Rama Final

Question 1

What is a hernia?

Answer 1

Protrusion of abdominal cavity (bowel or fat) through abdominal wall

Question 2

Name 3 types of hernia

Answer 2

inguinal 
femoral
umbilical
epigastric
semilunar
incisional

Question 3

What maneuver do you use to visualize hernias?

Answer 3

Valsalva maneuver

Question 4

Where does inguinal hernia appear?

Answer 4

in spermatic cord or round ligament

Question 5

Ultrasound appearance of hernia

Answer 5

interaction of peritoneal line
outline contents of mass
peristalsis (absent with incarceration)
valsalva
reducibility with pressure

Question 6

signs and symptoms of appendicitis

Answer 6

nausea
vomiting
RLQ or periumbilical pain
fever
elevated WBC

Question 7

Differential diagnosis for appendicitis

Answer 7

Crohn’s disease
ovarian pathology
lymphoma
neoplasm

Question 8

Evaluation/Protocol for appendix

Answer 8

compression at RLQ
longitudinal
transverse
peri-appendiceal fluid
measurements

Question 9

Landmark for appendix

Answer 9

Cecum

Question 10

Sonographic appearance of normal appendix

Answer 10

not visualized

Question 11

Transducer of choice for appendix

Answer 11

Linear 7.5-12.0 MHz

Question 12

Sonographic appearance of abnormal appendix

Answer 12

no peristalsis
bulbous tip
thickened wall
not compressible
>6mm diameter with compression
peri-appendiceal fluid
hyperemia

Question 13

What are the most important measurements in the carotid?

Answer 13

peak systolic and end diastolic

Question 14

What are random biopsies?

Answer 14

no mass, but you want a tissue sample. Usually due to abnormal blood/urine tests

Question 15

Where should the needle be places in relationship to the transducer

Answer 15

parallel to the transducer so you can see the entire length of the needle

Question 16

What should always be done prior to a biopsy

Answer 16

Blood work to check coagulation time

Question 17

What two tests are done/calculated to check for coagulation?

Answer 17

Prothrombin time (PT) and International Normalized Ration (INR)

Question 18

What are the reasons for liver biopsy?

Answer 18

To confirm malignancy
to determine whether lesion is primary or mets
to determine cause of transplant rejection

Question 19

Contraindication for US-guided procedures

Answer 19

uncorrectable bleeding disorder
lack of safe needle path
uncooperative patient

Question 20

What are biopsied used for

Answer 20

to determine whether mass is benign, malignant or infectious

Question 21

How much fluid do you need to drain for diagnosis

Answer 21

60cc

Question 22

Where is paracenthesis done?

Answer 22

LLQ or RLQ

paracolic gutters

Question 23

Benefits of using needle guides

Answer 23

faster learning curve
faster placement of needle
ability to keep needle going through anesthetized area for multiple passes

Question 24

Key roles of ultrasound testicular exam

Answer 24

rule out intra-testicular mass/pathology

elevate blood flow

Question 25

name for undescended testicles

Answer 25

chryptorchidism

Question 26

most common location of undescended testicle

Answer 26

inguinal/groin region

Question 27

surgery to free undescended testicle

Answer 27

orchiopexy

Question 28

Most common cause of acute pain in adolescence

Answer 28

testicular torsion

Question 29

Sonographic appearance of torsion

Answer 29

``` focal or diffusely hypoechoic decrease in size Ischemia (decrease in blood flow) spectral wall thickening associated hydrocele ```

Question 30

inflammation of epididymis

Answer 30

epididymitis

Question 31

presentation of epididymitis

Answer 31

``` fever and painful urination swelling asymmetry hypoechoic testicle increased vascularity associated hydrocele ```

Question 32

infection/inflammation of the testicle

Answer 32

orchitis

Question 33

presentation of orchitis

Answer 33

``` fever elevated WBC enlarged testicle hypoechoic increased vascularity ```

Question 34

Location and cause of epididymal cysts

Answer 34

head of epididymis | caused by obstructed ducts

Question 35

Spermatocele

Answer 35

cysts filled with non-viable sperm | common in the head

Question 36

hydrocele

Answer 36

collection of fluid between layers of tunic vaginalis | most common cause of painless swelling

Question 37

hematocele

Answer 37

collection of blood

Question 38

pyocele

Answer 38

pus containing collection

Question 39

Where does a varicocele occur?

Answer 39

pampiniform plexus

Question 40

What causes vericoceles?

Answer 40

incompetent valves in the spermatic vein

Question 41

Which side are varicoceles more common on?

Answer 41

left

Question 42

Appearance of a vericocele

Answer 42

tortuous tubular structures increased size during valsalva greater than 2mm

Question 43

True/False | intra-testicular masses are usually malignant and extra-testicular masses are usually benign

Answer 43

True

Question 44

What is the size of a normal testicle

Answer 44

3-5cm length 2-4cm width 3cm AP

Question 45

Where do hydroceles occur?

Answer 45

between visceral and parietal layers of tunica vaginalis

Question 46

location of epididymis

Answer 46

superior and posteriolateral to tesis

Question 47

Size of epididymal head

Answer 47

6-15mm

Question 48

What is acute appendicitis

Answer 48

result of laminal obstruction and inflammation leading to ischemia of the vermiform appendix

Question 49

symptoms of cute appendicitis

Answer 49

``` pain, rebound tenderness at McBurney's point nausia diarrhea elevated WBC fever ```

Question 50

Where do spermatoceles occur?

Answer 50

rete testis or epididymis