MISC Flashcards
If there is gas within an abscess what kind of artifact may be present?
reverberation (comet-tail) artifact
Most reliable finding in patients with abscesses
presence of fever
increased WBC
The sonographic apperance of an abscess can be variable but typically is
complex mass, cystic and solid with possible debris, septations, and gas seen within
Depending on the sytic component of an abscess they typically demonstrate
posterior enhancement
How is the distinction made between a hematoma and an abscess is there is no air present in the abscess?
percutaneous aspiration
Biloma
extrahepatic collections of extravasated bile
Bilomas are most commonly assoicated with ____ _____ but can also be found with _____ ______ and _____ ______
biliary surgery
abdominal trauma
GB disease
Predominant cytsic mass located in the RUQ
biloma
What are lymphoceles complications of
renal tx gyn surgery vascular surgery urological surgery -caused by leakage of lymph from a renal allograft or by a surgical disruption of the lymphatic channels
DDx of a lymphocele includes any fluid collection such as
loculated ascites urinoma hematoma abscess -internal echoes within the collection is more consistent with an abscess or hematoma than a lymphocele
Urinomas are most commonly associated with
renal tx
posterior uretheral valve obstruction
(renal trauma/surgery or oustide obstruction )
____ is a collection of urine which is located outside the of the kidneys, bladder/urinary tract
urinoma
How soon after a renal tx can a urinoma developm
directly after due to an anastomotic leak of the ureter
The sonograhic appearance of a urinoma is similar to a
lymphocele
Lymphoma encompasses two types of neoplasms, which are
non-hodgkin lymphoma (NHL)
Hodgkin’s disease
lymphoma is the abonormal proliferation of mature lymphocyte population. The most common subtype is the
diffuse large B-cell lymphoma
Lymphoma is clinically assoicated with what viral infections
Epstein-Barr virus Human T-lymphotropic virus 1 HIV Hep C HSV
classic sonographic signs of lymphoma
sandwhich or mantle sign is teh sign of perivessel lymphoma
Where does lymphatous nodules typically collect in lymphoma
typically cluster anterior and posterior to linear structures such as the Ao, IVC, SMA
Lymphoma is noted to displace the IVC and SMA ____.
anteriorly
-finding can be clinically important as it is found more frequently with non-hodgkin’s
Symptoms associated with lymphoma
fever
night sweats
weight loss
Ascites is the excessive accumulation of serous fluid in the peritoneal cavity. Two mechanisms that produce ascites are
low serum osmotic pressure (protein loss)
high portal venous pressure
Casues of asciets include
cirrhosis
renal failure
congetsive heart failure
cancer (malignant ascites)
Most common cause of ascites
cirrhosis
Hypoalbuminemia (low protein) can be the result of
liver failure
nephrotic syndrome
malnutrition
Ascites is commonly found at
the inferior aspect of the right lobe of the liver
Morison’s pouch
pelvic cul de sac
paracolic gutters
T/F - GB thickening is seen with ascites
T
Malignancy characterized by the progressive accumulation of mucus-secreting tumor cells within the peritoneum. Most commonly associated with the appednix. Bowel loops are seen matted to the posterior abdominal wall
Pseudomyxoma pertonei
Abdominal paras have to be careful to avoid the ______ vessels bilateral on the mammary line. Puncturing laterally to the mammary line is common.
epigastric
For paras, lidocaine is used to anesthitize the area dow to the _____ ______ and for a therapeutic para, a ____ guage cannula is used to vacuum aspirate from teh peritoneal cavity
parietal peritoneum
14-guage
Pleural effusions are an accumulation of fluid in the ______ space and are often _________.
pleural
asymptomatic, although they can produce dyspnea and peluritic chest pain
Pleural effusions are classified as _____ or _______ based on Light’s criteria which compares pleural fluid and blood chemistries (protein, LDH)
transudates
exudates
Transudative effusions are caused by
increased hydrostatic pressure and decreased plasma oncotic pressure (pressure infiltration)
In trasudative effusions, what causes the pressure infiltration
heart failure (most common) liver failure (cirrhosis) renal failure (nephrotic syndrome)
Exudative effusions are caused by
increased capillary permability (inflammation)
In exudative effusions, the inflammation is due to
pneumonia
cancer
pulmonary embolism
Lab analysis for thorax includes
total protein LDH cell count and diff gram stain aerobic and anaerobic bacterial cultures cytology
How is a pneumothorax identified
abscence of gliding of the parietal and visceral pleura and the presence of a comet tail artifact between these layers
patient in supine position, air can be located on the anterior medial location of the throax
Throacentesis aspirates fluid from the pleural space of the chest, either for ______ purposes or to relieve ______. It is typically performed with the patient sitting at the edge of the bed leaning over a table with their spine rounded. It is also possible to perform with teh patient in the ____ _____ _____ position
diagnostic
dyspnea
LLD
A dorsal intercostal space is selected superior to the diaphragm for a throa. ______ time should be checked before performing. The needle is inserted in the ____ aspect of the rib as vessels are located on the _____ aspect.
Bleeding time
superior
inferior
In a throa, fluid is aspirated slowly, n ot to exceed _____ liters per day to avoid hypotension and pulmonary edema
1.5liter
_____ occurs as the lung expands post thora becasue the visceral and parietal pleura rub together reuslting in pain
coughing
_______ _______ is a collection of synovial fluid in the popliteal fossa and is commonly located on the _____ aspect of the fossa. They can also extend down into the _____
baker’s cyst
medial
calf muscles
Causes of a BAker’s cyst
rheumatoid arthritis
osteoarthritis
overuse of the knees
Nosocomial infections include
central line assoc bloodstream infections
catheter associated UTIs
ventilaer assoc pneumonia
surgical site infection
