Clinical Applications- Final Exam Questions

Place your cursor on the pathology within this image:

*This image is showing choledocholithiasis. The shadowing posterior to the duct is key*

Select in this image which area is the bile duct:

*Top left of the portal triad*

Select the left renal vein in this image:

*anterior to aorta, posterior to SMA

Select the aorta in this image:

*posterior to neck and SMA

Click the SMA in this image

*posterior to the neck

Select the area of the portal confluence in this image:

*posterior to the neck

Select the uncinate process within this image:

*right below the head/neck area

Select in this image the hepatic artery:

*top right of the portal triad*

Select the splenic vein within this image:

*venous area by the tail

Hepatic metastases appear _____ on sonography

- All of the above - Hypoechoic - Cystic - Hyperechoic

Hepatic adenomas are associated with all of the following except:

- Cirrhosis - Birth control use - Glycogen storage disease - Anabolic steroid use - Von Gierke's Disease

All of the following tumors are benign except:

- Lymphoma - Adenoma - Cavernous hemangioma - Focal nodular hyperplasia

Which of the following is NOT true regarding cavernous hemangiomas?

- Shows increased, high velocity color Doppler signals - Usually asymptomatic - More common in women than men - Small, well-defined, hyperechoic masses

You are scanning a patient with suspected cirrhosis. All of the following are sonographic characteristics for cirrhosis EXCEPT:

- Shrunken caudate lobe - Nodular liver surface - Ascites - Altered liver echo texture

Explain at least three sonographic characteristics of a first trimester fetal demise

1. If the fetal dismise is from a missed abortion then you will be able to see the fetal parts that are still left within the pelvis. This is known as fetal mummy. 2. If the fetal dimise is from a placenta abrupting then you will be able to visualize a very irregular and uneven gestational sac within the pelvis 3. If there is a fetal dismise present then there will be no heart beat. You will place color over the baby and no color will be present. You will also use M-mode and there will be no fetal heartbeat with M-mode

A 27-year-old female presents for a viability exam. Her LMP was 7 weeks ago. She has been having some vaginal bleeding and slight cramping. Explain two pathologies which may be occurring at the time of the exam. With each pathology, explain the sonographic characteristics.

1. She could be having an ecotopic pregnancy. On ultrasound, you would see no gestational sac within the endometrium and instead visualize one possibly in the cervix, abd cavity, fallopian tube, ovary or interstitually. 2. She could also be having a form of a miscarriage or abortion. She could be having an inveitable abortion and on ultrasound you could visualize her cervix as being dilated and the fetal parts as being down lower in the cervix ready to be expelled. Baby could also have no heartbeat present.

Explain three sonographic signs of ovarian torsion:

1. The ovary will contain no blood flow when doppler is placed on it 2. The ovary will be enlarged 3. The ovary will present with corried vessels

Explain at least two sonographic characteristics of a blighted ovum

1. There will be no visualization of any embryo or yolk sac at all on ultrasound. 2. There will still be visualization of a gestational sac on ultrasound but it will appear empty. 3. There may sometimes be a yolk sac

Which of the following is the cut-off for portal vein enlargement:

1.3 cm

Each measurement is accompanied by a number. Which measurement corresponds with the "height" or A-P dimension of the uterus?

2

A patient is sent for an initial, first trimester viability exam. At what point should the mean sac diameter measurement be used in a normal pregnancy?

5 Weeks

The WES sign means:

A gallbladder filled with cholelithiasis

Match the pathology with the concurrent lab value that will be increased: Hepatocellular Carcinoma

AFP

Match the pathology with the concurrent lab value that will be increased: Hepatic Steatosis

ALT

Stone in neck sign is highly suggestive of:

Acute Cholecystitis

A patient present with abnormal LFTs. You see this while scanning- what is the most likely pathology?

Acute Hepatitis

A 33-year-old female presents from the ED for a RUQ exam with abdominal pain x2 days. What is the most likely diagnosis

Acute cholecystitis

Biliary sludge is associated with all of the following except:

Acute hepatitis

A patient presents with amylase levels that are twice the normal level as well as elevated lipase levels. What pathology might you expect to see based off these lab values?

Acute pancreatitis

A patient presents with epigastric pain. Upon examination, this pathology is noted. What is the most likely cause of this pathology

Acute pancreatitis

A 55 year-old male with a history of recent weight loss and abdominal pain presents for an abdominal ultrasound. The liver has this appearance throughout the right and left lobe. What is most likely the primary cause of this pathology?

Adenocarcinoma of the colon

A patient presents with dyspepsia. On a RUQ exam, you see this pathology. What is is most likely to be?

Adenomyomatosis

A patient presents with menorrhagia and pelvic pain. The Sonographer sees this on transvaginal imaging. What is it likely to be?

Adenomyosis

Which of the following would not be a cause of abnormal uterine bleeding:

Adenomyosis Ovarian torsion Endometrial hyperplasia Endometriosis

Cystic fibrosis

Affects the mucous cells of the body, creates fatty infiltration of the pancreas

What is the most common cause of this pathology in the United States?

Alcohol Abuse

Match the term with the definition: Complete abortion

All products of conception have been expelled

Demonstration of the pancreatic head surrounding the duodenum is consistent with:

Annular pancreas

Focal fatty liver is most commonly found in which location?

Anterior to the portal vein at the porta hepatis

Describe the hepatic arterial system starting/first at the abdominal aorta and finishing intrahepatically:

Aorta, Celiac Trunk, Common Hepatic artery, Proper hepatic artery, Right/Middle/Left hepatic arteries

The sonographer is going to scan a first trimester exam for viability. At what point should the amnion be fused with the chorion?

Around 14 weeks

A patient presents with abdominal distension. All of the following are potential gynecologic diagnoses except:

Ascites Ovarian hyperstimulation syndrome Ovarian torsion Leiomyoma

A patient with a history of a D&C presents for a transvaginal ultrasound. This is seen on sonography. What is it likely to be?

Asherman's Syndrome

Match the pathology with benign or malignant: Serous cystadenoma

Benign

Non-shadowing, low-amplitude echoes located in the dependent portion of the gallbladder BEST describes:

Biliary sludge

Mucinous cystadenomas typically occur in which portion of the pancreas?

Body or tail

During a 7-week IUP sonogram, the BPM was 90. This is considered:

Bradycardia

A female patient presents with abdominal pain and a history of the Factor V Leiden disorder. What pathology is likely shown here?

Budd-chiari syndrome

Saccular, communicating intrahepatic bile duct dilatation

Caroli's Disease

Which pathology is most likely demonstrated in this image?

Caroli's Disease

A 24 year-old female patient presents with this lesion in the right lobe. What is it most likely to be?

Cavernous hemangioma

A patient presents with mild pelvic pain and slight bleeding. On examination there is no sliding sac sign. What is this more likely to be?

Cervical ectopic

Two cyst-like structures in the right upper quadrant which are the gallbladder and the dilated common bile duct

Choledochal cyst

Match the following types of portal hypertension with an example of the pathology associated with it: Intrahepatic:

Cirrhosis

Primary sclerosing cholangitis can result in:

Cirrhosis

Sonographic evaluation demonstrates dilation of the right and left hepatic ducts. The gallbladder and common bile duct are normal in size. The point of obstruction is:

Common Hepatic Duct

Within what structure is a choledochal cyst most likely to occur?

Common bile duct

Compare the sonographic characteristics of complete abortion, missed abortion, and inevitable abortion.

Complete Abortion- All parts of the fetus will be ejected from the mother and on ultrasound there will be no fetal parts remaining to be seen anywhere in the uterus. Missed Abortion- There will be fetal dimise but the fetal parts or RPOC will be left within the mother and will not be relased and visable on ultrasound as what we know as fetal paparyaus or fetal mummy. I nevitable Abortion- The cervix will appear to be dilated and the fetal parts will be lower down much closer to the cervix ready to be ejected from the mother.

Match the pathology with the concurrent lab value that will be increased: Wilson's Disease

Copper

Which ligament attaches to the diaphragm and surrounds the bare area of the liver?

Coronary ligament

A patient presents for a routine OB viability ultrasound. A 7-week IUP is noted. While evaluating the right adnexa, this image is taken. What is most likely shown in this image?

Corpus luteum cyst

A 71-year-old female patient presents to the ER with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for:

Courvoiser gallbladder

An anechoic, thin-walled gallbladder appears enlarged and distended, measuring 12cm in length and 6cm in transverse. The patient presents with jaundice, but no pain. What is the term that refers to these findings?

Courvoisier Sign

The gallbladder is connected to the biliary tree by the:

Cystic duct

The spiral valves of Heister are found within:

Cystic duct

The endometrium is generally the thinnest between days __________ of the menstrual cycle.

Days 1-5

A patient presents to the sonography department with chills, fever, and vaginal discharge for the last 2 weeks. She has never had these symptoms before. Sonographically, you are likely to visualize all of the following except:

Dilated Fallopian tubes Uterine adhesions Cul-de-sac fluid Ill-define uterine border

A patient presents with jaundice. Upon examination of the pancreas, you see this. What else will likely be seen sonographically?

Dilated bile ducts

A patient with vague abdominal pain presents for a pelvic ultrasound. This is visualized within the adnexa. What would be an appropriate history question?

Do you have a history of any STIs?

What would be an appropriate history question to ask a patient with this pathology?

Do you have normal periods?

An abdominal sonography is on the schedule to rule out budd chiari syndrome. What is a key image you will have to obtain to do this?

Doppler analysis of the Hepatic Veins

A patient had a first trimester miscarriage two weeks ago. Upon examination you see this. What else will this patient be experiencing?

Elevated hCG

Beaver Tail Liver

Elongated left liver that extends laterally to surround the spleen

A patient presents with abdominal pain. On examination of the gallbladder, you see this. What is the most likely diagnosis?

Emphysematous cholecystitis

The result of acute cholecystitis that is complicated by gas in the gallbladder wall is:

Emphysematous cholecystitis

A 65 year-old female presents with AUB. On sonography, you see this. What is it most likely to be?

Endometrial carcinoma

Unopposed estrogen therapy has been shown to increase the risk of:

Endometrial carcinoma

A 45-year-old female presents with abnormal vaginal bleeding. Upon examination, you visualize this. What is the most likely diagnosis?

Endometrial hyperplasia

A 50-year-old female presents with abnormal vaginal bleeding. On examination, you see this. What is the most likely diagnosis?

Endometrial polyp

The presence of functional, ectopic endometrial tissue outside of the uterus is termed:

Endometriosis

Which ligament attaches the liver to the anterior abdominal wall?

Falciform ligament

Which ligament is being shown in this image?

Falciform ligament

True or False: A fresh, actively bleeding hematoma in the liver will be more anechoic

False

True or False: True pancreatic cysts are common

False

True or false: A chronic liver hematoma (a month old) will be more echogenic

False

A 45 year-old female patient presents with diffuse, increased echogenicity of the liver with a focal hypoechoic area anterior to the portal vein. This most likely represents:

Fatty liver with focal sparing

During a first trimester viability exam, you see this. What else is likely associated with the patient?

Fertility treatments

Match the term with the definition: Missed abortion

Fetal demise with retained fetus

With what ovarian tumor is Meigs syndrome most commonly associated with?

Fibroma

Which uterine layers sheds with menses?

Functional layer of the endometrium

Match the fallopian tube anatomic region with the description: Infundibulum

Funnel shaped, lateral portion, opens into abdominal cavity, free edge has fimbriae

A 83-year-old patient presents with jaundice. After examination, you see this as well as hypoechoic, well circumscribed areas throughout his liver. What is the most likely diagnosis?

Gallbladder carcinoma

A non-mobile, echogenic focus with no shadowing is seen within the anterior gallbladder lumen. This most likely represents:

Gallbladder polyp

Which of the following is true of porcelain gallbladder?

Gallstones are also present is most patients

Which pathology is likely shown in this image?

Gartner duct cyst

Which of the following is related to Zollinger-Ellison syndrome?

Gastrinoma

The arterial blood supply to the head of the pancreas is via the:

Gastroduodenal artery

While scanning an 11-week fetus, the sonographer notices this near the level of the abdominal circumference but adjacent to the umbilical cord insert. What is it is most likely to be?

Gastroschisis

Which of the following is the MOST OUTER layer of the ovary?

Germinal Epithelium

A 6 month-old female appears with a bulging abdomen and hypoglycemia but no increased alpha fetoprotein. What is the most likely pathology?

Glycogen storage disease

A small protrusion near the neck of the gallbladder describes:

Hartmann pouch

A 65-year-old female patient presents for a pelvic ultrasound. What would be an appropriate history question to ask?

Have you had Tamoxifen therapy?

A patient presents with hemobilia. What is an appropriate history question to ask in this scenario?

Have you had a recent liver biopsy?

A patient presents to the ED for pelvic pain. The ED orders a pelvic ultrasound. What is an appropriate history question to ask?

Have you had a recent uterine surgery?

A 12-year-old female presents with a history of cyclic pain, abdominal swelling, and amenorrhea. Sonographically, you visualize an enlarged uterus and a distended vagina that contains anechoic fluid with debris. What is the most likely diagnosis?

Hematocolpos

A 23-year-old patient presents to the ED with acute right pelvic pain. A pelvic ultrasound is ordered. You see this in the right adnexa. What is the most likely diagnosis?

Hemorrhagic cyst

20-30% of the liver's blood supply is supplied through the:

Hepatic Artery

All of the following are examples of well-defined hyperechoic masses within the liver except:

Hepatic Hemorrhagic cyst

A patient is referred with RUQ tenderness and a history of oral contraceptive use. A solid, hypoechoic mass is visualized in the right lobe of the liver. Color Doppler shows increased vascularity. Which of the following pathologies is this most likely to be?

Hepatic adenoma

A patient presents with a fever and a history of HIV. What is the most likely pathology shown here?

Hepatic candidiasis

Which normal liver vessel is most likely being shown on Doppler in this image?

Hepatic vein

A 2 year-old presents with a painful RUQ. Upon examination you notice a large, hypoechoic, hepatic mass. He also has an elevated alpha fetoprotein. What is this most likely to be?

Hepatoblastoma

A 74 year-old male patient presents for an abdominal ultrasound for elevated alpha-fetoprotein. What should you look for?

Hepatocellular carcinoma

Assisted reproductive therapy can result in all of the following except:

Heterotopic pregnancy Asherman syndrome Multiple gestations Ovarian hyperstimulation syndrome

Match the hCG level with the nature of the pregnancy: Twin pregnancy

Higher than normal hCG

Pancreatic ascites

History of pancreatic pseudocyst, free fluid

Which of the following is associated with infestation by a parasite and is most prevalent in sheep and cattle-raising countries?

Hydatid disease

Chronic pancreatitis is most likely to appear on ultrasound as:

Hyperechoic pancreas with a prominent pancreatic duct and multiple calcifications

You are scanning an obese patient to evaluate for fatty liver. Which of the following is a common sonographic characteristic associated with this pathology?

Increased echogenicity of the liver compared to a normal kidney

A patient presents for a RUQ exam. They have a history of hyperinsulinism and hypoglycemia. What pathology is this patient most likely to have of the pancreas?

Insulinoma

Which of the following is the most common islet cell tumor?

Insulinoma

A patient presents to the ER with vaginal bleeding and a positive pregnancy test. Upon examination you see this. What is shown in this image?

Intradecidual sign

The mass within this image is determined to be:

Intramural, anterior body

Match the pathology with the concurrent lab value that will be increased: Hemochromatosis

Iron

Which of the following sonographic findings would not increase the likelihood of an ovarian malignancy?

Irregular borders Septation measuring greater than 3 mm in thickness Solid wall nodule Anechoic components with acoustic enhancement Papillary projections

In a Whipple procedure, normal pancreatic tissue is attached to the:

Jejunum

Dilatation of the intrahepatic ducts with normal extrahepatic ducts is characteristic of:

Klatskin tumor

Type of cholangiocarcinoma that is located at the hepatic hilum

Klatskin tumor

What vessel divides the left lobe of the liver into the medial and lateral segments?

Left Hepatic Vein

Which structure is label "D" pointing to?

Left Portal Vein

What is the most common location of a pancreatic pseudocyst?

Lesser sac

Match the fallopian tube anatomic region with the description: Isthmus

Lies just lateral to the uterus

This ligament separates the left lobe from the caudate lobe:

Ligamentum venosum

What ligament lies within the falciform ligament?

Ligamenum teres

What structure is being pointed out by the arrow?

Ligamenum teres

Match the gestational trophoblastic disease with the definition: Partial Molar Pregnancy

Likely accompanied with a triploidy fetus

A patient has been exposed to histoplasmosis. What makes that patient more likely to have?

Liver granuloma

A two year-old girl runs into a table on her right side. A large bruise appears and she is in a lot of pain. In the ER that same day- the sonographer sees this on exam. What is the likely pathology?

Liver hematoma

A 7 year-old girl presents with RUQ pain after hitting a mailbox while sledding. What is the most likely pathology shown in this image?

Liver laceration

Phlegmon

Localized area of edema/pus within the pancreas

Match the fallopian tube anatomic region with the description: Ampulla

Longest part of the tube, where fertilization occurs

Match the hCG level with the nature of the pregnancy: Ectopic pregnancy

Lower than normal hCG

What is being pointed out in this image by the arrow?

Main Lobar Fissure

Based off the sonographic characteristics of this ovary, this pathology is most likely to be

Malignant

Match the pathology with benign or malignant: Mucinous cystadenoma

Malignant

Match the gestational trophoblastic disease with the definition: Invasive Molar Pregnancy

Malignant progression of molar pregnancy which invades the myometrial wall of the uterus

Match the hCG level with the nature of the pregnancy: Molar pregnancy

Markedly elevated hCG

What and where would you expect to see with a "Klatskin Tumor"?

Mass at the hilum of the liver, impacting the right, left, and common hepatic ducts leading to intrahepatic biliary dilation.

What type of primary cancer is most likely to metastasize to the pancreas?

Melanoma

Which hepatic vein separates the right and left lobes of the liver?

Middle Hepatic Vein

Extrahepatic bile duct obstruction due to a stone within the cystic duct

Mirrizi's Syndrome

What is this pregnancy at a higher risk for?

Miscarriage

Match the gestational trophoblastic disease with the definition: Complete molar pregnancy

Most Common Form

Match the gestational trophoblastic disease with the definition: Choriocarcinoma

Most malignant form, aggresive. May metastasize to distant locations.

Caroli Disease

Multi-focal, segmental dilation of the intra-hepatic bile ducts

Von Hippel Lindau

Multiple benign and/or malignant tumors of the pancreas

Autosomal dominant kidney disease

Multiple, benign cysts including the pancreas

A 38-year-old female presents to the sonography department for a pelvic ultrasound. Upon examination, an anechoic mass is noted within the cervix. This mass most likely represents a:

Nabothian cyst

What is the early sonographic appearance of pancreatitis?

Normal

This image most likely demonstrates:

Normal ovary

Predisposing factors linked to the development of cholelithiasis include all of the following EXCEPT:

Obsesity Diabetes mellitus Pregnancy Female gender

A patient presents for a first trimester exam. By CRL the fetus is 12w4d. You see this. What is likely being shown at the area of the umbilical cord insert?

Omphalocele

What does this pathology put the patient at a higher risk for?

Ovarian Torsion

A 13-year-old patient presents with acute pelvic pain, nausea, and vomiting. What is the most likely diagnosis?

Ovarian torsion

The sonographic "string of pearls" sign is associated with:

PCOS

A patient presents with jaundice. During the RUQ exam, you notice this pathology and a negative murphy's sign. What is a common cause?

Pancreatic adenocarcinoma

Select the area of the pancreas in which adenocarcinoma is most likely to occur:

Pancreatic adenocarcinoma is most likely to form in the head of the pancreas

Match the fallopian tube anatomic region with the description: Interstitial Portion

Passes through uterine wall at cornua, emptying into uterine cavity

A 67 year-old male presents for his yearly RUQ exam due to his history of cirrhosis. The sonographer confirms there are no focal masses visualized throughout the liver. The sonographer needs to carefully evaluate the liver because which of the following statements is true:

Patients with cirrhosis are at a higher risk of hepatocellular carcinoma

The arrow in this image is pointing to:

Phrygian cap

Air within the biliary tree is refered to as:

Pneumobilia

A patient with this pathology is also likely to have:

Polycystic kidney disease

Which of the following statements regarding gallbladder polyps is FALSE?

Polyps move to the gravity dependent portion of the gallbladder with a change in patient position.

A 74 year old patient complains of vague abdominal pain. Her lab values are normal and she has a negative Murphy's Sign. A hyperechoic focus with posterior acoustic shadowing is demonstrated in the anterior wall of the gallbladder. This imaging and history is most consistent with which of the following pathologies?

Porcelain Gallbladder

The majority of blood supply to the liver is provided by the:

Portal Vein

Which normal liver vessel is likely to be shown here?

Portal Vein

Match the following types of portal hypertension with an example of the pathology associated with it: Extra-hepatic pres-inusoidal:

Portal Vein Thrombosis

A recannalized umbilical vein may be seen as a result of:

Portal hypertension

An ultrasound evaluation of liver cirrhosis should include a search for what associated complication?

Portal hypertension

On an abdomen complete exam, you notice these vessels near the spleen. What is likely occurring with the liver?

Portal hypertension

The Sonographer puts the probe down midline and sees this. What other pathology does the patient have to have?

Portal hypertension

What is the most significant vascular event associated with schistosomiasis?

Portal hypertension

A patient has a history of TIPS. What vessels are connected during this surgery?

Portal vein and hepatic vein

A patient present for a RUQ ultrasound and you see this. Why does this pathology occur?

Portal vein thrombosis

These three structures comprise the portal triad

Portal vein, bile duct, hepatic artery

A patient with a history of dementia and presents for a pelvic ultrasound. From this image, what medical history can you document?

Prior hysterectomy

A patient needs a paracentesis due to ascites from cirrhosis. What lab value will likely be elevated and need to be drawn before the procedure?

Prothrombin time

What is the most common cystic mass of the pancreas?

Pseudocyst

A patient has known ascending cholangitis. Today she has severe RUQ pain with elevated WBC. She had a previous normal RUQ exam 3 months ago. What might you expect to see in the liver?

Pyogenic abscess

Hemorrhagic pancreatitis

Rapid progression of acute pancreatitis, rupture of pancreatic vessels

What anomaly is most commonly associated with what is shown in this image?

Renal agenesis

During a first trimester exam, you notice a round, cyst like structure within the fetal head. This most likely represents the:

Rhombencephalon

The right lobe of the liver is divided into anterior and posterior segments by the:

Right hepatic vein

What structure is label "A: pointing to?

Right posterior portal vein

A RUQ ultrasound is ordered on a 60 year-old female patient. While scanning the liver, you notice this with an otherwise normal appearing liver. These findings are most consistent with:

Right-sided heart failure

Match the following types of portal hypertension with an example of the pathology associated with it: Post-hepatic:

Right-sided heart failure

All of the following are associated with acute pelvic pain except:

Ruptured ovarian cyst Perforated intrauterine device Pelvic inflammatory disease Asherman Syndrome

PID can lead to all of the following except:

Scar formation in the fallopian tubes Infertility Ectopic pregnancy Polycystic ovarian disease

A parasitic disease of the liver causing portal hypertension and occlusion of the portal veins is:

Schistosomiasis

Extrapancreatic fluid

Severe acute pancreatitis, fluid in the sac between the stomach and pancreas

A 50 year-old patient presents for RUQ pain. You see this on imaging- what is it likely to be?

Simple Cyst

Name three sonographic signs of an ectopic pregnancy Name three patient symptoms and/or lab values associated with an ectopic pregnancy

Sonographic Signs: 1. Possible gestational sac visualizaed in the cervix and not endometrium 2. Possible gestational sac visualized in the ovary and not the endometrium 3. Possible gestational sac visualized in the ampulla portion of the fallopian tube and not the endometrium Patient Symptoms: 1. possible pain that is raidiating to the shoulder 2. low hCG blood values 3. pelvic pain or abnormal bleeding

The potential space situated between the urinary bladder and pubic symphysis is called:

Space of Retzius

A patient presents for vaginal bleeding to the ER. Upon examination, the sonographer notices this. What is the most likely pathology?

Subchorionic hemorrhage

Explain at least two sonographic characteristics of a subchorionic hemorrhage

Subchorionic hemorrhage can be described as a crescent shaped fluid collection near a first trimester pregnancy. The fluid can range from hyperechoic to anechoic depending on the age of the blood.

Which of the following fibroid locations would most likely cause abnormal uterine bleeding?

Submucosal

Which pathology is most likely shown in this image?

Submucosal leiomyoma

Which of the following is true regarding a uterus following menopause?

The uterus becomes more anechoic The uterus becomes atrophic The uterus enlarges The uterus becomes hypoechoic

What sign is being shown in this image of the RLQ?

Tip of the iceberg

Reidel's Lobe

Tongue- like projection of the right lobe of the liver

True or False? Gallbladder sludge can result from prolonged fasting

True

All of the following cause gallbladder wall thickening except:

Tumefactive sludge

Upon examination of a 12-week fetus, the sonographer notices this. What is this pathology associated with?

Turner Syndrome

A patient presents with a positive pregnancy test and is sent for a viability exam. What is indicated in this image?

Twin pregnancy

Match the term with the definition: Threatened abortion

Vaginal bleeding before 20 weeks, closed cervix

Match the term with the definition: Inevitable abortion

Vaginal bleeding with a dilated cervix

Which of the following is a component of coagulation?

Vitamin K

The most common cause of acute pancreatitis is:

biliary disease

All of the following are sonographic features of chronic pancreatitis except?

diffusely hypoechoic pancreas

Which lab is extremely elevated in the case of theca lutein cysts?

hCG

Which of the following is the most common complication associated with acute pancreatitis:

pseudocyst