Week 11

Question 1

kidneys located in __

Answer 1

retroperitoneal space

Question 2

renal parenchyma function

Answer 2

filters blood & makes urine

Question 3

renal pelvis function

Answer 3

moves urine to ureter

Question 4

patient prep for kidney US

Answer 4

Fasting not needed

500 – 600 ml of water 1 – 2 hours prior to scan

Not to empty bladder

Question 5

scanning approach to kidney US

Answer 5

anterior, posterior, coronal, intercostal

Question 6

how does kidney appear compared to liver

Answer 6

slightly hypoechoic

Question 7

patient scanning approach for US pancreas

Answer 7

Patient supine

Firm pressure to displace overlying bowels

RPO may help to move bowel out of the way

Water loading may be used to fill stomach & make acoustic window

Question 8

patient scanning approach for US spleen

Answer 8

Start with patient supine

Angle probe between ribs intercostal & posterolateral

If overlying bowel gas / lung base / rib shadows seen, slowly roll patient to improve visualization by placing sponge / roll towel under patient’s right side & opens rib cage

Question 9

what causes renal sinus to appear hyperechoic

Answer 9

adipose tissues, intrarenal vessels, renal pelvis

Question 10

causes of fetal lobulation

Answer 10

• Seen mainly in adults
• Incomplete fusion of developing renal lobules

Question 11

causes of double collecting system

Answer 11

Renal sinus divided by hypertrophid column of bertin / focal cortical hyperplasia

Question 12

Most common ectopic site for kidneys

Answer 12

lying obliquely in ipsilateral iliac fossa

Question 13

causes of cross fused ectopia

Answer 13

• Developing kidneys fuse while in pelvis
• One kidney ascend carrying the other with it

Question 14

causes of ectopic kidneys

Answer 14

Found outside of normal renal fossa due to birth defect / interrupted ascent during embryology

Question 15

what is a common complication of acute pancreatitis

Answer 15

pancreatic pseudocysts

Question 16

Carcinoma of pancreatic head / ampulla of vater associated with __

Answer 16

adenocarcinoma

Question 17

Carcinoma of body & tail associated with __

Answer 17

Mucinous cystadenocarcinoma

Question 18

acute pancreatitis raises ___ pancreatic enzymes

Answer 18

amylase & lipase

Question 19

how does acute pancreatitis appear on US image

Answer 19

enlarged parenchyma with hypoechoic changes

peripancreatic fluid present

Question 20

what forms wall-off collections / pseudocysts in acute pancreatitis

Answer 20

digestive enzymes leaking out of pancreas

Question 21

what is the normal shape of the spleen

Answer 21

half moon shape

Question 22

what is the normal size of kidneys

Answer 22

7 - 10mm

Question 23

how does medullary pyramids look compared to parenchyma in normal kidneys

Answer 23

hypoechoic

Question 24

how do horseshoe kidneys appear in US image

Answer 24

Kidneys connected at lower poles during renal development

Hard to see lower pole in US; connected above IVC and aorta

Question 25

what are the ectopic locations of kidneys

Answer 25

iliac, thoracic, crossed, pelvic

Question 26

how is renal parenchymal scarring seen on US image

Answer 26

Focal depression seen on cortex with focal parenchymal thinning

Question 27

how is nephrocalcinosis seen on US image

Answer 27

Medullary pyramids appear more echogenic than cortex Posterior acoustic shadowing

Question 28

what is nephrocalcinosis

Answer 28

Ca2+ salt deposition in renal parenchyma

Question 29

what does calculi cause

Answer 29

hydronephrosis

Question 30

how does calculi appear in US image

Answer 30

Echogenic & Strong posterior shadowing

Question 31

how does hydronephrosis appear in US image

Answer 31

Enlarged anechoic fluid structure in renal pelvis with thinning renal cortex

Question 32

what is the follow-up action after diagnosing hydronephrosis

Answer 32

identify obstruction site such as stones and masses

Question 33

how does angiomyolipoma appear in US image

Answer 33

Echogenic mass without vascularity

Question 34

what does angiomyolipoma look similar to

Answer 34

liver hemangioma

Question 35

how does pyelonephritis appear in US image

Answer 35

Vascular & Hypoechoic mass

Question 36

how does renal cell carcinoma appear in US image

Answer 36

hypervascular heterogenous mass at renal parenchyma

Question 37

most common renal neoplasm

Answer 37

renal cell carcinoma

Question 38

what does transitional cell carcinoma grow into

Answer 38

renal pelvi calyceal system

Question 39

how does perinephric fluid appear in US image

Answer 39

Anechoic encapsulated fluid accumulation in perinephric space

Question 40

adrenal glands lie ___ to each kidney over ___

Answer 40

superior-medial; upper renal poles

Question 41

adrenal gland indications

Answer 41

Poorly controlled hypertension Cushing's syndrome - Hypersecretion of adrenal hormones - Usually obese - Hyperplastic adrenal gland changes

Question 42

how does macroadenoma appear in US image

Answer 42

Enlarged echogenic adrenal gland

Question 43

what is the size & thickness needed for spleen to be considered enlarged

Answer 43

length > 13 cm thickness > 6cm

Question 44

double-duct sign involves dilatation of __

Answer 44

intrahepatic duct, common bile duct, pancreatic duct

Question 45

what are common indications of abdominal US

Answer 45

- RUQ pain - Jaundice - Palpable mass - Fever of unknown origin

Question 46

GB grows __ per decade

Answer 46

1mm

Question 47

what is the normal size of GB

Answer 47

8 - 10 cm long 2 - 5 cm wide

Question 48

nephrocalcinosis mainly occurs at

Answer 48

medullary pyramids

Question 49

calculi mainly seen at

Answer 49

renal pelvis

Question 50

angiomyolipoma looks similar to __

Answer 50

liver hemangioma

Question 51

renal cell carcinoma mainly occurs at

Answer 51

parenchyma

Question 52

spleen normal measurements are

Answer 52

12 cm long, 5 cm wide