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ARDMS ABD REVIEW > Pathology #5 > Flashcards

Pathology #5 Flashcards

1
Q

Which of the following is commonly associated with the abnormality on the image?

radiation exposure
down syndrome
tuberculosis
all of the above

A

all of the above

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2
Q

Which of the following is most suggestive of Ormond disease?

extrinsic compression of the celiac artery
pedal edema and scrotal swelling
bilateral staghorn calculi and posterior urethral valves
aortic arch aneurysm formation

A

pedal edema and scrotal swelling

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3
Q

Bacterial orchitis is most commonly caused by ___, while viral orchitis is most commonly caused by ___.

STDs, mumps
trauma, HIV
trauma, recent vasectomy
recent vasectomy, STD

A

STDs, mumps

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4
Q

The bell clapper deformity is a predisposing factor for testicular torsion. It is defined as:

the testicles are connected by thick dermal tissue and cannot move separately

the tunica vaginalis completely encircles the epididymis, distal spermatic cord, and testis

the epididymis floating freely in the scrotal sac

the tunica albuginea completely encircles the epididymis, distal spermatic cord, and testis

A

the tunica vaginalis completely encircles the epididymis, distal spermatic cord, and testis

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5
Q

Which of the following is true regarding hydrocele formation?

most hydroceles are due to infection
usually contains mucinous fluid
accumulation of serous fluid between the two layers of the tunica vaginalis
most common cause of acute scrotal pain

A

accumulation of serous fluid between the two layers of the tunica vaginalis

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6
Q

A thyroglossal duct cyst is most commonly found:

posterior to the ear at the level of the thyroid gland

on the midline neck, superior to the thyroid gland

near the angle of the mandible

within the isthmus of the thyroid gland

A

on the midline neck, superior to the thyroid gland

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7
Q

A patient presents with a small, palpable extratesticular mass on the left side. The US exam demonstrates a mobile, hyperechoic mass with posterior shadowing. Which of the following best describes the findings?

scrotal pearl
adenomatoid tumor
abscess
microlithiasis

A

scrotal pearl

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8
Q

A hypoechoic thyroid mass with microcalcifications, hypervascularity and no halo sign is most consistent with:

goiter
hyperfunctioning adenoma
papillary carcinoma
neuroma

A

papillary carcinoma

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9
Q

Which of the following has the highest risk of developing thyroid cancer?

parathyroid adenoma
Hashimoto thyroiditis
Graves’ disease
cirrhosis

A

Hashimoto thyroiditis

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10
Q

Retrograde flow in the common hepatic artery and splenic artery is highly suggestive of:

mesenteric ischemia
SMA occlusion
celiac artery occlusion
PHTN

A

celiac artery occlusion

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11
Q

Which of the following are the most common primary carcinomas to metastasize to the thyroid?

breast and lung
liver and spleen
stomach and GB
lung and bone

A

breast and lung

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12
Q

The halo sign is a sonographic characteristic of what thyroid abnormality?

adenoma
complex cyst
germ cell tumor
papillary carcinoma

A

adenoma

**60% of thyroid adenomas demonstrate a thin, echolucent rim known as the halo sign

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13
Q

Which of the following statements is true regarding the findings on the image?

radiation treatment of the breast cancer can lead to these findings

CHF can be associated with the findings on the image

the groin should be evaluated for serpiginous vessels related to the hydrocele

nutcracker syndrome can be associated with the findings on the image

A

CHF can be associated with the findings on the image

**notice scrotal wall thickening
normal scrotal wall thickness <8mm

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14
Q

A patient presents with acute scrotal pain after a 2 mile run. Which of the following statements best describes the findings on the image?

there is a hypoechoic avascular mass within the body of the epididymis. The head of the epididymis and testicle appear normal. These findings are consistent with epididymal torsion.

the testicle is abnormal with an occluded varicocele and loss of arterial inflow due to testicular congestion

both testicles are abnormal with no internal flow detected. the left testicle is severely atrophied. these findings are consistent with bilateral chronic torsion

the testicle and epididymis have abnormal echotexture and absence of normal internal flow. these findings are consistent with complete testicular torsion.

A

the testicle and epididymis have abnormal echotexture and absence of normal internal flow. these findings are consistent with complete testicular torsion.

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15
Q

Cervical lymphadenopathy is a common finding with:

papillary thyroid carcinoma
branchial cleft cyst
parathyroidism
hyperfunctioning thyroid adenoma

A

papillary thyroid carcinoma

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16
Q

When an AAA ruptures, which retroperitoneal space will fill with blood first?

omental bursa
anterior pararenal
posterior pararenal
perirenal

A

perirenal

**perirenal or perinephric space encloses the kidneys, adrenals, portions of the IVC and AO

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17
Q

The IVC is dilated and the spontaneous contrast phenomenon is seen in the proximal segment. Which of the following is the most likely cause?

CHF
hemophilia
dehydration
PHTN

A

CHF

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18
Q

Gonadal stromal tumors should be suspected in a patient with a painless testicular mass and:

hematuria
elevated AFP levels
gynecomastia
scrotal varicosities

A

gynecomastia

**gynecomastia and impotence cause gonadal stromal tumors (Leydig cell and Sertoli cell)

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19
Q

Epididymitis most commonly results from ___ in males 14-35years old and ___ in men over 35 years old.

bladder infection, STDs
poor hygiene, torsion
STDs, bladder infection
torsion, poor hygiene

A

STDs, bladder infection

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20
Q

A referring doctor requests a scrotal US to rule out orchitis. Which of the following is an expected sonographic finding for this abnormality?

hyperechoic testicle
hematocele
multiple small cysts within the testicle
increased intratesticular vascularity

A

increased intratesticular vascularity

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21
Q

Which of the following is the least likely complication of the pathology demonstrated on the ultrasound image?

blue toe syndrome
rupture
embolism
DVT

A

DVT

**occurs with thrombus formation in the deep venous system NOT in the AO

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22
Q

A patient presents with a history of a 5mm Leydig cell tumor identified on an exam 6 months ago. What is a common complication of this type of neoplasm?

gynecomastia
cellulitis
varicocele
metastasis

A

gynecomastia

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23
Q

The most common location for an aortic aneurysm is:

juxtarenal
suprarenal
aortic arch
infrarenal

A

infrarenal

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24
Q

Aneurysms of the iliac and popliteal arteries are commonly associated with:

prostate carcinoma
aortic aneurysm
renal failure
pancreatic pseudocysts

A

aortic aneurysm

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25
Q

The findings on the image are most suggestive of:

thyroglossal cyst
parathyroid adenoma
reactive lymph node from infection
normal lymph node

A

thyroglossal cyst

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26
Q

The abnormality on the images is a confirmed sperm granuloma. This is a common chronic complication of what procedure?

vasectomy
scrotal aspiration
hernia repair
testicular biopsy

A

vasectomy

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27
Q

An abdominal US is ordered for a patient with bilateral pedal edema. The abdomen demonstrates mild ascites but otherwise normal organs. The IVC appears prominent with a constant diameter of 2.8cm. These findings are most suggestive of:

PHTN
CHF
malignant HTN
all of the above

A

CHF

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28
Q

Extrinsic compression of the IVC is an expected finding with:

pancreatic pseudocyst or PHTN
CHF or mass in the diaphragmatic crura
large AAA or large hepatoma
CHF or large AAA

A

large AAA or large hepatoma

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29
Q

The most common extra-testicular neoplasm is:

adenomatoid tumor
lipoma
hamartoma
AV malformation

A

adenomatoid tumor

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30
Q

A vein in the pampiniform plexus is considered abnormally dilated when the diameter exceeds:

6mm
8mm
2mm
4mm

A

2mm

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31
Q

Which of the following correctly describes a difference between De Quervain and Hashimoto thyroiditis?

De Quervain thyroiditis causes hypothyroidism, Hashimoto thyroiditis causes hyperthyroidism

De Quervain thyroiditis causes hyperthyroidism, Hashimoto thyroiditis causes hypothyroidism

De Quervain thyroiditis is caused by a virus, Hashimoto thyroiditis is caused by bacteria

De Quervain thyroiditis has no effect on TSH levels, Hashimoto thyroiditis causes a significant decrease in TSH levels

A

De Quervain thyroiditis is caused by a virus, Hashimoto thyroiditis is caused by bacteria

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32
Q

Graves’ disease refers to a type of:

carcinoma
multinodular goiter
hypothyroidism
hyperthyroidism

A

hyperthyroidism

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33
Q

Serpiginous vessels are identified on the examinations of patients with:

PHTN or testicular varicoceles
situs inversus and organ agenesis
renal artery and mesenteric artery stenosis
renal or liver transplants

A

PHTN or testicular varicoceles

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34
Q

Chronic moderate CHF can cause this tributary of the IVC to be visualized sonographically due to the formation of collateral pathway.

azygous vein
portal vein
coronary vein
umbilical vein

A

azygous vein

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35
Q

Median arcuate ligament syndrome involves compression of which vessel during respiration?

inferior mesenteric artery
MPV
SMA
celiac axis

A

celiac axis

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36
Q

A patient with a seminoma of the left testicle will usually be treated by ___, while a patient with a non-seminomatous tumor of the left testicle will usually be treated by ___.

unilateral orchiectomy and chemotherapy; unilateral orchiectomy

bilateral orchiectomy; unilateral orchiectomy

unilateral orchiectomy; radiation therapy and unilateral orchiectomy

chemotherapy; radiation therapy

A

unilateral orchiectomy and chemotherapy; unilateral orchiectomy

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37
Q

What is the best way to differentiate an undescended testicle from other inguinal masses?

identify the epididymis
identify the mediastinum testis
identify the presence of internal vascularity
identify the spermatic cord extending to the scrotal sac

A

identify the mediastinum testis

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38
Q

A mass is identified in the left testicle. It is rounded with well-defined borders. There are internal rings of hyperechoic and hypoechoic tissues giving the appearance of an onion. No color flow is demonstrated within the mass. These findings are most consistent with:

sperm granuloma
epidermoid cyst
dilated rete testes
testicular infarct

A

epidermoid cyst

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39
Q

A 1 year old presents for a testicular sonogram due to a palpable lump. The lab work in the chart indicates high levels of AFP. A mostly solid intratesticular mass is identified in the right testicle. There is a small area of possible necrosis centrally. These findings are most consistent with:

yolk sac tumor
lymphoma
epidermoid cyst
seminoma

A

yolk sac tumor

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40
Q

All of the following are risk factors for thyroid cancer, EXCEPT:

diagnosis of (MEN) syndrome

personal history of previous papillary cancer

family history of hypercalcemia

personal history of radiation treatment of a cerebral malignancy

A

family history of hypercalcemia

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41
Q

Primary testicular carcinoma is usually ___ and secondary testicular malignancy is usually ___.

heterogenous, isoechoic
hypoechoic, isoechoic
unilateral, bilateral
hypervascular, hypovascular

A

unilateral, bilateral

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42
Q

According to the DeBakey Classification system, what type of aortic dissection is most commonly associated with Marfan syndrome?

type I
type II
type III
type IV

A

type II

**DeBakey Classification
type I - ascending and descending AO
type II - ascending AO, Marfan syndrome, least common
type III - descending AO, lowest mortality rate

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43
Q

A right adrenal mass will displace the IVC:

inferiorly
posteriorly
superiorly
anteriorly

A

anteriorly

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44
Q

What technique can be used to differentiate a seminoma and an adenomatoid tumor?

scan the patient in standing position
scan the patient in the Trendelenburg position
apply gentle transducer pressure to the affected testicle
ask the patient to perform the Valsalva maneuver

A

apply gentle transducer pressure to the affected testicle

seminomas - intratesticular
adenomatoid tumors - extratesticular

gentle pressure can be used to demonstrate an extratesticular mass can move independently of testis

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45
Q

Patients with ___ have a significantly increased risk of developing a seminoma.

hydrocele
cryptorchidism
varicocele
diabetes

A

cryptorchidism

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46
Q

Which of the following correctly describes papillary thyroid cancer?

most masses are complex cysts with thick and nodule formation

most commonly presents as a hypoechoic mass with calcifications

has a very high mortality rate

associated with colloid cyst formation

A

most commonly presents as a hypoechoic mass with calcifications

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47
Q

Which of the following findings are seen on the image?

orchitis, intratesticular cyst and extratesticular varicocele

orchitis and intratesticular cyst

intratesticular and extratesticular varicocele

intratesticular cyst and extratesticular variocele

A

intratesticular cyst and extratesticular variocele

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48
Q

Regarding the AO, fusiform aneurysm formation usually occurs in the ___ while dissecting aneurysms usually occur in the ___.

proximal abdominal AO, thoracic AO
aortic arch, distal abdominal AO
distal abdominal AO, thoracic AO

A

distal abdominal AO, thoracic AO

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49
Q

Which of the following statements best describes the Doppler tracing found within the body of a pseudoaneurysm?

high resistance to and fro flow
low resistance to and fro flow
phasic forwards flow
continuous forward flow

A

low resistance to and fro flow

** body will demonstrate a low resistance “swirling” flow

neck/stalk will demonstrate a high resistance, biphasic flow

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50
Q

A 16 year old male presents with acute onset of significant left scrotal pain. The US exam reveals a 1cm hypoechoic, heterogenous mass located between the head of the epididymis and the testicle. The mass demonstrates no vascularity with color Doppler evaluation. Normal flow is demonstrated in the epididymis and testicle. These findings are most suggestive of:

adenomatoid tumor
torsion of the appendix testis
seminoma
sarcoidosis

A

torsion of the appendix testis

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51
Q

Which of the following statements best describes the findings on the image?

the arrows indicate a remnant of the Mullerian duct and a scrotal calcification

the arrows indicate two scrotal calcifications, one much older than the other

chronic atrophy of the epididymis has led to a very small epididymal head and calcified tail portion

the arrows indicate two extratesticular neoplasms, one is solid and the other is calcified

A

the arrows indicate a remnant of the Mullerian duct and a scrotal calcification

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52
Q

A patient presents for a thyroid US due to increased T3 and T4 levels in the blood. Additional symptoms include weight loss, night sweats and exophthalmos. The thyroid demonstrates an increase in size and a diffuse decrease in echogenicity with a coarse, heterogeneous texture. Which of the following best describes these findings?

Graves’ disease
Hurthle Cell cancer
Goiter
Hashimoto disease

A

Graves’ disease

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53
Q

Which testicular tumor will cause b-hCG levels to rise but AFP levels will be normal?

yolk sac tumor
choriocarcinoma
epidermoid cyst
embryonal cell carcinoma

A

choriocarcinoma

54
Q

What is the arrow pointing to on the midline view of the abdomen?

IVC thrombosis
recanalized umbilical vein
gastroesophageal junction
lymphadenopathy

A

IVC thrombosis

55
Q

A small, hypoechoic testicular mass with a large calcification in a patient with gynecomastia is most likely a:

embryonal cell carcinoma
sertoli cell tumor
lymphoma
seminoma

A

sertoli cell tumor

56
Q

The most common cause of acute scrotal pain in postpubertal men is:

torsion
acute epididymitis
orchitis
hydrocele

A

acute epididymitis

57
Q

Which of the following statements is true regarding the image displayed?

the parathyroid adenoma causes reduced calcium excretion by the intestines leading to serum hypercalcemia and potential renal stone formation

the parathyroid adenoma causes decreased calcium absorption in the intestines leading to the formation of renal calculi

the thyroid adenoma causes decreased calcium absorption in the intestines leading to increased calcium concentrations in the blood filtered by the kidneys which may cause the formation of renal calculi

the thyroid adenoma causes calcium filtration in the kidneys leading to the formation of renal calculi

A

the parathyroid adenoma causes reduced calcium excretion by the intestines leading to serum hypercalcemia and potential renal stone formation

58
Q

The most common cause for fluid collection in the perirenal space is ___. The most common cause for fluid collection in the posterior pararenal space is ___.

renal abnormalities, aortic disease
pancreatic disease, renal disease
aortic disease, renal abnormalities
small bowel infection, colitis

A

renal abnormalities, aortic disease

59
Q

A patient presents with mild testicular pain that has increased over the last few months. The US exam demonstrates a normal right testicle. The left testicle demonstrates many tiny cysts clustered centrally along the mediastinum. No color flow is identified within the cystic structures. Which of the following best describes the findings?

varicocele
spermatocele
tubular ectasia
cystadenoma

A

tubular ectasia - dilated testicular mediastinal tubules

60
Q

A patient presents for a scrotal ultrasound following a recent herniorrhaphy. The findings on the image are most consistent with:

dilated rete testis
filariasis
orchitis
intratesticular varicocele

A

intratesticular varicocele

61
Q

A 65 year old male patient presents with bilateral scrotal swelling and mild pain. The US exam demonstrates bilateral hypoechoic, solid masses within the testicular parenchyma. Which of the following is the most likely diagnosis for the findings?

bilateral orchitis
choriocarcinoma
bilateral seminoma
lymphoma

A

lymphoma

62
Q

Which of the following Doppler findings is most consistent with uncomplicated epididymo-orchitis?

high resistance flow, RI 0.2
low resistance flow, RI 0.8
high resistance flow, RI 1.2
low resistance flow, RI 0.4

A

low resistance flow, RI 0.4

63
Q

Which of the following statements describes the appearance of a testicular prosthetic on the US image?

solid, oblong structure with homogenous, hypoechoic texture compared to the native teste

solid, round structure with homogenous, hypoechoic texture compared to the native teste

homogenous, hypoechoic structure with sound attenuation posteriorly causing decreased visibility of the posterior borders of the prosthesis

round structure with reflective borders and an anechoic lumen

A

round structure with reflective borders and an anechoic lumen

64
Q

Which of the following Doppler findings is most suggestive of partial testicular torsion?

asymmetric resistive indices on the intratesticular Doppler evaluations

increased diastolic flow velocities with a very low resistive index on the affected side

increased diastolic flow velocities with a very high resistive index on the affected side

antegrade flow throughout the cardiac cycle

A

asymmetric resistive indices on the intratesticular Doppler evaluations

65
Q

All of the following are associated with an increased risk of thyroid malignancy, EXCEPT:

wider than tall mass orientation
absence of the halo sign
psammoma bodies
intranodular flow patterns

A

wider than tall mass orientation

66
Q

A right renal mass will displace the IVC:

superiorly
medially
inferiorly
laterally

A

medially

67
Q

If an abdominal aortic aneurysm is identified, what two other vessels should be evaluated for associated aneurysm formation?

celiac axis and superior mesenteric aneurysm

common femoral and popliteal arteries

bilateral renal arteries

inferior and superior vena cava

A

common femoral and popliteal arteries

68
Q

Which of the following is an intratesticular mass associated with Cushing syndrome and adrenal hyperplasia?

epidermoid cyst
adrenal rest
mixed germ cell tumor
yolk sac tumor

A

adrenal rest

69
Q

Hashimoto disease is the most common type of ___ and leads to ___.

hypothyroidism, nodule formation
hyperthyroidism, goiter formation
hyperthyroidism, diffuse enlargement of gland
hypothyroidism, diffuse enlargement of gland

A

hypothyroidism, diffuse enlargement of gland

70
Q

A 30 year old male presents with fever, malaise, and mild to moderate right scrotal pain that began 3 days ago. Lab results indicate leukocytosis is present. The right testicle demonstrates mild diffuse heterogeneity. PW Doppler evaluation of the affected side produces a waveform with peaked antegrade systolic flow and diastolic flow reversal. These findings are most suggestive of:

testicular rupture
acute orchitis with venous infarction
partial torsion
uncomplicated acute orchitis

A

acute orchitis with venous infarction

71
Q

A patient presents with a new onset of scrotal pain and a low grade fever. Which statement below offers the most accurate summary of findings?

there is a complicated fluid collection compressing the testicle

the spermatic cord is torsed and the scrotal sac is becoming edematous and inflamed

the patient has tubular ectasia of the rete testis

there is a varicocele present

A

there is a complicated fluid collection compressing the testicle

72
Q

A patient presents for their annual screening ultrasound after a complete thyroidectomy due to papillary carcinoma. You identify a 1cm uniformly hypoechoic mass lateral to the trachea. The mass is painful with transducer pressure and pain radiates to the head and chest. These findings are most suggestive of:

post-traumatic neuroma
parathyroid adenoma
abnormal lymph node
parathyroid carcinoma

A

post-traumatic neuroma

73
Q

The findings on the image are most suggestive of:

right heart failure
cirrhosis
Budd Chiari Disease
PHTN

A

right heart failure

74
Q

Which of the following describes an adenomatoid tumor?

hypovascular testicular tumor
a benign intrascrotal tumor
hypervascular testicular tumor
a benign intratesticular tumor

A

a benign intrascrotal tumor (extratesticular)
**hypovascular mass in the tail of the epididymis

75
Q

A 28 year old presents for a testicular sonogram due to a palpable lump. The lab work in the chart indicates high levels of AFP and b-hCG. A mostly solid intratesticular mass is identified in the right testicle that disrupts the smooth contour of the teste. There is a small cystic area centrally. These findings are most suggestive of:

embryonal cell carcinoma
lymphoma
seminoma
yolk sac tumor

A

embryonal cell carcinoma

76
Q

Which type of thyroid cancer is most lethal?

medullary
follicular
papillary
anaplastic

A

anaplastic

77
Q

Which of the following statements is correct regarding testicular seminoma?

spreads to liver first with metastasis
most common in African American males
unresponsive to radiation and chemotherapy
associated with cryptorchidism, trisomy 21, Klinefleter syndrome, and smoking

A

associated with cryptorchidism, trisomy 21, Klinefleter syndrome, and smoking

78
Q

A patient presents with a fever, scrotal swelling and leukocytosis. Which of the following statements is correct regarding the image?

Power Doppler demonstrates normal vascularity of the scrotum testicle with neoplasm formation within the testicle

Power Doppler demonstrates no flow within the hypoechoic testicle with scrotal inflammation

the focal hypoechoic area represents focal orchitis within the testicle

Power Doppler demonstrates an avascular intratesticular mass with increased peripheral vascularity

A

Power Doppler demonstrates an avascular intratesticular mass with increased peripheral vascularity

79
Q

A benign thyroid adenoma is associated with ___ calcification(s), while malignant adenomas are associated with ___ calcification(s).

punctuate, coarse
large, coarse
punctuate, fine
eggshell, punctuate

A

eggshell, punctuate

79
Q

Which of the following statements best describes the findings on the image?

the testicle demonstrates a dilated rete testes

there is a hydrocele and appendix testis visible on the image

the image is a normal scrotal ultrasound with a normal testicle with the appendix testis demonstrated

there is a hydrocele present on the image

A

there is a hydrocele and appendix testis visible on the image

79
Q

Which of the following is most likely to be affected by a mumps infection?

thyroid gland
renal vein
parotid gland
prostate

A

parotid gland

80
Q

Which of the following statements is true regarding the image of the left testicle?

the Valsalva maneuver was used to demonstrate the increased vascular flow within the testicle

the image demonstrates a normal testicle

the patient should be rescanned while standing

the hypervascularity suggests orchitis

A

the hypervascularity suggests orchitis

81
Q

Which of the following is most likely to cause anterior displacement of the abdominal AO?

pleural effusion
lymphadenopathy
ascites
mass in the left diaphragm crura

A

lymphadenopathy

82
Q

A patient presents with a palpable scrotal mass. There is no evidence of fever. AFP levels are normal and b-hCG levels are elevated. These findings are most suggestive of?

embryonal cell tumor
epidermoid cyst
yolk sac tumor
seminoma

A

seminoma

83
Q

A patient presents with a fever, fatigue, hoarseness, and a painful thyroid on clinical examination. The lab test results indicate low levels of TSH and high levels of T3 and T4. These findings are most suggestive of:

Hashimoto thyroiditis
De Quervain thyroiditis
Grave disease
Sjrogen disease

A

De Quervain thyroiditis

** type of hypothyroidism that is PAINFUL, Hashimoto thyroiditis is painless

84
Q

Which of the following vessels are a common source for a Type II endoleak?

left gastric artery and right hepatic artery
celiac axis and SMA
common iliac artery and gonadal arteries
IMA and lumbar arteries

A

IMA and lumbar arteries

85
Q

Lack of tapering of the AO as it travels distally, without focal dilatation, indicates:

Marfan syndrome
retroperitoneal fibrosis
fusiform aneurysm
ectasia

A

ectasia

86
Q

A patient presents for a neck ultrasound that has history of papillary carcinoma and bilateral thyroidectomy. What area of the neck is most commonly involved in recurrence?

level I lymph nodes below mylohyoid muscle to the lower margin of the hyoid bone

level III and IV lymph nodes between the carotid artery and the sternocleidomastoid muscle

level VI lymph nodes from the inferior margin of hyoid bone to the manubrium

level VII lymph nodes infraclavicular and anterior mediastinal

A

level III and IV lymph nodes between the carotid artery and the sternocleidomastoid muscle

87
Q

Increased thyroid volume is associated with:

chronic renal failure
chronic hepatitis
radioactive iodine treatment
thyroxine treatment

A

chronic renal failure

88
Q

Which of the following statements best describes the Doppler tracing found in the stalk of a pseudoaneurysm?

continuous forward flow
high resistance to and fro flow
phasic forward flow
low resistance to and fro flow

A

high resistance to and fro flow

89
Q

Which of the following are associated with an increased risk of thyroid malignancy?

wider than tall mass orientation and intranodular cystic changes

prominent halo around mass and intranodular cystic changes

prominent halo around mass and intranodular flow patterns

psammoma bodies and intranodular flow patterns

A

psammoma bodies and intranodular flow patterns

90
Q

When evaluating a patient with an aortic endograft, what is the minimum increase in aortic sac size that indicates a possible endoleak?

0.6cm
0.9cm
0.2cm
1.5cm

A

0.6cm or greater

91
Q

What is indicated by the arrow?

longus colli muscle
parathyroid adenoma
esophagus
internal jugular vein

A

parathyroid adenoma

92
Q

A solid nodule in the left lobe of the thyroid that measures 2cm AP and 1cm width is most suggestive of:

papillary carcinoma
adenoma
anaplastic carcinoma
colloid cyst

A

papillary carcinoma

** taller than wide is associated with malignancy

93
Q

The findings on the image are common complication of:

irritable bowel syndrome
Marfan syndrome
Leriche syndrome
lupus

A

Marfan syndrome

94
Q

Which of the testicular masses is most likely an abscess?

A
95
Q

A patient presents with an acute onset of left scrotal pain this morning. The US exam demonstrates small hydrocele and enlarged body and tail of the epididymis. There is very minimal flow demonstrated in the body and tail but the head appears normal. These findings are most suggestive of:

sperm granuloma
torsion of the epididymal body
focal epididymitis of the body and tail
focal epididymitis of the head

A

torsion of the epididymal body

96
Q

What therapeutic device is implanted inside the distal IVC?

pacemaker
stent
greenfield filter
catheter

A

greenfield filter

97
Q

A patient presents with an enlarged left scrotum and palpable mass. The US demonstrates an intratesticular mass that is hypoechoic and heterogeneous with multiple coarse calcifications. There is also an irregular central cystic area. These findings are most suggestive of:

teratoma only
seminoma only
embryonal cell tumor or teratoma
seminoma, embryonal cell tumor or teratoma

A

embryonal cell tumor or teratoma

**cystic calcifications are common in embryonal cell tumors and testicular teratomas

98
Q

Why did the sonographer measure the distance with the first set of calipers?

to evaluate the length of the pseudoaneurysm

to determine the length of the needle for Thrombin injection

to demonstrate the inflamed anterior tissues

to evaluate the width of the pseudoaneurysm

A

to determine the length of the needle for Thrombin injection

99
Q

The image demonstrates the most common malignant testicular neoplasm that occurs in men age 30-50 years. This neoplasm is:

mixed germ cell tumor
seminoma
teratoma
embryonal cell tumor

A

seminoma

100
Q

Which of the following describes tubular ectasia of the rete testis?

unilateral and associated with chronic bacterial infection

bilateral and has as strong association with malignant transformation

bilateral and associated with spermatocele formation

unilateral and associated with infertility

A

bilateral and associated with spermatocele formation

101
Q

A significant increase in blood supply/drainage to thyroid will be seen with thyroiditis. This can be demonstrated with ___ Doppler and is called the ___ sign.

Color, flame
PW, color flash
Color, string of pearls sign
Color, inferno

A

Color, inferno

102
Q

Which of the following correctly describes Marfan syndrome?

genetic disorder that affects connective tissues of the heart, vessels, and bones

abdominal situs defects are common

genetic weakness of all arterial walls resulting in the formation of aneurysms throughout the systemic circulatory system

patients are usually less than 48 inches tall with foreshortened limbs and digits

A

genetic disorder that affects connective tissues of the heart, vessels, and bones

103
Q

A patient presents for an ultrasound due to a suspected nodule in the thyroid found incidentally. Locate the nodule on the image.

A
104
Q

The most common benign, solid lesion of the thyroid is ___.

Goiter
hematoma
adenoma
cyst

A

adenoma

105
Q

Which of the following is NOT a medication that can be used to treat patients with hypothyroidism?

coumadin
iron supplements
levothyroxine
iodine supplements

A

coumadin

106
Q

Which of the following statements best describes the appearance of color Doppler evaluation of a testicular abscess?

there will be focal areas of increased vascularity in the central abscess and limited color flow demonstrated at the periphery of the abscess

there will be significant increase in vascularity within the abscess due to inflammation

due to fluid accumulation with inflammation, color Doppler does not usually demonstrate flow around or within an abscess

there will be no color flow demonstrated centrally with increased color flow displayed around the periphery of the abscess

A

there will be no color flow demonstrated centrally with increased color flow displayed around the periphery of the abscess

107
Q

You are scanning a patient that had a bilateral thyroidectomy 3 years ago. There are 3 round, anechoic lymph nodes identified between the mid common carotid artery and the sternocleidomastoid muscle. How will you report these findings?

possible abnormal lymph nodes in level V
possible abnormal lymph nodes in level I
possible abnormal lymph nodes in level III
possible abnormal lymph nodes in level VII

A

possible abnormal lymph nodes in level III

108
Q

A patient presents with a palpable lump in the right testicle. Lab values are normal and there is no fever. What is the most likely diagnosis for the abnormality on the image?

dilated rete testis
epidermoid cyst
seminoma
yolk sac tumor

A

epidermoid cyst

109
Q

A heterogenous, hypervascular mass with microcalcifications is identified in the left upper pole of the thyroid gland. Left side lymphadenopathy is also present. These findings are most suggestive of:

anaplastic carcinoma
colloid cyst
parathyroid adenoma
papillary carcinoma

A

papillary carcinoma

110
Q

Which of the following statements best describes the findings on the image?

the findings should raise significant suspicion for thyroid malignancy

there are several colloid cysts present within the thyroid and some demonstrate the propagation speed artifact

there are several colloid cysts present within the thyroid and some demonstrate the comet tail artifact

there are several milk of calcium cysts within the thyroid

A

there are several colloid cysts present within the thyroid and some demonstrate the comet tail artifact

111
Q

Which of the following statements is true regarding the non-seminomatous germ cell tumor displayed on the image?

seminomatous tumors usually contain cystic areas and calcifications that assist in differentiating them from non-seminomatous tumors

these tumors are less aggressive than a seminoma tumor

they are the second most common secondary malignancy of the testicles

the tumors are more common in men age 20-30 years old

A

the tumors are more common in men age 20-30 years old

112
Q

Which testicular tumor is composed of bone, cartilage and smooth muscle fibers?

choriocarcinoma
teratoma
yolk sac tumor
seminoma

A

teratoma

113
Q

Which of the following statements is true regarding the abnormality on the image?

the valsalva maneuver will have minimal effect on the already engorged vessels

it is more commonly seen on the right side due to the relationship of the gonadal vascular anatomy to surrounding structures

it can be caused by Nutcracker syndrome

the abnormality has no association with male infertility

A

it can be caused by Nutcracker syndrome

114
Q

The most common secondary malignancy of the testicles is:

leukemia
hypernephroma
lymphoma
myleoma

A

lymphoma

115
Q

___ artery aneurysms are commonly associated with pancreatitis and peptic ulcer disease, while ___ artery aneurysms are usually caused by cystic medial necrosis.

celiac, superior mesenteric
splenic, superior mesenteric
hepatic, splenic
celiac hepatic

A

splenic, superior mesenteric

116
Q

A patient presents with epigastric pain. The findings on the image are most suggestive of:

fusiform aortic aneurysm
pseudocyst
duplicated AO
aortic dissection

A

aortic dissection

117
Q

Leydig cell tumors of the testicle will demonstrate high serum levels of ___ which can lead to ___.

hematocrit, thrombus formation
AFP, cancer
tesosterone, precocious puberty
b-hCG, cancer

A

testosterone, precocious puberty

118
Q

All of the following symptoms would be associated with the findings on the image, EXCEPT:

leukocytosis

palpable area that increases in size with the valsalva maneuver

fever

swelling

A

palpable area that increases in size with the valsalva maneuver

119
Q

Which of the following is an immune system disorder that commonly affects the salivary glands?

sjogren syndrome
klippel-trenaunay-weber syndrome
kasabach-merritt syndrome
epstein-barr syndrome

A

sjogren syndrome

120
Q

The mass on the image is a confirmed embryonal cell tumor. Which statement is true regarding this type of neoplasm?

usually presents with normal AFP levels
usually presents with normal b-hCG levels
normally affects men in their late 50’s, early 60’s
most aggressive testicular malignancy

A

most aggressive testicular malignancy

**embryonal cell carcinoma is the most aggressive testicular cancer
AFP and b-hCG are elelvated

121
Q

Which of the following is the most commonly occurring germ cell tumor of the testicle?

teratoma
seminoma
choriocarcinoma
embryonal cell tumor

A

seminoma

122
Q

medullary carcinoma of the thyroid is a common occurrence with:

zollinger-ellison
marfan syndrome
von hippel lindau syndrome
MEN syndrome

A

MEN syndrome

123
Q

Zenker diverticulum can be mistaken for:

a thyroid mass
a dilated bile duct
a bowel obstruction
the appendix

A

a thyroid mass

124
Q

A scrotal pearl refers to:

microlithiasis formation only in the central portion of the testae adjacent to the rete testes
a large intra-testicular calcification
a large extra-testicular calcification
testicular prosthesis

A

a large intra-testicular calcification

125
Q

Which of the following statements regarding the image is true?

the mass on the image is most likely a non-seminomatous germ cell tumor because of the characteristic heterogeneous texture with areas of cytstic degeneration

the mass on the image is most likely a seminoma because of the characteristic heterogenous texture with areas of cystic degeneration

the image demonstrates the most common typer of testicular malignancy

this type of malignancy is treatable with radiation only, no surgical intervention required

A

the mass on the image is most likely a non-seminomatous germ cell tumor because of the characteristic heterogeneous texture with areas of cytstic degeneration

126
Q

A lab report demonstrates that a testicular tumor contains choriocarcinoma cells and embryonal cell carcinoma. Which of the following best describes the tumor?

metastatic tumor
mature teratoma
mixed germ cell tumor
seminomatous tumor

A

mixed germ cell tumor

127
Q

The most common location of ectopic thyroid tissue formation outside the neck is in the ___.

shoulder
groin
base of skull
chest

A

chest

128
Q

Which of the following correctly describes how to aid in differentiation of a thyroid adenoma in the lower pole from a parathyroid adenoma?

thyroid adenomas are hyperechoic and parathyroid adenomas are hypoechoic

thyroid adenomas are hypoechoic and parathyroid adenomas are hyperechoic

thyroid adenomas are homogenous and parathyroid adenomas are heterogenous

thyroid adenomas are hypovascular and parathyroid adenomas are hypervascular

A

thyroid adenomas are hypovascular and parathyroid adenomas are hypervascular

ARDMS ABD REVIEW (27 decks)

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