Spleen Flashcards
A 15 year old male patient presents to the sonography department with a history of left sided trauma 5 years earlier. He currently has no LUQ discomfort. The sonographic findings of the spleen include a mass that contains calcification producing distinct posterior shadowing. What is the most likely diagnosis?
splenic hemangioma
splenic hamartoma
splenic lymphangioma
splenic hematoma
splenic hematoma
A 25 year old female patient presents to the sonography department for a complete abdominal sonogram. She complains of RLQ pain and nausea. The RUQ 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?
pancreatic cystadenocarcinoma
splenic hemangioma
accessory spleen
neuroblastoma
accessory spleen
a rare malignant tumor of the spleen that consists of blood vessels is a/an:
lymphoma
angiosarcoma
hemangioma
granuloma
angiosarcoma
A 48 year old male with a history of severe, sudden onset of LUQ pain without trauma presents to the sonography department for a sonogram of the spleen. You visualize a wedge-shaped, hypoechoic area within the spleen. This most likely represents a:
splenic infarct
splenic hematoma
splenic hemangioma
splenic metastasis
splenic infarct
a patient with a wandering spleen would have an increased risk for:
splenic infection
splenosis
splenic carcinoma
splenic torsion
splenic torsion
what is the most common sonographic appearance of a splenic hemangioma?
echogenic
hypoechoic
anechoic
complex
echogenic
the process of making RBCs is termed:
erythropoiesis
leukopoiesis
histopoiesis
anemia
erythropoiesis
multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most likely represent:
sarcoidosis
granulomas
lynphangiomas
hemangiomas
granulomas
the splenic artery marks the:
posterior aspect of the pancreatic body and tail
superior aspect of the pancreatic body and tail
medial surface of the pancreatic body and tail
lateral aspect of the pancreatic body and tail
superior aspect of the pancreatic body and tail
the most common cause of splenomegaly is:
hepatitis
PHTN
lymphoma
trauma
PHTN
the splenic hamartoma may be discovered more often in individuals with a history of:
HIV
splenic carcinoma
tuberous sclerosis
Meckel-Gruber syndrome
tuberous sclerosis
the type of tissue within the spleen that is responsible for its phagocytic function is the:
red pulp
white pulp
culling pulp
pitting pulp
red pulp
An evaluation of the spleen reveals a 1cm, rounded, echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis?
pheochromocytoma
lipoma
splenic metastasis
hemangioma
hemangioma
which of the following is a benign lesion that is a congenital malformation of the lymphatic system:
lymphangioma
hemangioma
angiosarcoma
myeloma
lymphangioma
the spleen is a/an:
intraperitoneal organ
retroperitoneal organ
intraperitoneal organ
the type of tissue within the spleen that is responsible for its lymphatic function is the:
red pulp
white pulp
culling segment
putting segment
white pulp
which of the following children would least likely to suffer from sickle cell anemia?
african american
caucasian
middle eastern
mediterranean
caucasian
the splenic vein marks the:
posterior aspect of the pancreatic body and tail
anterior aspect of the pancreatic body and tail
medial surface of the pancreatic body and tail
lateral aspect of the pancreatic body and tail
posterior aspect of the pancreatic body and tail
all of the following are functions of the spleen except:
storage of iron
defense against disease
blood reservoir
destruction of phagocytic cells
destruction of phagocytic cells
A 26 year old patient with a long-standing history of multiple sickle cell crises and subsequent splenic infarctions presents for an abdominal sonography. After thoroughly evaluating the LUQ, only a fraction of the splenic tissue can be identified. This describes the process of:
splenomegaly
asplenia
splenosis
autosplenectomy
autosplenectomy
where is the most common location of an accessory spleen?
superior to the spleen
medial to the diaphragm and Lt kidney
splenic hilum
anterior to the pancreatic body
splenic hilum
all of the following can be associated with splenomegaly EXCEPT:
trauma
hemolytic abnormalities
mononucleosis
pancreatitis
pancreatitis
what is the splenic process of cleaning RBCs of unwanted material?
pitting
plucking
culling
coring
pitting
diffuse involvement of lymphoma or leukemia of the spleen will often lead to:
splenomegaly
splenic atrophy
Epstein-Barr infection
splenic torsion
splenomegaly
the splenic artery originates at the:
SMA
inferior phrenic artery
celiac trunk
gastroduodenal artery
celiac trunk
which of the following is a congenital anomaly in which the spleen is divided into two portions by a band of tissue?
splenic infarct
splenic cleft
splenosis
splenic imperfecta
splenic cleft
A 35 year old male patient presents for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen?
multiple histomas
multiple hemangiomas
multiple metastatic lesions
multiple granulomas
multiple granulomas
A 14 year old male present for an ultrasound after falling from his bicycle. An abdominal sonogram reveals a complex-appearing mass within the spleen. This most likely represents a:
splenic hemangioma
splenic granuloma
splenic hematoma
splenic infarct
splenic hematoma
a sickle cell crisis will often lead to:
splenic metastasis
sarcoidosis
splenomegaly
wandering spleen
splenomegaly
Epstein-Barr infection is best described as:
a herpes virus that can lead to infectious mononucleosis
a herpes virus that is often associated with splenic granulomatous disease
an infection that results in sickle cell anemia in children
an infection within a splenic hematoma following blunt trauma
a herpes virus that can lead to infectious mononucleosis
the spleen removes irregular cells from the bloodstream through a process called:
pitting
culling
crimping
amassing
culling
an area within the spleen that has become necrotic because of a lack of oxygen is referred to as a:
splenic hemangioma
splenic hematoma
splenic infarct
granuloma
splenic infarct
what systemic disease results in the development of granulomas within the spleen and throughout the body?
granulomatosis
sarcoidosis
sickle cell anemia
Beckwith-Weismann syndrome
sarcoidosis
a complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the:
bacterial endocarditis cyst
cholecdochal cyst
hydatid cyst
candidiasis
hydatid cyst
what is the most likely clinical finding of a patient who has a splenic hemangioma?
fever
decreased hematocrit
elevated WBC count
asymptomatic
asymptomatic
in a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates:
Hodgkin lymphoma
Non-hodgkin lymphoma
metastatic liver disease
splenic infarction
Hodgkin lymphoma
which of the following describe the implantation of ectopic splenic tissue possibly secondary to splenic rupture?
splenosis
polysplenia
asplenia
wandering spleen
splenosis
all of the following are true of the spleen EXCEPT:
it is the largest structure of the reticuloendothelial system
the primary objective of the spleen is to filter peripheral blood
the spleen has a convex inferior margin and concave superior border
the spleen is considered the largest lymphatic organ
the spleen has a convex inferior margin and a concave superior border
the splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?
IMA
SMV
cephalic vein
main hepatic vein
SMV
small echogenic foci scattered throughout the spleen most likely represents:
multiple benign hemangioma
multiple benign hematomas
multiple benign granulomas
malignant lymphoma
multiple benign granulomas
which of the following structures is in contact with the spleen?
left hemidiaphragm
stomach
pancreas
splenic flexure of the colon
all of the above
all of the above
what view provides the best long-axis image of the spleen?
sag view from anterior position with patient supine
intercostal coronal view with patient supine
coronal view with patient in LLD
anterior sag view with patient in LLD
posterior sag view with patient in prone position
intercostal coronal view with the patient supine
which of the following is a cause of mild to moderate splenomegaly?
A. PHTN
B. infection
C. AIDS
D. lymphoma
A, B, and C only
A, B, and C only
what is the most common finding in the spleen in patients with AIDS?
abscess
metastasis
accessory spleen
moderate splenomegaly
lymphoma
moderate splenomegaly
which of the following would be most helpful in improving diagnostic confidence in splenic infarction?
have the patient perform valsalva maneuver
evaluate the lesion in both inspiration and expiration
evaluate lesion with color doppler
have the patient drink 48oz of water and rescan
rescan the patient in an upright position
evaluate the lesion with color doppler
During splenic sonography, you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum. What condition do you suspect?
PHTN
histoplasmosis
lymphoma
splenic rupture
splenic pseudocyst
PHTN
which structure will you detect at the splenic hilum?
diaphragm
splenic vein
left kidney
duodenum
LLL
splenic vein
what is the relationship of the pancreatic tail to the spleen?
superior and lateral
superior and medial
anterior
inferomedial
posterior
inferomedial
which can be used to describe the normal sonographic appearance of the splenic parenchyma?
heterogenous with mid to low level echogenicity
homogenous with mid to low level echogenicity
homogenous with echogenicity exceeding that of the liver
heterogenous with mixed echogenicity
normal spleen has varied appearance on ultrasound
homogenous with mid to low level echogenicity
what transducer provides the highest resolution images of the spleen?
2.25 MHz linear array
3.5 MHz phased array
5.0 MHz curved linear array
3.5 MHz curved linear array
2.25 MHz phased array
5.0 MHz curved linear array
which of the following is NOT true regarding the spleen?
located in the LUQ
is a retroperitoneal structure
lies between the fundus of the stomach and diaphragm
average adult spleen measures 12 cm in length
normal spleen decreases in size and weight with advanced age
the spleen is NOT a retroperitoneal structure
which of the following is a pitfall you might encounter in ultrasound scanning of the the spleen?
intercostal scanning may produce rib shadows obscuring the splenic parenchyma
in hepatomegaly, the LLL may be mistaken for the spleen
a mass on the tail of the pancreas may be confused with a splenic mass
an accessory spleen may be confused with an enlarged lymph node
all of the above
all of the above
You are performing and abdominal ultrasound on a patient with histoplasmosis. What findings of the spleen are commonly seen with this condition?
small, shrunken spleen
multiple hypoechoic masses throughout the spleen
splenic abscess
multiple focal, bright echogenic granulomatous lesions throughout the spleen
solitary cyst with calcified walls
multiple focal, bright echogenic granulomatous lesions throughout the spleen
the splenic vein drains into the what vein?
IMV
SMV
PV
LRV
IVC
PV
You are performing an ultrasound study on a patient with a history of recent blunt left-sided trauma in a motor vehicle accident. Which finding below is NOT associated with this history?
splenic laceration
subcapsular hematoma of the spleen
free fluid
perisplenic hematoma
calcified splenic cyst
calcified splenic cyst
You are performing an ultrasound study on a patient with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents:
histoplasmosis
tuberculosis
pseudocyst
metastasis
infarction
metastasis
During abdominal sonography of a patient with PHTN and splenomegaly, you detect a calcified ring at the splenic hilum. What should you do?
evaluate the area with color doppler
roll the patient into a decubitus position to see if the structure moves
have the patient drink 24 oz. of water and rescan
have the patient return for a repeat study in 1 week for comparison.
nothing, as this is not a significant finding
evaluate the area with color doppler
which of the following is NOT a feature you would detect in a splenic cyst?
smooth border
posterior acoustic enhancement
anechoic appearance
increased attenuation
rounded shape
increased attenuation