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CDP > Ultrasound > Flashcards

Ultrasound Flashcards

1
Q

Is image quality (resolution) directly or inversely related to the frequency of the sound wave in ultrasound?

A

Directly

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2
Q

Does ultrasound send more pulses to return or listen for more pulses to return?

A

Ultrasound listens for pulses to return more than it sends them

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3
Q

Which, a hemorrhagic cyst or an endometrioma, is more likely to resolve on its own?

A

Hemorrhagic cyst

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4
Q

How is a gallstone different from a polyp on ultrasound?

A

Gallstones move and create shadows

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5
Q

Five most common types of artifacts to occur in ultrasound

A
  • Reverberation
  • Shadow
  • Enhancement
  • Mirror image
  • Refraction
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6
Q

Which, a gallstone or gallbladder polyp, is more likely to be found incidentally?

A

Polyp

(asymptomatic)

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7
Q

How to distinguish appendix from bowel on ultrasound?

A

Appendix won’t compress under pressure like bowel

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8
Q

A cyst with this type of boundary is more concerning for malignancy

A

Hypoechoic rim

(also blurred indistinct is worrying and maybe hyperechoic)

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9
Q

Can an ultrasound show heart anatomy?

A

Yes, with motion!

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10
Q

A string of pearls seen around the periphery of the ovary might suggest this condition

A

PCOS

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11
Q

Appearance of fluid on ultrasound

A

Black

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12
Q

Is depth of penetration directly or inversely related to frequency of the ultrasound wave?

A

Inversely

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13
Q

A cyst with this type of boundary is the least concerning for malignancy

A

Sharp, distinct border

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14
Q

What happens when any of the six assumptions of imaging systems is incorrect?

A

Artifacts in the image appear

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15
Q

If an ultrasound transducer is being held in the long position (indicator towards head) will the superior structures be shown on the left or right of the ultrasound screen?

A

Left

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16
Q

Stones on ultrasound can have this artifact

A

Twinkle artifact

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17
Q

Is an organ that appears lighter than surrounding tissue on ultrasound considered hyperechoic or hypoechoic?

A

Hyperechoic

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18
Q

Appearance of a trichobezoar on ultrasound

A

Air trapped around hair fibers causing the appearance of an echogenic arc with shadowing

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19
Q

Is a lesion that appears darker than surrounding tissue on ultrasound considered hyperechoic or hypoechoic?

A

Hypoechoic

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20
Q

Which chamber of the heart sits most anterior in the body?

A

Right ventricle

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21
Q

Most useful ultrasound technique for evaluating the endometrium in a retroflexed uterus

A

Transvaginal

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22
Q

Is doppler shift a higher or lower frequency than regular ultrasound?

A

Lower (within range of human hearing)

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23
Q

How long into pregnancy can you reliably see a gestational sac on transvaginal ultrasound?

A

4.5 to 5 weeks

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24
Q

Which parts of the body attenuate the most in ultrasound as it travels through the body?

A

Lung and bone

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25
Q

In ovarian pathology, how many papillary structures are needed to classify a tumor as malignant?

A

At least four

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26
Q

True or false. A healthy post menopausal woman should never have a thick, complex looking endometrium

A

True

If it looks this way, may be endometrial carcinoma

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27
Q

Do higher frequency waves have longer or shorter wave length?

A

Shorter

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28
Q

On ultrasound, a patient’s kidneys are seen to be 24cm in size and contain multiple cysts. What diagnosis might run in their family?

A

ADPKD (autosomal dominant polycystic kidney disease)

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29
Q

Four things required for a cyst to be called simple

A

“STAR”

  • Smooth outer border
  • Through transmission
  • Anechoic
  • Round/oval shape
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30
Q

Complication of pancreatitis that makes ultrasound difficult

A

Severe epigastric pain/tenderness makes it hard to push deep enough with transducer and move air from stomach out of the way

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31
Q

Ultrasound is above the human range of hearing, at this kHz

A

Above 20 kHz (20,000 Hz)

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32
Q

In terms of echogenicity, how will a fatty liver appear on ultrasound?

A

Hyperechoic/echogenic

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33
Q

Which transducer, a 12-5 or a 6-2, will give a sharper image with higher resolution?

A

12-5

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34
Q

Hepatic duct normal measurement

A

2 mm

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35
Q

Transvaginal ultrasound is the best technique to visualize a gestational sac within the uterus when hCG is at this level

A

1000 to 2000

36
Q

Can an ultrasound show chest/thorax anatomy?

A

No really, air in lungs makes it difficult

37
Q

What shape will the display of an L, P, and C transducer be on the ultrasound display?

A

L = linear, square image

P = pie, conical pie shape, point at top

C = curved, blunted pie shape

38
Q

Which is typically larger, serous cystadenoma or mucinous cystadenoma?

A

Mucinous much larger

39
Q

Which transducer, a 12-5, or a 6-2, will give a deeper image?

A

6-2

40
Q

In a FAST scan lung ultrasound, what sign suggests pneumothroax?

A

Barcode/stratosphere sign, no motion

41
Q

Six assumptions of imaging systems

A
  1. Sound travels in a straight line
  2. Sound travels directly to a reflector and back
  3. Sound travels in soft tissues at exactly 1,540 m/sec
  4. Reflections arise only from structures positioned within the main axis of the beam
  5. The imaging plane is very thin
  6. The strength of a reflection is related to the characteristics of the tissue creating reflection
42
Q

A patient receiving a full bladder ultrasound should be instructed to do this before coming in

A

Drink lots of fluid, come with full bladder

43
Q

What is the name for a large gestational sac (>18 mm) with no sign of a yolk sac?

A

Blighted ovum

44
Q

Normal AP measurement of the aorta

A

< 3cm

45
Q

Why are measurement calipers placed on the outer walls of blood vessels like the aorta when measuring, rather than just measuring the lumen?

A

To include any potential thrombus

46
Q

In ovarian pathology a tumor is more likely to be malignant if it is multilocular, solid, and with a largest diameter measuring at least this many centimetres

A

At least 10 cm

47
Q

What is the 10x10x10 rule in PCOS?

A
  • Ovaries are enlarged >10 cm
  • 10+ follicles in each ovary
  • Follicles < 10 mm
48
Q

Most common cause of uterine enlargement

A

Uterine leiomyoma

49
Q

When utilizing contrast enhanced ultrasound to analyze a liver tumor, does a late and weak washout suggest hepatocellular (primary) cancer or metastasis from elsewhere?

A

Hepatocellular carcinoma

Tumor originated in the liver

50
Q

Appearance of bone on ultrasound

A

Reflective, creates a shadow

51
Q

In Doppler ultrasound, when a wave is bouncing back from an object moving towards the transducer have a higher or lower frequency?

A

Towards transducer = higher frequency

52
Q

In hypertrophic pyloric stenosis, pyloric muscle will be this thick and the pyloric canal will be this long

A

Pyloric muscle thicker than 3 mm

Pyloric canal longer than 15 mm

53
Q

At what point of the menstrual cycle will the endometrium appear thickest?

A

Start of menstrual cycle

54
Q

Why is an anechoic cyst less concerning than an echogenic cyst?

A

Anechoic suggests fluid filled

Echogenic suggests tissue filled

55
Q

Three parameters to make a sound wave

A
  • Pressure
  • Density
  • Distance
56
Q

What does a black gap seen between the liver and kidney suggest?

A

Morrison’s pouch
- free fluid in hepatorenal recess

57
Q

Most common solid, malignant abdominal mass in children

A

Wilm’s tumor aka nephroblastoma

58
Q

Which chamber of the heart lies closest to the spine/descending aorta?

A

Left atrium

59
Q

When measuring a blood vessel, which view is typically more accurate, transverse or long (sagittal)?

A

Transverse

(better to look straight down the lumen)

60
Q

What does isoechoic mean?

A

Adjacent structures are similar in echotexture (same shade of grey)

61
Q

What should be present in the ovary in early pregnancy?

A

Corpus luteum cyst of pregnancy

62
Q

Are superficial structures like the thyroid better viewed with a 12-5 or 6-2 ultrasound transducer?

A

12-5

Higher frequency = higher resolution and not much penetration needed for superficial structures

63
Q

Normal right lobe of liver measurment

A

< 18 cm

64
Q

In ovarian pathology, a tumor is more likely to be benign if ascites is absent, and the largest solid component is no larger than this many centimetres

A

No more than 7 cm

65
Q

As hemorrhagic cysts resolve they begin to resemble this on ultrasound

A

Broken glass

66
Q

Ultrasound method for analyzing degree of liver fibrosis

A

Elastography

67
Q

When holding the ultrasound transducer in the transverse position over the aorta, will the vessel appear circular or seen side on?

A

Circular, looking down the lumen

68
Q

Right and left kidneys should be the within this measurement of each other

A

Less than 1 cm difference in size between kidneys

69
Q

How should a transducer and needle be aligned when doing ultrasound guided biopsy?

A

Needle should be parallel to the long side of the transducer

70
Q

Renal cell carcinoma typically affects this area of the kidney whereas transitional cell carcinoma typically affects this area of the kidney

A

RCC = cortex of the kidney

TCC = collecting system

71
Q

When utilizing contrast enhanced ultrasound to analyze a liver tumor, does a rapid and marked washout suggest hepatocellular (primary) cancer or metastasis from elsewhere?

A

Metastasis

Tumor needs lots of blood flow

72
Q

Size range for normal kidneys on ultrasound

A

9 to 12 cm

73
Q

A normal spleen should be this size

A

13 cm or less

74
Q

If free fluid seen on ultrasound is not completely black, what might it contain?

A

Blood

75
Q

Normal nulliparous uterus size

A

Up to 8 cm

76
Q

Appearance of air on ultrasound

A

Reflective, creates a shadow

77
Q

Appearance of soft tissue on ultrasound

A

Grey

78
Q

When hCG is > 3600 you can see a gestational sac in the uterus on this ultrasound technique

A

Transabdominal

79
Q

Normal common bile duct measurements in a normal person and a person who had their gallbladder removed or is older

A

Normal = 7 mm

GB removed/elderly = 11 mm

80
Q

What does ALARA stand for?

A

As Low As Reasonably Achievable

(frequency = how often, not Hz)

81
Q

Which parts of the body attenuate the least in ultrasound as it travels through the body?

A

Water and blood

82
Q

What should a vein do when pressure is applied with a transducer than an artery wouldn’t?

A

Compress

83
Q

Ultrasound uses this type of sound waves

A

Pulsed sound waves

84
Q

What does a double decidua sign indicate?

A

Intrauterine pregnancy

85
Q

Ways to differentiate aorta from IVC on ultrasound

A

Aorta:
- will pulse
- has branches
- dives posterior to heart
- sits left of midline

IVC
- less motion
- no proximal confluences (branches?)
- cusps the liver as it dumps into right atrium
- sits right of midline

CDP (12 decks)

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