Penny Review Questions

Question 1

Transitional cell carcinoma is commonly found in all of the following locations except:

a. liver
b. renal pelvis
c. urinary bladder
d. ureter

Answer 1

A

Question 2

The neuroblastoma is a malignant pediatric mass commonly found in:

a. kidney
b. liver
c. testicle
d. adrenal gland

Answer 2

D

Question 3

The pheochromocytoma is a benign mass commonly located in:

a. testicle
b. thyroid gland
c. adrenal gland
d. liver

Answer 3

C

Question 4

Which of the following is not considered an intaperitoneal organ?

a. liver
b. pancreas
c. gallbladder
d. spleen

Answer 4

B

Question 5

Which of the following is not considered retroperitoneal organs?

a. abdominal lymph nodes
b. kidneys
c. adrenal glands
d. ovaries

Answer 5

D

Question 6

The hypernephroma may also be referred to as:

a. nephroblastoma
b. neuroblastoma
c. hepatocellular carcinoma
d. renal cell carcinoma

Answer 6

D

Question 7

A type of reverberation artifact caused by several small, highly reflective interfaces, such as gas bubbles, describes:

a. mirror image artifact
b. posterior shadowing
c. comet tail artifact
d. ring-down artifact

Answer 7

C

Question 8

The term cholangiocarcinoma denotes:

a. bile duct carcinoma
b. hepatic carcinoma
c. pancreatic carcinoma
d. splenic carcinoma

Answer 8

A

Question 9

The hepatoma is a:

a. benign tumor of the spleen
b. benign tumor of the liver
c. malignant tumor of the pancreas
d. malignant tumor of the liver

Answer 9

D

Question 10

The hepatoblastoma is a:

a. benign tumor of the pediatric liver
b. benign tumor of the adult liver
c. malignant tumor of the pediatric liver
d. malignant tumor of the pediatric adrenal gland

Answer 10

C

Question 11

A Wilms tumor may also be referred to as a:

a. neuroblastoma
b. nephroblastoma
c. hepatoblastoma
d. hepatoma

Answer 11

B

Question 12

An angiosarcoma would most likely be discovered in the:

a. rectum
b. gallbladder
c. spleen
d. pancreas

Answer 12

C

Question 13

A gastronoma would most likely be discovered in the:

a. pancreas
b. adrenal gland
c. stomach
d. spleen

Answer 13

A

Question 14

The space located behind the liver and stomach, and posterior to the pancreas is the:

a. hepatosplenic space
b. lesser sac
c. greater sac
d. supraduodenal space

Answer 14

B

Question 15

Of the list below, which is considered to be an intraperitoneal organ?

a. left kidney
b. aorta
c. inferior vena cava
d. liver

Answer 15

D

Question 16

Of the list below, which is considered to be a malignant testicular neoplasm?

a. neuroblastoma
b. hepatoma
c. yolk sac tumor
d. hamartoma

Answer 16

C

Question 17

The oncocytoma is a mass noted more commonly in the:

a. liver
b. adrenal gland
c. pancreas
d. kidneys

Answer 17

D

Question 18

These potential spaces extend alongside the ascending and descending colon on both sides of the abdomen.

a. parabolica gutters
b. periumbilical gutters
c. greater gutters
d. suprapubic gutters

Answer 18

A

Question 19

This common tumor of the kidney consists of blood vessels, muscle, and fat.

a. hemangioma
b. angiomyolipoma
c. oncocytoma
d. pheochromocytoma

Answer 19

B

Question 20

Which of the following is not a pediatric malignant mass?

a. hepatoblastoma
b. neuroblastoma
c. pheochromocytoma
d. nephroblastoma

Answer 20

C

Question 21

A tumor that consists of tissue from all three germ cell layers is the:

a. pheochromocytoma
b. oncocytoma
c. choriocarcinoma
d. teratoma

Answer 21

D

Question 22

A benign tumor that consists primarily of blood vessels best describes:

a. adenocarcinoma
b. oncocytoma
c. hemangioma
d. lymphoma

Answer 22

C

Question 23

The insulinoma is a:

a. malignant pediatric adrenal tumor
b. benign pancreatic tumor
c. malignant pancreatic tumor
d. benign liver tumor

Answer 23

B

Question 24

A tumor that consists of a group of inflammatory cells best describes the:

a. hematoma
b. hemangioma
c. lymphoma
d. granuloma

Answer 24

D

Question 25

A tumor that consists of a focal collection of blood best describes the:

a. hematoma
b. hemangioma
c. hamartoma
d. hepatoma

Answer 25

A

Question 26

The malignant testicular tumor that consists of trophoblastic cells is the:

a. cholangiocarcinoma
b. teratoma
c. yolk sac tumor
d. choriocarcinoma

Answer 26

D

Question 27

Which of the following laboratory values would be most helpful in evaluating a patient with recent trauma?

a. white blood cell count
b. alpha-fetoprotein
c. blood urea nitrogen
d. hematocrit

Answer 27

D

Question 28

Which of the following laboratory values would be most helpful in evaluating a patient with an infection?

a. white blood cell count
b. alpha-fetoprotein
c. blood urea nitrogen
d. hematocrit

Answer 28

A

Question 29

The artifact most commonly encountered posterior to a gallstone is:

a. acoustic enhancement
b. shadowing
c. ring down
d. reverberation

Answer 29

B

Question 30

A collection of abdominal fluid within the peritoneal cavity often associated with cancer is termed:

a. transudate ascites
b. peritoneal ascites
c. exudate ascites
d. chromatin ascites

Answer 30

C

Question 31

The covering of the liver is referred to as:

a. glisson capsule
b. gerona fascia
c. morison pouch
d. hepatic fascia

Answer 31

A

Question 32

The left lobe of the liver can be separated from the right lobe by:

a. right hepatic vein
b. middle hepatic vein
c. left hepatic vein
d. falciform ligament

Answer 32

B

Question 33

The right lobe of the liver is divided into segments by the:

a. middle lobar fissure
b. middle hepatic vein
c. right hepatic vein
d. left hepatic vein

Answer 33

C

Question 34

The right intersegmental fissure contains the:

a. right hepatic vein
b. middle hepatic vein
c. left portal vein
d. right portal vein

Answer 34

A

Question 35

The main portal vein divides into:

a. middle, left, and right branches
b. left and right branches
c. anterior and posterior branches
d. medial and lateral branches

Answer 35

B

Question 36

The ligament trees can be used to separate the:

a. medial and lateral segments of the left lobe
b. medial and posterior segments of the right lobe
c. anterior and medial segments of the left lobe
d. anterior and posterior segments of the right lobe

Answer 36

A

Question 37

The main lobar fissure contains the:

a. right hepatic vein
b. middle hepatic vein
c. main portal vein
d. right portal vein

Answer 37

B

Question 38

All of the following are located within the portal hepatic except:

a. main portal vein
b. common bile duct
c. hepatic artery
d. middle hepatic vein

Answer 38

D

Question 39

Right-sided heart failure often leads to enlargement of the:

a. abdominal aorta
b. inferior vena cava and hepatic veins
c. inferior vena cava and portal veins
d. portal veins and spleen

Answer 39

B

Question 40

The right portal vein divides into:

a. middle, left, and right branches
b. left and right branches
c. anterior and posterior branches
d. medial and lateral branches

Answer 40

C

Question 41

The diameter of the portal vein should not exceed:

a. 4 mm
b. 8 mm
c. 10 mm
d. 13 mm

Answer 41

D

Question 42

The right lobe of the liver can be divided into:

a. medial and lateral segments
b. medial and posterior segments
c. anterior and medial segments
d. anterior and posterior segments

Answer 42

D

Question 43

Which of the following is true concerning the portal veins?

a. portal veins carry deoxygenated blood away from the liver
b. portal veins have brighter walls than the hepatic veins
c. portal veins should demonstrate hepatofugal flow
d. portal veins increase in diameter as they approach the diaphragm

Answer 43

B

Question 44

The left lobe of the liver can be divided onto:

a. medial and lateral segments
b. medial and posterior segments
c. anterior and medial segments
d. anterior and posterior segments

Answer 44

A

Question 45

Budd-Chiari syndrome leads to a reduction in the size of the:

a. hepatic arteries
b. portal veins
c. hepatic veins
d. common bile duct

Answer 45

C

Question 46

A tonguelike extension of the right lobe of the liver is termed:

a. papillary lobe
b. focal hepatomegaly
c. riedel lobe
d. morison pouch

Answer 46

C

Question 47

The left portal vein divides into:

a. middle, left, and right branches
b. left and right branches
c. anterior and posterior branches
d. medial and lateral branches

Answer 47

D

Question 48

The left umbilical vein after birth becomes the:

a. falciform ligament
b. main lobar fissure
c. ligamentum teres
d. ligamentum venosum

Answer 48

C

Question 49

The inferior extension of the caudate lobe is referred to as:

a. papillary process
b. focal hepatomegaly
c. riedel process
d. morison lobe

Answer 49

A

Question 50

Clinical findings of fatty infiltration of the liver include:

a. elevated liver function tests
b. fever
c. fatigue
d. weight loss

Answer 50

A

Question 51

Shortly after birth, the ductus venous collapses and becomes the:

a. falciform ligament
b. main lobar fissure
c. ligamentum teres
d. ligamentum venosum

Answer 51

D

Question 52

Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of:

a. portal vein thrombosis
b. metastatic liver disease
c. primary liver carcinoma
d. fatty liver disease

Answer 52

D

Question 53

The most common cause of cirrhosis is:

a. portal hypertension
b. hepatitis
c. alcoholism
d. Cholangitis

Answer 53

C

Question 54

Clinical findings of hepatitis include all of the following except:

a. jaundice
b. fever
c. chills
d. pericholecystic fluid

Answer 54

D

Question 55

Immunocompromised patients are more prone to develop what form of hepatic abnormality?

a. hepatic adenoma
b. amebic abscess
c. hydatid liver abscess
d. candidiasis

Answer 55

D

Question 56

All of the following are sequela of cirrhosis except:

a. portal vein thrombosis
b. hepatic artery enlargement
c. portal hypertension
d. splenomegaly

Answer 56

B

Question 57

Normal flow toward the liver in the portal veins is termed:

a. hepatopetal
b. hepatofugal

Answer 57

A

Question 58

Which of the following is the most common form of liver cancer?

a. hepatocellular carcinoma
b. adenocarcinoma
c. metastatic liver disease
d. hepatoblastoma

Answer 58

C

Question 59

Which hepatic mass is closely associated with oral contraceptive use?

a. hepatic adenoma
b. hepatic hypernephroma
c. hepatic hamartoma
d. hepatic hemangioma

Answer 59

A

Question 60

All of the following are clinical findings of hepatocellular carcinoma except:

a. reduction in alpha-fetoprotein
b. unexplained weight loss
c. fever
d. cirrhosis

Answer 60

A

Question 61

A 71-year-old patient presents to the emergency department with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for:

a. acute cholecystitis
b. chronic cholecystitis
c. courvoisier gallbladder
d. porcelain gallbladder

Answer 61

C

Question 62

The innermost layer of the gallbladder wall is the:

a. fibromuscular layer
b. mucosal layer
c. serial layer
d. muscular layer

Answer 62

B

Question 63

The cystic artery is branch of the:

a. main pancreatic artery
b. celiac artery
c. right hepatic artery
d. left hepatic artery

Answer 63

C

Question 64

The middle layer of the gallbladder wall is the:

a. fibromuscular layer
b. mucosal layer
c. serosal layer
d. muscularis layer

Answer 64

A

Question 65

Which structure is a useful landmark for identifying the gallbladder?

a. main lobar fissure
b. hepatoduodenal ligament
c. falciform ligament
d. ligamentum venosum

Answer 65

A

Question 66

What hormone causes the gallbladder to contact?

a. estrogen
b. cholecystokinin
c. bilirubin
d. biliverdin

Answer 66

B

Question 67

The gallbladder wall should measure no more than:

a. 5 mm
b. 6 mm
c. 4 mm
d. 3 mm

Answer 67

D

Question 68

The direct blood supply to the gallbladder is the:

a. cholecystectomy artery
b. common hepatic artery
c. main portal vein
d. cystic artery

Answer 68

D

Question 69

The outermost layer of the gallbladder wall is the:

a. fibromuscular layer
b. mucosal layer
c. serosal layer
d. muscularis layer

Answer 69

C

Question 70

Hartmann pouch involves which part of the gallbladder:

a. neck
b. fundus
c. body
d. phrygian cap

Answer 70

A

Question 71

The gallbladder is connected to the biliary tree by the:

a. common hepatic duct
b. common bile duct
c. cystic duct
d. right hepatic duct

Answer 71

C

Question 72

The junctional fold is found at which level of the gallbladder:

a. neck
b. fundus
c. body
d. phrygian cap

Answer 72

A

Question 73

What is/are cholelithiasis?

a. inflammation of the gallbladder
b. gallstones
c. hyperplasia of the gallbladder wall
d. stones within the biliary tree

Answer 73

B

Question 74

The most common variant of gallbladder shape is the:

a. phrygian cap
b. hartmann pouch
c. septated gallbladder
d. junctional fold

Answer 74

A

Question 75

The diameter of the gallbladder should not exceed:

a. 8 cm
b. 5 cm
c. 7 mm
d. 3 cm

Answer 75

B

Question 76

Acute cholecystitis that leads to necrosis and abscess development within the gallbladder wall describes:

a. emphysematous cholecystitis
b. gangrenous cholecystitis
c. chronic cholecystitis
d. gallbladder perforation

Answer 76

B

Question 77

All of the following are sources of diffuse gallbladder wall thickening except:

a. malignant ascites
b. AIDS
c. hepatitis
d. adenomyomatosis

Answer 77

A

Question 78

Which statement is not true of cholelithiasis?

a. men have an increased likelihood of developing cholelithiasis
b. patients who have been or are pregnant have an increased occurrence of cholelithiasis
c. a rapid weight loss may increase the likelihood of developing cholelithiasis
d. patients who have hemolytic disorders have an increased occurrence of cholelithiasis

Answer 78

A

Question 79

WES sign denotes:

a. the presence of a gallstone lodged in the cystic duct
b. multiple biliary stones and biliary dilatation
c. a gallbladder filled with cholelithiasis
d. the sonographic sign of a porcelain gallbladder

Answer 79

C

Question 80

All of the following are sources of diffuse gallbladder wall thickening except:

a. benign ascites
b. hepatitis
c. congestive heart failure
d. gallbladder polyp

Answer 80

D

Question 81

Tumefactive sludge can resemble the sonographic appearance of:

a. cholelithiasis
b. gallbladder carcinoma
c. cholecystitis
d. adenomyomatosis

Answer 81

B

Question 82

The sequela of acute cholecystitis that is complicated by gas within the gallbladder wall is:

a. emphysematous cholecystitis
b. membranous cholecystitis
c. chronic cholecystitis
d. gallbladder perforation

Answer 82

A

Question 83

A 32-year-old female patient presents to the sonography department with vague abdominal pain. The sonographic investigation of the gallbladder reveals a focal area of gallbladder wall thickening that produces comet tail artifact. These findings are consistent with:

a. gangrenous cholecystitis
b. gallbladder perforation
c. calculus cholecystitis
d. acute cholecystitis

Answer 83

D

Question 84

Intermittent obstruction of the cystic duct by a gallstone results in:

a. emphysematous cholecystitis
b. gangrenous cholecystitis
c. chronic cholecystitis
d. acute cholecystitis

Answer 84

C

Question 85

A nonmobile, non shadowing focus seen within the gallbladder lumen. This most likely represents a:

a. gallstone
b. gallbladder carcinoma
c. gallbladder polyp
d. sludge ball

Answer 85

C

Question 86

Focal tenderness over the gallbladder with probe pressure describes:

a. murphy sign
b. strawberry sign
c. courvoisier sign
d. hydrops sign

Answer 86

A

Question 87

The sequela of acute cholecystitis that is found more often in diabetic patients is:

a. emphysematous cholecystitis
b. gangrenous cholecystitis
c. chronic cholecystitis
d. gallbladder perforation

Answer 87

A

Question 88

Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with:

a. acute cholecystitis
b. acalculous cholecystitis
c. adenomyomatosis
d. gallbladder perforation

Answer 88

C

Question 89

The spiral valves of Heister are found within the:

a. gallbladder neck
b. cystic duct
c. gallbladder fundus
d. gallbladder wall

Answer 89

B

Question 90

Courvoisier’s gallbladder is associated with which of the following:

a. a pancreatic head mass
b. a stone in the cystic duct
c. cholecystitis
d. chronic diverticulitis

Answer 90

A

Question 91

A congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as:

a. caroli disease
b. mitizzi disease
c. choledochal cysts
d. biliary atresia

Answer 91

D

Question 92

Primary biliary tree cancer is referred to as:

a. gallbladder carcinoma
b. biloma
c. cholangiocarcinoma
d. lymphangioma

Answer 92

C

Question 93

The merging point of the pancreatic duct and common bile duct at the level of duodenum is referred to as the:

a. sphincter of Oddi
b. ampulla of vater
c. common bile duct
d. cystic duct

Answer 93

B

Question 94

A gallstone located within the biliary tree is referred to as:

a. cholecystitis
b. choledocholithiasis
c. cholangitis
d. cholangiocarcinoma

Answer 94

B

Question 95

The yellowish staining of the whites of the eyes and the skin secondary to a liver disorder or biliary obstruction is referred to as:

a. AIDS cholangitis
b. pruritus
c. jaundice
d. bilirubinemia

Answer 95

C

Question 96

The Klatskin tumor is located:

a. at the junction of the right and left hepatic ducts
b. at the junction of the cystic and common bile duct
c. at the junction of the common bile duct and common hepatic duct
d. between the pancreatic head and duodenum

Answer 96

A

Question 97

Inflammation of the bile ducts is referred to as:

a. pneumobilia
b. choledocholithiasis
c. cholelithiasis
d. cholangitis

Answer 97

D

Question 98

A patient presents with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct. This is referred to as:

a. caroli syndrome
b. mirizzi syndrome
c. choledochal cysts
d. biliary atresia

Answer 98

B

Question 99

Air within the biliary tree is referred to as:

a. pneumobilia
b. cholangitis
c. choledocholithiasis
d. cholesterolosis

Answer 99

A

Question 100

The spiral valves of Heister are located within the:

a. common bile duct
b. pancreatic duct
c. common hepatic duct
d. cystic duct

Answer 100

D

Question 101

If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated?

a. common bile duct only
b. gallbladder only
c. intrahepatic ducts
d. all of the above

Answer 101

C

Question 102

Which of the following is considered the most proximal portion of the biliary tree?

a. intrahepatic radicles
b. cystic duct
c. common hepatic duct
d. common bile duct

Answer 102

A

Question 103

Which of the following would be the most distal portion of the biliary tree?

a. common bile duct
b. common hepatic duct
c. gallbladder
d. intrahepatic radicles

Answer 103

A

Question 104

If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate?

a. common bile duct
b. gallbladder
c. common hepatic duct
d. all of the above

Answer 104

D

Question 105

The gallbladder is connected to the biliary tree by the:

a. cystic duct
b. ampulla of vater
c. sphincter of oddi
d. common bile duct

Answer 105

A

Question 106

The most common level for biliary obstruction to occur is the:

a. junction of the right and left hepatic ducts
b. proximal common hepatic duct
c. distal common bile duct
d. cystic duct

Answer 106

C

Question 107

A 32-year-old female patient presents to the sonography department with a history of fever, leukocytosis, and right upper quadrant pain. Sonographically, you visualize dilated bile ducts that have thickened walls and contains sludge. What is the most likely diagnosis?

a. choledocholithiasis
b. cholangitis
c. mirizzi syndrome
d. biliary atresia

Answer 107

B

Question 108

Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma that produce ring-down artifact. What is the most likely diagnosis?

a. pneumobilia
b. choledocholithiasis
c. sludge balls
d. cholesterolosis

Answer 108

A

Question 109

A 64-year-old man presents to the sonography department for a right upper quadrant sonogram. He is complaining of abdominal pain, weight loss, and pruritus. Sonographically, you visualize an area of dilated ducts that abruptly end. What is the most likely diagnosis?

a. biliary atresia
b. choledocholithiasis
c. caroli syndrome
d. cholangiocarcinoma

Answer 109

D

Question 110

An abdominal sonogram is ordered on an infant in the intensive care unit who is suffering from jaundice and fever. Sonographically, you visualize a cystic mass within the common bile duct that is causing a focal enlargement. This is most suggestive of:

a. cholangiocarcinoma
b. mirizzi syndrome
c. choledochal cyst
d. biliary atresia

Answer 110

C

Question 111

All of the following are clinical findings consistent with cholangiocarcinoma except:

a. pruritus
b. weight loss
c. elevated bilirubin
d. dilation of the intrahepatic ducts

Answer 111

D

Question 112

Which of the following is not associated with the development of pneumobilia?

a. cholangiocarcinoma
b. gastric surgery
c. acute cholecystitis
d. fistula formation

Answer 112

A

Question 113

A Klatskin tumor is a form of:

a. lymphocytic carcinoma
b. cholangiocarcinoma
c. pancreatic carcinoma
d. gallbladder carcinoma

Answer 113

B

Question 114

The biliary duct wall should never measure more than:

a. 2 mm
b. 9 mm
c. 4 mm
d. 5 mm

Answer 114

D

Question 115

Clinical findings of choledocholithiasis include all of the following except:

a. jaundice
b. elevated bilirubin
c. elevated blood urea nitrogen
d. elevated alkaline phosphatase

Answer 115

C

Question 116

Which segment of the biliary tree tends to dilate first with obstruction:

a. intrahepatic
b. extrahepatic

Answer 116

B

Question 117

Which of the following is not a plausible cause of common bile duct obstruction in adults?

a. choledocholithiasis
b. chronic pancreatitis
c. choledochal cyst
d. pancreatic carcinoma

Answer 117

C

Question 118

All of the following are forms of cholangitis except:

a. acute bacterial
b. AIDS
c. oriental
d. parabolic

Answer 118

D

Question 119

The yellow pigment found in bile that is produced by the breakdown of old red blood cells by the liver is:

a. alkaline phosphatase
b. bilirubin
c. cholesterol
d. chyme

Answer 119

B

Question 120

For patients older than age 60, or those who have had a cholecystectomy, a maximum diameter of _____ may be considered normal.

a. 1 cm
b. 12 mm
c. 14 mm
d. 1.5 cm

Answer 120

A

Question 121

All of the following are part of the exocrine function of the pancreas except for the:

a. production of lipase
b. production of glucagon
c. production of amylase
d. production of sodium bicarbonate

Answer 121

B

Question 122

What is an additional name for the accessory duct of the pancreas?

a. duct of santorini
b. duct of langerhans
c. duct of oddi
d. duct of wirsung

Answer 122

A

Question 123

Which of the following is associated with development of cysts within the pancreas?

a. autosomal recessive polycystic kidney disease
b. von hippel-lindau disease
c. zollinger-ellison syndrome
d. endoscopic retrograde cholangiopancreatography

Answer 123

B

Question 124

The most common form of malignancy of the pancreas is:

a. cystadenocarcinoma
b. islet cell tumors
c. cyst adenoma
d. adenocarcinoma

Answer 124

D

Question 125

The most common location of adenocarcinoma of the pancreas is within the:

a. head of the pancreas
b. neck of the pancreas
c. body of the pancreas
d. tail of the pancreas

Answer 125

A

Question 126

The most common location of focal pancreatitis is within the:

a. head of the pancreas
b. neck of the pancreas
c. body of the pancreas
d. tail of the pancreas

Answer 126

A

Question 127

All of the following are sonoraphic features of chronic pancreatitis except:

a. dilated pancreatic duct
b. calcifications within the pancreas
c. pancreatic pseudocyst
d. diffusely hypo echoic pancreas

Answer 127

D

Question 128

All of the following are classic clinical features of acute pancreatitis except:

a. leukocytosis
b. back pain
c. weight gain
d. fever

Answer 128

C

Question 129

Which laboratory value listed below appears to be more specific for acute pancreatitis?

a. amylase
b. lipase
c. AST
d. SGOT

Answer 129

B

Question 130

One of the most common locations for a pancreatic pseudocyst is within the:

a. parabolica gutters
b. groin
c. spleen
d. lesser sac

Answer 130

D

Question 131

Which of the following is the most common islet cell tumor?

a. granuloma
b. gastrinoma
c. insulinoma
d. cystadenoma

Answer 131

C

Question 132

Courvoisier gallbladder is found in the presence of:

a. hepatitis
b. cholecystitis and chronic pancreatitis
c. adenocarcinoma in the head of the pancreas
d. islet cell tumor in the tail of the pancreas

Answer 132

C

Question 133

A gastrinoma of the pancreas can produce:

a. autosomal recessive polycystic kidney disease
b. von hippel-lindau disease
c. zollinger-ellsion syndrome
d. hyperinsulinemia

Answer 133

C

Question 134

The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the:

a. sphincter of vater
b. sphincter of oddi
c. ampulla of vater
d. ampulla of oddi

Answer 134

B

Question 135

What is the name for the main pancreatic duct?

a. duct of santorini
b. duct of langerhans
c. duct of oddi
d. duct of wirsung

Answer 135

D

Question 136

All of the following are clinical findings associated with pancreatic adenocarcinoma except:

a. epigastric pain
b. weight loss
c. jaundice
d. decrease amylase and lipase

Answer 136

D

Question 137

The portion of the bowel that encompasses the head of the pancreas is the:

a. duodenum
b. jejunum
c. ileum
d. cecum

Answer 137

A

Question 138

Which cells carry out the exocrine function of the pancreas?

a. whipple cells
b. Isles of langerhans
c. delta cells
d. acing cells

Answer 138

D

Question 139

The most common echogenicity of an acutely inflamed pancreas is via the:

a. anechoic
b. hyperechoic
c. hypoechoic
d. calcified

Answer 139

C

Question 140

The arterial blood supply to the head of the pancreas is via the:

a. superior mesenteric artery
b. splenic artery
c. gastroduodenal artery
d. hepatic artery

Answer 140

C

Question 141

One clinical sign of an insulinoma is the presence of:

a. low blood sugar symptoms
b. elevated alpha-fetaprotein
c. hepatitis
d. zollinger-ellison syndrome

Answer 141

A

Question 142

What is the early sonographic appearance of acute pancreatitis?

a. calcifications within the gland
b. pancreatic pseudocyst
c. normal
d. hyper echoic glandular echotexture

Answer 142

C

Question 143

Mucinous cystadenocarcinomas of the pancreas are most often located within which parts of the pancreas?

a. uncinate process and neck
b. head and neck
c. body and tail
d. fundus and neck

Answer 143

C

Question 144

Co-existing obstruction of the common bile duct and pancreatic duct may be referred to as the:

a. double-barrel shotgun sign
b. courvoisier sign
c. mitizzi sign
d. double-duct sign

Answer 144

D

Question 145

Courvoisier gallbladder is:

a. enlargement of the pancreatic duct secondary to co-existing masses within the pancreatic body and gallbladder
b. palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head
c. gallbladder disorder associated with the buildup of cholesterol crystals within the gallbladder wall
d. type of the gallbladder carcinoma that is the result of chronic cholecystitis

Answer 145

B

Question 146

The pancreas is an:

a. intraperitoneal organ
b. retroperitoneal organ

Answer 146

B

Question 147

Which part of the pancreas is located right lateral to superior mesenteric vein, anterior to inferior vena cava, and inferior to portal vein?

a. head
b. neck
c. body
d. tail

Answer 147

A

Question 148

The pancreatic tail is outlined posteriorly by what vascular structure?

a. superior mesenteric artery
b. inferior mesenteric vein
c. portal confluence
d. splenic vein

Answer 148

D

Question 149

Which part of the pancreas is located anterior to portal confluence?

a. uncinate process
b. pancreatic body
c. pancreatic neck
d. pancreatic tail

Answer 149

C

Question 150

Which of the following is the hormone released by the pancreas that encourages the body’s use of glucagon?

a. insulin
b. somatostatin
c. glycogen
d. sodium bicarbonate

Answer 150

A

Question 151

A 25-year-old female patient presents to the ultrasound department for a complete abdominal ultrasound. She complains of right upper abdomen appears normal. A small mass is noted in the area of the splenic hilum. This mass appears isoechoic to the spleen. What does this most likely represent?

a. pancreatic cystadenocarcinoma
b. splenic hemangioma
c. accessory spleen
d. neuroblastoma

Answer 151

C

Question 152

A rare malignant tumor of the spleen that consists of blood vessels is a/an:

a. lymphoma
b. angiosarcoma
c. hemangioma
d. granuloma

Answer 152

B

Question 153

A 48-year-old male patient with a history of severe, sudden onset of the left upper quadrant pain without trauma presents to the ultrasound department for a sonogram of the spleen. You visualize a wedge-shaped, hypo echoic area within the spleen. This most likely represents a:

a. splenic infarct
b. splenic hematoma
c. splenic hemangioma
d. splenic metastasis

Answer 153

A

Question 154

What is the most common sonographic appearance of a splenic hemangioma?

a. echogenic
b. hypoechoic
c. anechoic
d. complex

Answer 154

A

Question 155

The process of making red blood cells is termed:

a. erythropoiesis
b. leukopoiesis
c. histopoiesis
d. anemia

Answer 155

A

Question 156

The splenic artery marks the:

a. posterior aspect of the pancreatic body and tail
b. superior aspect of the pancreatic body and tail
c. medial surface of the pancreatic body and tail
d. lateral aspect of the pancreatic body and tail

Answer 156

B

Question 157

The most common cause of splenomegaly is:

a. hepatitis
b. portal hypertension
c. lymphoma
d. trauma

Answer 157

B

Question 158

The type of tissue within the spleen that is responsible for its phagocytic function is the:

a. red pulp
b. white pulp
c. culling pulp
d. pitting pulp

Answer 158

A

Question 159

A 32-year-old female patient presents to the ultrasound department for an abdominal sonogram. An evaluation of the spleen reveals a 1 cm, rounded, echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis?

a. pheochromocytoma
b. lipoma
c. splenic metastasis
d. hemangioma

Answer 159

D

Question 160

The spleen is a/an:

a. intraperitoneal organ
b. retroperitoneal organ

Answer 160

A

Question 161

The type of tissue within the spleen that is responsible for its lymphatic function us the:

a. red pulp
b. white pulp
c. culling segment
d. pitting segment

Answer 161

B

Question 162

The splenic vein marks the:

a. posterior aspect of the pancreatic body and tail
b. anterior aspect of the pancreatic body and tail
c. medial aspect of the pancreatic body and tail
d. lateral aspect of the pancreatic body and tail

Answer 162

A

Question 163

All of the following are functions of the spleen except:

a. storage of iron
b. defense against disease
c. blood reservoir
d. destruction of phagocytic cells

Answer 163

D

Question 164

Where is the most common location of an accessory spleen?

a. superior to the spleen
b. medial to the diaphragm and left kidney
c. splenic hilum
d. anterior to the pancreatic body

Answer 164

C

Question 165

All of the following can be associated with splenomegaly except:

a. trauma
b. hemolytic abnormalities
c. mononucleosis
d. pancreatitis

Answer 165

D

Question 166

Diffuse involvement of lymphoma or leukemia of the spleen will often lead to:

a. splenomegaly
b. splenic atrophy
c. epstein-barr infection
d. splenic torsion

Answer 166

A

Question 167

The splenic artery originates at the:

a. superior mesenteric artery
b. inferior phrenic artery
c. celiac trunk
d. gastroduodenal artery

Answer 167

C

Question 168

A 35-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen?

a. multiple histomas
b. multiple hemangioma
c. multiple metastatic lesions
d. multiple granulomas

Answer 168

D

Question 169

A 14-year-old male patient presents to the ultrasound department after falling for his bicycle. An abdominal sonogram reveals a complex-appearing mass within the spleen. This most likely represents a:

a. splenic hemangioma
b. splenic granuloma
c. splenic hematoma
d. splenic infarct

Answer 169

C

Question 170

Sickle cell disease will often lead to:

a. splenic metastasis
b. sarcoidosis
c. splenomegaly
d. wandering spleen

Answer 170

C

Question 171

Epstein-Barr infection is best described as:

a. a herpesvirus that can lead to infectious mononucleosis in children
b. a herpesvirus that is often associated with splenic granulomatous disease
c. an infection that results in sickle cell anemia in children
d. an infection within a splenic hematoma following blunt trauma

Answer 171

A

Question 172

The spleen removes irregular cells from the bloodstream and retains them through a process called:

a. pitting
b. culling
c. crimping
d. amassing

Answer 172

B

Question 173

An area within the spleen that has become necrotic because of a lack of oxygen is referred to as a:

a. splenic hemangioma
b. splenic hematoma
c. splenic infarct
d. granuloma

Answer 173

C

Question 174

What systemic disease results in the development of granulomas within the spleen and throughout the body?

a. granulomatosis
b. sarcoidosis
c. sickle cell anemia
d. histoplasmosis

Answer 174

B

Question 175

A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the:

a. bacterial endocarditic cyst
b. choledochal cyst
c. hydatid cyst
d. candidiasis

Answer 175

C

Question 176

From the list below, what is the most likely clinical finding of a patient who has a splenic hemangioma?

a. fever
b. decreased hematocrit
c. elevated white blood cell count
d. none

Answer 176

D

Question 177

In a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates:

a. Hodgkin lymphoma
b. Non-Hodgkin lymphoma
c. metastatic liver disease
d. splenic infarction

Answer 177

A

Question 178

All of the following are true of the spleen except:

a. it is the largest structure of the reticuloendothelial system
b. the primary objective of the spleen is to filter the peripheral blood
c. the spleen has a convex inferior margin and a concave superior border
d. the spleen is considered the largest lymphatic organ

Answer 178

C

Question 179

The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?

a. inferior mesenteric artery
b. superior mesenteric vein
c. inferior mesenteric artery
d. main hepatic vein

Answer 179

B

Question 180

Small echogenic foci scattered throughout the spleen most likely represent:

a. multiple benign hemangioma
b. multiple benign hematomas
c. multiple benign granulomas
d. malignant lymphoma

Answer 180

C