdomen suggests what?
Pyloric stenosis
Which of the following accurately describes the portal veins?
A. Portal veins are intralobar in location
B. The walls of the portal veins contain lipids.
C. Oxygen-rich blood is transported through the portal veins.
D. The majority of the liver’s blood supply is empties through portal veins.
E. The main portal veins divides into the anterior and posterior portal veins.
A. Portal veins are intralobar in location
Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? A. Splenic vein B. Left renal vein C. Splenic artery D. Left gastric artery E. Superior mesenteric vein
B. Left renal vein
A post surgical patient presents with abdominal tenderness and leukocytosis. A sonogram demonstrates a superficial ill-defined mass beneath the surgical incision. Based on the clinical history, the sonographic findings are most suspicious for:
Abscess
Which of the following conditions is associated with secondary subacute thyroiditis? A. Grave’s disease B. Mirizzi syndrome C. Hashimoto’s disease D. DeQuervain’s syndrome E. Courvoisier’s syndrome
D. DeQuervain’s syndrome
Mirizzi syndrome demonstrates a:
Normal common bile duct
(Mirizzi syndrome demonstrates an immobile calculus in the cystic duct or GB neck, obstructing the CHD. The CHD and intrahepatic biliary ducts are dilated, while the CBD remains normal)
The blunt apex of the renal pyramid is termed the:
Papilla
Which of the following is a clinical symptom of hypothyroidism? A. Weight loss B. Palpitations C. Nervousness D. Exophthalmos E. Muscle cramps
E. Muscle cramps
The duct of Santorini empties into the:
Duodenum
Hematuria is a possible clinical finding in all of the following abnormalities EXCEPT: A. Pyelonephritis B. Nephrolithiasis C. Renal carcinoma D. Angiomyolipoma E. Bladder carcinoma
A. Pyelonephritis
The most common sonographic appearance of the mediastinum testis is described as a(n):
Hyperechoic linear structure
A hepatic abscess is most likely to develop within the:
Right lobe
The sonographic appearance of candiasis is described as:
Uniform hypoechoic masses
Retroperitoneal fibrosis is more commonly located near large blood vessels in the region of the:
Lumbar spine
The caudate lobe is located: A. Medial to the lesser sac B. Anterior to the porta hepatis C. Anterior to the ligamentum venosum D. Posterior to the inferior vena cava E. Medial to the inferior vena cava
E. Medial to the inferior vena cava
The gastroduodenal artery arises from which of the following arteries? A. Gastric artery B. Splenic artery C. Hepatic artery D. Duodenal artery E. Superior mesenteric artery
C. Hepatic artery
Presence of a palpable “thrill” over a vascular structure is highly suspicious for a(n):
Arteriovenous fistula
An abrupt increase in alkaline phosphatase levels is suggestive of:
Obstructive jaundice
Which of the following gallbladder abnormalities is not always pathological in origin? A. Cholecystitis B. Cholelithiasis C. Biliary sludge D. Cholesterolosis E. Adenomyomatosis
C. Biliary sludge
Biliary sludge may develop in cases of prolong fasting or biliary disease
Sonographic findings in cases of mesenteric lymphomatous are described by the:
Sandwich sign
Which benign liver neoplasm is composed of large blood filled cystic spaces?
Cavernous hemangioma
Predisposing factors correlating with development of renal vein thrombosis include all of the following EXCEPT: A. Trauma B. Renal disease C. Overhydration D. Malignant renal neoplasm E. Post surgical complication
C. Overhydration
The coronary vein enters the venous system near the:
Superior border of the porto-splenic confluence
Which of the following terms describe the sections of the epididymis? A. Head, body, tail B. Right, left, posterior C. Superior, hilum, and inferior D. Medial, posterior, and lateral E. Superior, midline, and inferior
A. Head, body, tail
Which of the following structures is most likely mistaken for the splenic artery? A. Celiac axis B. Splenic vein C. Hepatic artery D. Pancreatic duct E. Superior mesenteric artery
D. Pancreatic duct
Secretion of the thyroid stimulating hormone is controlled by the:
Pituitary gland
All of the following structures attach to the liver by a ligament EXCEPT: A. Stomach B. Diaphragm C. Gallbladder D. Retroperitoneum E. Anterior abdominal wall
C. Gallbladder
Which of the following structures connects the apex of the bladder with the umbilicus? A. Urinoma B. Ureterocele C. Urachal sinus D. Umbilical hernia E. Meckel’s diverticulum
C. Urachal sinus
What structure separates the subphrenic space into two compartments?
Falciform ligament
A decrease in serum amylase levels can be associated with: A. Cirrhosis B. Acute pancreatitis C. Biliary obstruction D. Peptic ulcer disease E. Pancreatic carcinoma
A. Cirrhosis
- decrease in amylase —> cirrhosis & hepatitis
- elevated amylase —> acute pancreatitis & peptic ulcer disease
What laboratory value is associated with malignancy in the elderly population?
Alpha-feto protein
*This lab value is associated with an underlying malignancy in non-pregnant patients
Visceral lymph nodes are located in which of the following? A. Around the aorta B. Near the sacrum C. In the peritoneum D. Near the adrenal glands E. Along the prevertebral vessels
C. In the peritoneum
A beaded appearance in the intrahepatic ducts is a sonographic finding in what condition?
Caroli’s disease
Enlarged lymph nodes demonstrating smooth wall margins are most consistent with an underlying:
Infection
Which of the following vascular structures is located directly posterior to the neck of the pancreas? A. Inferior vena cava B. Proper hepatic artery C. Gastroduodenal artery D. Superior mesenteric vein E. Superior mesenteric artery
D. Superior mesenteric vein
*SMV and SPC are both directly posterior to the neck of the pancreas
Bile pigments are produced by the:
Liver
Splenomegaly is a consistent finding in which of the following pathologies? A. Cirrhosis B. Biliary obstruction C. Portal hypertension D. Polycystic liver disease E. Portal vein thrombosis
C. Portal hypertension
Location of a Klatskin tumor is near which of the following structures? A. Adrenal gland B. Hepatic hilum C. IVC D. Head of the pancreas E. Gastroesophageal junction
B. Hepatic hilum
Which of the following structures is located posterior to the superior mesenteric vein and anterior to the aorta? A. Splenic vein B. Uncinate process C. Body of the pancreas D. Caudate lobe of the liver E. Inferior mesenteric artery
B. Uncinate process
The distance between the abdominal aorta and the superior mesenteric artery should not exceed:
11mm
Which of the following will likely demonstrate a rapid increase in size on serial examinations? A. Cyst B. Seroma C. Urinoma D. Hematoma E. Lymphocele
C. Urinoma
Which of the following conditions is more likely to result in acute pancreatitis? A. Cirrhosis B. Diverticulitis C. Cholelithiasis D. Hyperthyroidism E. Portal hypertension
C. Cholelithiasis
*Biliary disease is the most common cause of acute pancreatitis followed by alcohol abuse
What lab value reflects the balance between production and excretion of bile?
Bilirubin
A complication generally occuring within days of a renal transplant:
Renal vein thrombosis
*Renal artery stenosis typically occurs months to years after transplantation
Vascular structures are more prominent in which portion of the scrotum?
Inferior
Which of the following structures is NOT located within the perirenal space? A. Aorta B. Ureters C. Kidneys D. Adrenal glands E. Descending duodenum
E. Descending duodenum
*Descending duodenum is located in the anterior pararenal space
The kidneys, adrenal glands, perinephric fat, ureters, renal vessels, aorta, inferior vena cava, and lymph nodes are located within what region in the body?
Perirenal space
A patient with a history of splenomegaly demonstrates multiple tubular structures posterior to the left lobe of the liver. These tubular structures are most suspicious for:
Gastric varices
What hormone stimulates contraction of the gallbladder?
Cholecytokinin
Which complication is most likely associated with an annular pancreas? A. Hepatitis B. Pancreatitis C. Cholelithiasis D. Bowel obstruction E. Urinary obstruction
D. Bowel obstruction
*Annular pancreas is a rare congenital anomaly where the head of the pancreas surrounds the duodenum. This anomaly may result in obstruction of the duodenum or biliary tree.
Proteinuria is a common clinical finding in which of the following conditions? A. Hypotension B. Hydronephrosis C. Glomerulonephritis D. Hyperparathyroidism E. Medullary sponge disease
C. Glomerulonephritis
*Proteinuria is a finding in cases of glomerulonephritis, nephrolithiasis, renal carcinoma, polycystic disease, hypertension, and diabetes mellitus
Which branch of the aorta supplies the ascending colon?
Superior mesenteric artery (SMA)
A splenic rupture below the splenic capsule will appear on ultrasound as a:
Crescent shaped fluid collection inferior to the diaphragm
Marked elevation, in which of the following laboratory tests, is associated with obstructive jaundice? A. Serum albumin B. Indirect bilirubin C. Alpha-fetoprotein D. Alkaline phosphatase E. Alanine amniotransferase
D. Alkaline phosphatase
Sonographic findings associated with acute hepatitis may include all of the following EXCEPT: A. Hepatomegaly B. Splenomegaly C. Irregular liver contour D. Prominent portal veins E. Hypoechoic liver parenchyma
C. Irregular liver contour
Clinical findings associated with an ileus may include all of the following EXCEPT: A. Fever B. Constipation C. Abdominal pain D. Nausea and vomiting E. Hyperactive bowel sounds
E. Hyperactive bowel sounds
Complications associated with acute pancreatitis include all of the following EXCEPT: A. Phlegmon B. Pseudocyst C. Splenomegaly D. Abscess formation E. Duodenal obstruction
C. Splenomegaly
An endocrine function of the pancreas includes secretion of: A. Lipase B. Pepsin C. Gastrin D. Amylase E. Glucagon
E. Glucagon
- Endocrine pancreatic functions —> secretion of glucagon, insulin, somatostatin
- Exocrine pancreatic functions —> amylase, lipase, trypsin
Galactoceles develop in which of the following patients? A. Pre-menarche patients B. Post-surgical patients C. Post-menopausal patients D. Post-partum patients E. Peri-menopausal patients
D. Post-partum patients
An inward extension of the renal cortex describes a:
Column of Bertin
*Dromedary hump —> outward cortical bulge
The presence of gallbladder varices raises suspicion for: A. Acute hepatitis B. Peliosis hepatitis C. Acute pancreatitis D. Choledocholithiasis E. Portal vein thrombosis
E. Portal vein thrombosis
*Gallbladder varices are generally a result of portal vein thrombosis, portal hypertension, and cholecystitis
In cases of renal sinus lipomatosis, sonographic findings may include of the following EXCEPT: A. Renal atrophy B. Hyperechoic renal sinus C. Irregular renal contour D. Hyperechoic renal cortex E. Decreased cortical thickness
C. Irregular renal contour
Portal veins appear prominent on ultrasound because the walls contain:
Fibrin
Which of the following structures divides the left lobe into two segments?
A. Left portal vein and ligamentum teres
B. Middle hepatic vein and main lobar fissure
C. Left hepatic vein and ligamentum venosum
D. Left hepatic vein and ligamentum teres
E. Main portal vein and ligamentum venosum
D. Left hepatic vein and ligamentum teres
The left lobe of the liver is separated from the right lobe by what two structures?
Middle hepatic vein
Main lobar fissure
Extended use of oral contraceptives is a predisposing factor in developing which of the following hepatic neoplasms? A. Cyst B. Adenoma C. Hepatoma D. Cystadenoma E. Cavernous hemangioma
B. Adenoma
The diameter of the main pancreatic duct should not exceed:
2mm
The main lobar fissure is a sonographic landmark used for locating the:
Gallbladder fossa
Which of the following laboratory tests will most likely elevate in cases of non-obstructive jaundice? A. Serum albumin B. Indirect bilirubin C. Alkaline phosphatase D. Conjugated bilirubin E. Aspertate aminotransferase
B. Indirect bilirubin
Which of the following structures in located anterior to the IVC? A. Spine B. Psoas muscle C. Right adrenal gland D. Head of pancreas E. Crura of the diaphragm
D. Head of pancreas
Clinical findings associated with Addison’s disease include all of the following EXCEPT: A. Dehydration B. Chronic fatigue C. Emotional changes D. Bronze skin pigmentation E. Decreased serum potassium
E. Decreased serum potassium
Which of the following accurately describes the spleen?
A. The spleen is a retroperitoneal organ
B. The kidney is located anterior to the spleen
C. The spleen is located medial to the pancreas
D. The peritoneum completely covers the spleen
E. The spleen lies posterior and lateral to the stomach
E. The spleen lies posterior and lateral to the stomach
*Spleen is located within the peritoneum. Peritoneum covers the spleen except at the hilum.
When empty, bladder wall thickness should not exceed:
5mm
A metabolic disorder resulting from excessive production of cortisol describes what condition?
Cushing’s syndrome
The gallbladder lies posterior and inferior to the:
Main lobar fissure
The gallbladder lies lateral to the:
IVC
The gallbladder lies anterior medial to the:
Right kidney
Which of the following is NOT a sonographic finding associated with Achilles’ tendonitis?
A. Irregular margins
B. Hypervascular tendon
C. Thickening of the tendon
D. Tendon thickness exceeding 7mm
E. Prominent hyperechoic areas interspersed within the tendon
E. Prominent hyperechoic areas interspersed within the tendon
Elevation in serum lipase is NOT associated with which of the following conditions? A. Cirrhosis B. Acute pancreatitis C. Acute cholecystitis D. Chronic pancreatitis E. Pancreatic neoplasm
D. Chronic pancreatitis
Which of the following is an abnormal flow characteristic of the hepatic veins? A. Pulsatile B. Hepatopetal C. Multiphasic D. Spontaneous E. Slow flow velocity
B. Hepatopetal
*Hepatic veins course away from the liver toward the IVC termed hepatofugal flow. Hepatic veins demonstrate spontaneous multiphasic (pulsatile) flow
Which sonographic finding suggests renal transplant rejection? A. Superficial location B. Hyperechoic renal sinus C. A circular renal contour D. Hypoechoic renal cortex E. Prominent columns of Bertin
C. A circular renal contour
Hyperparathyroidism may lead to which of the following renal pathologies? A. Hydronephrosis B. Pyelonephritis C. Nephrolithiasis D. Acute tubular necrosis E. Multicystic dysplasia
C. Nephrolithiasis
*Excessive function of the parathyroid glands may lead to osteoporosis and nephrolithiasis
A contracted gallbladder is a common sonographic finding in which of the following conditions? A. Cholesterolosis B. Adenomyomatosis C. Portal hypertension D. Chronic cholecystitis E. Metastatic gallbladder disease
D. Chronic cholecystitis
Acute tubular necrosis demonstrates on ultrasound as:
Bilateral renal enlargement with hyperechoic renal pyramids
A seven-year-old child presents with severe abdominal pain and abnormal bowel patterns. Based on the clinical history, the sonogram is most likely suspicious for:
Intussusception
In a renal transplant patient, a lymphocele is generally located:
Medial
How many centimeters below the SMA do the main renal arteries arise?
1.0 - 1.5 cm
Which of the following anatomical variants involve the fundus of the gallbladder? A. Junctional fold B. Fetal lobulation C. Phrygians cap D. Hartmann’s pouch E. Multiseptated gallbladder
C. Phrygians cap
A transplanted kidney is commonly placed in the:
Right iliac fossa
The spermatic vein is considered dilated once the diameter exceeds:
4mm
Gallbladder enlargement is suggested once the transverse diameter exceeds:
5cm
A true abdominal aortic aneurysms is defined as dilatation of the aorta:
With a diameter measuring 3 cm or greater
All of the following statements accurately describe the location of the kidneys EXCEPT:
A. The left kidney lies superior to the right kidney
B. The kidneys lie medial to the transversus abdominus muscles
C. The inferior poles of the kidneys lie anterior to the psoas muscles
D. The inferior pole lies medial to the superior pole of each kidney
E. The kidneys lie anterior and lateral to the quadratus lumborum muscle
D. The inferior pole lies medial to the superior pole of each kidney
*The inferior pole of the kidneys are located lateral and anterior when compared to the superior pole
The subhepatic space communicates with the lesser sac through the foramen of:
Winslow
Progression of which of the following abnormalities flattens the portal vein? A. Ascariasis B. Pneumobilia C. Portal hypertension D. Biliary obstruction E. Portal vein thrombosis
D. Biliary obstruction
A congenital anomaly associated with the fusion of the kidneys by a connecting isthmus describes a:
Horseshoe kidney
Which of the following laboratory increases in Addison’s disease? A. Cortisol B. Calcitonin C. Aldosterone D. Serum sodium E. Serum potassium
E. Serum potassium
The renal cortex is bound by the renal capsule and:
Arcuate vessels
Which of the following most accurately describes the location of the common hepatic duct?
A. Medial to the main portal vein and anterior to the proper hepatic artery
B. Anterior to the main portal vein and lateral to the proper hepatic artery
C. Lateral to the main portal vein and medial to the common hepatic artery
D. Anterior to the main portal vein and medial to the proper hepatic artery
E. Anterior to the main portal vein and posterior to the proper hepatic artery
B. Anterior to the main portal vein and lateral to the proper hepatic artery
Elevation in creatinine levels is associated with:
Renal failure, chronic nephritis, or urinary obstruction
The expected sonographic appearance of a subacute hematoma is described as a(n):
Complex mass
The main portal vein supplies blood to which organ?
The liver
Dehydration increases the risk for developing:
Renal vein thrombosis
Which arteries are termed the hypogastric arteries?
Internal iliac arteries
Which of the following liver pathologies is associated with glycogen storage disease? A. Hepatitis B. Adenoma C. Hepatoma D. Polycystic disease E. Cavernous hemangioma
B. Adenoma
The “water lily” sign is associated with which of the following abnormalities? A. Hydronephrosis B. Echinococcal cyst C. Chronic pancreatitis D. Hepatic cystadenoma E. Polycystic liver disease
B. Echinococcal cyst
Which of the following accurately describes the sonographic appearance of the seminal vesicles?
A. Hyperechoic structures inferior to the prostate gland
B. Hypoechoic structures superior to the prostate gland
C. Hypoechoic structures medial to the prostate gland
D. Anechoic structures within the central zone of the prostate gland
E. Anechoic structures within the peripheral zone of the prostate gland
B. Hypoechoic structures superior to the prostate gland
Prothrombin is an enzyme produced by the:
Liver
Malignancy is more likely to develop in which portion of the pancreas?
Head
The main lobar fissure is a landmark used to locate the:
Gallbladder fossa
A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence in the stomach rugae. These findings are most suspicious for:
Gastritis
Hyperechoic foci within the intrahepatic ducts most likely represents:
Pneumobilia
Which of the following enzymes will most likely affect blood pressure? A. Renin B. Trypsin C. Secretin D. Aldosterone E. Somatostatin
A. Renin
Cryptorchism has a predisposing risk factor for developing which of the following abnormalities? A. Orchitis B. Hydrocele C. Varicocele D. Malignancy E. Spermatocele
D. Malignancy
If cholelithiasis is discovered on an ultrasound, the sonographer must determine the:
Mobility of the stone(s)
Focal dilatation of the anterior wall of the abdominal aorta describes a:
Saccular aneurysm
A patients presents with a history of abdominal pain to rule out Budd-Chiari syndrome. The sonographer should thoroughly evaluate which of the following organs? A. Liver B. Spleen C. Kidneys D. Pancreas E. Adrenal glands
A. Liver
Which of the following neoplasms is commonly located in the tail of the pancreas? A. Cyst B. Adenoma C. Phlegmon D. Islet cell tumor E. Adenocarcinoma
D. Islet cell tumor
Connective tissue separating the peripheral and central zones of the prostate gland is/are termed:
Surgical capsule
Which of the following conditions is associated with secondary subacute thyroiditis? A. Grave’s disease B. Mirizzi syndrome C. Hashimoto’s disease D. DeQuervain’s syndrome E. Courvoisier’s syndrome
D. DeQuervain’s syndrome
The liver is considered enlarged once the length exceeds:
18 cm
Sonographic findings associated with chronic pancreatitis include all of the following EXCEPT: A. Atrophy B. Calcifications C. Smooth margins D. Hyperechoic parenchyma E. Prominent pancreatic duct
C. Smooth margins
The tail of the pancreas is located: A. Medial to the spine B. Lateral to the spleen C. Superior to the stomach D. Anterior to the left kidney E. Posterior to the renal hilum
D. Anterior to the left kidney
Which laboratory value reveals cell injury or damage?
Aspartate aminotransferase
The wall thickness in a normal fasting gallbladder should not exceed:
3mm
Abnormal Doppler findings associated with a transjugular intrahepatic portosystemic shunt (TIPS) include:
Stent velocity below 60cm/sec
*Normal flow velocities within the stent range from 60 -225 cm/sec
Sharp, severe flank pain radiating to the groin describes:
Renal colic
Techniques to improve visualization of the pancreas include all of the following EXCEPT: A. Suspended expiration B. Valsalva maneuver C. Suspended inspiration D. Distending the stomach with air E. Using the liver as an acoustic window
D. Distending the stomach with air
Production of prothrombin depends on the amount of vitamin:
K
The coronary vein enters the venous system near the:
Superior border of the porto-splenic confluence
A round anechoic mass adjacent to the renal pelvis is most likely a(n):
Parapelvic cyst
The protective connective tissue surrounding each kidney is termed:
Renal capsule
A small hyperechoic pancreas is most suspicious for which of the following abnormalities? A. Islet cell tumor B. Cystic fibrosis C. Angiomyelipoma D. Fatty infiltration E. Chronic pancreatitis
E. Chronic pancreatitis
Which of the following arteries arises caudal to the inferior mesenteric artery? A. Lumbar B. Gonadal C. Infrarenal D. Median sacral E. Inferior phrenic
D. Median sacral
The inferior poles of the kidneys lie: A. Lateral to the superior poles B. Medial to the liver or spleen C. Posterior to the superior poles D. Cephalic to the superior poles E. Posterior to the psoas muscles
A. Lateral to the superior poles
Which of the following is the optimal technique for evaluating the kidneys? A. Harmonic imaging B. Patient lying supine C. Empty urinary bladder D. Phased array linear transducer E. Lowest possible transducer frequency
C. Empty urinary bladder
Risk factors associated with development of a Wilms tumor include all of the following EXCEPT: A. Omphalocele B. Hemihypertrophy C. Sporadic aniridia D. Polysplenia syndrome E. Beckwith-Weidermann syndrome
D. Polysplenia syndrome