Test 4 Flashcards
Anatomy should always be evaluated with (blank) prior to biopsy
ultrasound
What must be visible on ultrasound to be successful?
Targeted area
What is staging of known parenchymal disease?
Cirrhosis
Non-alcoholic fatty liver disease (NAFLD)
Primary biliary cirrhosis (PBC)
Which of the following is a contraindication for a liver biopsy?
a) Uncooperative patient
b) Elevated blood pressure
c) Healthy coagulation parameters
d) Stable ascites
a) Uncooperative patient
What should be discontinued 7-10 days before a liver biopsy?
a) Warfarin
b) Heparin
c) Antiplatelet medications
d) Sedation medication
c) Antiplatelet medications
For how many hours should a patient remain NPO before a liver biopsy?
a) 2 hours
b) 4 hours minimum
c) 8 hours
d) No restriction
b) 4 hours minimum
What is the most commonly used gauge size for a liver biopsy needle?
a) 12g
b) 14g
c) 18g
d) 20g
b) 14g
What type of renal biopsy is performed when there is a focal lesion?
a) Non-targeted biopsy
b) Non-focal biopsy
c) Targeted biopsy
d) Radial biopsy
c) Targeted biopsy
Which of the following is NOT a contraindication for a renal biopsy?
a) Peri-renal abscess
b) Renal malformations
c) Normal blood pressure
d) Abnormal coagulation parameters
c) Normal blood pressure
What is a major risk associated with a renal biopsy?
a) Elevated cholesterol
b) Perinephric hematoma
c) Increased white blood cell count
d) Joint pain
b) Perinephric hematoma
Which gauge is most commonly used for a renal biopsy needle?
a) 10g
b) 12g
c) 18g
d) 22g
c) 18g
In breast procedures, lesions classified as BI-RADS 4 are considered to be:
a) Normal
b) Probably benign
c) Suspicious
d) Malignant
c) Suspicious
During a thyroid FNA, which TI-RADS category indicates a high risk of malignancy (>80%)?
a) TI-RADS 2
b) TI-RADS 3
c) TI-RADS 5
d) TI-RADS 4a
c) TI-RADS 5
- What is the typical patient position for a lateral approach in a breast biopsy?
a) Supine
b) Prone
c) Slightly oblique with the affected side’s arm raised
d) Sitting upright
c) Slightly oblique with the affected side’s arm raised
- Which of the following is NOT typically included in the supply list for a liver biopsy?
a) Sterile biopsy kit
b) Anticoagulants
c) Sterile gel
d) Scalpel
b) Anticoagulants
- Which anticoagulant should be resumed 48 hours after a liver biopsy?
a) Plavix
b) Warfarin
c) Heparin
d) Aspirin
c) Heparin
- What is the recommended blood pressure threshold for a renal biopsy?
a) 160/100 mmHg
b) 140/90 mmHg or less
c) 130/85 mmHg
d) No specific threshold
b) 140/90 mmHg or less
- Which of the following is a common risk associated with thyroid FNA?
a) Severe allergic reaction
b) Vasovagal reaction
c) Cardiovascular collapse
d) Severe infection
b) Vasovagal reaction
- For a thyroid FNA, the patient is typically positioned:
a) Prone with head turned to the side
b) Supine with chin raised and shoulders elevated
c) Sitting upright with neck tilted back
d) Lying on the side
b) Supine with chin raised and shoulders elevated
- What is used to extend the neck during a thyroid FNA?
a) A rolled towel
b) A firm pillow
c) A foam neck brace
d) A surgical collar
b) A firm pillow
- What does the TI-RADS classification system assess?
a) Breast density
b) Liver lesion risk
c) Renal mass size
d) Thyroid nodule malignancy risk
d) Thyroid nodule malignancy risk
- What is the recommended needle size range for a thyroid FNA?
a) 14-16 gauge
b) 18-20 gauge
c) 22-27 gauge
d) 30-35 gauge
c) 22-27 gauge
- What should be documented before performing a thyroid FNA?
a) Patient’s fasting blood sugar levels
b) Informed consent
c) Prior biopsy reports
d) Family history of thyroid disease
b) Informed consent
- In breast imaging, what does a location annotated as “RT breast 1:30, 4 cm” indicate?
a) Right breast, upper outer quadrant, 4 cm from nipple
b) Right breast, lower inner quadrant, 4 cm from nipple
c) Right breast, at the 1:30 clock position, 4 cm from the nipple
d) Right breast, 4 cm below the nipple
c) Right breast, at the 1:30 clock position, 4 cm from the nipple
- Which of the following describes the recommended anticoagulant management before a renal biopsy?
a) Discontinue 1-2 days prior
b) Continue anticoagulants without interruption
c) Discontinue approximately 1 week prior
d) Double the dosage 2 days before procedure
c) Discontinue approximately 1 week prior
- During a breast core biopsy, which of the following types of lesions are typically targeted?
a) Cystic lesions
b) Solid lesions
c) Non-palpable lesions
d) Vascular lesions
b) Solid lesions
- What is the primary purpose of using sterile gel in ultrasound-guided biopsies?
a) To reduce patient discomfort
b) To improve image clarity
c) To sterilize the skin
d) To act as a local anesthetic
b) To improve image clarity
- What is the appropriate action if abnormal coagulation parameters are identified before a biopsy?
a) Proceed with the biopsy
b) Postpone and correct the coagulation issues
c) Use a larger needle to compensate
d) Ignore the results if the patient is asymptomatic
b) Postpone and correct the coagulation issues
- Which of the following is NOT a typical indication for a renal biopsy?
a) Acute kidney injury
b) Proteinuria > 1g/day
c) Renal malformations
d) Decreasing renal function in transplant patients
c) Renal malformations
- What should be done immediately following a liver biopsy?
a) Send the patient home
b) Perform a scan to check for bleeding
c) Place the patient in an upright position
d) Initiate anticoagulant therapy
b) Perform a scan to check for bleeding
- In breast biopsy procedures, what is the purpose of clip placement?
a) To reduce bleeding risk
b) To mark the biopsy site for future reference
c) To collect more tissue
d) To anesthetize the area
b) To mark the biopsy site for future reference
- What is a common complication following a renal biopsy?
a) Joint pain
b) Hematuria
c) Severe nausea
d) Loss of vision
b) Hematuria
- Which of the following is used to anesthetize the skin during a biopsy procedure?
a) Morphine
b) Lidocaine
c) Ibuprofen
d) Sterile saline
b) Lidocaine
- What should be done if a patient presents with ascites before a liver biopsy?
a) Proceed without any changes
b) Drain the ascites prior to the biopsy
c) Use a larger biopsy needle
d) Increase the amount of local anesthetic
b) Drain the ascites prior to the biopsy
- What type of biopsy is typically performed for non-palpable breast lesions visible on ultrasound?
a) Core biopsy
b) Fine needle aspiration
c) Open surgical biopsy
d) Excisional biopsy
a) Core biopsy
- For a targeted renal biopsy, which imaging technique is commonly used for guidance?
a) X-ray
b) Ultrasound
c) MRI
d) CT scan
b) Ultrasound
- Which of the following should NOT be used immediately after a biopsy procedure?
a) Sterile bandages
b) Antibiotics if necessary
c) Anticoagulants
d) Ice pack for swelling
c) Anticoagulants
- What type of biopsy uses a vacuum-assisted device for tissue collection?
a) Core biopsy
b) Fine needle aspiration
c) Punch biopsy
d) Stereotactic biopsy
a) Core biopsy
- When imaging a breast, which annotation is used to specify the location?
a) Quadrant and clock-face reference
b) Height and weight of the patient
c) Skin color and texture
d) Gender and age
a) Quadrant and clock-face reference
- What is the primary risk of a thyroid FNA?
a) Respiratory failure
b) Vasovagal reaction
c) Loss of voice
d) Severe anemia
b) Vasovagal reaction
- What factor determines whether a breast cyst should be aspirated?
a) Patient age
b) Cyst size and visibility on ultrasound
c) Presence of calcifications
d) Family history of cancer
b) Cyst size and visibility on ultrasound
- How long should a patient avoid strenuous activity after a liver biopsy?
a) 12 hours
b) 24 hours
c) 48 hours
d) 72 hours
c) 48 hours
- Which of the following describes a BI-RADS 3 lesion?
a) Normal
b) Benign
c) Probably benign
d) Malignant
c) Probably benign
What is the role of a “time out” before a biopsy procedure?
a) To allow the patient to relax
b) To check for allergies
c) To confirm patient identity and procedure details
d) To sanitize the equipment
c) To confirm patient identity and procedure details
Which patient position is recommended for a liver biopsy?
a) Upright with arms raised
b) Supine with the right arm extended above the head
c) Prone with the back arched
d) Side-lying with legs crossed
b) Supine with the right arm extended above the head
What is a primary contraindication for a thyroid FNA?
a) Previous history of hypertension
b) Skin infection at the biopsy site
c) Normal coagulation profile
d) Prior thyroid surgery
b) Skin infection at the biopsy site
In which situation is local anesthetic typically NOT required?
a) Core biopsy
b) Vacuum-assisted biopsy
c) Thyroid FNA without sedation
d) Renal biopsy under sedation
d) Renal biopsy under sedation
Which TI-RADS category would suggest a nodule with a 5-10% risk of malignancy?
a) TI-RADS 2
b) TI-RADS 3
c) TI-RADS 4a
d) TI-RADS 5
c) TI-RADS 4a
What is the purpose of using a probe cover in ultrasound-guided procedures?
a) To reduce friction on the patient’s skin
b) To improve visibility of the lesion
c) To maintain a sterile environment
d) To enhance the resolution of the ultrasound image
c) To maintain a sterile environment
How many hours before a liver biopsy should a patient ideally be NPO if using sedation?
a) 2 hours
b) 4-6 hours
c) 8-10 hours
d) No restriction if using sedation
b) 4-6 hours
What is the recommended action if a patient experiences a vasovagal reaction during a thyroid FNA?
a) Increase the speed of the procedure
b) Apply ice to the thyroid area
c) Pause the procedure and provide reassurance
d) Administer antibiotics
c) Pause the procedure and provide reassurance
• What is a potential complication of a renal biopsy involving the colon?
a) Colonic stricture
b) Colonic ulcer
c) Colonic injury
d) Colonic perforation
c) Colonic injury
Which type of biopsy is commonly performed with a 14, 16, or 18-gauge needle?
a) Fine needle aspiration
b) Core biopsy
c) Open surgical biopsy
d) Punch biopsy
b) Core biopsy
What should be explained to a patient before a liver biopsy?
a) Expected time of procedure
b) Possible change in taste sensation
c) The sound the biopsy needle will make when deployed
d) Risk of permanent scarring
c) The sound the biopsy needle will make when deployed
- Which of the following is NOT typically an indication for a breast biopsy?
a) Palpable lump
b) Lesion classified as BI-RADS 5
c) Normal ultrasound appearance
d) Cystic lesion with suspicious characteristics
c) Normal ultrasound appearance
- What type of needle is commonly used for thyroid FNA?
a) 10-gauge
b) 14-gauge
c) 22-27 gauge
d) 20-gauge
c) 22-27 gauge
- What complication should be monitored immediately after a renal biopsy?
a) Loss of appetite
b) Hematuria
c) High blood pressure
d) Joint pain
b) Hematuria
- What is a common follow-up action after a breast biopsy with clip placement?
a) Immediate surgery
b) Follow-up imaging to confirm clip position
c) Blood transfusion
d) Removal of the clip after 24 hours
b) Follow-up imaging to confirm clip position
- In which type of biopsy would the patient likely receive IV sedation?
a) Thyroid FNA
b) Liver biopsy
c) Breast cyst aspiration
d) Core biopsy with clip placement
b) Liver biopsy
- What is the purpose of using a specimen collection container during a biopsy?
a) To prevent contamination of the biopsy needle
b) To store the anesthetic
c) To collect tissue samples for analysis
d) To dispose of used gloves
c) To collect tissue samples for analysis
- Which condition should be corrected before proceeding with a renal biopsy?
a) High white blood cell count
b) Abnormal coagulation parameters
c) Low red blood cell count
d) Minor skin infection
b) Abnormal coagulation parameters
- What is the risk of bleeding during a renal biopsy if the patient’s systolic blood pressure is over 170?
a) 5 times higher
b) 10 times higher
c) 15 times higher
d) 26 times higher
d) 26 times higher
- What is the recommended management for anticoagulants before a liver biopsy?
a) Continue anticoagulants normally
b) Discontinue anticoagulants 24 hours before
c) Withhold anticoagulants 5-7 days prior
d) Discontinue anticoagulants on the day of the biopsy
c) Withhold anticoagulants 5-7 days prior
Which of the following is typically used to anesthetize the area during a thyroid FNA?
a) Lidocaine
b) Morphine
c) Ibuprofen
d) Acetaminophen
a) Lidocaine
Which of the following supplies is essential for ensuring sterility during a biopsy?
a) Surgical mask
b) Bandages
c) Sterile gloves
d) Cotton swabs
c) Sterile gloves
What should be documented as part of the informed consent for a biopsy?
a) Patient’s employment history
b) Previous surgeries
c) Risks and benefits of the procedure
d) Medications used during the last year
c) Risks and benefits of the procedure
Which factor is essential to evaluate in a patient’s medical history before performing a renal biopsy?
a) History of allergic reactions
b) History of liver disease
c) Blood pressure control
d) Recent travel history
c) Blood pressure control
For a liver biopsy, what is the primary purpose of numbing the area from the skin to the liver capsule?
a) To prevent infection
b) To ensure patient comfort during the biopsy
c) To increase blood flow to the biopsy site
d) To stimulate healing post-procedure
b) To ensure patient comfort during the biopsy
What type of breast lesion typically requires vacuum-assisted biopsy?
a) Non-suspicious cystic lesions
b) Calcifications visible on ultrasound
c) Solid, suspicious lesions
d) Large, palpable masses
c) Solid, suspicious lesions
What is a potential risk during an ultrasound-guided thyroid FNA?
a) Severe blood loss
b) Vasovagal reaction
c) Hypertensive crisis
d) Acute renal failure
b) Vasovagal reaction
Why is ultrasound preferred during renal biopsies?
a) It is less expensive than CT
b) It provides real-time visualization of the needle
c) It uses no ionizing radiation
d) It is faster than MRI
b) It provides real-time visualization of the needle
What post-biopsy instructions are typically given to a patient after a breast biopsy?
a) Resume normal activities immediately
b) Avoid eating solid food for 12 hours
c) Avoid heavy lifting or strenuous activity for 24-48 hours
d) Apply heat to the biopsy site
c) Avoid heavy lifting or strenuous activity for 24-48 hours
What is the typical indication for performing a renal biopsy in a transplant patient?
a) Generalized pain
b) Decreasing renal function
c) High blood pressure
d) Cough and shortness of breath
b) Decreasing renal function
- What should a patient avoid after a liver biopsy to minimize bleeding risk?
a) Sleeping on the left side
b) Heavy meals
c) Strenuous activity for 48 hours
d) Drinking water
c) Strenuous activity for 48 hours
- Which biopsy method involves the removal of a small amount of tissue using a fine needle?
a) Core biopsy
b) Vacuum-assisted biopsy
c) Open surgical biopsy
d) Fine needle aspiration (FNA)
d) Fine needle aspiration (FNA)
- Which of the following supplies is NOT typically used during a liver biopsy?
a) Biopsy needle
b) Anesthetic
c) Bandages
d) Oral antibiotics
d) Oral antibiotics
- What is the main advantage of using a vacuum-assisted biopsy for breast tissue?
a) It is faster than an FNA
b) It provides a larger tissue sample
c) It requires no local anesthesia
d) It is less expensive than other methods
b) It provides a larger tissue sample
- In which situation is a thyroid FNA considered unnecessary?
a) Presence of a palpable nodule
b) Normal thyroid gland appearance
c) High TI-RADS score
d) Suspicious ultrasound findings
b) Normal thyroid gland appearance
- What should be evaluated using ultrasound immediately after a liver biopsy?
a) Blood sugar levels
b) Presence of bleeding or hematoma
c) White blood cell count
d) Liver enzyme levels
b) Presence of bleeding or hematoma
- Which of the following patients may NOT be a good candidate for a renal biopsy?
a) Patient with low blood pressure
b) Patient with well-controlled diabetes
c) Patient with peri-renal abscess
d) Patient with high cholesterol
c) Patient with peri-renal abscess
- What complication can occur if anticoagulants are not properly managed before a biopsy?
a) Increased risk of infection
b) Decreased biopsy accuracy
c) Increased bleeding risk
d) Reduced patient comfort
c) Increased bleeding risk
- What is a typical patient instruction before a renal biopsy?
a) Eat a high-protein meal the night before
b) Remain NPO the night before
c) Take a laxative before the procedure
d) Avoid sleep the night before
b) Remain NPO the night before
- Which lesion characteristic would likely require a breast core biopsy?
a) Simple cyst with no suspicious features
b) Solid mass categorized as BI-RADS 4
c) Palpable, mobile, non-tender mass
d) Non-palpable calcifications
b) Solid mass categorized as BI-RADS 4
What is the primary purpose of using sterile drapes during a biopsy?
a) To absorb excess fluid
b) To create a sterile field and prevent contamination
c) To provide cushioning for the patient
d) To improve the ultrasound image quality
b) To create a sterile field and prevent contamination
What is a potential complication of a breast biopsy if the procedure is not performed properly?
a) Increased liver enzymes
b) Infection at the biopsy site
c) Heart arrhythmia
d) Severe joint pain
b) Infection at the biopsy site
Which factor determines whether a breast biopsy should be performed on a solid lesion?
a) Presence of palpable pain
b) BI-RADS classification
c) Patient’s age
b) BI-RADS classification
What size needle is generally used for cyst aspiration in breast procedures?
a) 10-gauge
b) 14-gauge
c) 18-gauge
d) 22-27 gauge
d) 22-27 gauge
What is a typical risk associated with a liver biopsy?
a) Allergic reaction to anesthesia
b) Severe hematuria
c) Bleeding at the biopsy site
d) Chronic fatigue
c) Bleeding at the biopsy site
For a liver biopsy, anticoagulants like Warfarin should be resumed how soon after the procedure?
a) Immediately
b) The next day
c) One week later
d) Three days later
b) The next day
What should be avoided for 24-48 hours after a breast biopsy to prevent complications?
a) Resting
b) Drinking water
c) Heavy physical activity
d) Normal breathing
c) Heavy physical activity
Which condition is considered low risk for bleeding and does NOT require routine coagulation screening before a biopsy?
a) Liver abscess
b) Thyroid biopsy
c) Renal failure
d) Severe hypertension
b) Thyroid biopsy
What is a common indicator for performing a liver biopsy?
a) Elevated white blood cell count
b) Decrease in platelet count
c) Liver masses or abnormal liver function tests
d) Recent travel history
c) Liver masses or abnormal liver function tests
Which type of ultrasound probe is typically used for guidance during a biopsy?
a) Linear probe
b) Curved array probe
c) Sector probe
d) Doppler probe
a) Linear probe
What is the typical needle size used for a core biopsy of the breast?
a) 10-gauge
b) 14-gauge
c) 16-gauge
d) 18-gauge
b) 14-gauge
What should be done if a patient experiences pain or discomfort during a thyroid FNA?
a) Increase the dosage of local anesthetic
b) Pause the procedure and reassess
c) Continue without modification
d) Stop the procedure immediately and refer to surgery
b) Pause the procedure and reassess
Which of the following is a contraindication for a renal biopsy?
a) Controlled hypertension
b) Peri-renal abscess
c) Normal coagulation parameters
d) Healthy renal function
b) Peri-renal abscess
What is the primary goal of using a sterile probe cover during an ultrasound-guided biopsy?
a) To reduce discomfort for the patient
b) To prevent contamination and maintain sterility
c) To improve tissue visibility during imaging
d) To provide a clear image of the lesion
b) To prevent contamination and maintain sterility
What is the most common reason for performing a thyroid FNA?
a) Suspected thyroid cancer
b) To assess thyroid hormone levels
c) To measure the size of thyroid nodules
d) To drain a thyroid cyst
a) Suspected thyroid cancer
Which patient condition requires correction before proceeding with a liver biopsy?
a) High cholesterol
b) Abnormal coagulation parameters
c) History of asthma
d) Dehydration
b) Abnormal coagulation parameters
Which imaging modality is commonly used for both liver and renal biopsies?
a) X-ray
b) MRI
c) Ultrasound
d) CT scan
c) Ultrasound
Which of the following complications is a risk during a renal biopsy?
a) Pneumothorax
b) Colonic injury
c) Liver abscess
b) Colonic injury
In thyroid FNA, what TI-RADS score indicates a nodule is likely to be malignant?
a) TI-RADS 1
b) TI-RADS 4a
c) TI-RADS 5
d) TI-RADS 2
c) TI-RADS 5
What is the typical post-procedure care for a patient undergoing a liver biopsy?
a) Immediate discharge
b) Monitoring for bleeding and vital sign stabilization for 2-4 hours
c) Administering anticoagulants immediately
d) No special care needed
b) Monitoring for bleeding and vital sign stabilization for 2-4 hours
