URR 36 Flashcards

1
Q

When pancreatic enzymes leak into the peritoneal space, a ___ forms.
a. cystadenoma
b. biloma
c. phlegmon
d. pseudocyst

A

d

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2
Q

Splenic torsion is most commonly associated with:
a. Gaucher disease
b. accessory spleen
c. ectopic spleen
d. asplenia

A

c

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3
Q

Weakened gastrosplenic and splenorenal ligaments can lead to:
a. situs inversus
b. polysplenia
c. wandering spleen
d. asplenia

A

c

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4
Q

Glandular atrophy, dilated main duct, and intraductal calculi are hallmark signs of:
a. chronic cholecystitis
b. chronic renal failure
c. cholangitis
d. chronic pancreatitis

A

d

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5
Q

A 56 year old male presents with epigastric pain, nausea, and a chronic history of alcoholism. Lab values demonstrate increased levels of amylase and lipase. Hematocrit levels are below normal values. The US exam demonstrates a hypoechoic, enlarged pancreas with periglandular fluid. Which of the following best describes the findings?
a. phlegmon
b. hemorrhagic pancreatitis
c. acute pancreatitis
d. chronic pancreatitis

A

b

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6
Q

The most likely primary malignancy to metastasize to the spleen is ___. The most common malignancies that do metastasize to the spleen are ___.
a. lung cancer; breast and parathyroid adenocarcinoma
b. melanoma; lung and breast cancer
c. breast cancer; melanoma and hepatocellular carcinoma
d. renal cell carcinoma; breast and thyroid carcinoma

A

b

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7
Q

__ refers to a rare genetic disorder characterized by visceral cysts, renal and pancreatic cysts, benign masses, and the potential for malignant transformation in multiple organ systems.
a. Osler-Weber-Rendu syndrome
b. Edwards syndrome
c. Von Hippel Lindau Syndrome
d. polycystic disease

A

c

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8
Q

When inflammation from pancreatitis extends into the tissues surrounding the pancreas, this is called:
a. cystadenoma
b. phlegmon
c. pseudocyst
d. biloma

A

b

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9
Q

Splenic atrophy in adults is often associated with:
a. splenitis
b. tuberculosis
c. sickle cell anemia
d. typhoid fever

A

c

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10
Q

A pseudocyst has no ___, which helps to differentiate it from a true pancreatic cyst.
a. pancreatic enzymes within it
b. epithelial lining
c. posterior shadowing
d. posterior enhancement

A

b

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11
Q

Splenosis is a complication of:
a. splenic infection
b. sickle cell anemia
c. splenic trauma
d. portal HTN

A

c

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12
Q

Which of the following statements regarding insulinomas is true?
a. they commonly occur in the head of the pancreas
b. patients are usually hypoglycemic
c. most patients require an insulin pump to counteract the effects of the tumor on the serum glucose levels
d. commonly associated with a peptic ulcer

A

b

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13
Q

Which of the following describes the sonographic appearance of acute pancreatic allograft rejection?
a. small atrophied gland with numerous cysts within the parenchyma
b. small atrophied gland with numerous calcifications within the parenchyma
c. high resistance flow in the transplant arteries with numerous calcifications within the parenchyma
d. high resistance flow in transplant arteries and heterogeneous appearance of the gland

A

d

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14
Q

It may be difficult to differentiate a ___ from a splenic disease process at the hilum.
a. pancreatic pseudocyst
b. duodenal tumor
c. liver mass in the caudate lobe
d. right renal cyst in the upper pole

A

a

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15
Q

Renal cell carcinoma, insulinoma, and pancreas cystadenoma are associated with what syndrome?
a. Beckwith-Wiedemann Syndrome
b. Gaucher disease
c. Multiple endocrine neoplasia syndrome
d. Von Hippel Lindau syndrome

A

d

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16
Q

Pseudoaneurysm formation, biliary obstruction and phlegmon are complications typically seen with:
a. non-alcoholic steatosis
b. insulinomas
c. pancreatitis
d. alcoholic cirrhosis

A

c

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17
Q

A patient with a known history of Zollinger-Ellison syndrome presents with symptoms that include indigestion and esophageal reflux. Lab testing indicates elevated levels of gastrin. These findings are most suggestive of:
a. gastrinoma formation in the pancreas
b. pancreatic pseudocyst
c. appendicitis
d. Crohn disease

A

a

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18
Q

A disorder that affects the pancreas by causing it to excrete a thick mucus-like substance that inhibits the exocrine function is called:
a. tuberculosis
b. insulinoma
c. cystic fibrosis
d. pancreatitis

A

c

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19
Q

When a pancreas transplant has enteric drainage:
a. it is common for the stomach to be dilated with pancreatic juices
b. the urinary bladder should be evaluated for abnormalities
c. the allograft will be located in the chest
d. bowel should be evaluated for obstruction

A

d

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20
Q

What are the two most common infections that cause granuloma formation in the spleen?
a. colitis and cholecystitis
b. tuberous sclerosis and mononucleosis
c. tuberculosis and histoplasmosis
d. mononucleosis and syphilis

A

c

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21
Q

Chronic infection in soft tissue organs typically leads to:
a. the development of cavernous transformation
b. there is a small bowel obstruction at the duodenum resulting in fecalith formation around the head of the pancreas
c. the formation of calcifications
d. the development of systemic hypertension

A

c

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22
Q

A patient presents with congenital absence of the spleen, this condition is called:
a. splenomegaly
b. asplenia
c. hamartoma
d. accessory spleen

A

b

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23
Q

A pseudocyst most commonly forms in which retroperitoneal space?
a. perinephric space
b. posterior pararenal space
c. omental bursa
d. anterior pararenal space

A

d

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24
Q

What is the Asher sign suggestive of?
a. pancreatic malignancy
b. splenomegaly
c. tumoral invasion of the splenic vein
d. acute pancreatitis

A

b

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25
Which of the following is most commonly associated with an autosplenectomy? a. splenic lymphoma b. sickle cell anemia c. wandering spleen d. splenic hamartoma
b
26
Which of the following is commonly associated with pancreatitis? a. pancreatic divisum b. low fat diet c. high protein diet d. annular pancreas
a
27
Which of the following describes splenomegaly? a. the spleen extends below the mid pole of the left kidney b. the spleen extends below the upper pole of the left kidney c. the spleen extends before the lower pole of the left kidney d. the spleen extends to a position immediately adjacent to the pancreatic tail
c
28
Which of the following correctly describes Non-Hodgkin lymphoma? a. much less responsive to treatment than Hodgkin type b. more commonly affects lymph nodes in arms, upper chest, and neck c. usually affects the retroaortic and pelvic lymph nodes first d. average patient age 20 years
a
29
Which of the following correctly describes angiosarcoma of the spleen? a. very responsive to chemotherapy with good prognosis b. usually presents as a homogeneous hyperechoic mass near the periphery of the spleen c. arises from the vascular endothelium and demonstrates increased vascularity d. most common primary malignancy of the spleen
c
30
What type of pancreatic mass has the strongest risk of malignant conversion? a. gastrinoma b. microcystic cystadenoma c. macrocystic cystadenoma d. insulinoma
c
31
While scanning in the transverse plane of the abdomen, you notice a small round anechoic structure just anterior to the pancreatic head. Which of the following should be the next step in evaluating this finding? a. have the patient drink water b. scan the patient in the decubitus position c. evaluate the kidneys for cysts d. apply color Doppler
d
32
The accessory duct of the pancreas is called: a. duct of wirsung b. duct of heister c. duct of vater d. duct of santorini
d
33
Which of the following is a potential collateral pathway formed in patients with cirrhosis? a. blood moves from the emissary veins to the umbilical vein b. blood moves from the splenic vein to the coronary vein c. blood moves from the superior rectal vein to middle rectal vein d. blood moves from the gastric vein to the splenic vein
c
34
A resistance index over 0.8 in the common hepatic artery would be an expected finding in patients with: a. portal hypertension and transplant rejection b. Budd Chiari Syndrome and a healthy liver transplant c. focal nodular hyperplasia and cirrhosis d. cholangitis and steatosis
a
35
Which of the following is an intratesticular mass associated with Cushing syndrome and adrenal hyperplasia? a. adrenal rest b. yolk sac tumor c. epidermoid cyst d. mixed germ cell tumor
a
36
When pancreatic enzymes leak into the peritoneal space, a __ forms a. pseudocyst b. cystadenoma c. biloma d. phlegmon
a
37
When evaluating intratesticular flow, which vessel is sampled by Doppler? a. centripetal b. cremasteric c. deferential d. gonadal
a
38
What is the sonographic appearance of pseudomyxoma peritonei? a. multiple echogenic foci throughout the psoas muscle b. multiple echogenic foci throughout the abdominal wall c. mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall d. mucinous secretions and tumor formation within abdomen that cause the liver to be pushed inferiorly against the diaphragm
c
39
What is caput medusae? a. formation of splenorenal varices b. tortuous vessels around the umbilicus caused by portal HTN c. failure of a TIPS shunt d. formation of gastroesophageal varices
b
40
Which of the following hepatic ligaments separate the medial and lateral left lobes of the liver? a. ligamentum venosum b. triangular ligament c. broad ligament d. falciform ligament
d
41
A patient presents with an isolated slight increase in liver function tests. You identify two hyperechoic, homogeneous masses in the area of the porta hepatis. These findings are most consistent with: a. adenoma development b. focal fatty infiltration c. cavernous hemangioma formation d. focal fatty sparing
b
42
When evaluation a patient with testicular pain: a. the epididymis on the affected side should be scanned first b. the us system settings should be established while scanning the unaffected side and remain unchanged when scanning the affected side c. the us system settings should be established while scanning the affected side and remain unchanged when scanning the unaffected side d. the testicle on the affected side should be scanned first
b
43
When you change the angle on the Doppler cursor, the __ also changes. a. the wall filter settings b. flow velocity displayed c. amplitude of the reflected signal d. volume of flow interrogated
b
44
Which type of thyroid cancer is associated with elevated calcitonin levels? a. medullary b. follicular c. anaplastic d. papillary
a
45
A patient presents for an abdominal us exam with a history of a recent single episode of significant indigestion. The lab results demonstrate increased levels of AST and normal levels of ALT, ALP, and bilirubin. These clinical findings are most consistent with: a. chronic hepatitis C b. schistosomiasis c. biliary stasis with a partial ductal obstruction due to Klatskin tumor d. myocardial infarction
d
46
Which of the following is an appropriate indication for a liver transplant? a. cholangiocarcinoma b. extrahepatic malignancy c. hepatitis C d. current alcohol abuse
c
47
Which metabolic infiltrative disorder is associated with hepatic adenoma formation? a. amyloidosis b. hemochromatosis c. Von Gierke disease d. Wilson disease
c
48
Which of the following produces insulin? a. islets of langerhans b. pituitary gland c. Kupffer cells in the liver d. acini glands of the pancreas
a
49
Which of the following is true regarding the difference between the sample obtained from a fine needle aspiration and a core biopsy sample taken from the liver? a. the needle used for the FNA is usually much larger than the biopsy needle b. core needle biopsies are more commonly performed for liver masses than to assess parenchymal disease c. the cytology lab evaluates the sample obtained from the FNA. The histology lab evaluates the sample obtained from the needle biopsy. d. FNA procedures are more traumatic to the tissues than needle biopsy procedures
c
50
The most common benign liver tumor is: a. cavernous hemangioma b. klatskin tumor c. polycystic liver disease d. hepatitis
a
51
What type of hernia is a delayed complication of upper abdominal surgery? a. amyand hernia b. direct inguinal hernia c. indirect inguinal hernia d. incisional hernia
d
52
Which congenital anomaly is associated with hydronephrosis of the upper OR lower pole of the kidney? a. UPJ obstruction b. column of Bertin c. duplicated collecting system d. posterior urethral valves
c
53
An infant patient is referred for an abdomen ultrasound to rule out UPJ obstruction of the left kidney. What are the expected findings if the exam is positive? a. the left renal calyces, renal pelvis, and ureter will be dilated with or without the bladder distended b. a normal ureter will be identified but the left renal calyces and renal pelvis will be chronically dilated, with or without the bladder distended c. the renal calyces and renal pelvis will be normal but the ureter will be dilated anytime the bladder is distended d. the left renal calyces, renal pelvis, and ureter will be dilated when the bladder is distended
b
54
A patient presents for a neck ultrasound that has a history of papillary carcinoma and bilateral thyroidectomy. What area of the neck is most commonly involved in recurrence? a. Level I lymph nodes below mylohyoid muscle to the lower margin of the hyoid bone b. Level VII lymph nodes infraclavicular and anterior mediastinal c. level III and IV lymph nodes between the carotid artery and the sternocleidomastoid muscle d. Level VI lymph nodes from the inferior margin of hyoid bone to the manubrium
c
55
Which of the following is caused by infection or ischemia of the gallbladder wall? a. hartmann pouch b. adenomyomatosis c. Bouveret syndrome d. membranous gangrenous gallbladder
d
56
When preparing the sterile tray for a liver biopsy, the cover on the tray should be opened: a. no more than 2 hours before the procedure begins b. by the radiologist c. by pulling the far corner of the cover toward you d. while wearing sterile gloves
c
57
Which of the following describes the best way to image the patellar tendon with ultrasound? a. the central portion of the tendon is best imaged from the posterior approach b. evaluate the patellar attachments from an anterior approach c. patient must be evaluated with leg fully extended d. due to the proximity of the tendon to bone, the patellar tendon cannot be evaluated with US
b
58
Primary gallbladder carcinoma most commonly presents as: a. focal wall mass without stones b. enlarged gb surrounded by fluid c. small gb with thickened walls d. diffusely thickened gb wall with stones
d
59
Which of the following operator controls adjusts the beam intensity? a. TGC b. output c. dynamic range d. overall gain
b
60
Which of the following usually affects the pancreatic head? a. cystadenoma and islet cell tumors b. focal pancreatitis and adenocarcinoma c. pseudocyst and focal pancreatitis d. adenocarcinoma and cystadenoma
b
61
The __ lobe of the liver is located between the right and middle hepatic vein. a. medial left b. lateral left c. anterior right d. caudate
c
62
Increasing the imaging depth will: a. improve temporal resolution b. reduce beam intensity c. reduce the frame rate d. increase the PRF
c
63
A four month old presents for an abdominal ultrasound following a recent Kasai procedure. Which of the following ultrasound findings would indicate the procedure was a success? a. normal liver echotexture with normal biliary duct diameter b. echogenic graft connecting the hepatic and portal venous systems in the liver with flow velocity greater than 40 cm/s c. echogenic mesh in the abdominal wall used to close an inguinal hernia d. echogenic mesh in the abdominal wall used to close an umbilcal hernia
a
64
A patient presents for an abdominal ultrasound due to elevated LDH and a low grade fever. Which of the following is the most likely finding on the exam? a. Wilson disease b. steatosis c. choledocholithiasis d. hepatitis
d
65
Which of the following is a contraindication for a renal biopsy? a. current antibiotic treatment b. AIDS c. current Warfarin use d. polycystic kidney disease
c
66
The __ is a part of the prostate gland that is mostly composed of smooth muscle cells and makes up approximately 1/3 of the gland. a. fibromuscular region b. transitional zone c. central zone d. peripheral zone
a
67
Which of the following is true regarding pyloric stenosis? a. abnormal channel length >1mm b. presents as a short thick pyloric canal c. abnormal muscle thickness >4mm d. more common in females
c
68
Which of the following is a common complication of cystic fibrosis? a. AAA b. systemic HTN c. renal calculi d. meconium ileus
d
69
Which of the following typically presents in men over 60 years with bilateral hypoechoic, solid masses within the testicular parenchyma? a. choriocarcinoma b. seminoma c. lymphoma d. orchitis
c
70
When evaluating a liver transplant, you must use an angle correction during Doppler evaluation of: a. hepatic arteries and veins b. hepatic arteries only c. hepatic arteries and portal veins d. portal veins only
c
71
Which of the following correctly describes how to determine if a peripheral mass is intrahepatic or extrahepatic? a. assess the location of the mass in relation to the stomach b. use PW Doppler to obtain the resistive index of the lesion and compare it to the resistive index of the normal liver tissue c. evaluate the biliary tree for the presence of dilatation which is only seen with an extrahepatic mass d. assess the liver capsule and look for indentations that indicate extrahepatic origin or outward bulging that indicates intrahepatic origin
d
72
What liver complication is associated with cholangitis, diverticulitis, and osteomyelitis? a. metastasis b. fungal abscess c. steatosis d. pyogenic abscess
d
73
Billroth cords in the red pulp of the spleen are responsible for __ destruction. Malpighian corpuscles in the white pulp of the spleen are responsible for ____ production. a. red blood cell, lymphocte b. platelet, lymphocyte c. lymphocyte, red blood cells d. lymphocyte, platelet
a
74
Potential bioeffects of ultrasound can be minimized by which of the following? a. decrease overall gain b. reduce exam time c. using a lower frequency transducer d. increase PRF
b
75
The length measurements of the adult kidneys should be within ___ of each other. a. 1cm b. 2cm c. 3cm d. 4cm
b
76
The bile duct diameter should be measured with the calipers placed from: a. outer wall to outer wall b. leading edge to leading edge c. inner wall to outer wall d. inner wall to inner wall
d
77
Which portion of the GI tract contains numerous valvulae conniventes that cause a feathery appearance of the structure on ultrasound? a. jejunum b. appendix c. cecum d. ilium
a
78
When reviewing a prior US exam for an upcoming follow up exam for the same patient, you come across an image labeled "sandwich sign". What are they referring to? a. extrinsic compression of the IVC by a pancreatic tumor b. the head of the pancreas is abnormally compressed between the liver and great vessels c. lymphadenopathy surrounding the portal vein d. the layering of the stomach wall at the head of the pancreas
c
79
Which muscle group is located anteromedial to the lobes of the thyroid gland? a. longus colli muscle b. strap muscles c. tracheal muscles d. sternocleidomastoid
b
80
The superior mesenteric artery originates from the aorta approximately __ below the celiac axis and posterior to the __. a. 1-2cm, stomach and duodenum b. 2-3 cm, body of the pancreas c. 2-3cm, stomach and duodenum d. 1-2cm, body of the pancreas
d
81
What patient position is used to evaluate the Achilles' tendon with ultrasound? a. prone, feet dangling b. standing c. seated, knee flexed and ankle extended d. seated, knee and ankle flexed
a
82
A 56 year old male presents with a 4 year history of cirrhosis. The size of which of the following structures should be assessed to evaluate the affects of cirrhosis? a. portal vein, hepatic vein, hepatic artery b. left lobe and caudate lobe c. caudate lobe and hepatic artery d. right lobe, portal vein, and caudate lobe
d
83
The gastroesopheal junction is best seen in the __ plane, anterior to the aorta and posterior to the left lobe of the liver. a. longitudinal b. radial c. coronal d. transverse
a
84
Which of the following Doppler parameters is most commonly used when evaluating the common hepatic artery in patient with a liver transplant? a. peak systolic velocity b. resistive index c. S/D ratio d. pulsatility index
b
85
Which of the following will demonstrate the lowest resistive index value in the parenchymal arteries? a. renal vein thrombosis b. acute tubular necrosis c. acute renal failure d. acute renal artery occlusion
d
86
If gallstone impaction is suspected: a. ask the patient to stand during the exam and perform the valsalva maneuver to attempt to move the stone b. place the patient in the LLD position and tap the patients back between the scapulas with the base of your wrist to attempt to move the stone c. scan the patient in multiple positions to attempt to move the stone d. place the patient in the LLD position and ask the patient to perform the valsalva maneuver to attempt to move the stone
c
87
Which of the following describes how to differentiate adenomyomatosis of the gallbladder from cholesterolosis of the gallbladder? a. adenomyomatosis is usually a focal process and cholesterolosis is a diffuse process b. the polyps in adenomyomatosis do not exhibit the comet tail artifact but polyps with cholesterolosis do demonstrate the artifact c. adenomyomatosis is usually a diffuse process and cholesterolosis is a focal process d. the polyps in cholesterolosis do not exhibit the comet tail artifact but polyps with adenomyomatosis do demonstrate the artifact
d
88
What is the term for a normal renal variant of a single cortical bulge off of the lateral border of the left kidney? a. cortical hyperplasia b. dromedary hump c. fetal lobulation d. column of Bertin
b
89
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
c
90
a top normal thyroid isthmus measurement would be: a. 4mm b. 6mm c. 4cm d. 6cm
b
91
When the superior mesenteric artery is in view in a transverse plane, the probe must be angled ___ to see the celiac axis. a. ventral b. oblique c. cephalad d. caudal
c
92
What is the primary function of lymph nodes? a. release endorphins that aid in blood filtration b. filter blood and protect the body from infection c. filter lymphatic fluid and protect the body from infection d. release enzymes that fight infection in the body
c
93
A 64 year old female presents with recent weight loss and mild jaundice. Lab values demonstrate normal WBC levels, but increased levels of direct bilirubin, alkaline phosphatase and prothrombin time. The gallbladder demonstrates a small wall mass that is isoechoic to the wall tissues. The wall measures 4.5 mm in maximum thickness. Multiple stones are present within the lumen. Which of the following best describes the findings on the image? a. primary GB carcinoma and cholelithiasis b. adenomyomatosis c. acute cholecystitis, polyp formation, and cholelithiasis d. acute cholecystitis and cholelithiasis
a
94
What congenital anomaly of the pancreas is most associated with duodenal obstruction? a. aberrant pancreatic tissue b. pancreas divisum c. pancreatic sequestration d. annular pancreas
d
95
Zenker diverticulum can be mistaken for: a. the appendix b. a thyroid mass c. a bowel obstruction d. a dilated bile duct
b
96
Autoregulation of the systemic blood pressure refers to: a. the renin-angiotensis system that controls the level of constriction of the convoluted tubules b. the renin-angiotensin system that controls the glomerular filtration rate of the kidneys and systemic BP level c. the release of norepinephrine to cause constriction of the convoluted tubules d. the release of epinephrine to cause constriction of the convoluted tubules
b
97
A tardus parvus waveform is described as? a. pronounced of early systolic peak and prolonged acceleration time b. reduced systolic velocity with diastolic flow reversal c. absence of early systolic peak and prolonged acceleration time d. resistive index of 1.0 or greater
c
98
Creeping fat is a sign of: a. wilson disease b. pancreatic adenocarcinoma c. mesenteric ischemia d. crohn disease
d
99
Massive adrenal gland enlargement, hepatomegaly, and splenomegaly are common findings in what fatal autosomal recessive disorder? a. wilson disease b. marfan syndrome c. wolman disease d. beckwith-weidemann syndrome
c
100
Mirrizzi syndrome is caused by obstruction of the ____, while Courvoisier gallbladder is related to ___. a. distal cbd, cystic duct b. cystic duct, distal cbd c. proximal cbd, distal cbd d. intrahepatic cbd, extrahepatic cbd
b