Ultrasound 2 Flashcards
What is the imaging modality of choice for testicular pain?
testicular ultrasound
On testicular u/s you notice an increase in the size of the affected testis and an absence of blood flow what are you concerned for?
testicular torsion
What is the imaging modality of choice for pelvic complaints in female?
pelvic ultrasound
What is the difference between transabdominal u/s and transvaginal u/s?
- TAUS = utilizes the curvilinear probe and uterus better visualized with a full bladder
- TVUS = utilizes the endocavitary probe and uterus better visualized with an empty bladder
On a pelvic ultrasound what female structure is not normally seen unless there is associated pathology?
- fallopian tubes
What finding on pelvic u/s is consistent with endometrial cancer?
> 5 mm thickness post-menopause
How do fibroids (leiomyoma) appear on u/s?
- typically hypo or isoechoic masses within the myometrium
How can you tell the difference between simple cysts and hemorrhagic cysts?
- hemorrhagic cysts have a lace-like echoes within it = “fish-net appearance”
How can you distinguish a benign ovarian cyst from ovarian malignancy?
- features of malignancy that diff from benign include:
1. thick, irregular walls
2. solid components
3. increase blood flow
3. papillary structures
Ovarian cysts that are how big can be indicative of ovarian torsion?
5-10 cm in size
What is the relationship between blood flow and ovarian torsion?
- no blood flow is specific for torsion but torsion can not be ruled out if there is blood flow
What imaging test is used to confirm intrauterine pregnancy (IUP) in the first trimester?
- ultrasound
What is the first sign of pregnancy on ultrasound?
Gestational sac
At what serum HCG level do you expect to see a gestational sac?
1500 mIU/mL
In which order are the following structures able to be seen under ultrasound during the first trimester?
gestational sac, fetal pole, yolk sac
- gestational sac
- yolk sac
- fetal pole
What can be used to estimate the gestational age of the fetus during the first trimester?
- crown rump length (CRL)
* length from top of its head to bottom of torso*
T/F: You cannot reliably determine sex in first trimester with U/S.
True
How is fetal heart rate calculated?
using M-mode on u/s
normal = 120-160 bpm
What sign on ultrasound is indicative of Trisomy 21?
nuchal translucency at 11-14 weeks
Where is the common location of an ectopic pregnancy?
fallopian tube (95-96%)
How can you distinguish an ectopic pregnancy vs a cyst or mass?
- applying gentle pressure during real time imaging will separate ectopic pregnancy but NOT cysts or masses
When comparing the serum HCG and ultrasound findings, what correlation is concerning for ectopic pregnancy?
- serum HCG >1500-2000 without visible IUP
What sign is indicative of a ruptured ectopic pregnancy until proven otherwise?
- sudden onset abdominal pain and hypotension in a pregnant patient
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- free fluid
ultrasound is the test of choice to evaluate for all of the following except:
a. ejection fraction
b. valvular disease
c. endocarditis
d. cardiomyopathy
e. pericardial effusion
f. coronary artery disease
f. coronary artery disease
How is the ejection fraction measured under u/s?
- change in volume at end diastole and end systole
* normal = 55-70%*
what u/s findings are consistent with stenosis?
- abnormal valve anatomy
- hyperechoic leaflefts d/t calcification
- elevated outflow velocity
what u/s finding is consistent with regurgitation?
- retrograde flow on color doppler
when is an agitated saline echo used? “bubble study”
- to examine for a defect in the walls of the heart (e.g. PFO)
what sonographic findings are consistent with HOCM?
- increases LV wall thickness > 15mm
+ outflow obstruction?
Cardiac tamponade correlates with what?
time rather than size
What is the criteria for a small, moderate, and large pericardial effusion? For each, what do they correspond to in terms of fluid amount?
- small = < 10mm = 100 cc fluid
- mod = 10-20mm = 100-500 cc fluid
- large = > 20mm = >500 cc fluid
What is Beck’s triad?
-clinical signs that correlate to cardiac tamponade
- Hypotension
- distended neck veins
- muffled heart sounds
What u/s findings are consistent with cardiac tamponade?
- pericardial effusion
- right atrial systolic collapse
- right ventricular diastolic collapse
- dilated IVC
In which population are you especially concerned for endocarditis?
IVDU
Using the modified Duke criteria, what sonographic findings are consistent with endocarditis?
- presence of vegetation
- presence of abscess
- presence of a new dehiscence of a valvular prothesis
- new valve regurgitation
Which of the following is more sensitive TTE or TEE?
TEE
