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ARDMS ABD REVIEW > Spleen > Flashcards

Spleen Flashcards

1
Q

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

A

splenic hematoma

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2
Q

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

A

accessory spleen

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3
Q

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

lymphoma
angiosarcoma
hemangioma
granuloma

A

angiosarcoma

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4
Q

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

A

splenic infarct

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5
Q

a patient with a wandering spleen would have an increased risk for:

splenic infection
splenosis
splenic carcinoma
splenic torsion

A

splenic torsion

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6
Q

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

echogenic
hypoechoic
anechoic
complex

A

echogenic

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7
Q

the process of making RBCs is termed:

erythropoiesis
leukopoiesis
histopoiesis
anemia

A

erythropoiesis

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8
Q

multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most likely represent:

sarcoidosis
granulomas
lynphangiomas
hemangiomas

A

granulomas

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9
Q

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

A

superior aspect of the pancreatic body and tail

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10
Q

the most common cause of splenomegaly is:

hepatitis
PHTN
lymphoma
trauma

A

PHTN

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11
Q

the splenic hamartoma may be discovered more often in individuals with a history of:

HIV
splenic carcinoma
tuberous sclerosis
Meckel-Gruber syndrome

A

tuberous sclerosis

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12
Q

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

red pulp
white pulp
culling pulp
pitting pulp

A

red pulp

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13
Q

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

A

hemangioma

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14
Q

which of the following is a benign lesion that is a congenital malformation of the lymphatic system:

lymphangioma
hemangioma
angiosarcoma
myeloma

A

lymphangioma

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15
Q

the spleen is a/an:

intraperitoneal organ
retroperitoneal organ

A

intraperitoneal organ

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16
Q

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

red pulp
white pulp
culling segment
putting segment

A

white pulp

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17
Q

which of the following children would least likely to suffer from sickle cell anemia?

african american
caucasian
middle eastern
mediterranean

A

caucasian

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18
Q

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

A

posterior aspect of the pancreatic body and tail

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19
Q

all of the following are functions of the spleen except:

storage of iron
defense against disease
blood reservoir
destruction of phagocytic cells

A

destruction of phagocytic cells

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20
Q

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

A

autosplenectomy

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21
Q

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

A

splenic hilum

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22
Q

all of the following can be associated with splenomegaly EXCEPT:

trauma
hemolytic abnormalities
mononucleosis
pancreatitis

A

pancreatitis

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23
Q

what is the splenic process of cleaning RBCs of unwanted material?

pitting
plucking
culling
coring

A

pitting

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24
Q

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

splenomegaly
splenic atrophy
Epstein-Barr infection
splenic torsion

A

splenomegaly

25
Q

the splenic artery originates at the:

SMA
inferior phrenic artery
celiac trunk
gastroduodenal artery

A

celiac trunk

26
Q

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

A

splenic cleft

27
Q

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

A

multiple granulomas

28
Q

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

A

splenic hematoma

29
Q

a sickle cell crisis will often lead to:

splenic metastasis
sarcoidosis
splenomegaly
wandering spleen

A

splenomegaly

30
Q

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

a herpes virus that can lead to infectious mononucleosis

31
Q

the spleen removes irregular cells from the bloodstream through a process called:

pitting
culling
crimping
amassing

A

culling

32
Q

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

A

splenic infarct

33
Q

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

granulomatosis
sarcoidosis
sickle cell anemia
Beckwith-Weismann syndrome

A

sarcoidosis

34
Q

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

A

hydatid cyst

35
Q

what is the most likely clinical finding of a patient who has a splenic hemangioma?

fever
decreased hematocrit
elevated WBC count
asymptomatic

A

asymptomatic

36
Q

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

Hodgkin lymphoma
Non-hodgkin lymphoma
metastatic liver disease
splenic infarction

A

Hodgkin lymphoma

37
Q

which of the following describe the implantation of ectopic splenic tissue possibly secondary to splenic rupture?

splenosis
polysplenia
asplenia
wandering spleen

A

splenosis

38
Q

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

A

the spleen has a convex inferior margin and a concave superior border

39
Q

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

IMA
SMV
cephalic vein
main hepatic vein

A

SMV

40
Q

small echogenic foci scattered throughout the spleen most likely represents:

multiple benign hemangioma
multiple benign hematomas
multiple benign granulomas
malignant lymphoma

A

multiple benign granulomas

41
Q

which of the following structures is in contact with the spleen?

left hemidiaphragm
stomach
pancreas
splenic flexure of the colon
all of the above

A

all of the above

42
Q

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

A

intercostal coronal view with the patient supine

43
Q

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

A, B, and C only

44
Q

what is the most common finding in the spleen in patients with AIDS?

abscess
metastasis
accessory spleen
moderate splenomegaly
lymphoma

A

moderate splenomegaly

45
Q

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

A

evaluate the lesion with color doppler

46
Q

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

A

PHTN

47
Q

which structure will you detect at the splenic hilum?

diaphragm
splenic vein
left kidney
duodenum
LLL

A

splenic vein

48
Q

what is the relationship of the pancreatic tail to the spleen?

superior and lateral
superior and medial
anterior
inferomedial
posterior

A

inferomedial

49
Q

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

A

homogenous with mid to low level echogenicity

50
Q

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

A

5.0 MHz curved linear array

51
Q

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

A

the spleen is NOT a retroperitoneal structure

52
Q

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

A

all of the above

53
Q

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

A

multiple focal, bright echogenic granulomatous lesions throughout the spleen

54
Q

the splenic vein drains into the what vein?

IMV
SMV
PV
LRV
IVC

A

PV

55
Q

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

A

calcified splenic cyst

56
Q

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

A

metastasis

57
Q

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

A

evaluate the area with color doppler

58
Q

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

A

increased attenuation

ARDMS ABD REVIEW (27 decks)

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