Davie's: Part 5 & 6 Scrotum and Prostate

307. What lab test is most helpful in screening patients for prostate cancer? a. PSA b. serum AFP c. serum bilirubin d. prostate cancer detection factor e. prostate temperature

a. PSA

290. You have identified a hydrocele during a scrotal ultrasound. Hydroceles form in what potential space? a. between the two layers to the tunica vaginalis b. between the tunica albuginea and the tunica vaginalis c. between the two layers of the tunica albuginea d. between the tunica albuginea and the testis e. none of the above

a. between the two layers to the tunica vaginalis

286. The left testicular vein drains into what vein? a. left renal vein b. inferior vena cava c. epigastric vein d. internal iliac vein e. external iliac vein

a. left renal vein

303. You are performing a prostate sonogram to evaluate a patient with known prostate cancer. Which anatomic zone is most likely involved with the cancer? a. peripheral zone b. central zone c. transition zone d. periurethral glandular area e. prostate cancer occurs equally between the peripheral zone and the central zone

a. peripheral zone

279. The most common germ cell testicular tumor: a. seminoma b. teratoma c. embyronal carcinoma d. choriocarcinoma e. lymphoma

a. seminoma

297. The most common germ cell tumor of the testis is: a. seminoma b. yolk sac tuor c. chorion carcinoma d. embryonal cell carcinoma e. adenomatoid carcinoma

a. seminoma

292. Which of the following arteries show a low-resistance waveform: a. testicular artery b. deferential artery c. cremasteric artery d. external iliac artery e. all of the above

a. testicular artery

301. You are performing a scrotal ultrasound on a 21-year-old male with acute scrotal pain. You do not detect flow with color Doppler in the painful testis. This finding is most consistent with which of the following: a. torsion b. orchitis c. microlithiasis d. seminoma e. none of the above

a. torsion

282. The testicular artery is a branch of which artery? a. deferential b. abdominal aorta c. internal iliac d. external iliac e. left renal

b. abdominal aorta

321. You are performing a transrectal ultrasound in a patient with acute prostatitis. An anechoic mass is seen within the prostate. This most likely represents: a. prostate utricle cyst b. abscess c. hematoma d. lymphocele e. seroma

b. abscess

310. A referring physician has asked if your department uses color Doppler during transrectal prostate sonography. What is the role of color Doppler in this procedure? a. color Doppler has not been shown to be helpful during prostate sonography b. color Doppler allows improved perception of pathologic vessels associated with cancer c. increased color Doppler signals are diagnostic of chronic prostatitis d. absence of flow with color Doppler is indicative of benign prostatic hypertrophy e. increased color Doppler signals in the seminal vesicles indicates the presence of seminal vesicle cysts

b. color Doppler allows improved perception of pathologic vessels associated with cancer

318. Which of the following describes the most common appearance of the seminal vesicles by transrectal prostate sonography? a. hyperechoic, symmetrical, irregularly shaped structures b. hypoechoic, symmetrical, irregularly shaped structures c. hyperechoic, asymmetrical, smooth structures d. hyperechoic, asymmetrical, irregularly shaped structures e. hypoechoic, asymmetrical, smooth structures

b. hypoechoic, symmetrical, irregularly shaped structures

288. You are performing an ultrasound study on a 27-year-old male with scrotal pain to rule out epididymo-orchitis versus torsion. Which finding below is most consistent with epididymitis? a. absence of flow by color Doppler b. increased flow by color Doppler c. small cyst in the epididymal head d. small calcification in the epididymal head e. multiple tiny calcifications throughout the testis

b. increased flow by color Doppler

314. The prostaticovesical arteries that supply the prostate are branches from which artery? a. abdominal aorta b. internal iliac c. external iliac d. inferior mesenteric e. superior mesenteric

b. internal iliac

306. Which of the following describes the most common patient positioning for performance of a transrectal prostate ultrasound? a. supine b. left lateral decubitus c. right oblique d. supine in a reversed trendelenburg position e. standing

b. left lateral decubitus

315. Which of the following describes the most widely used conventional display of the prostate using transrectal sonography? a. the anterior abdominal wall is shown at the bottom of the screen b. the rectum is shown at the bottom of the screen c. the rectum is shown to the right of the screen in a sagittal view d. the left side of the patient is shown on the left side of the image in a transverse plane e. the head of the patient is on the right side of the image in a sagittal plane

b. the rectum is shown at the bottom of the screen

280. You are performing an ultrasound of a patient with a known "bell clapper" deformity. This deformity is associated with which condition? a. seminoma b. torsion c. varicocele d. epididymitis e. infarction

b. torsion

308. A patient has been referred for transrectal sonography due to symptoms of prostatism. What are the most common patient symptoms of prostatism? a. nausea, painful urination, pressure sensation on urinary bladder b. weight loss, nocturia, hematuria, and small stream c. difficult initiation of voiding, nocturia, and small stream d. hematuria, dysuria, and nocturia e. swelling, lethargy, dysuria, and nocturia

c. difficult initiation of voiding, nocturia, and small stream

319. You have been requested to perform a transrectal ultrasound of the prostate in a patient with suspected benign prostatic hyperplasia. What is the ultrasound appearance of this condition? a. small, shrunken, prostate gland with numerous calcifications b. small prostate gland with increased vascularity and hypoechoic nodules c. enlarged prostate gland which may be diffuse or focal d. enlargement of the peripheral zone with sparing of the inner gland e. all of the above appearances are commonly encountered with BPH

c. enlarged prostate gland which may be diffuse or focal

291. The rete testis is located in the: a. pampiniform plexus b. spermatic cord c. mediastinum testis d. appendix testis e. appendix epididymis

c. mediastinum testis

277. Which of the following conditions would show hyperemic flow on color Doppler? a. testicular torsion b. spermatocele c. orchitis d. hydrocele e. infarction

c. orchitis

276. The mediastinum testis is identified sonographically as: a. hypoechoic structure coursing through midline of testis b. pyramid shaped structure adjacent to the upper pole of the testis c. prominent echogenic linear echo in the midline of the testis d. homogeneous ovoid structure adjacent to the lower pole of the testis e. cystic, spherical structure of variable location

c. prominent echogenic linear echo in the midline of the testis

304. You are imaging a patient with suspected benign prostatic hypertrophy. Which zone is most commonly involved? a. peripheral zone b. central zone c. transition zone d. BPH occurs with equal frequency in all zones e. BPH occurs with equal frequency in the central and transition zone

c. transition zone

289. A 33-year-old male has been referred for a scrotal ultrasound as a part of an infertility work-up. You will tailor your exam to include an evaluation for which of the following? a. epididymal cyst b. torsion of the appendix testis c. varicocele d. testicular artery aneurysm e. testicular cyst

c. varicocele

313. Which anatomic classification is most commonly used to describe the prostate during sonographic evaluation? a. lobar anatomy b. microscopic anatomy c. zonal anatomy d. topographic anatomy e. all of the above are used routinely in ultrasound

c. zonal anatomy

295. In performing scrotal sonography, you should tailor your exam to include color Doppler analysis in which of the following conditions? a. epididymitis b. torsion c. testicular microlithiasis d. a and b only e. all of the above

d. a and b only

285. The intratesticular arteries that arise from the capsular artery are known as: a. deferential arteries b. cremasteric arteries c. vas deferens d. centripetal arteries e. pampiniform plexus

d. centripetal arteries

293. Which of the following arteries courses within the testicular parenchyma? a. testicular artery b. deferential artery c. cremasteric artery d. centripetal artery e. all of the above

d. centripetal artery

320. You are performing a prostate ultrasound in a patient having an infertility work-up. Which cyst may be associated with infertility? a. mullerian duct cysts b. prostatic utricle cysts c. retention cysts d. ejaculatory duct cysts e. seminal vesicle cysts

d. ejaculatory duct cysts

298. You are imaging a patient presenting with trauma, pain, and scrotal swelling. You detect a large hydrocele with prominent internal echoes. This most likely represents: a. pyocele b. simple hydrocele c. varicocele d. hematocele e. hernia

d. hematocele

287. You are performing an ultrasound exam on an adolescent male to rule out testicular torsion. How should you adjust the system color Doppler parameters to achieve the greatest sensitivity to slow flow? a. high PRF, low filter, high gain, high packet size b. low PRF, low filter, high gain, low packet size c. high PRF, high filter, high gain, high packet size d. low PRF, low filter, high gain, high packet size e. low PRF, low filter, low gain, low packet size

d. low PRF, low filter, high gain, high packet size

283. You are performing a Doppler evaluation of the testis. Which of the following describes the waveform you will see within an artery of the testicular parenchyma if the testis is normal? a. high resistance b. bidirectional c. phasic d. low resistance e. continuous

d. low resistance

278. A large complex hydrocele is most commonly associated with which of the following? a. seminoma b. epididymal cyst c. varicocele d. orchitis e. infarction

d. orchitis

316. You are performing a transrectal prostate ultrasound in a sagittal plane. The most lateral images of the gland show which tissue? a. transition zone b. central zone c. periurethral zone d. peripheral zone e. fibromuscular stroma

d. peripheral zone

305. You have been asked to identify the seminal vesicles. What is their anatomic relation to the prostate gland? a. posterior and inferior b. anterior and inferior c. anterior and superior d. posterior and superior e. medial

d. posterior and superior

322. You have been asked to perform a transrectal ultrasound of the prostate in a patient with metastasis of unknown origin. What are you looking for? a. BPH b. ejaculatory duct cysts c. prostatic abscess d. prostate cancer e. prostatitis

d. prostate cancer

302. Which structure would you image posterior to the prostate gland? a. urinary bladder b. pubic bones c. levator ani muscles d. rectum e. urethra

d. rectum

281. The capsular artery of the testis is a branch of what artery? a. deferential b. abdominal aorta c. cremasteric d. testicular e. internal iliac

d. testicular

317. You have been asked to perform a transrectal prostate ultrasound exam. What frequency transudcer is best suited for this study? a. 2-3 MHz b. 3-4 MHz c. 4-5 MHz d. 5-6 MHz e. 7-8 MHZ

e. 7-8 MHZ

29. You detect a mass within the left testis on a 43-year-old male. Which of the following is a sign indicative of malignancy? a. irregular shape of testis b. intratesticular location of mass c. presence of a large hydrocele d. all of the above e. a and b only

e. a and b only

284. You are performing Doppler Analysis of the spermatic cord. Which of the following arteries or structures is found within the spermatic cord? a. vas deferens b. testicular artery c. cremasteric artery d. deferential artery e. all of the above

e. all of the above

299. You have detected a transtesticular artery during scrotal sonography. Which of the following is true regarding this finding? a. it is a common anatomic variant b. it courses in the opposite direction of centripetal arteries c. it enters the testicular parenchyma at the mediastinum testis d. a large vein frequently accompanies it e. all of the above

e. all of the above

311. What is the sonographic appearance of prostate cancer? a. hypoechoic lesions b. isoechoic lesions c. hyperechoic lesions d. a and b only e. all of the above appearances have been encountered

e. all of the above appearances have been encountered

312. You are aiding a physician in a transrectal biopsy of the prostate. What patient preparation is required? a. no patient preparation is required for a transrectal biopsy b. a cleansing enema is performed immediately prior to the procedure c. antibiotics are administered prior to and following the examination d. the patient is requested to have nothing to eat or drink 12 hours prior to the procedure e. b and c only

e. b and c only

300. You are performing a scrotal ultrasound exam on a 38-year-old male with acute scrotal pain to rule out orchitis. Which finding below would not be associated with orchitis? a. hypoechoic testis b. hyperemic testicular flow c. enlargement of testis d. thickened scrotal wall e. microlithiasis

e. microlithiasis

296. You have detected an intratesticular mass on a patient with mild scrotal swelling. Which of the following is an ultrasound feature of seminoma should you look for? a. hyperechoic intratesticular lesions b. ill-defined tumor borders c. large hydrocele d. all of the above e. none of the above

e. none of the above

309. Which of the following is an indication for transrectal ultrasound of the prostate? a. abnormal digital rectal exam b. abnormal lab tests results indicative of prostate cancer c. guidance for directed sonographic biopsy d. monitor response to treatment of prostate cancer e. all of the above

e. all of the above