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URR 33 Flashcards

1
Q

When you change the angle on the Doppler cursor, the ___ also changes.
a. amplitude of the reflected signal
b. the volume of flow interrogated
c. flow velocity displayed
d. the wall filter settings also change

A

c

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2
Q

You are scanning the gb and there appears to be sludge within the lumen. Which of the following will aid in differentiating sludge from artifact?
a. apply color Doppler
b. ask the patient to perform the valsalva maneuver
c. ask the patient to fast for 3-4 more hours and rescan the gb for changes
d. increase the transducer frequency

A

d

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3
Q

Which of the following machine adjustments will produce a more black and white 2D image?
a. increasing compression
b. reducing overall gain
c. increasing dynamic range
d. reducing monitor contrast

A

a

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4
Q

Which of the following is a resonance artifact only seen with a gas/tissue interface?
a. posterior shadowing
b. mirror imaging
c. ring down
d. misregistration

A

c

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5
Q

While performing color Doppler on a routine renal ultrasound, extreme turbulence is noted at the right renal artery origin. How should you exam change to evaluate the finding?
a. advise the patient that they may have to return for additional exam because of the suspected renal stenosis
b. use PW doppler to record a flow pattern in the area of turbulence
c. have the patient perform the valsalva maneuver and reassess the vessel for changes
d. turn of color doppler and activate power doppler to remove the aliasing

A

b

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6
Q

If there is no diastolic flow demonstrated on a Doppler tracing of the interlobar artery of the upper pole of the right kidney, what will the resistive index be?
a. 0.5
b. 0
c. unable to calculate the RI, not enough information given
d. 1.0

A

d

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7
Q

A large angiomyolipoma in the right kidney is most commonly associated with what acoustic artifact?
a. propagation speed artifact
b. mirror image
c. comet tail artifact
d. reverberation

A

a

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8
Q

All of the following characteristics of Power Doppler, except:
a. demonstrates presence or absence of flow
b. more sensitive to slow flow than color doppler
c. demonstrates velocity of flow within the organ
d. demonstrates organ perfusion better than color doppler

A

c

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9
Q

While performing a doppler evaluation of the main renal arteries, multiple patient positions may be required in order to maintain a Doppler angle of ___ degrees or less.
a. 0
b. 30
c. 60
d. 90

A

c

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10
Q

which of the following will reduce anistropy artifact?
a. rocking the transducer
b. turn off harmonic imaging
c. dual screen imaging
d. reduce color Doppler gain

A

a

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11
Q

In order to assess low velocity flow, which of the following operator adjustments should be made?
a. decrease wall filter setting and compression
b. increase scale setting
c. decrease compression
d. decrease the rejection and wall filter setting

A

d

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12
Q

A patient presents for a liver ultrasound with contrast to evaluate a tumor. Which of the following lists the correct machine settings needed for the exam?
a. low mechanical index, harmonic imaging on, and focal zone placed at the AOI
b. highest output power setting available, harmonic imaging on, and at least three focal zones surrounding the AOI
c. low mechanical index, harmonic imaging off, and focal zone at the abdominal wall
d. mechanical index over 1.5, harmonic imaging off, and focal zone at the abdominal wall

A

a

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13
Q

Which probe can best evaluate the surface nodularity of the liver in a patient with cirrhosis?
a. curved 8 MHz
b. curved 5MHz
c. linear 7.5 MHz
d. vector 10 MHz

A

c

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14
Q

Increasing the imaging depth will:
a. increase the PRF
b. reduce beam intensity
c. reduce the frame rate
d. improve temporal resolution

A

c

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15
Q

When the sonographer decreases the imaging depth the ___.
a. frame rate will decrease
b. elevational resolution will improve
c. PRF will increase
d. PRF will decrease

A

c

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16
Q

TGC is necessary due to:
a. the non-linear behavior of sound waves
b. reflection, refraction, and scatter
c. sound impedance difference between transducer and skin
d. the inability of high frequency transducers to penetrate the body effectively

A

b

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17
Q

Harmonic imaging:
a. uses information from reflections created by the non-linear behavior of sound waves to form the image
b. is not recommended for use of fetal exams due to increased beam intensity
c. degrades spatial resolution but improves temporal resolution
d. improves spatial resolution but causes degradation of contrast resolution

A

a

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18
Q

Harmonic imaging leads to:
a. reduced signal to noise ratio
b. increased image noise
c. improved axial but degraded lateral resolution
d. reduced appearance of lobe artifact

A

d

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19
Q

Which of the following operator controls adjusts the beam intensity?
a. output
b. overall gain
c. dynamic range
d. TGC

A

a

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20
Q

___ resolution is defined as the ability of an ultrasound system to differentiate structures on an image based on variations in the brightness of the echo/pixel.
a. axial
b. contrast
c. lateral
d. elevational

A

b

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21
Q

What is the twinkle artifact?
a. mosaic color displayed in a linear pattern posterior to a dense object, such as renal stone
b. thin line of reverberation artifact that is caused by calcium deposits in the renal parenchyma
c. describes the color display seen as urine is entering the bladder during real time imaging
d. varied brightness of vascular calcifications causes a twinkling effect on 2D

A

a

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22
Q

When performing contrast enhanced ultrasound evaluation of the liver, when are the images obtained?
a. after the saline flush, record an image the AOI every 60 seconds
b. when the contrast is first visualized in the AOIs and again when it dissipates completely
c. at the start of the saline flush, record the AOI for 1 minute and an image every
30-60 seconds until the 6 minute mark
d. at the start of the contrast injection, record an image at the AOI every 30 seconds

A

c

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23
Q

Overgaining on an US exam can cause:
a. blood to appear anechoic
b. increased posterior shadowing
c. overestimation of Doppler velocity
d. underestimation of arterial stenosis

A

c

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24
Q

Harmonic imaging will:
a. reduce the appearance of microbubble contrast on a contrast echo
b. allow for deeper penetration with improved spatial resolution
c. improve temporal resolution
d. degrade lateral resolution and improve axial resolution

A

b

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25
An ERCP is commonly performed to evaluate: a. right renal vein b. pyloric stenosis c. left renal vein d. the Ampulla of Vater
d
26
A patient presents for an abdominal sonogram due to a history of hepatic congestion. What structure(s) should be closely evaluated for related findings? a. left renal vein b. celiac axis c. renal arteries d. portal system
d
27
The CBD is formed by: a. right and left hepatic ducts + cystic duct b. varies per patient c. cystic duct + the duct of Wirsung d. CHD + cystic duct
d
28
Which of the following ligaments separates the medial and lateral left lobes? a. ligamentum teres b. broad ligament c. coronary ligament d. ligamentum venosum
a
29
During an abdominal ultrasound, a small circular anechoic structure is identified at the anterior portion of the pancreas head. Color flow is identified in the structure. What is it? a. IMA b. GDA c. celiac axis d. CBD
b
30
On a transverse sonogram, the CBD enters the ___ aspect of the head of the pancreas and lays ___ to the IVC. a. posterior, posterior b. anterior, medial c. posterior, anterior d. none of the above
c
31
The __ separates the caudate lobe from the left lobe of the liver. a. ligamentum venosum b. falciform ligament c. main lobar fissure d. ligamentum teres
a
32
What structure prevents free fluid in the Morison pouch from moving into the subphrenic space? a. ligamentum teres b. falciform ligament c. right hepatoduodenal ligament d. right coronary ligament
d
33
Hepatomegaly in a 5 year old is diagnosed using which of the following criteria? a. normal liver should not extend more than 1cm below the costal margin b. divide the patient's age in years by the number 2 to obtain the maximum normal liver length for the patient's age c. divide the patient's height in inches by the number 10 to obtain the maximum normal liver length for the patients age d. multiply the patients age in years by the number 2 to obtain the maximum normal liver length for the patients age
a
34
while discussing the medical history with a patient, he tells you that the doctor recommended that he increase his intake of vitamin K due to some recent abnormal lab results. Which of the following lab values was abnormal? a. red blood cell count b. prothrombin time c. alpha feto-protein d. lactate dehydrogenase
b
35
Which abdominal vessel is the best landmark to identify the body and tail of the pancreas? a. left renal vein b. right renal vein c. splenic vein d. superior mesenteric vein
c
36
Which of the following correctly lists the structures found in an intrahepatic portal triad? a. common hepatic artery, hepatic vein, and portal vein b. hepatic vein, proper hepatic artery, and bile duct c. portal vein, proper hepatic artery, and bile duct d. portal vein, hepatic vein, and bile duct
c
37
The hepatoduodenal ligament contains which of the following structures? a. the umbilical arteries and vein b. the emissary veins c. right portal vein, right hepatic artery and cystic duct d. main portal vein, proper hepatic artery and common bile duct
d
38
The bare area of the liver is in direct contact with: a. right portal vein b. diaphragm c. IVC d. right kidney
b
39
The caudate lobe lies between what two structures? a. main lobar fissure and GB b. IVC and lateral left lobe c. right and left portal veins d. IVC and medial left lobe
d
40
If a liver mass is located between the middle hepatic vein and the right portal vein, in what lobe of the liver is the mass located? a. posterior right lobe b. anterior right lobe c. medial left lobe d. caudate lobe
b
41
The cystic artery originates at the ___ and the cystic vein empties into the ___ a. left hepatic artery, left portal vein b. right hepatic artery, right portal vein c. common hepatic artery, main portal vein d. right hepatic artery, right hepatic vein
b
42
The liver is divided into superior and inferior segments by the: a. course of the fissures through the tissue b. course of the biliary vessels through the tissue c. branching of the hepatic veins d. branching of the portal veins
d
43
The ___ is located within the inferior margin of the falciform ligament. a. middle hepatic vein b. ligamentum venosum c. ligamentum teres d. left hepatic vin
c
44
The ___ can be identified anterolateral to the pancreas tail. a. stomach b. SMA c. left kidney d. hepatic flexure of the colon
a
45
The IVC is located posterior to the pancreatic: a. body b. tail c. neck d. head
d
46
Which of the following statements correctly describes imaging of the dome of the liver? a. intercostal scanning is the preferred scanning approach to evaluate the dome of the liver b. the portal confluence should be used to locate the dome of the liver c. because the dome is bordered superiorly by the diaphragm, lobe artifact commonly inhibits complete evaluation of this portion of the liver d. deep inspiration is required to evaluate this portion of the liver
d
47
In a normal fasting adult, blood sugar levels should not exceed __ of blood. a. 50 mg/100 ml b. 100 mg/ 100 ml c. 150 mg/ 100 ml d, 200 mg/ 100 ml
b
48
The right lobe of the liver is divided into ___ segments, while the left lobe is divided into ___ segments. a. medial and lateral, anterior and posterior b. anterior and posterior, medial and lateral c. caudate and posterior, quadrate and anterior d. caudate and anterior, quadrate and posterior
b
49
Which lab value is associated with the development of jaundice? a. blood urea nitrogen b. bilirubin c. leukocytes d. hematocrit
b
50
The main lobar fissure: a. separates the IVC and medial left lobe b. separates anterior right lobe and medial left lobe c. separates the anterior and posterior right lobes d. separates the medial and lateral left lobes
b
51
A small rounded prominence on the anteroinferior aspect of the normal caudate lobe is called: a. elongated left lobe b. quadrate lobe c. distal papillary process d. reidel lobe
c
52
All of the following are true regarding Couinaud liver segmentation, except: a. each of the 8 segments has its own branch of the portal vein, hepatic vein, and bile duct b. allows for liver resection/surgery without negatively affecting other segments c. divides liver into 8 functional segments d. right and left lobes are divided by the branches of the main hepatic vein
d
53
__ is produced by the exocrine function of the pancreas and __ is produced by the endocrine function of the pancreas. a. amylase, lipase b. insulin, trypsin c. sodium bicarbonate, insulin d. sodium bicarbonate, amylase
c
54
Trypsin breaks down __, amylase breaks down ___, and lipase breaks down ___ during digestion. a. sugar, carbohydrates, fat b. protein, carbohydrates, fat c. fat, carbohydrates, protein d. carbohydrates, protein, fat
b
55
Which of the following correctly describes the location of the right hepatic vein? a. courses inferiorly through the falciform ligament b. courses superiorly through the right intersegmental fissure c. courses superiorly through the main lobar fissure d. courses superiorly through the falciform ligament
b
56
In the normal liver, which of the following correctly describes the changes in flow in the hepatic artery after eating? a. no change occurs in the hepatic artery after eating b. decreased peak and end diastolic flow velocities c. increased end diastolic flow velocities d. increased resistive index (RI)
d
57
The ligamentum venosum travels between: a. the main portal vein and the IVC b. the left portal vein and the IVC c. caudate lobe and right lobe d. the right portal vein and IVC
b
58
The liver's exocrine function includes producing: a. hemoglobin b. urea c. bile d. heparin
c
59
Normal hepatic venous flow will demonstrate: a. two large antegrade diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction b. two large retrograde diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction c. two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction d. two large retrograde diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction
c
60
The caudate lobe occupies much of the __ surface of the liver a. posterior superior b. anterior inferior c. anterior superior d. posterior inferior
a
61
The pancreatic tail is anterior to all of the following, except: a. upper pole of left kidney b. splenic hilum c. left adrenal gland d. lesser omental sac
d
62
What vessels drain the blood from the caudate lobe? a. umbilical vein b. left portal vein c. coronary vein\ d. emissary veins
d
63
The pancreas is found in what retroperitoneal space? a. perirenal b. posterior pararenal c. retrofascial d. anterior pararenal
d
64
Which of the following terms can be used to describe a normal doppler tracing from the hepatic veins? a. continuous b. non-pulsatile c. monophasic d. triphasic
d
65
A patient presents with a history of choledocholithiasis. How will you assess the common bile duct for the presence of a stone? a. locate the main portal vein and look for the CBD posterior to it b. demonstrate a long axis gallbladder image and look for the CBD superior to it c. demonstrate a transverse view of the pancreatic head and look for the CBD entering the anterior aspect d. demonstrate a longitudinal view on the main portal vein and look for the CBD anterior to it
d
66
Which of the following can be used to differentiate Reidel lobe from hepatomegaly? a. the right lobe is normal in size in Reidel lobe but enlarged with hepatomegaly b. the ligamentum venosum is not visible in cases of Reidel lobe but well seen in hepatomegaly c. the left lobe is normal in size in Reidel lobe but enlarged with hepatomegaly d. the ligamentum teres is not visible in cases of Reidel lobe but well seen in hepatomegaly
c
67
In the porta hepatis, what structure is anterior to the portal vein and medial to the common hepatic duct? a. Duct of Wirsung b. common hepatic artery c. proper hepatic artery d. cystic duct
c
68
The ___ are called intersegmental vessels of the liver. a. portal veins b. hepatic arteries c. hepatic veins d. hepatic arteries and veins
c
69
Which of the following terms can be used to describe the normal flow in the portal vein? a. pulsatile b. biphasic c. hepatofugal d. continuous
d
70
Sonographically, the __ appears to connect the GB neck and junction of right and left portal veins. a. ligamentum venosum b. main lobar fissure c. intersegmental fissure d. ligamentum teres
b
71
Which lobe of the liver receives blood from the left and right portal veins? a. medial left lobe b. anterior right lobe c. posterior right lobe d. caudate lobe
d
72
The right and left hepatic ducts come together to form the common hepatic duct: a. at the pancreas head b. deep within the liver parenchyma c. at the level of the Ampulla of Vater d. inside the liver, near the porta hepatis
d
73
What causes the hepatic vein flow to have a triphasic waveform? a. left atrial contraction and relaxation b. hepatic congestion c. portal HTN d. right atrial contraction and relaxation
d
74
Branches of which of the following vessels supply the pancreas with blood? a. SMA and right gastric artery b. PHA and SMA c. GDA and PHA d. SMA and GDA
d
75
Which of the following hepatic ligaments separate the medial and lateral left lobes of the liver? a. ligamentum venosum b. triangular ligament c. falciform ligament d. broad ligament
c
76
Which of the following produces insulin? a. acini glands of the pancreas b. Kupffer cells in the liver c. Pituitary gland d. Islets of Langerhans
d
77
__ merge to form the ampulla of Vater just prior to the duct entering the second portion of the duodenum. a. the CHD and cystic duct b. the CBD and duct of Wirsung c. The CBD and cystic duct d. the CBD and CHD
b
78
The __ lobe of the liver is located between the right and middle hepatic vein. a. anterior right b. medial left c. caudate lobe d. lateral left
a
79
Which statement best describes the location of the ligamentum venosum? a. it forms the anterior border of the caudate lobe b. it lies between the right and left lobes of the liver c. it forms the posterior border of the right lobe d. on us, it appears as a thick, triangular, echogenic foci in the left lobe of the liver
a
80
Which of the following blood vessels delivers the majority of oxygenated blood that enters the liver? a. hepatic veins b. common hepatic artery c. proper hepatic artery d. main portal vein
d
81
All of the following laboratory tests are used to evaluate the liver function, except: a. AST b. bilirubin c. sodium bicarbonate d. prothrombin time
c
82
Which of the following hormones is responsible for causing the gallbladder to contract? a. cholecystokinin b. lipase c. insulin d. trypsin
a
83
In a normal adult patient, the intrahepatic common hepatic duct lumen measures less than or equal to __. a. 6mm b. 2mm c. 4mm d. 2cm
c
84
The first branch of the CHA is the: a. pancreatic artery b. cystic artery c. duodenal artery d. gastroduodenal artery
d
85
The formation of the Hartmann pouch usually occurs in what portion of the gallbladder? a. fundus b. cystic duct c. neck d. body
c
86
Which of the following is located between the transversalis fascia and the posterior parietal peritoneum? a. spleen b. pancreas c. linea alba d. stomach
b
87
Which of the following correctly describes the pediatric pancreas? a. pancreatic echogenicity increases with age b. the ducts are dilated at >2mm at birth and decrease in size throughout the first year c. cystic fibrosis leads to the production of mucus and the gland is reduced in echogenicity d. it normally decreases in echogenicity as the patient reaches adulthood.
a
88
The superior mesenteric vein: a. joins the splenic vein posterior to the neck of the pancreas b. lies to left of SMA c. joins the portal vein to form the splenic vein d. joins the splenic vein anterior to the neck of the pancreas
a
89
All of the following are intrasegmental vessels of the liver, except: a. portal veins b. hepatic arteries c. bile ducts d. hepatic veins
d
90
In a patient with complete situs inversus, the liver will be: a. divided into 3 separate lobes b. absent c. located in the LUQ d. located in the RLQ
c
91
A patient presents with a history of Reidel lobe. What are the expected findings on the us exam? a. the liver will demonstrate diffuse fatty infiltration of the right lobe only b. the left lobe will extend across the midline to touch the upper pole of the spleen c. the caudate lobe will be at least 2X greater in size than the left lobe d. the right lobe of the liver will have a tongue-like extension that extends inferior to the lower pole of the right kidney
d
92
Which portions of the gallbladder and/or biliary tree are involved in the formation of a phrygian cap? a. cystic duct and common bile duct b. body and fundus c. neck and body d. neck and cystic duct
b
93
The majority of the liver is covered by a thick capsule composed of fibrous and elastic elements caused: a. morrison pouch b. gerota fascia c. bowman capsule d. glisson capsule
d
94
The medial segment of the left lobe lies between: a. the ligamentum venosum and IVC b. the middle hepatic vein and ligamentum teres c. the right hepatic vein and middle hepatic vein d. the ligamentum teres and the spleen
b
95
Which of the following correctly describes the ducts of Luschka? a. associated with porcelain gb and gb carcinoma b. only visible in obese patients c. bile thickening occurs within them d. located within the 3rd segment of the duodenum
c
96
The accessory duct of the pancreas is called: a. duct of vater b. ducter of heister c. duct of wirsung d. duct of santorini
d
97
The pancreatic duct should normally be less than __ in diameter in children and young adults a. 0.5 mm b. 1mm c. 2mm d. 4mm
c
98
A normal portal vein will: a. decrease in diameter after eating b. increase in diameter by more than 20% with deep inspiration c. increase in diameter after exercise d. increase in diameter by placing patient in upright position
b
99
Which liver vessel courses within the main lobar fissure? a. common hepatic artery b. right hepatic vein c. middle hepatic vein d. main portal vein
c
100
What blood vessel separates the right and left lobes of the liver? a. left hepatic vein b. common hepatic artery c. right portal vein d. middle hepatic vein
d

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