Pancreas and Spleen Pathology Flashcards
What sonographic artifact may be visualized with the presence of gas?
gas does not cause any artifact
edge side lobes
reverberation
acoustic enhancement
reverberation
This is an inflammatory process that produces changes in pancreatic enzyme levels. Sonographically, the pancreas appears hypoechoic and enlarged.
Acute pancreatitis
Chronic pancreatitis
Cystic fibrosis
Annular pancreas
Acute pancreatitis
This pancreatic tumor is cancerous and is a common cause of biliary dilation, specifically the double-duct sign.
mucinous cystadenocarcinoma
gastrinoma
insulinoma
pancreatic ductal adenocarcinoma
pancreatic ductal adenocarcinoma
Which condition is associated with a midline liver and GB, reversed great vessels, and has right-sided predominance?
Polysplenia
Polycythemia vera
Asplenia
Sickle cell anemia
Intraperitoneal hematoma
Asplenia
What elevated lab value would be associated with a mucinous cystic neoplasm?
amylase
lipase
CEA
A1C
blood glucose
CEA
The most common cause of pancreatic pseudocyst in children is
Trauma
Acute pancreatitis
Diabetes
Hypoglycemia
Trauma
Repetitive bouts of pancreatitis will cause this.
acute pancreatitits
adenocarcinoma
chronic pancreatitis
pancreatic cysts
chronic pancreatitis
The most common cause of this is alcoholism. It is irreversible.
Pancreas divisum
Chronic pancreatitis
Pancreatic adenocarcinoma
Pancreatic cysts
Chronic pancreatitis
Sarcoidosis, malignancy, and ____ are the most common causes of granulomas.
splenic abscess
histoplasmosis
splenic artery aneurysm
infection
infection
What is the most common benign primary neoplasm found in the spleen?
Hemangioma
Granuloma
Splenic infarct
Adenocarcinoma
Hemangioma
Which of the following are considered malignant tumors of the pancreas? mark all that apply
Insulinoma
Gastrinoma
mucinous cystic neoplasm
serous cystic neoplasm
Gastrinoma
mucinous cystic neoplasm
This patient has come to you from chemotherapy. She is having some left upper quadrant pain and the doctor thinks her spleen is enlarged. What pathology is visualized in this image?
Splenic abcess
Granulomas
Splenic hemangiomas
Splenic mets
Splenic infarc
Splenic mets
Pancreatic cysts are associated with _________ and Von-Hipple-Lindau syndrome
hepatomegaly
adult polycystic kidney disease
Mirizzi syndrome
stones
adult polycystic kidney disease
With which of the following pathologies will blood possibly spread to peritoneal cavity and fluid may appear around the spleen?
Posttraumatic splenosis
Perisplenic hematoma
Subcapsular hematoma
Intraparenchymal hematoma
Perisplenic hematoma
____________ is when spleen cells are implanted throughout the peritoneal cavity, can be due to a traumatic event, resulting in ectopic spleen.
Asplenia
Polysplenia
Accessory spleen
Posttraumatic splenosis
Posttraumatic splenosis
What is the second most common GEP-NET aka islet cell tumor?
Insulinoma
Serous cystadenoma
Gastrinoma
Mucinous cystic neoplasm
Gastrinoma
This pathology was formerly called microcystic cystadenoma, is typically benign and has the appearance of cluster of grape-like cysts.
PDA
IPMN
Serous cystic neoplasm
Mucinous cystic neoplasm
Serous cystic neoplasm
A splenic abscess is commonly caused by endocarditis, septicemia and __________.
Portal HTN
trauma
coughing
splenomegaly
trauma
A _________ is typically visualized as a calcified circle in the left upper quadrant. Think of the pictures….
splenic artery calcification
sickle cell disease
splenic infarct
subcapsular hematoma
perisplenic hematoma
splenic artery calcification
Massive splenomegaly is defined as a spleen greater than ________.
28 cm
8 mm
18 cm
18 mm
18 cm
The Whipple procedure is used as treatment for ______.
Pancreatic ductal adenocarcinoma
Pancreas mets
Cystic fibrosis
Islet cell tumors
Pancreatic ductal adenocarcinoma
Indications for sonographic evaluation of the abdomen to include the pancreas would include all of the following except:
Dysmenorrhea
Biliary disease
Painless jaundice
Abdominal distention
Dysmenorrhea
The function of the pancreas includes all of the following except
Breaks down proteins
Breaks down fat
Regulates blood pressure
Regulates sugar metabolism
Regulates blood pressure
Select 4 complications associated with sickle cell disease.
massive infarction
autosplenectomy
splenomegaly
acute sequestration
pseudo abscess
hypersplenism
massive infarction
autosplenectomy
acute sequestration
hypersplenism
The Whipple procedure is used as treatment for ______.
Islet cell tumors
Pancreas mets
Cystic fibrosis
Pancreatic ductal adenocarcinoma
Pancreatic ductal adenocarcinoma
This patient has come to you from chemotherapy. She is having some left upper quadrant pain and the doctor thinks her spleen is enlarged. What pathology is visualized in this image?
Splenic mets
Splenic infarct
Granulomas
Splenic hemangiomas
Splenic abcess
Splenic mets
This patient is having pain, nausea, and vomiting. She has gallstones. Her amylase and lipase is elevated. All of this started 2 days ago.
acute pancreatitis
pancreatic adenocarcinoma
gastrinoma
chronic pancreatitis
acute pancreatitis
A patient presents with an elevated insulin level and clinical signs of hypoglycemia. This is most characteristic of:
Insulinoma
Gastrinoma
Adenoma
Adenocarcinoma
Insulinoma
When compared to the normal liver, the echogenicity of the pancreas in a 60-year-old patient is:
Heterogeneous
Hypoechoic
Incorrect answer:
Isoechoic
Hyperechoic
Hyperechoic
This pancreatic tumor is cancerous and is a common cause of biliary dilation, specifically the double-duct sign.
mucinous cystadenocarcinoma
pancreatic ductal adenocarcinoma
insulinoma
gastrinoma
pancreatic ductal adenocarcinoma
What lab value would be associated with an insulinoma?
amylase
CEA
low blood sugar
lipase
high blood sugar
low blood sugar
Which condition is associated with biliary atresia and absent GB?
Accessory spleen
Subcapsular hematoma
Asplenia
Posttraumatic splenosis
Polysplenia
Polysplenia
This pathology could be a complex appearing mass, with reverberation artifact. Clinically, the patient would likely have a fever and increased WBC.
Splenic infarct
Hemangioma
Perisplenic hematoma
Splenic abcess
Malignant splenic tumor
Splenic abcess
A 60-year-old patient presents with painless jaundice and weight loss. The pancreatic head measures 4 cm with an enlarged pancreatic duct. This is most likely:
Pancreatitis
Related to blood sugar
Pancreatic cancer
Complicated pseudocyst
Pancreatic cancer
Pancreatic cysts are associated with _________ and Von-Hipple-Lindau syndrome
adult polycystic kidney disease
Mirizzi syndrome
stones
liver cysts
adult polycystic kidney disease
What is the most common benign primary neoplasm found in the spleen?
Adenocarcinoma
Splenic infarct
Granuloma
Hemangioma
Hemangioma
This pathology can be confused with a pseudocyst and is managed as malignant.
adenocarcinoma
mucinous cystic neoplasm
serous cystadenoma
MEN type 2
insulinoma
mucinous cystic neoplasm
What wouldn’t be done to improve pancreas visualization during an abdominal ultrasound?
Reverse trendelenberg position to lessen bowel interference
Proper placement of focal zones
, Not Selected
Consumption of water to fill the stomach for pancreas tail visualization
Ingesting a high protein meal right before
Ingesting a high protein meal right before
__________ are small, bright echogenic lesions visualized in the spleen, with or without shadowing.
Abcess
Splenic infarct
Granulomas
Epidermoid cysts
Granulomas
your patient is a 66-year-old male with complaints of abdominal and back pain, jaundice, and weight loss. A solid hypoechoic mass is visualized in the head of the pancreas. His lab findings include elevated alkaline phosphatase, amylase, lipase, and GGTP.
What is the most likely pathology?
Serous cystadenoma
Annular pancreas
Pancreatic ductal adenocarcinoma
Islet cell tumors
Mucinous cystic neoplasms
Pancreatic ductal adenocarcinoma
This is an exocrine gland disorder that causes viscous secretions resulting in pancreatic dysfunction.
Pseudocyst
Mucinous cystic neoplasm
Acute pancreatitis
Cystic fibrosis
Cystic fibrosis
How can a pancreatic pseudocyst affect the spleen? select all that apply
won’t affect the spleen
create perisplenic hematoma
create pseudoaneurysms
weaken blood vessels
cause left sided hydronephrosis
erode into the spleen
create pseudoaneurysms
erode into the spleen
weaken blood vessels
Which is the most common location for a pancreatic pseudo cyst?
Lesser sac
Body of pancreas
Tail of the pancreas
Posterior to the pararenal space
Tail of the pancreas
What is the second most common GEP-NET aka islet cell tumor?
Insulinoma
Mucinous cystic neoplasm
Serous cystadenoma
Gastrinoma
Gastrinoma
Massive splenomegaly is defined as a spleen greater than 16cm.
True
False
False
A _________ is typically visualized as a calcified circle in the left upper quadrant.
sickle cell disease
subcapsular hematoma
perisplenic hematoma
splenic artery calcification
splenic infarct
splenic artery calcification
This is an inflammatory process that produces changes in pancreatic enzyme levels. Sonographically, the pancreas appears hypoechoic and enlarged.
Acute pancreatitis
Annular pancreas
Chronic pancreatitis
Cystic fibrosis
Acute pancreatitis
The most common cause of pseudocyst in children is
Trauma
Acute pancreatitis
Hypoglycemia
Diabetes
Trauma
____________ is when spleen cells are implanted throughout the peritoneal cavity, can be due to a traumatic event, resulting in ectopic splenic tissue.
Asplenia
Accessory spleen
Posttraumatic splenosis
Polysplenia
Posttraumatic splenosis
Pseudocysts contain high amounts of _______. Mark all the correct answers.
GGTP
Lipase
Bilirubin
Trypsin
Amylase
Amylase
Lipase
Trypsin
Which is a landmark for the anterior-lateral aspect of the pancreas?
Common bile duct
Gastroduodenal artery
Hepatic artery
Superior mesenteric artery
Gastroduodenal artery
_______ are true cysts found in the spleen that are lined with epithelial cells.
Epidermoid cyst
Hemorrhagic cyst
Splenic artery aneurysm
Complex cyst
Pseudocyst
Epidermoid cyst
In cases of acute pancreatitis, which lab value is elevated? It rises significantly in the early phase and decreases within a few days is:
Alkaline phosphatase
Serum glucose
Serum amylase
Bilirubin
Serum amylase
Repetitive bouts of pancreatitis will cause pancreatic ductal adenocarcinoma.
True
False
False
With which of the following pathologies will blood possibly spread to peritoneal cavity and fluid may appear loculated around the spleen?
Intraperitoneal hematoma
Intraparenchymal hematoma
Posttraumatic splenosis
Subcapsular hematoma
Intraperitoneal hematoma
The most common cause of this is alcoholism. It is irreversible.
Pancreatic cysts
Pancreatic adenocarcinoma
Chronic pancreatitis
Pancreas divisum
Chronic pancreatitis
Sarcoidosis, malignancy, and ____ are the most common causes of granulomas.
hemangioma
infection
splenic abscess
splenic artery aneurysm
infection
Pancreatic ductal adenocarcinoma is typically found in the _____ of the pancreas.
head
body
tail
neck
head
What sonographic artifact may be visualized with the presence of gas?
reverberation
acoustic enhancement
gas does not cause an artifact
side lobes
reverberation
A splenic abscess is commonly caused by endocarditis, septicemia and __________.
splenomegaly
Portal HTN
coughing
trauma
trauma
What are the 2 most common causes of acute pancreatitis?
low blood sugar
cancer
biliary disease
alcoholism
biliary disease
alcoholism
Which condition is associated with a midline liver and GB, absent spleen, and has right-sided predominance?
Intraperitoneal hematoma
Polysplenia
Polycythemia vera
Asplenia
Sickle cell anemia
Asplenia
The normal anteroposterior measurement of the duct of Wirsung at the level of the body is:
Less than or equal to 2 mm
Less than or equal to 1 mm
Less than or equal to 4 mm
Less than or equal to 3 mm
Less than or equal to 2 mm
Which describes the typical appearance of a mucinous cystic neoplasm?
solid hypoechoic mass
cyst w/ numerous internal septations and debris
cyst w/ numerous internal septations and debris
Which of the following are considered malignant tumors of the pancreas? mark all that apply
insulinoma
gastrinoma
serous cystic neoplasm
pancreatic ductal adenocarcinoma
mucinous cystic neoplasm
gastrinoma
pancreatic ductal adenocarcinoma
mucinous cystic neoplasm
________ are an accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum.
Pseudocysts
Serous cystadenoma
Pancreatic phlegmon
Mucinous cystic neoplasms
Pseudocysts
This pathology was formerly called microcystic cystadenoma, is typically benign and has the appearance of an echogenic mass with possible external lobulation.
Serous cystic neoplasm
IPMN
Mucinous cystic neoplasm
PDA
Serous cystic neoplasm
The sonographic appearance of this pathology is a peripheral wedge-shaped hypoechoic lesion in the spleen.
Polycythemia vera
Splenic infarct
Splenic mets
Sickle cell disease
Splenic hematoma
Splenic infarct
Enlargement of the pancreatic head may cause
Biliary obstruction
Cystic fibrosis
Ascites
Renal vein obstruction
Biliary obstruction
What is the most common hyperfunctioning GEP-NET aka islet cell tumor?
Serous cystadenoma
Gastrinoma
Insulinoma
Macrocystic cystadenoma
Insulinoma
