Pathology #2 Flashcards
Based in the images, where is the obstruction?
MPV thrombosis with dilated portal branches in the liver
distal CBD
distal hepatic duct
cystic duct
distal CBD
Which of the following biliary conditions is associated with the formation of Rokitansky-Aschoff sinuses?
emphysematous cholecystitis
adenomyomatosis
pneumobilia
choledochal cyst
adenomyomatosis
Which of the following correctly describes the abnormal response seen on an ultrasound exam when a fatty meal is given to a patient with suspected biliary obstruction?
if a biliary obstruction is present, the bile duct diameter will increase immediately after the meal
the cystic duct dilates to allow for a detailed lumen evaluation for a possible stone
if a biliary obstruction is present, the bile duct diameter will decrease immediately after the meal
if a biliary obstruction is present, the bile duct diameter will remain unchanged immediately after the meal
if a biliary obstruction is present, the bile duct diameter will increase immediately after the meal
A patient presents for an abdominal US to further evaluate findings identified on a CT exam. The CT report indicates numerous cystic structures throughout the liver that communicate with the biliary tree. Which of the following could be used to describe the expected US diagnosis?
Wilson disease
polycystic liver disease
Caroli disease or choledochal cysts
choledochal cysts or polycystic liver disease
Caroli disease or choledochal cysts
A 56 year old male presents with a history of abdominal pain. Lab testing demonstrates isolated leukocytosis. He had a recent colonoscopy that demonstrated left sided ulcerative colitis. These ultrasound findings are most suggestive of:
sclerosing cholangitis
HIV cholangitis
cholangiocarcinoma
HA stenosis
sclerosing cholangitis
Primary GB carcinoma most commonly presents as:
focal wall mass without stones
enlarged GB surrounded by fluid
small GB with thickened walls
diffusely thickened GB wall with stones
diffusely thickened GB wall with stones
Numerous liver cysts with the central dot sign are most suggestive of:
hemorrhagic cysts
Caroli disease
Von Meyenburg complexes
polycystic liver disease
Caroli disease
This patient has an increased risk of developing:
porcelain GB
GB metastasis
Marfan syndrome
nephrolithiasis
porcelain GB
Which of the following can lead to a false positive diagnosis of stones in the biliary system?
rejection setting too high
decreased color Doppler gain
shadowing from surgical clip in porta hepatis
improperly decreased TGC settings
shadowing from surgical clip in porta hepatis
Chronic cholecystitis is commonly associated with:
GB carcinoma
polyps
pancreatic head mass
increased RBC count
GB carcinoma
Because there is a risk of cholangiocarcinoma with all cases of ___, surgical resection is recommended.
choledocholithiasis
mucocele of the GB
cholelithiasis
choledochal cysts
choledochal cysts
Diffuse or focal GB wall thickening may be seen with all of the following, EXCEPT:
adenomyomatosis
acute cholecystitis
carcinoma of the GB
courvoisier GB
courvoisier GB
An US demonstrates a non-shadowing, non-mobile, echogenic foci within the GB that most likely represents:
polyp
calculus
sludge ball
porcelain GB
polyp
Primary sclerosing cholangitis significantly increases the risk of developing:
hepatic lipoma formation
pancreatic carcinoma
klatskin tumor
cholangiocarcinoma
cholangiocarcinoma
RUQ pain, positive Murphy sign, and fever are common clinical signs of:
ascites
acute cholecystitis
adenomyomatosis
appendicitis
acute cholecystitis
Which of the following causes of diffuse dilatation of the intrahepatic biliary tree, without dilatation of the extrahepatic biliary tree?
Brenner tumor
mass at the valves of Heister
mass at the Ampulla of Vater
klatskin tumor
klatskin tumor
Which of the following biliary conditions is the most common cause of acute cholecystitis?
pancreatitis
mass in the duodenum
stone lodged in cystic duct
hepatitis
stone lodged in cystic duct
Distal cholangiocarcinoma is most commonly found ___ and a klatskin tumor is most commonly found ___.
in the left lobe, in the right lobe
near the dome of the liver, in the CBD near the porta hepatis
at the junction of the right and left hepatic ducts, outside the liver in the CBD
in the extrahepatic CBD near the porta hepatis, at the junction of the right and left hepatic ducts
in the extrahepatic CBD near the porta hepatis, at the junction of the right and left hepatic ducts
What is the most likely cause for the findings on the image?
hepatitis
chronic cholecystitis
acute cholecystitis
CHF
CHF
Which of the following abnormalities is associated with the production of milk of calcium bile?
cirrhosis
chronic cholecystitis
hepatoma
acute cholecystitis
chronic cholecystitis
Which of the following statements is true regarding the image displayed?
the MPV is significantly dilated, most likely due to PHTN
the GB is normal in appearance but the CBD is significantly dilated
the GB contains a stone and the MPV is significantly dilated
the GB wall demonstrates a solid mass and the CBD is significantly dilated
the GB wall demonstrates a solid mass and the CBD is significantly dilated
A 45 year old female patient presents with nausea and vomiting, RUQ pain, fever, and increased WBC. The GB is enlarged and filled with echogenic material that does not shadow or demonstrate fluid levels. These findings are most consistent with:
emphysematous cholecystitis
adenomyomatosis
empyema of the GB
porcelain GB
empyema of the GB
Which of the following is a congenital defect that causes bile stasis, impairs liver function and is associated with medullary sponge kidney and hepatic fibrosis?
choledocholithiasis
choledochal cyst
Caroli disease
Bouveret syndrome
Caroli disease
Which of the following is a true statement regarding the displayed image?
the GB is contracted with thickened walls and polyp formation caused by adenocarcinoma
the GB is contracted with thickened walls and polyp formation caused by adenomyomatosis
the GB is contracted and contains multiple shadowing stones within the lumen
the GB is contracted with thickened walls and pus formation caused by infection
the GB is contracted with thickened walls and polyp formation caused by adenomyomatosis
What is the most common cause of pneumobilia?
pancreatitis
GB perforation
ERCP
biliary duct stones
ERCP
An inflammation of the biliary tree common in HIV patients is called:
HIV cholangitis
primary sclerosing cholangitis
pneumobilia
bacterial cholangitis
HIV cholangitis
What two acoustic artifacts are associated with biliary hamartoma formation in the liver?
reverberation and shadowing
shadowing and speed propagation
enhancement and speed propagation
comet tail and twinkle
comet tail and twinkle
The most common finding with choledochal cysts is:
cyst formation at the ampulla of Vater
cystic dilatation of the CBD
cystic dilatation of multiple intrahepatic ducts
cyst formation on the fundus of the GB
cystic dilatation of the CBD
A cholecochal cyst is:
outpouching in the GB wall
complication of a portal thrombosis
associated with angiomyolipoma
focal dilatation of the biliary tree
focal dilatation of the biliary tree
Which of the following is associated with prolonged fasting?
pyloric stenosis
steatosis
splenosis
GB sludge
GB sludge
What biliary abnormality is a common finding in patients with hemolytic anemia?
cholelithiasis
adenomyomatosis
cholecystitis
gangrenous cholecystitis
cholelithiasis
Which of the following would present with no signs of jaundice?
mucocele of the GB
a stone at the ampulla of Vater
hepatitis
sphincter of Oddi dysfunction
mucocele of the GB
What is the most common cause of cholangitis?
adenomyomatosis
choledocholithiasis
klatskin tumor
AIDS
choledocholithiasis
Which of the following correctly describes how to differentiate cholangitis from cholangiocarcinoma?
cholangitis leads to dilated extrahepatic ducts while cholangiocarcinoma leads to dilated intrahepatic ducts
cholangitis is a focal disease process while cholangiocarcinoma causes diffuse mass formation
cholangitis leads to dilated intraheptic ducts while cholangiocarcinoma leads to dilated extraheptic ducts
cholangitis is a diffuse disease process while cholangiocarcinoma causes focal mass formation
cholangitis is a diffuse disease process while cholangiocarcinoma causes focal mass formation
A 64 year old patient presents with painless jaundice. The GB is over-distended with a biliary obstruction at the level of the ampulla of Vater. Which of the following best describes this condition?
Mirizzi syndrome
Courvoisier sign
hydropic GB
choledochal cyst
Courvoisier sign
While scanning the GB, you notice several echogenic foci within the mildly thickened wall that do not demonstrate reverberation artifact. These findings are most suggestive of:
adenomyomatosis
cholesterolosis
secondary GB carcinoma
chronic cholecystitis
cholesterolosis
A patient presents for a 2 month follow up for liver transplant. Lab tests indicate abnormal LFTs, increased bilirubin and jaundice. The US exam demonstrates a new focal dilatation of the bile duct at the porta hepatis with mildly dilated intrahepatic ducts just inside the liver. The pancreas is normal. These findings are most consistent with:
mass in the ampulla of Vater
Budd Chiari
biliary stricture
choledochal cyst
biliary stricture
If pneumobilia is suspected, visualization of what acoustic artifact would support that diagnosis?
posterior enhancement
slice thickness
range resolution
ringdown
ringdown
What term describes a GB that is filled with bile is isoechoic to the liver and is difficult to identify on ultrasound?
Charcot triad
Courvoisier GB
hepatization
Mirizzi syndrome
hepatization
Which of the following is the most likely cause for the findings on the image?
Kaposi sarcoma, intrahepatic obstruction
portal thrombosis at the porta hepatis
cystic duct obstruction
tumor of the ampulla of Vater
tumor at the ampulla of Vater
** GB is enlarged with internal debris with intrahepatic ductal dilatation = extrahepatic obstruction
Cholelithiasis without cholecystitis is most likely to be seen in a patient with:
a history of recent abdominal surgery
AIDS
a history of a prolonged low fat diet
sepsis
a history of a prolonged low fat diet
Which of the following describes how to differentiate tumefactive sludge from GB carcinoma?
use color Doppler over the area of interest
give the patient a fatty meal and rescan
turn off harmonic imaging
ask the patient to perform the Valsalva maneuver
use color Doppler over the area of interest
A 66 year old female presents for an abdominal ultrasound due to bloating and pain following a recent cholecystectomy. The bile ducts demonstrate varied levels of increased echogenicity with dirty shadowing and ringdown artifact posterior to several segments. These findings are most consistent with:
cholangiocarcinoma
pneumobilia
choledocholithiasis
sclerosing cholangitis
pneumobilia
** dirty shadowing and ringdown artifact are associated with the presence of air/tissue interface
The twinkle artifact is an expected finding in cases of:
MCDK
ADPKD
adenomyomatosis
renal carbuncle
adenomyomatosis
Cholelithiasis without cholecystitis is a common finding in patients with ___, while cholecystitis without cholelithiasis is a common finding in patients ___.
CHF, with sepsis
on long-term total parenteral nutrition, on a consistently low fat diet
a consistently low fat diet, on long-term total parenteral nutrition
a consistently high diet, on a consistently low fat diet
a consistently low fat diet, on long-term total parenteral nutrition
A patient presents for an abdominal ultrasound due to nausea and vomiting. While scanning the GB, the patient asks you to take a break due to the pain caused by the transducer pressure. How should you report this to the radiologist?
patient uncooperative, unable to efficiently perform the exam
positive Homan sign
positive Morrison sign
positive Murphy sign
positive Murphy sign
A porcelain GB causes an increase in the patient’s risk for ___.
adenomyomatosis
choedocholithiasis
primary carcinoma
sclerosing cholangitis
primary carcinoma
A patient presents for an abdominal ultrasound for pain. The chart holds a recent x-ray report that states there is a possible porcelain GB present. How will this abnormality appear on the ultrasound exam?
the GB wall will demonstrate varied levels of linear calcification
the GB will be hydropic with a thickened wall and an increased risk of rupture
there is a single large stone present with a thickened GB wall
the GB will be completely packed full of small stones
the GB wall will demonstrate varied levels of linear calcification
A patient presents with a low grade fever, leukocytosis, nausea, diarrhea and LLQ pain. What is the most likely explanation for the findings on the image?
biliary stricture in the cystic duct
mass at the ampulla of Vater
primary sclerosing cholangitis
Caroli disease
primary sclerosing cholangitis
The GB wall is asymmetrically thickened with hypervascularity and perfusion defects noted on color Doppler evaluation. Intraluminal membranes and sludge are also present. What is the most likely cause for these findings?
cholesterolosis
chronic cholecystitis
gangrenous cholecystitis
adenomyomatosis
gangrenous cholecystitis
Which of the following is caused by infection or ischemia of the GB wall?
Hartmann pouch
adenomyomatosis
Bouveret syndrome
membranous gangrenous GB
membranous gangrenous GB
All of the following terms can be used to describe the findings on the image, EXCEPT:
adenomyomatosis
strawberry GB
hyperplastic cholecystosis
cholesterolosis
adenomyomatosis
A patient presents with RUQ pain after a recent endoscopy procedure. The findings on the image are most suggestive of:
retained surgical instruments
choledocholithiasis
surgical clips
pneumobilia
pneumobilia
Which of the following statements regarding GB sludge is NOT true?
sludge can appear as varied layers of echogenic material in the GB lumen
tumefactive sludge can have a sonographic appearance similar to GB carcinoma
changing patient position and rescanning the GB ca differentiate sludge from artifact
GB sludge is always associated with wall thickening
GB sludge is always associated with wall thickening
Which of the following biliary abnormalities would be an acute complication caused by a bacterial infection of the GB?
emphysematous cholecystitis
adenomyomatosis
porcelain GB
strawberry GB
emphysematous cholecystitis
A patient presents with intermittent RUQ pain and nausea. No lab information was available at the time of the ultrasound exam. The findings on the image are most suggestive of:
empyema of the GB
GB mestastasis
primary GB carcinoma
tumefactive sludge
GB metastasis
** most commonly presents as an intraluminal mass without associated stones
If gallstone impaction is suspected:
scan the patient in multiple positions to attempt to move the stone
place the patient in the LLD position and ask the patient to perform the Valsalva maneuver to attempt to move the stone
place the patient in the LLD position and tap the patient’s back between the scapulas with the base of your wrist to attempt to move the stone
ask the patient to stand during the exam and perform the Valsalva maneuver to attempt to move the stone
scan the patient in multiple positions to attempt to move the stone
A patient with choledochal cysts has an increased risk of developing ___.
PHTN
cholangiocarcinoma
polycystic liver disease
biliary atresia
cholangiocarcinoma
Which image demonstrates a GB with characteristics of adenomyomatosis?
A 4 month old presents for an abdominal ultrasound following a recent Kasai procedure. Which of the following ultrasound findings would indicate the procedure was a success?
echogenic graft connecting the hepatic and portal venous systems in the liver with flow velocity greater than 40cm/s
normal liver echotexture with normal biliary duct diameter
echogenic mesh in the abdominal wall used to close an umbilical hernia
echogenic mesh in the abdominal wall used to close an inguinal hernia
normal liver echotexture with normal biliary duct diameter
Which of the following describe how to differentiate adenomyomatosis of the GB from cholesterolosis of the GB?
the polyps in cholesterolosis do not exhibit the comet tail artifact but polyps with adenomyomatosis do
the polyps in adenomyomatosis do not exhibit the comet tail artifact but polyps with cholesterolosis do
adenomyomatosis is usually focal process and cholesterolosis is a diffuse process
adenomyomatosis is usually a diffuse process and cholesterolosis is a focal process
the polyps in cholesterolosis do not exhibit the comet tail artifact but polyps with adenomyomatosis do
What structure is indicated by #3?
CBD
MPV
IVC
splenic vein
MPV
An 85 year old patient presents with a history of epigastric pain. Lab values are normal. The exam demonstrates normal intrahepatic ducts and a 10mm CBD that appears patent. The pancreas appears normal. What is the most likely reason for the 10mm CBD?
the obstruction in the CBD must be due to biliary stricture which is hard to visualize sonographically
the patient most likely has PHTN which can cause ductal dilatation
the CBD normally dilates with age
cholangitis usually only affects the CBD and can lead to a focal extrahepatic dilatation
the CBD normally dilates with age
Which of the following correctly describes how to differentiate a large gallstone ( >3cm ) from a porcelain GB?
a large gallstone and porcelain GB are not easily differentiated sonographically
the posterior wall of the GB can be evaluated in patients with porcelain GB but not in patients with a large stone
a gallstone will demonstrate significant posterior shadowing but there is no shadowing associated with the wall calcification seen with a porcelain GB
the gallstone can be located in any part of the GB while porcelain calcification only affects the GB fundus
the posterior wall of the GB can be evaluated in patients with porcelain GB but not in patients with a large stone
Acaculous cholecystitis is a common finding in all of the following, EXCEPT:
AIDS
a history of a prolonged low fat diet
sepsis
a history of recent abdominal surgery
a history of a prolonged low fat diet
What structure is indicated by #1?
MPV
CBD
splenic vein
HA
CBD
The bile duct diameter should be measured with the calipers placed from:
inner wall to outer wall
inner wall to inner wall
leading edge to leading edge
outer wall to outer wall
inner wall to inner wall
Acute cholecystitis can lead to a prominent ___ and its branches with color Doppler evaluation of the thickened GB wall.
LHA
proper HA
common HA
cystic artery
cystic artery
An impacted stone in the GB neck increases the risk of developing:
cholecystitis and gangrene
stones and dilatation in the intrahepatic ducts
stones and dilatation in the extrahepatic ducts
adenomyomatosis and polyp formation
cholecystitis and gangrene
A 6 year old female presents with recent weight loss and mild jaundice. Lab values demonstrate normal WBC levels, but increased levels of direct bilirubin, ALP and PT. The GB demonstrates a small wall mass that is isoechoic to the wall tissues. The wall measures 4.5mm in maximum thickness. Multiple stones are present within the lumen. Which of the following best describes the findings on the image?
acute cholecystitis, polyp formation and cholethiasis
primary GB carcinoma and cholelithiasis
acute cholecystitis and cholelithiasis
adenomyomatosis
primary GB carcinoma and cholelithiasis
A patient has a history of adenomyomatosis of the GB. What acoustic artifact is expected to be present on the US images of the GB?
volume averagig
mirror image
side lobe
comet tail
comet tail
Mirizzi syndrome is caused by obstruction of the ___, while Courvoisier GB is related to obstruction of the ___.
cystic duct, distal CBD
intrahepatic CBD, extrahepatic CBD
proximal CBD, distal CBD
distal CBD, cystic duct
cystic duct, distal CBD
The WES sign indicates a diagnosis of:
cholelithiasis
porcelain GB
GB adenocarcinoma
tumefactive sludge
cholelithiasis
What biliary anomaly is suspected if jaundice persists more than 14 days after birth?
choledochal cyst
biliary atresia
agenesis of the GB
ectopic GB
biliary atresia
Which of the following are types of hyperplastic cholecystosis?
adenomyomatosis and cholesterolosis
perforation and pericholecystic fluid
cholelithiasis and choledocholithiasis
sludge and tumefactive sludge
adenomyomatosis and cholesterolosis
An otherwise asymptomatic patient presents for an abdomen ultrasound due to elevated LFTs. The GB demonstrates thickened walls with an irregular internal contour. Several small echogenic foci are noted within the wall and each exhibits a comet tail artifact. Which of the following conditions is identified on this exam?
cholesterol polyps
emphysematous cholecystitis
chronic cholecystitis
adenomyomatosis
adenomyomatosis
A patient presents with RUQ pain and nausea 1 week post-cholecystectomy. The findings on the image are most suggestive of:
pneumobilia
abscess formation in GB fossa
porcelain GB
biloma formation in GB fossa
abscess formation in GB fossa
** note the irregular mass in the fossa with echogenic foci, debris, and dirty shadowing consistent with pus formation and air pockets from the bacteria
Which of the following statements best describes the findings on the image?
there is a polyp located on the posterior wall of the GB fundus
there is a polyp located on the inferior wall of the GB neck
there is a polyp located on the inferior wall of the GB fundus
the GB demonstrates a cholesterol polyp with the comet tail artifact
there is a polyp located on the inferior wall of the GB neck
Which type of GB disease is more common in males and diabetic patients?
chronic cholecystitis
cholangitis
emphysematous cholecystitis
GB perforation
emphysematous cholecystitis
Acute cholecystitis is associated with GB wall thickening ___. Cholangitis is associated with ductal wall thickening ___.
> 2mm, >3mm
3mm, >2mm
3mm, >5mm
6mm, >3mm
> 3mm, >2mm
Which of the following is NOT true regarding milk of calcium bile?
lumen filled with highly echogenic material with shadowing
related to hyperfunction of the GB
layering of bile/calcium with change of patient position
also called limey bile
related to hyperfunction of the GB
GB polyps measuring greater than ___ in diameter are highly suspicious for malignancy.
5mm
10mm
15mm
20mm
10mm
A 6 month old Asian female presents with jaundice and fever. While scanning the liver, you note a 1cm anechoic, round dilatation of the extrahepatic CBD at the porta hepatis. Color Doppler does not demonstrate flow within the structure. Which of the following is the most likely diagnosis?
choledochal cyst
pneumobilia
cholangitis
pseudoaneurysm of the HA
choledochal cyst
Tumefactive sludge can be found in:
renal pelvis
paracolic gutters
GB
gastric antrum
GB
A new liver mass in a patient with sclerosing cholangitis should cause suspicion of:
the development of schistosomiasis
the development of cholangiocarcinoma
a peribiliary leak
PHTN
the development of cholangiocarcinoma
Jaundice is a complication of:
steatosis and hemangiomas
ductal obstruction and RBC destruction
steatosis and polycystic liver disease
ductal obstruction and WBC destruction
ductal obstruction and RBC destruction
Which of the following is a cause of parasitic cholangitis?
biliary ascariasis
ulcerative colitis
HIV infection
gram negative bacteria
biliary ascariasis
Which of the following is associated with the findings on the image displayed?
adenocarcinoma formation in the pancreatic head
obstruction of the ampulla of Vater
Krukeberg tumor formation in the duodenum
more than one of the above
more than one of the above
A non-infectious cause of acalculous cholecystitis is ___ and an infectious cause of acalculous cholecystitis is ___.
HIV, viscous bile
CHF, total parenteral nutrition
total parenteral nutrition, HIV
viscous bile, Mirizzi syndrome
total parenteral nutrition, HIV
Which of the following is least likely to be associated with GB sludge?
cystic duct obstruction
elevated cholecystokinin levels
fasting
alcoholism
elevated cholecystokinin levels
An infant is referred for an abdominal sonogram due to prolonged jaundice after birth. A small triangular echogenic area is identified at the portal vein bifurcation, but no definite extrahepatic duct is noted. The GB is very small and abnormally shaped. These findings are most suggestive of:
biliary atresia
Caroli disease
biliary ascariasis
choledochal cyst
biliary atresia
A choledochocele is:
a collection of bile that forms around a perforated GB
a cyst of the intraduodenal portion of the duct
a type of cyst that forms at the terminal ducts in the biliary tree
an intrahepatic collection of bile that forms around a major branch of the biliary tree
a cyst of the intraduodenal portion of the duct
What structure is indicated by #2?
CBD
MPV
HA
splenic vein
HA
A 35 year old male patient presents for a RUQ ultrasound due to pain, increased ALP and conjugated bilirubin. You identify dilated intrahepatic ducts in both lobes of the liver, while CBD and GB appear within normal limits. Which of the following describes the cause of these findings?
stone in the right hepatic duct
stone in the common hepatic duct
stone in the left hepatic duct
biliary atresia
stone in the common hepatic duct
** dilated intrahepatic ducts = obstruction at the CHD
Tumefactive sludge would demonstrate a sonographic appearance similar to all of the following, EXCEPT:
membranous gangrenous cholecystitis
secondary GB carcinoma
benign polyp
primary GB carcinoma
membranous gangrenous cholecystitis
The complications caused by a large gallstone in the duodenum obstructing the gastric outlet are collectively referred to as:
Courvoisier syndrome
Mirizzi syndrome
Marfan syndrome
Bouveret syndrome
Bouveret syndrome = large gallstone in the duodenum that causes an obstruction of the gastric outlet
A long standing, partial obstruction of the cystic duct will most likely lead to which of the following?
mucocele of the GB
porcelain GB
septated GB
Hartmann pouch
mucocele of the GB
Obstruction of the CBD by a pancreatic head mass will lead to:
contracted, small GB with normal biliary tree
dilated GB and biliary tree
contracted, small GB with dilated biliary tree
all of the above are potential findings
dilated GB and biliary tree
A biloma is:
associated with malignancy of the biliary tree
a possible complication of left renal surgery
a collection of bile in the peritoneal cavity
a congenital malformation of the biliary tree
a collection of bile in the peritoneal cavity
If the common hepatic duct is obstructed, how will this affect the other biliary structures?
contracted GB and dilated intrahepatic ducts
dilated GB and dilated intrahepatic ducts
dilated extrahepatic ducts
contracted GB and dilated extrahepatic and intrahepatic ducts
contracted GB and dilated intrahepatic ducts
A patient presents for an abdomen ultrasound with RUQ pain, nausea, fever, and leukocytosis. An abnormal enlarged GB demonstrates thickened walls at 1.2cm. An anterior segment of the wall is echogenic and ringdown artifact and dirty shadowing are present posterior to this area. Which of the following conditions is identified on this exam?
emphysematous cholecystitis
adenomyomatosis
chronic cholecystitis
cholesterol polyps
emphysematous cholecystitis
Bacterial cholangitis is nearly always seen with:
HIV cholangitis
ductal obstruction by a stone or tumor
ulcerative colitis
biliary ascariasis
ductal obstruction by a stone or tumor
Which of the following GB abnormalities have a very similar appearance on ultrasound evaluation and clinical history is necessary for differentiation?
chronic cholecystitis and Courvoisier GB
porcelain GB and tumefactive sludge
acalculous cholecystitis and adenomyomatosis
hemobilia and sludge
hemobilia and sludge
