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ARDMS Practice Questions > Review Questions > Flashcards

Review Questions Flashcards

1
Q

Which organ is most likely to be affected in adult polycystic kidney disease?

A

Liver

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2
Q

Bilateral echogenic kidneys in newborns most likely represent?

A

Wilms’ tumors and autosomal recessive polycystic kidney disease

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3
Q

the most common cause of acute renal failure is

A

Acute tubular necrosis

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4
Q

A hypernephroma is a solid renal mass. it is known as

A
  • von grawitz tumor
    -renal cell carcinoma
    -adenocarcinoma of the kidney
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5
Q

What laboratory values may be elevated in renal failure

A

-protein
-creatinine
-BUN

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6
Q

elevated serum amylase may be secondary to all of the following except;
a. pancreatic duct obstruction
b. acute pancreatitis
c. liver disease
d. obstruction of the ampulla of Vater

A

Liver Disease

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7
Q

which laboratory value is associated with prostate carcinoma

A

Acid phosphatase

PAP Prostatic acid phosphatase aka PSAP prostatic specific acid phosphatase will be increase

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8
Q

Which laboratory values are elevated with liver metastases?

A

alpha-fetoprotein

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9
Q

which lab value is the most sensitive indicator of hepatocellular disease?

A

ALT (alanine aminotransferase)

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10
Q

Which laboratory value is specific for obstructive jaundice

A

Direct bilirubin

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11
Q

all of the following increase with hepatocellular disease except:
a. AST
b. SGOT
c. SGPT
d. PSA
e. ALT

A

PSA

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12
Q

alkaline phosphatase increased without elevation of alt maybe seen in

A
  • Mirizzi syndrome
  • Pancreatic carcinoma
  • Choledocholithiasis
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13
Q

Choledocholithiasis may result in

A

Increased direct bilirubin
Increased indirect bilirubin

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14
Q

Hemolytic disorders may result in

A

predominant increase in indirect bilirubin

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15
Q

What is the most common adrenal mass in a neonatal?

A

Adrenal Hemorrhage

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16
Q

What is the most common childhood adrenal mass

A

Wilm’s Tumor and Nueroblastoma

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17
Q

What is the most common primary carcinoma associated with adrenal metastases?

A

Lung

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18
Q

An adrenal mass which causes a propagation speed artifact is a

A

Myelolipoma

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19
Q

The adrenal glands and kidneys lie with in the

A

Perirenal space

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20
Q

Which vessels is interlobar and which is intrasegnmental

A

Hepatic Vein is interlobar ; Portal vein is intrasegmental

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21
Q

Addison’s disease is a syndrome that results from

A

Chronic Hypofunction

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22
Q

What structure lies directly medial to both adrenal glands?

A

Crus of the diaphragm

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23
Q

The IVC and Aorta are located in which retroperitoneum space?

A

Anterior pararenal space

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24
Q

Which of the following syndromes are associated with an adrenal mass

A

Cushing’s syndrome

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25
Q

Which of the following is not retroperitoneal?

Kidney
Prostate
Aorta
Colon
Spleen

A

Spleen

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26
Q

The retroperitoneal space is defined as the area between the

A

Posterior parietal peritoneum and the posterior abdominal wall muscles

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27
Q

Which is spread through a fecal -oral route?

A

Hepatitis A

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28
Q

if retroperitoneal fibrosis is suspected, what is the most common secondary finding?

A

Hydronephrosis due to bilateral ureteral obstruction.

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29
Q

the inferior mesenteric vein drains into the

A

Splenic Vein

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30
Q

Which vessel is imaged between the SMA and the Aorta

A

Left Renal Vein

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31
Q

The azygous vein

A

Connects the proximal abdominal IVC to the superior vena cava

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31
Q

Which vessel does not drain directly into the IVC

A

Left Gonadal Vein

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32
Q

Which of the following is a branch of the celiac axis?

A

Left gastric artery

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33
Q

Which of the following is not a correct anatomic landmark in relation to the thyroid

Sternocleidomastoid - anteriolateral
Longus colli muscle - posterior
Internal jugular vein - lateral
Trachea - medial
Minor neurovascular bundle – lateral

A

Minor neurovascular bundle – lateral

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34
Q

all of the following a para mimic a parathyroid adenoma

A

-minor nuerovascular bundle
-esophagus
-intrathyroidal adenoma

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35
Q

The halo sign is defined as a sonolucent rim surrounding a throid mass, it is commonly seen in

A

Adenomas

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36
Q

graves disease is associated with all of the following except
-Hypothyroidism
-Audible bruit
-Diffusely enlarged thyroid
-prominent eye (exophthalmos)
-Cardiovascular symptoms

A

Hypothyroidism

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37
Q

parathyroid adenomas may be associated with

A

Hypercalcemia

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38
Q

What is the most common primary thyroid cancer

A

papillary carcinoma

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39
Q

Peripheral or eggshell like calcification are indicative of a

A

Benign nodule

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40
Q

which of the following lab values would reflect a pt with graves?

A

decreased TSH, Increased T3 and T4

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41
Q

Hashimoto’s thyroiditis is characterized by all of the following

A

Glandular enlargement
coarse echotexture
hypothyroidism

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42
Q

Thyroglossal duct cysts are usually located

A

Anterior to the trachea

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43
Q

Strap muscle is ______ to thyroid

A

Anterior

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44
Q

sternocleidomastoid is ___________ to the thyroid

A

anterolateral

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45
Q

common carotid A, Internal Jugular V. are _________ to thyroid

A

lateral

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46
Q

Minor neurvascular bundle, Longus Colli Muscle parathyroid are ____________ to the thyroid

A

Posterior

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47
Q

The most common testicular tumor is a

A

Seminoma

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48
Q

to better image flow in a testicle for evaluation a torsion, you should

A

Decrease PRF

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49
Q

Anechoic lesions associated with the epididymis are

A

Epididymal cysts and spermatoceles

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50
Q

The spermatic cord consists of the

A

-Vas Deferens
- Creamasteric, deferential, testicular arteries
- Pampiniform plexus of veins
- Lymphatics

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51
Q

The most common cause of an acute scrotum in postpubertal males is

A

Epididymitis

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52
Q

A complication of cryptorchidism/orchioplexy is

A

Increased risk of malignancy

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53
Q

Hydroceles can be defined as serous fluid accumulated between the

A

Two layers of the tunica vaginalis

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54
Q

Most intratesticular masses are. . . Benign or Malignant?

A

Malignant

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55
Q

Most extratesticular masses are . . . Benign or Malignant?

A

Benign

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56
Q

Varicoceles are more common in the left or right of the scrotum?

A

Left

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57
Q

Which is the correct pathway of sperm from the testicle

A

ST,TR,RT,ED,DE,VD
Seminiferous Tubules, Tubuli recti, Rete Testes, Efferent ductules, Epididymis, Vas Deferens

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58
Q

Hypertrophic pyloric stenosis is characterized as

A

Increase in pyloric channel length, cross-sectional diameter, pyloric muscle thickness

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59
Q

Acute diverticulitis is characterized by

A

LLQ Pain, fever, Leukocytosis, Thickened bowel

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60
Q

Sonographically, the Gastroesophageal Junction can be visualized

A

Anterior to the Aorta and Posterior to the left lobe

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61
Q

Name the space of that is a recess of the peritoneum located between the uterus and the rectum

A

Pouch of Douglas

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62
Q

A 4 Month old infant presents with abdominal pain, rectal bleeding, and a palpable abdominal mass. What is the most likely pathology?

A

Intussusception

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63
Q

Which of the following is a component oof coagulation?

A

Vitamin K

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64
Q

What is the most likely dx in a pt with an elevation of CEA, Alkaline phosphatase, and GGT?

A

Liver Metastasis

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65
Q

Elevation of both GGT and ALP would most likely repersent

A

Biliary obstruction

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66
Q

A right adrenal mass will displace the superior pole of the kidney

A

Laterally

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67
Q

SGPT is the same laboratory value as

A

Alanine aminotransferase

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68
Q

Calcifications of the prostate are termed

A

Corpora amylacea

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69
Q

The largest percentage of cancers originate from which area of the prostate?

A

Peripheral Zone

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70
Q

The most common location for a pseudocyst is

A

Lesser sac

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71
Q

What is the classical sonographic appearance of prostate cancer?

A

Peripherally located and hypoechoic lesion.

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72
Q

PSA Levels Increase due to

A

prostate volume and age increase

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73
Q

What will increase PSA levels higher than that of BPH

A

Prostate cancer

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74
Q

Benign prostatic hyperplasia originates from the

A

transition zone

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75
Q

The Caudad portion of the gland is the

A

Prostatic Apex

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76
Q

What zone does the ejaculatory ducts pass through

A

Central zone of the prostate

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77
Q

What is the dcision between the inner gland and the peripheral zone

A

the surgical capsule

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78
Q

The fibromuscular stroma is a

A

Non-glandular anterior portion of the prostate

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79
Q

What structure marks the mid-point of the prostatic urethra by a small elevation of the urethral crest

A

Verumontanum

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80
Q

The seminal vesicles are located on which surface of the prostate?

A

Posterior/Superior surface

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81
Q

What is the most likely diagnosis in a pt with elevated AST and ALT

A

Hepatitis

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82
Q

Which of the following mist accurately describes the location of the caudate lobe

A

posterior to porta hepatis

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83
Q

Which of the following ligaments attaches the live to the anterior abdominal wall

A

Falciform

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84
Q

on spectral doppler, the hepatic veins are characterized by which of the following flow types

A

Multiphasic

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85
Q

Enlargement of the caudate lobe is most commonly associated with which of the following pathologies?

A

Cirrhosis

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86
Q

Which of the following spaces is located superior to the liver and inferior to the diaphragm?

A

Subphrenic Space

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87
Q

Which of the following conditions describes a congenital extension of the liver anterior and inferior to the right kidney?

A

Reidel lobe

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88
Q

The umbilical vein courses from the umbilicus to the

A

Left portal vein

89
Q

A transjugular intra hepatic portosystemic shunt (TIPS) is most commonly placed between the

A

RHV & RPV, (right hepatic vein and right portal vein)

90
Q

Prominence of the portal veins (starry night sign or periportal cuffing) is most commonly associated with which of the following pathologies?

A

Acute hepatitis

91
Q

Von Gierke disease is most commonly associated with:

A

Glycogen storage disease

92
Q

Which of the following liver pathologies is associated with immune-suppressed pts?

A

Candidiasis

93
Q

Which of the following hepatic structures is interlobar in locations

A

Hepatic Veins

94
Q

Pts with history of Hepatitis B have a predisposing risk factor for developing a (an)

A

Hepatoma

95
Q

The right lobe of the liver is divided into anterior and posterior segments by the

A

Right hepatic Vein (RHV)

96
Q

The left lobe of the liver is separated from the right lobe by which of the following structures

A

Middle Hepatic Vein and Main Lobar Fissure (MHV & MLF)

97
Q

The ductus venosum drains into the

A

IVC

98
Q

A Cavernous Hemangioma most commonly appears on ultrasound as a

A

Homogeneous hyperechoic mass

99
Q

Organs associated with polycystic disease include:

A

Adrenal Gland

100
Q

Which of the following landmarks are used to divide the liver into right and left lobes

A

GB Fossa, Main Lobar Fissure, Middle Hepatic Vein, Inferior vena cava

101
Q

Which of the following describes diffuse foci within the liver with or without shadowing, most often associated with acquired immunodeficiency syndrome?

A

Pneumocystis (carinii) jiroveci

102
Q

Which of the following are associated with an increase in incidence in renal cell carcinoma?

A

Multiple sclerosis

103
Q

Which of the following more commonly invades the Inferior Vena Cava?

A

Renal Cell Carcinoma

104
Q

Which of the following is a type of Hamartoma?

A

Angiomyolipoma

105
Q

What is the common cause of a hepatic abscess?

A

Biliary tract disease

106
Q

What is the most common location of a hepatic pyogenic abscess?

A

Right lobe

107
Q

A “Daughter Cyst” is associated with which of the following pathologies?

A

Hydatid Cyst

108
Q

Marked elevation in which of the following laboratory test is associated with obstructive jaundice?

A

Alkaline Phosphatase

109
Q

Which is the location of a Klatskin tumor?

A

Porta Hepatis

110
Q

what is the most common form of glycogen storage disease?

A

Von Gierke’s disease

111
Q

Which of the following is considered a “stealth lesion”?

A

Focal nodular hyperplasia

112
Q

Which of the following pharmacologic agents has been postulated to promote cavernous hemangioma growth?

A

Estrogen

113
Q

Which What is associated with pneumobilia?

A

-Sphincter of Odi Incompetency
-Emphysematous cholecystitis
-ERCP

114
Q

Choledochal cysts are more commonly associated with which ethnic group?

A

Japanese

115
Q

What portion of the pancreas is perpendicular to the sound beam?

A

Body

116
Q

what are the tributary of the main portal vein

A

-Right gastric vein
-Coronary vein
-Cystic Vein

117
Q

What is the most common cause of a hyperechoic pancreas is a child

A

Cystic Fibrosis

118
Q

Which of the following is a branch of the proper hepatic artery?

A

Right Gastric Artery

119
Q

What is the single most common cause of acute pancreatitis

A

Gallstones
Alcohol abuse is 2nd

120
Q

What is the single most common cause of chronic pancreatitis

A

Alcohol abuse

121
Q

What is the most common cause of a pseudocyst in a child

A

Abdominal trauma

122
Q

Which vessel may demonstrate retrograde flow with anterior nutcracker syndrome

A

Gonadal Vein

123
Q

What condition is suggested by intrahepatic ductal dilatation and the absence of the common hepatic duct in the neonate?

A

Biliary atresia

124
Q

What is the most likely diagnosis of a round anechoic mass located on the midline of the neck?

A

Thyroglossal duct cyst

125
Q

Which would be most diagnostically useful when hydronephrosis is discovered

A

Check Bladder for Ureteral jets

126
Q

What is the term for a color doppler artifact seen posterior to a strong reflector

A

Twinkle

127
Q

Which medicine may be discontinued before performing an ultrasound-guided biopsy

A

Heparin

128
Q

Describes a fact the caudate lobe

A

It receives its blood supply from the right and left portal vein

129
Q

Where is the superior mesenteric artery in relation to the pacreas

A

Posterior

130
Q

Ascites in the upper abdomen of a supine PT will accumulate between which structure

A

Liver and the right kidney

131
Q

Where are the spiral valves of heister located?

A

Cystic duct

132
Q

What is the term for hyperplasia of the thyroid?

A

Goiter

133
Q

The ligamentum venosum appears as a echogenic band that divides which two structures

A

Left lobe of the liver and the caudate lobe

134
Q

An ultrasound examination of a PT who has a cholangiocarcinoma at the level of the common hepatic duct is most likely to reveal which finding?

A

Dilated intrahepatic bile ducts

135
Q

What velocity info do the pixels of a color doppler image provide?

A

Mean Velocity

136
Q

What waveform characteristic produces power or energy imaging?

A

Amplitude

137
Q

The parallel channel sign is most often associated with which disease process

A

Cholangiocarcinoma

138
Q

What is the most likely clinical sign in a PT with elevated indirect bilirubin

A

Jaundice

139
Q

Which laboratory value decreases in the hepatocellular disease?

A

Albumin

140
Q

Which term defines hospital acquired infections?

A

Nosocomial

141
Q

Which portion of the penis contains the urethra

A

Corpus spongiosum

142
Q

In a PT with normal portal pressures, the left (coronary) gastric vein drains into the

A

Main Portal Vein

143
Q

if testicular torsion occurs in a neonate, it is most likely a (an)

A

Extravaginal torsion

144
Q

Peyronies disease is a demonstration of calcifications along what portion of the penis?

A

Dorsal

145
Q

Which portion of the penis contains the urethra?

A

corpus spongiosum

146
Q

When scanning the penis in the anatomic position, what structure is in the near field?

A

Corpus spongiosum

147
Q

The superior extension of the thyroid isthmus is referred to as the

A

Pyramidal lobe

148
Q

why is paracentesis performed prior to TIPS placement in PTs with ascites?

A

creates a more favorable angle between the hepatic veins and IVC for the procedure

149
Q

Which of the following is a prehepatic cause for jaundice?

A

Gilbert’s syndrome

150
Q

Which of the following is an intra-hepatic cause for jaundice?

A

Primary sclerosing cholangitis

151
Q

Which of the following is a post-hepatic cause for jaundice?

A

Pancreatic adenocarcinoma

152
Q

when preforming shear wave elastography, what is the recommended number of sampling

A

10

153
Q

Which METAVIR stage is indicative of cirrhosis?

A

F4

154
Q

Which METAVIR stage is indicative of normal liver parenchyma

A

F0

155
Q

When performing hepatic elastography, the region of intrest is

A

2 cm below Glisson’s capsule in the right lobe of the liver

156
Q

Which sonoelastography technique is used to determine hepatic fibrosis

A

shear wave

157
Q

An Ectopic ureterocele is associated with which complication?

A

Upper pole hydronephrosis

158
Q

Which of the following represents the most commonly reported cause of a palpable abdominal mass in the newborn

A

multicystic dysplastic kidney

159
Q

Anechoic masses that occur around a renal transplant included

A

-Urinoma
-Lymphocele
-Hematoma
-Corpus luteal cyst

160
Q

Which statement about the kidney is false?

A

Kidneys rest on the psoas laterally and quadratus lumborum medially

161
Q

a 3 year old boy present with hematuria and a palpable left flank mass. sonography depicts a solid renal mass. This finding would most likely represent

A

Wilms’ tumor

162
Q

While preforming an ultrasound exam, the sonographer finds that both kidneys measure 5 cm in length. they are very echogenic. What or possible DX?

A

-Chronic glomerulonephritis
-Chronic pyelonephritis
-Bilateral renal artery disease

163
Q

What is the most common newborn abdominal mass associated with a decrease in hematocrit?

A

Adrenal Hemorrhage

164
Q

Which of the following is not a cause of splenomegaly?

A

Pancreatitis

165
Q

Which of the following is not associated with splenic trauma

A

Perinephric fluid collection

166
Q

A Wedge-shaped lesion within the spleen is associated with

A

splenic infarct

167
Q

the most common cause of splenomegaly is

A

portal hypertension

168
Q

The congenital absence of the spleen is associated with

A

visceral heterotaxy

169
Q

Which of the following diseases would result in splenic atrophy (autosplenectomy)

A

sickle-cell anemia

170
Q

which of the following are associated with splenomegaly?

A

polycythemia vera
lymphoma
portal vein thrombosis
schistosomiasis

171
Q

What is the correct path of a red blood cell returning to the heart

A

Splenic vein, Portal vein, Right portal vein, emissary veins, IVC, right atrium

172
Q

Which o the following will displace the the superior mesenteric artery anteriorly?

A

left renal vein thrombosis

173
Q

Which of the following is correct?

A

The lesser sac is located anterior and superior to the pancreas

174
Q

Which of the following will displace the superior mesenteric artery anteriorly?

A

left renal vein thrombosis.

175
Q

Which of the following is correct?

A

the lesser sac is located anterior and superior to the pancreas

176
Q

The CBD is joined with the pancreatic duct before entering the

A

second portion of the duodenum

177
Q

the gastroduodenal artery

A

-is the first branch of the common hepatic artery
-proceeds caudally along the anterolateral margin of the pancreatic head
-is seen in the transverse views directly anterior to the common bile duct
-is the point where the common hepatic artery becomes the hepatic artery proper

178
Q

islet cell tumors of the pancreas are most likely to be located

A

frequently in the body and tail, rarely in the head

179
Q

Chronic pancreatitis may be associated with which of the following sonographic patterns?

A

-Increased echogenicity
-decrease in pancreas size
-calcifications
-dilated pancreatic duct

180
Q

Occasionally a puesdocysts may have internal echoes and be confused with an abscess. to distinguish the two, one should look for

A

Gas

181
Q

The pancreas is located in the

A

Retroperitoneum

182
Q

The portion of the pancreas that lies posterior to the superior mesenteric artery and vein is the

A

uncinate process

183
Q

the most common primary neoplasm of the pancreas is adenocarcinoma

A

-usually found in the head of the pancreas
-accompanies by weight loss and painless jaundice
-accompanied by dilated gallbladder
-causes dilatation of the CBD

184
Q

Throughout its course, the splenic vein is located on the

A

posterior surface of the pancreatic body and tail

185
Q

Courvoisier sign is associated with all of the following except

A

hepatocellular carcinoma

186
Q

Throughout it’s course, the splenic vein is located on the

A

posterior surface of the pancreatic body and tail.

187
Q

Courvoisiers sign is associated with all the following

A

-Pancreatic carcinoma
-Dilated GB
-Biliary duct dilatation
-painless jaundice

188
Q

Courvoisiers sign is associated with all the following:
-Pancreatic carcinoma
-Dilated GB
-Hepatocellular Carcinoma
-Biliary duct dilatation
-painless jaundice

A

-Hepatocellular carcinoma

189
Q

G B wall thickening may be due to all of the following

A

-Ascites
-Hypoproteinemia
-right-sided congestive failure
-acute cholecystitis

190
Q

Which of the following is associated with Caroli’s disease

A

dilated intrahepatic bile ducts

191
Q

The causes of a large GB include all of the following

A

-Cystic duct obstruction
-Pancreatic Carcinoma
-Diabetes Mellitus
-A fasting PT
-Common duct obstruction

192
Q

A Phrygian cap is

A

A fold at the GB Fundus

193
Q

increased levels of alkaline phosphatase are expected with

A

-Biliary obstruction
-Children
-Hepatocellular disease
-Pregnancy

194
Q

A 48 year old female presents post cholecystectomy with RUQ pain, Elevated serum bilirubin (manly conjugated) and bilirubin in her urine. It is true that

A

she probably has a stone tumor or stricture obstructing the bile duct

195
Q

Dilatational of the intrahepatic biliary tree without dilatation of the extrahepatic duct includes all of the following except

A

-Klatskin tumor
-Enlarged portal lymph nodes at the porta hepatis
-Cholangiocarcinoma

196
Q

if on US exam, one finds a PT with intrahepatic dilated ducts and a small GB, this may indicated that the level of obstruction

A

Above the cystic duct

197
Q

A parasitic, disease of the liver that causes portal hypertension and occlusion of the portal veins is

A

Schistosomiasis

198
Q

All of the following mass lesions are benign

A

-Hematoma
-Hamartoma
-Hepatic adenoma
-Hemangioma

199
Q

Which part of the liver is least affected by Budd Chiari?

A

Caudate

200
Q

Caudate lobe venous drainage is primarily through

A

The emissary veins

201
Q

Budd Chiari is occlusion of the

A

Hepatic Veins

202
Q

Which is in decreasing order of echogenicity

A

Renal sinus > Pancreas > Liver > Renal Parenchyma

203
Q

Cystic Lesions with in the liver included all of the following except
-Congenital cysts
-Polycystic liver disease
-Caroli’s disease
-Hemangiomas

A

Hemangiomas

204
Q

The ligamentum teres

A

-Resides in the left intersegmental fissure
-A remnant of the umbilical vein
-Recanalized in servere cirrhosis
-An echogenic spot on transverse liver images

205
Q

The caudate lobe is located on the

A

posterosuperior surface of the liver

206
Q

the ligamentum venosum is all of the following except

A

A remnant of the umbilical vein

207
Q

Which fetal circulation pathway connects the left portal vein to the IVC

A

Ductus Venosus

208
Q

All of the following are associated with echinococcal cysts except

A

Ascites

209
Q

Right liver lobe is supplied by what vessel

A

right portal vein

210
Q

Left liver lobe is supplied by what vessel

A

left portal vein

211
Q

Caudate lobe is supplied by what vessel

A

Right and Left vein

212
Q

Where does the caudate lobe lie

A

posterior-superior surface between the IVC and medial left lobe

213
Q

What vessels drain the caudate lobe

A

Emissary veins drain directly into the IVC

214
Q

Caudate lobe is specifically located

A

-Posterior to the Ligamentum venosum & Porta Hepatis
-Anterior and Medial to IVC
-Lateral to Lesser Sac

215
Q

IVC maybe compressed if what part of the level is enlarged

A

Caudate Lobe

216
Q

What segments are in the right posterior

A

Segments VI (6) & VII (7)

217
Q

What segments are in the right anterior

A

Segments V (5) & VIII (8)

218
Q

What segments are in the left medial

A

Segments IVa (4a) & IVb (4b)

219
Q
A

ARDMS Practice Questions (2 decks)

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