Abdominal Sonography CTL: Pathology 42% Pt 3
A choledochal cyst is: Outpouching in GB wall Focal dilatation of the biliary tree Complication of a portal thrombosis Associated with angiomyolipoma
focal dilation of the biliary tree
which of the following usually affects the pancreatic head adenocarcinoma and cystadenoma focal pancreatitis and adenocarcinoma cystadenoma and islet cell tumors psuedocyst and focal pancreatitis
focal pancreatitis and adenocarcinoma
An inflammation of the biliary tree common in HIV patients is called pneumobilia bacterial cholangitis HIV cholangitis primary sclerosing cholangitis
HIV cholangitis
Which of the following is most likely to be confused with a breast carcinoma multiple fibroadenomas in both breast sebaceous cyst fat necrosis after breast surgery single 5 cm fibroadenoma in the breast
fat necrosis after breast surgery
Jaundice is usually associated with all of the following except red blood cell destruction fatty infiltration hepatocellular disease ductal obscruction
fatty infiltration
A patient presents with a history of fatty infiltration of the liver. Which of the following statements regarding the sonographic apperance of a fatty liver is false? fatty infiltration will increase in patients with history of alcoholism as the level of fatty infiltration increases, the less visible the liver vessels will become fatty infiltration is an irreversible condiiton fatty infiltration of the liver can be a diffuse or focal condition
fatty infiltration is an irreversible condition
What causes pseudopancreatitis hepatitis polycystic liver disease fatty liver cholecystitis
fatty liver
Acute cholecystitis is associated with gallbladder wall thickening _____. Cholangitis is associated with ductal wall thickening _____. >2mm, >3mm >3mm, >2mm >3mm,>5mm >6mm,>3mm
> 3 mm, >2mm
Massive splenomegaly is defined as a spleen that exceeds _____ in length 23 cm 18 cm 15 cm 13 cm
18 cm
A patient is referred for a renal ultrasound due to suspected cross fused renal ectopia. What is the expected ultrasound finding for this condition? Both kidneys are located on the same side of the body and fused together at varied locations. There is a single kidney located in the midline pelvic region. The kidneys are in their normal position but the upper poles of the kidneys are joined across the midline, usually anterior to the mid aorta. The kidneys are in their normal
Both kidneys are located on the same side of the body and fused together at varied locations.
CAuses of dilation of the intrahepatic biliary tree without dilation of the extrahepatic biliary tree includes all of the following except cholangiocarcinoma liver mass in porta hepatis region Brenner tumor Klatskin
Brenner tumor (Brenner tumor form in the ovaries)
Which of the following is true regarding a liver hemangioma? Most hemangiomas demonstrate some level of posterior shadowing. A hemangioma is composed of an abnormal concentration of smooth muscle and Kupffer cells within the liver. Fluid and debris levels are commonly present in a hemangioma. Color Doppler is not usually helpful in evaluating this highly vascular mass.
Color Doppler is not usually helpful in evaluating this highly vascular mass.
Chronic cholecystitis is commonly associated with: Increased RBC count Polyps Pancreatic head mass GB carcinoma
GB carcinoma
The WES sign indicates a diagnosis or solid mass in GB GB stone cyst in GB portal thrombosis
GB stone
Which of the following statements regarding gallbladder sludge is not true? Gallbladder sludge is always associated with wall thickening. Sludge can appear as varied layers of echogenic material in the gallbladder lumen. Changing patient position and rescanning the gallbladder can differentiate sludge from artifact. Tumefactive sludge can have a sonographic appearance similar to GB carcinoma.
Gallbladder sludge is always associated with wall thickening
Which of the following is not an expected complitation of pancreatitis IVC thrombosis biliary obstruction pseudoaneurysm phlegmon
IVC thrombisis
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? Level VI lymph nodes from the inferior margin of hyoid bone to the manubrium Level III and IV lymph nodes between the carotid artery and the sternocleidomastoid muscle Level I lymph nodes below mylohyoid muscle to the lower margin of the hyoid bone Level VII lymph nodes infraclavicular and anterior mediastinal
Level III and IV lymph nodes between the carotid artery and the
acalculous cholecystitis is commonly associated wit all of the following, except total parenteral nutrition HIV infection Mirizzi syndrome trauma patients
Mirizzi syndrome
Which of the following statements regarding insulinomas is false? Patients are usually hypoglycemic. They usually occur in patients 40 - 60 yrs of age. They commonly occur in the body and tail of the pancreas. Most patients require an insulin pump to counteract the effects of the tumor on the serum glucose levels
Most patients require an insulin pump to counteract the effects of the tumor on the serum glucose levels
Which of the following is an immune system disorder that commonly affects the salivary glands? Kasabach - Merritt syndrome Klippel-Trenaunay-Weber syndrome Epstein-Barr syndrome Sjogren syndrome
Sjogren syndrome (Sjogren syndrome is an immune system disorder that causes a reduction in saliva and tear production. It is associated with rheumatoid arthritis and lupus. Primary symptoms are dry eyes and dry mouth. It may cause swelling of the salivary glands. Usually affects the parotid and submandibular glands)
According to the DeBakey Classification system, what type of aortic dissection is most commonly associated with Marfan syndrome? Type II Type IV Type III Type I
Type II (type I- involves ascending and desencing orta type II involved ascending aorta; associated with Marfan syndrome; least common type III involves the descending aorta, lowest mprtality rate)
A biloma is associated with malignancy of the biliary tree a possible complication of left renal surgery a collection of bile in the peritoneal cavity a congenital malformation of the biliary tree
a collection of bile in the peritoneal cavity
Which of the following is true regarding a liver hemangioma? Fluid and debris levels are commonly present in a hemangioma. A hemangioma is composed of an abnormal concentration of vascular tissues within the liver. Most hemangiomas demonstrate some level of posterior shadowing. Color Doppler is a valuable tool in evaluating this highly vascular mass.
a hemangioma is composed of an abnormal concentration of vascular tissues within the liver (Most hemangiomas demonstrate some level of posterior enhancement. Flow within the hemangioma is usually very slow and color Doppler is not an effective evaluation tool.)
A patient presents with increasing RUQ pain and vomiting after a recent liver biopsy. An irregular mass with internal debris and an overall heterogeneous appearance is noted in the right lobe. Th e mass also demonstrates several echogenic foci with ringdown artifact. What is the most likely diagnosis of this finding abscess hematoma lymphocele pseudoansurysm
abscess (the echogenic foci are related to air produced by the microorganisms causing the infection. Ringdown artifact is associated with air/tissue interface)
RUQ pain, positive Murphy sign, and fever are common clinical signs of: Appendicitis Ascites Adenomyomatosis acute cholecystitis
acute cholecystitis (RUQ pain, positive murphys sign, and fever are common clinical signs of acute cholecystitis)
Reduced glycogen storage in the liver usually causes the liver parenchyma to have a sonographic appearance similar to cirrhosis acute hepatitis steatosis polycystic disease
acute hepatitis
A 56 year old male presents with acute onset of epigastric pain that has persisted for about 2 days. His lab tests demonstrate elevated bilirubin, amylase and lipase. Multiple mobile echogenic foci are present in the gallbladder with a wall thickenss of 2.4 mm. The CBD measures 6mm and appears patent. The pancreas is mildly enlarged with posterior enhancement. Which of hte following best describes these findings? cystic fibrosis with cholelithiasis adenomyomatosis with cholelithiasis and cholecustitis chronic pancreatitis with cholelithiasis acute pancreatitis with cholelithiasis
acute pancreatitis with cholelithiasis
The most common cause of acute renal failure is ____________________ and the most common cause of chronic renal failure is _____________________. acute tubular necrosis, diabetes mellitus acute tubular necrosis, renal artery stenosis renal artery stenosis, renal vein thrombosis trauma, renal vein thrombosis
acute tubulasr necrosis, diabetes mellitus
Which of the following will not cause an increase in values on liver function tests? fatty liver adenoma hepatocellular carcinoma hepatoblastoma
adenoma
Which of the following biliary conditions is associated with the formation of Rokitansky-Aschoff sinuses pneumobilia emphysematous cholecystitis adenomyomatosis choledochal cyst
adenomyomatosis (Rokitansky-Aschoff sinuses are associated with adenomyomatosis. They are caused by herniation of the GB wall layers which forms a pocket or sinus. The sinuses may fill with bile or cholesterol deposits)
An otherwise asymptomatic patient presents for an abdomen ultrasound due to elevated LFT's. The gallbladder demonstrated thickened walls with an irregular internal contour. Several small echogenic foci are noted within the wall and each exhibits a comet tail artifact. Which of the following conditions is identified on this exam emphysematous cholecustitis cholesterol polyps chronic cholecustitis adenomyomatosis
adenomyomatosis (asymptomatic and would lead to an abnormally contracted gall bladder, thickened walls with an irregular internal contour.)
Which of the following is an intratesticular mass associated with Cushing syndrome and adrenal hyperplasia adrenal rest epidermoid cyst mixed germ cell tumor yolk sac tumor
adrenal rest (appear hypoechioc, multifocal masses with wheel spoke vascularity)
Which of the following biliary abnormalities will cause an increase in prothrombin time (PT)? primary carcinoma of the GB acute cholecystitis 3cm pancreatic head mass all of the above
all of the above
All of the following lab values will be increased with cirrhosis, except bilirubin alkaline hosphatase AST and ALT alpha fetoprotein
alpha fetoprotein (hepatocellular carcinoma develops with cirrhosis then AFP will rise)
An incidentaloma is an unexpected mass on an imaging exam an aggressive adrenal carcinoma an aggressive splenic carcinoma always a critical finding
an unexpected mass on an imaging exam
An asymptomatic patient presents for a renal US for size evaluation due to chronic systemic HTN. The right kidney demonstrates a 1 cm rounded hyperechoic mass within the renal cortex. There is no posterior enhancement or shadowing noted with the mass. Which of the following can be used to describe the US findings angiomyolipoma or lipoma adenoma or fibroma oncocytoma hepatoma
angiomyolipoma or lipoma
A patient presents with congenital absence of the spleen, this condition is called: Splenomegaly Accessory spleen Asplenia Hamartoma
asplenia
In cases of moderate to severe medical renal disease the renal parenchyma will be _____ hypoechoic to the sinus hypertrophied to >10 mm thickness isoechoic to the liver atrophied to <10mm thickness
atrophied to <10mm thickness
Which renal condition is always fatal autosomal dominant polycystic disease unilateral renal agenesis autosomal recessive polycystic disease horseshoe kidney
autosomal recessive polycystic disease
A patient presents for a 2 month follow up for liver transplant. Lab tests indicate abnormal LFT's, increased bilirubin and jaundice. The US exam demonstrates a new focal dilation of the bile duct at the porta hepatis with mildly dilated intrahepatic ducts just inside the liver. The pancreas is normal. These findings are most consistent with budd chiari syndrome biliary stricture choledochal cyst mas sin the ampulla of vater
biliary stricture
Which of the following correctly describes peliosis hepatis numerous AV fistulas form throughout the liver numerous cysts form that connect to the extrahepatic portal vein infection of the cystic duct that transfers to the pancreas blood filled cavities of varied size form in the liver tissue
blood filled cavities of varied size form in the liver tissue
In a patient with cirrhosis, the _____ lobe of the liver can enlarge to nearly half the sixe oof the right lobe left caudate quadrate non of the ebove, the entire liver shirnks in size with cirrhosis
caudate
Which of the following is the least likely cause of shadowing from the area of the GB fossa? Valves of Heister Choledochal cyst Pneumobilia Gas in duodenum
choledochal cyst
A 6 month old Asian female presents with jaundice and fever. While scanning the liver, you note a 1cm anechoic, round dilatation of the extrahepatic CBD at the porta hepatis. Color Doppler does not demonstrate flow within the structure. Which of the following is the most likely diagnosis? choledochal cyst pneumobilia pseudoaneurysm cholangitis
choledochal cyst (Choledochal cysts are congenital defects of the biliary tree that are more commonly found in the Asian population. Ultrasound usually demonstrates a focal dilatation of the biliary tree near the porta hepatis. The dilatation can be cystic or fusiform. If the cyst causes ductal obstruction, pain, jaundice and fever can develop.)
While scanning the gallbladder, you notice several echogenic foci within the mildly thickened wall that do not demonstrate reverberation artifact. These findings are most suggestive of adenomyomatosis secondary GB carcinoma chronic cholecustitis cholesterolosis
cholesterolosis
What liver abnormailties is commonly associated with the recanalization of the umbilical vessel acute hepatitis cirrhosis fatty infiltration hydatid disease
cirrhosis
You are scanning through the liver and note the caudate lobe is nearly the same size as the right lobe. The surface of the liver appears lobulated or nodular. Which of the following is the most likely diagnosis of these findings hepatitis focal nodular hyperplasia cirrhosis hepatocellular carcinoma
cirrhosis
A 43 year old female with a history of hepatitis C presents with jaundice, increased abdominal girth and pain. The most probable US finding in the liver will be cirrhosis and ascites schistosomiasis and splenic atrophy fatty infiltration metastasis from GI tract
cirrhosis and ascites
A compensatory enlargement of the caudate lobe occurs with which of the following wilson disease and glycogen storage disease cirrhosis and acute hepatitis cirrhosis and budd chiari syndrome fatty infiltration and glycogen storage disease
cirrhosis and budd chiari syndrome
A patient has a history of adenomyomatosis of the gallbladder. What acoustic artifact is expected to be present on the US images of the gallbladder mirror image side lobe comet tail volume averaging
comet tail
An abdominal US is ordered for a patient with bilateral pedal edema. The abdomen demonstrates mild ascites but otherwise normal organs. The IVC appears prominent with a constant diameter of 2.8cm. A continuous venous waveform is demonstrated on Doppler evaluation. These findings are most suggestive of: congestive heart failure portal HTN malignant HTN all of the above
congestive heart failure
A 64yr old patient presents with painless jaundice. The GB is over-distended with a biliary obstruction at the level of the Ampulla of Vater. Which of the following best describes this condition? Hydropic GB Choledochal cyst Courvoisier sign Mirizzi syndrome
courvoiser sign
Diffuse or focal GB wall thickening may be seen with all of the following, except: Adenomyomatosis Carcinoma of the GB Acute Cholecystitis courvoiser GB
courvoisier GB (Courvoisier GB refers to an overdistended non-tender GB without wall thickening (hydrops) commonly caused by an ampulla of Vater obstruction.)
A patient presents for an abdominal US due to a family history of pancreatic cystadenocarcinoma. The ultrasound demonstrates a complex mass in the pancreatic head. Also demonstrated is a 12 cm gallbladder with no stones or wall thickening and the CBD is patient measuring 10mm. The patient has a negative Murphy sign. These findings are most suggestive of courvoisier gallbladder secondary biliary metastasis mirizzi syntrome caroli disease
courvoisier gallbaldder (refers to an enlarged, non-tender GB caused by a distal obstruction. The pancreatic mass is obstructing the distal CBD/Ampulla of Vater)
All of the following are potential malignant features of a pancreatic cyst, except? increase in cyst size on serial examinations thickened septations internal nodule cyst size <3cm
cyst size < 3 cm
A patient presents with epigastric pain and nausea. Lab values demonstrate increased levels of amylase, direct bilirubin, alkaline phosphatase and LFTs. A cystic mass with thickened walls is identified in the head of the pancreas. No Color flow is identified in the mass. Two small hypoechoic masses are identified in the area of the pancreatic head near the porta hepatis. Which of the following best describes the findings? Biliary ascariasis Adenocarcinoma Choledochal cyst Cystadenocarcinoma
cystadenocarcinoma
Acute cholecystitis can lead to a prominent ___ and its branches with color doppler evaluation of the thickened gallbladder wall left hepatic artery proper hepatic artery cystic artery common hepatic artery
cystic artery
Sonographically, one may recognize fatty infiltratoin of the liver by all of the following except degraded visualization of vessels brighter parenchymal echoes cystic degeneration increased attenuation
cystic degeneration
Primary GB carcinoma most commonly presents as small GB with thickened walls diffusely thickened GB wall with stones focal wall mass without stones enlarged GB surrounded bu fluid
diffusely thickened GB wall with stones
Obstruction of the CBD by a pancreatic head mass will lead to: Contracted, small GB with normal biliary tree Contracted, small GB with dilated biliary tree Dilated GB and biliary tree All of the above are potential findings
dilated GB and biliary tree
Bacterial cholangitis is nearly always seen with ductal obstruction by a stone or tumor biliary ascariasis HIV cholangitis ulcerative colitis
ductal obstruction by a stone or tumor
The renal anomaly where the kidneys demonstrate congenital duplication of the renal pelvis/calyces is called ectopic kidney renal agenesis buplicated collecting system horseshoe kidney
duplicated collecting system
A patient presents for an abdomen ultrasound with RUQ pain, nausea, fever and leukocytosis. An abdominal enlarged gall bladder demonstrates thickened walls at 1.2 cm. An anterior segment of the wall is echogenic and ring down artifact and dirty shadowing are present posterior to this area. Which of the following conditions is identified on this exam? emphysematous cholecysitis cholesterol polyps chronic cholecystitis adenomyomatosis
emphysematous cholecystitis
Which of the following biliary abnormalities would be an acute complication caused by a bacterial infection of the gallbladder? emphysematous cholecystitis strawberry GB adenomyomatosis porcelain GB
emphysematous cholecystitis
A 45 year old female patient presents with nausea and vomiting, RUQ pain, fever and increased WBC. The GB is enlarged and filled with echogenic material that does not shadow or demonstrate fluid levels. These findings are most consistent with porcelain GB Emphyema of the GB adenomyomatosis emphysematous cholecystitis
empyema of the GB
You can identify free fluid above the right diaphragm that contains internal debris and septations. The fluid collection has honeycomb appearance. These findings are most suggestive of exudative pleural effusion pnemothorax hemothorax transudative pleural effusion
exudative pleural effusion
All of the following will demonstrate normal values on liver function tests, except fungal abscess focal nodular hyperplasia glycogen storage disease adenoma
fungal abscess (normal LFT values are seen with simple cysts, hemorrhagic cysts PCLD, adenoma, hemangioma, FNH, and Glycogen storage disease)
Which of the following correctly describes Marfan syndrome? genetic disorder that affects connective tissues of the heart, vessels, and bones genetic weakness of all arterial walls resulting in the formation of aneurysms throughout the systemic circulatory system abdominal situs defects are common patients are usually less than 48 inches tall with foreshortened limbs and digits
genetic disorder that affects connective tissues of the heart, vessels, and bones
Which of the following splenic tumors is associated with tuberous sclerosis or Wiskott-Aldrich syndrome hemangioma cystic lymphangioma chondroma hamartoma
hamartoma (benign masses of the spleen that usually compress and displace the adjacent normal splenic parenchyma)
A 56yr 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? acute pancreatitis chronic pancreatitis phlegmon hemorrhagic pancreatitis
hemorrhagic pancreatitis
Which way does the hepatic artery and portal vein run
hepatic artery=hepatopetal portal vein=hepatofugal
Which of the following will cause an increase in values on liver function tests hepatitis focal nodular hyperplasia glycogen storage disease adenoma
hepatitis
__________________ is the most common malignant liver mass found in children. Hepatoblastoma Mets from brain Mets from nephroblastoma Hepatoma
hepatoblastoma
Which of the following will cause an increase in alpha fetoprotein values in pediatric patients? focal nodular hyperplasia liver adenoma glycogen storage disease hepatoblastoma
hepatoblastoma (Alpha-fetoprotein levels will increase with malignancy and pregnancy.)
A 75 year old female presents with RUQ pain. She was diagnosed with cirrhosis 4 years ago. Lab values demonstrate increased levels of alpha fetoprotein, ALP, AST and ALT. The US exam demonstrated a heterogeneous liver texture that is decreased in size. The left lobe contains a new round hypoechoic mass with increased vascularity. These findings are most suggestive of. focal nodular hyperplasia metastatic lesion hepatocellular carcinoma hydatid cyst
hepatocellular carcinoma
Which of the following will cause a moderate increase in alpha-fetoprotein values in an adult glycogen sotrage disease hepatocellular carcinoma adenoma hepatoblastoma
hepatocellular carcinoma
_____ is one of the most common surgical produdure in the US and most patients are males, less than 1 year old herniorrhaphy appendectomy cholecystectomy nephrectomy
herniorrhaphy (hernia repair, most are male under 1)
The renal anomaly where the kidneys do not separate completely during embryonic development is called: Renal agenesis Duplicated collecting system Ectopic kidney Horseshoe kidney
horseshoe kidney
A patient presents with abdominal pain for 3 months following a missionary trip to India. Lab values demonstrate normal LFTs. The US exam demonstrates a 3cm cyst with septations in the right lobe of the liver. These findings are most consistent with: hydatid disease candidiasis histoplasmosis infection schistosomiasis
hydatid disease
A contrast enhanced ultrasound examination is performed on a patient with suspected hepatocellular carcinoma. What are the expected findings if the exam is positive for HCC hyperechoic lesions that demonstreate sustained levels of contrast uptake throughout the arterial and venous phases of circulation hypoechoic lesions during the arterial phase and hyperechoic lesions during the portal venous phase hypoechoic lesions that demonstrate absence of contrast uptake throughout the arterial and venous phases of circulation hyperechoic lesions during the arterial phase and hypoechoic lesions during the portal venous phsase
hyperechoic lesions during the arterial phase and hypoechoic lesions during the portal venouse phase
A liver cyst is suspectred. All of the following are sonographic charasteristics of a cyst, except increased attenuation posterior enhancement thin walls round or oval shape
increased attenuation (simple cysts do not attenuate sound)
A hernia with a narrow neck is at an increased risk for incarceration and strangulation should no be evaluated with the Valsalva maneuver is usually completely reducible with compression can be closed with compression therapy instead of surgery
is at an increased risk for incarceration and strangulation
A mass that demonstrates propagation speed artifact may lead to a positive diagnosis of: Lipoma Staghorn calculus Renal cyst Renal cell carcinoma
lipoma
The most common primary malignacy to metastasize to the spleen is breast cancer melanoma lung cancer renal cancer
melanoma
A mass that presents with a bull's eye appearance within the liver tissue is most likely __________________. focal nodular hyperplasia fatty sparing lymphoma metastasis
metastasis (a mass that presents like a bull's eye within the liver is most likely metastasis from a primary cancer of another organ)
A patient presents with a recent history of gastric carcinoma diagnosis. The patients liver most likely demonstrates which of the following abnormalities. hepatocellular carcinoma metastatic lesions PCLD gastric carcinoma
metastatic lesions ( the liver receives and filters the venous blood that is drained from the digestive organs. The blood from the stomach with the primary carcinoma is being sent through the liver. The risk for metastasis is very high. The image demonstrates several solid masses, some with a halo or bull's eye appearance most consistent with metastatic lesions)
As a long standing, partial obstruction of the cystic duct will most likely lead to which of the following hartmann pouch mucocele of the GB septated GB porcelain GB
mucocele of the GB
What is the most common type of splenic lymphoma?
non-hodgkin lymphoma
A 45yr old male presents for an Abdominal US due to suspected hepatomegaly. The exam demonstrates numerous cysts of all sizes throughout the liver parenchyma. Which of the following should also be evaluated for the same abnormality? prostate diaphragm pancreas retroperitoneal lymph nodes
pancreas
What congenital anomaly of the pancreas results in two separate ductal systems that drain the pancreas annylar pancreas aberrant pancreatic tissue pancreas divisum pancreatis sequestration
pancreas divisum
A patient is scheduled for abdominal ultrasound every six months due to their history of cirrhosis. Which of the following is true patients with cirrhosis do not need to be evaluated regularly once the diagnosis has been made because the treatment options are limited cirrhosis commonly leads to ascites which may require intermittent thoracentesis treatments patients with cirrhosis should have theri liver vasculature evaluated regularly due to an increased risk of tumor invasion from metastasis patients with cirrhosis should have their liver vasculature evaluated regularly due to an increased risk or portal thrombosis
patients with cirrhosis should have their liver vasculature evaluated regularly due to an increased risk of portal thrombosis
Which of the following statements is correct regarding hernias? Patients with one hernia should be evaluated for other types of ipsilateral and contralateral groin or anterior abdominal hernias Varicose vein formation is the most significant complication of a hernia Herniorrhaphy is the most common surgical procedure performed on post-partum females Most hernias are closed using a skin graft taken from the opposite groin
patients with one hernia should be evaluated for other types of ipsilateral and contralateral groin or anterior abdominal hernias
When a AAA ruptures, which retroperitoneal space will fill the blood first posterior pararenal omental bursa anterior pararenal perirenal
perirenal
The development of scar tissue and fibrous plaque formation involving the tunica albuginea of the penis describes: Priapism Peyronie disease Penile fracture Squamous cell carcinoma of the penis
peyronie disease
A 66yr old female presents for an abdominal ultrasound due to bloating and pain following a recent cholecystectomy. The bile ducts demonstrate varied level of increased echogenicity with dirty shadowing and ring down artifact posterior to several segments. These findings are most consistent with? choledocholithiasis sclerosing cholangitis pneumobilia cholangiocarcinoma
pneumobilia
An US demonstrates a non-shadowing, non-mobile, echogenic foci within the GB that most likely represents polyp calculus sludge ball porcelain GB
polyp
Which of the following biliary abnormalities is associated with chronic cholecystitis? strawberry GB empyema porcelain GB biloma
porcelain GB
The most common cause of splenomegaly is mononucleosis infection malignant HTN AIDS portal HTN
portal HTN
A patient presents for an abdominal ultrasound due to nausea and vomiting. While scanning the gallbladder, the patient asks you to take a break due to the pain caused bu the transducer pressure. How should you report this to the radiolgisy patient uncooperative, unable to effciently perform the exam positive Murphy's sign positive Morrison sign positive homan sign
positive Murphy sign
A porcelain GB causes an increase in the patient's risk for ____________________. primary carcinoma choledocholithiasis adenomyomatosis sclerosing cholangitis
primary carcinoma
While evaluating the liver and biliary tree, a stone is noted in the CBD adjacent to the pancreatic head. Which of the following is not an expected finding on the rest of the exam pseudoaneurysm dilated biliary tree pancreatitis cholelithiasis
pseudoaneurysm
The most common cause for fluid collection in the perirenal space is _______________________. The most common cause for fluid collection in the posterior pararenal space is _____________________. pancreatic disease, renal disease renal abnormalities, aortic disease small bowel infection, colitis aortic disease, renal abnormalities
renal abnormaliies, aortic disease
A 55 year old with a history of alcoholism and jaundice presents for an abdominal ultrasound. Cirrhosis of the liver is identified on the exam. All of the following are commonly associated findings, except portal thormbisis ascites dilated coronary vein renal oncocytoma
renal oncocytoma (benign tumor of the kidney)
A patient presents for a post-transplant evaluation of the pancreas. Where is the most common location for the allograft right iliac fossa left lower quadrant epigastric area periumbilical area
right iliac fossa
Which of the following can lead to a false positive diagnosis of stones in the biliary system? Shadowing from surgical clip in porta hepatis Improperly decreased TGC settings Decreased color Doppler gain Rejection setting too high
shadowing from surgical clip in porta hepatis
A pyogenic abscess in the liver has been associated with all of the following except dicerticulitis sickle cell anemia osteomyelitis cholangitis
sickle cell anemia
An autosplenectomy is a common complication of: left renal transplant sickle cell anemia pancreatic pseudocyst Gaucher disease
sickle cell anemia
Spolenic atrophy in adults is often associated with splenitis typhoid fever sickle cell anemia tuverculosis
sickle cell anemia
All of the following are congenital anomalies of the spleen, except: Agenesis splenomegaly ectopic spleen splenunculi
spleenomegaly
Which of the following biliary conditions is the most common cause of acute cholecystitis stone lodged in cystic duct pancreatitis mass in the duodenum hepatitis
stone lodged in cystic duct
What is the most significant complication of a hernia? strangulation ascites recanalization of the umbilical vein lymphadenopathy
strangulation
Which of the following is NOT required when reporting a suspected hernia reducibility tenderness at the area of interest suspected age of the hernia contents of the hernia sac
suspected age of hernia (you need to report dynamic maneuvers used in the exam, presence or absence of hernia, hernia size, hernia contents, reducibility of the hernia, tender versus nontender during the exam)
The double duct sign refers to the dilation of the common bile duct and cystic duct right and left hepatic ducts the main pancreatic duct and accessory pancreatic duct the common bile duct and the duct of Wirsung
the common bile duct and the duct of wirsung (associated with pancreatic adenocarcinoma)
A new liver mass in a patient with sclerosing cholangitis should cause suspicion of: portal HTN a peribiliary leak the development of cholangiocarcinoma the development of schistosomiasis
the development of cholangiocarcinoma (Primary sclerosing cholangitis is the #1 risk factor for the development of cholangiocarcinoma.)
A patient presents for an abdominal ultrasound for pain. The chart holds a recent x-ray report that states there is not a possible porcelain gallbladder present. How will this abnormality appear on the ultrasound exam? there is a single large stone present with a thickened gallbladder wall the gallbladder will be completely packed full of small stones the gallbladder will be hydropic with a thickened wall and an increased risk of rupture the gallbladder wall will demonstrate varied leveles of linear calcification
the gallbladder wall will demonstrate varied levels of linear calcification
Which of the following correctly describes a pneumothorax? ultrasound is not able to demonstrate a pneumothorax the lung-gliding sign is not present with free air in the chest there are two types of pneumothorax, transudate and exudate fluid accumulation between the visceral and parietal pleura
the lung-gliding sign is not present with free air in the chest
A patient presents for a follow up ultrasound due to Budd Chiari syndrome. Which of the following is an expected finding on the exam? adrenal adenoma and/or kidney adenoma thrombosis of the hepatic veins with hepatic congestion prostatitis and neurogenic bladder pancreatic head mass and dilated intrahepatic ducts
thrombosis of the hepatic veins with hepatic congestion
What are the two most common infections that cause granuloma formation in the spleen? mononucleosis and syphilis tuberculosis and histoplasmosis tuberous sclerosis and mononucleosis colitis and cholecystitis
tuberculosis and histoplasmosis
A patient presents for an abdominal ultrasound with a history of a renal and pancreatic transplant. What chronic medical condition is a common primary reason for the transplant? Pancreatic adenocarcinoma Chronic pancreatitis Hypertension Type I diabetes
type I diabetes (can lead to renal failure)
While scanning the urinary bladder using color Doppler, the left urinary jet is detected but is partially obstructed by a thin membrane that balloons into the bladder lumen. What is the finding displayed? urethrocele ureterocele posterior urethral valves UPJ obstruction
ureterocele
Which of the following is not an expected complication of a liver transplant? seroma urinoma abscess biloma
urinoma (A urinoma is a pocket of urine outside the urinary system. They are usually related to renal or bladder surgery.)
Which of the following describes how to differentiate tumefactive sludge from gallbladder carcinoma turn off harmonic imaging five the patient a fatty meal and rescan ask the patient to perform the Valsalva maneuver use color doppler over the area of interest
use color doppler over the area of interest
Causes of hydronephrosis include all of the following, except: Stone formation Vascular calcification Mass effect Pregnancy
vascular calcification
The most common location for the formation of a pancreatic pseudocyst is ___________________________. adjacent to the uncinate process. within the greater sac of the omental layers. within the peritoneal cavity. within the lesser sac of the omental layers.
within the lesser sac of the omental layers