Penny Ch. 4, 5, & 6

Epstein-Barr infection is best described as: a. Herpesvirus that can lead to infectious mononucleosis in children b. A herpesvirus that is often associated with splenic granulomatous disease c. An infection that results in sickle cell anemia in children d. An infection within a splenic hematoma following blunt trauma

A

In a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates: a. Hodgkin lymphoma b. Non-Hodgkin lymphoma c. Metastatic liver disease d. Splenic infarction

A

The Klatskin tumor is located: a. AT the junction of the right and left hepatic ducts b. At the junction of the cystic and common bile duct c. At the junction of the common bile duct and common hepatic duct d. Between the pancreatic head and duodenum

A

The type of tissue within the spleen that is responsible for its phagocytic function is the: a. Red pulp b. White pulp c. Culling pulp d. Pitting pulp

A

Which lab value appears to be more specific for acute pancreatitis? a. Amylase b. Lipase c. AST d. SGOT

A

Which of the following is considered the most proximal portion of the biliary tree? a. Intrahepatic radicles b. Cystic duct c. Common hepatic duct d. Common bile duct

A

Which of the following would be the most distal portion of the biliary tree? a. Common bile duct b. Common hepatic duct c. Gallbladder d. Intrahepatic radicles

A

Which of the following is not associated with the development of pneumobilia? a. Cholangiopneumonia b. Gastric surgery c. Acute cholecystitis d. Fistula formation

A (Pneumobilia is defined as air within the biliary tree. Pneumobilia may be associated with recent biliary or gastric surgery, emphysematous or prolonged acute cholecystitis, or fistula formation.)

A patient presents with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct. This is referred to as: a. Caroli syndrome b. Mirizzi syndrome c. Choledochal cyst d. Biliary atresia

B

The most common cause of splenomegaly is: a. Hepatitis b. Portal hypertension c. Lymphoma d. Trauma

B

The spleen removes irregular cells from the blood stream and retains them through a process called: a. Pitting b. Culling c. Crimping d. Amassing

B

The type of tissue within the spleen that is responsible for its lymphatic function is the: a. Red pulp b. White pulp c. Culling segment d. Pitting segment

B

What systemic disease results in the development of granulomas within the spleen and throughout the body? a. Granulomatosis b. Sarcoidosis c. Sickle cell anemia d. Histoplasmosis

B

Which of the following is associated with development of cysts within the pancreas? a. Autosomal recessive polycystic kidney disease b. Von Hippel-Lindau disease c. Zollinger-Ellison syndrome d. Endoscopic retrograde cholangiopancreatography

B

Which segment of the biliary tree tends to dilate first with obstruction? a. Intrahepatic b. Extrahepatic

B

The most common level for biliary obstruction to occur is the: a. Junction of the right and left hepatic ducts b. Proximal common hepatic duct c. Distal common bile duct d. Cystic duct

C

A gastronoma of the pancreas can produce: a. Autosomal recessive polycystic kidney disease b. Von Hippel-Lindau disease c. Zollinger-Ellison syndrome d. Hyperinsulinemia

C (The functional gastronomas can produce Zollinger-Ellison syndrome, which is described as the excessive secretion of acid by the stomach that leads to peptic ulcers.)

Which of the following is not a plausible cause of common bile duct obstruction in adults? a. Choledocholithiasis b. Chronic pancreatitis c. Choledochal cyst d. Pancreatic carcinoma

C (common causes of common bile duct obstruction are choledocholithiasis, chronic pancreatitis, acute pancreatitis, and pancreatic carcinoma.)

A 32-year-old female patient presents to the ultrasound department for an abdominal sonogram. An echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis? a. Pheochromocytoma b. Lipoma c. Splenic metastasis d. Hemangioma

D

A 35-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen? a. Multiple hi stomas b. Multiple hemangiomas c. Multiple metastatic lesions d. Multiple granulomas

D

A 64-year-old man presents to the sonography department for a right upper quadrant sonogram. He is complaining of abdominal pain, weight loss, and pruritus. Sonographically, you visualize an are of dilated ducts that abruptly end. What is the most likely diagnosis. a. Biliary atresia b. Choledocholithiasis c. Caroli syndrome d. Cholagniocarcinoma

D

All of the following are clinical findings consistent with cholangiocarcinoma except: a. Pruritus b. Weight loss c. Elevated bilirubin d. Dilation of the intrahepatic ducts

D

All of the following are functions of the spleen except: a. Storage of iron b. Defense against disease c. Blood reservoir d. Destruction of phagocytic cells

D

All of the following can be associated with splenomegaly except: a. Trauma b. Hemolytic abnormalities c. Mononucleosis d. Pancreatitis

D

Co-existing obstruction of the common bile duct and pancreatic duct may be referred to as the: a. Double-barrel shotgun sign b. Courvoisier sign c. Mirizzi sign d. Double-duct sign

D

The biliary duct wall should never measure more than: a. 2 mm b. 9 mm c. 4 mm d. 5 mm

D

The most common form of malignancy of the pancreas is: a. Cystadenocarcinoma b. Islet cell tumors c. Cystadenoma d. Adenocarcinoma

D

Which cells carry out the exocrine function of the pancreas? a. Whipple cells b. Isles of langerhans c. Delta cells d. Acinar cells

D

All of the following are forms of cholangitis except: a. Acute bacterial b. AIDS c. Oriental d. Parabolic

D (Types of cholangitis include acute bacterial, AIDS, Oriental -recurrent pyogenic cholangitis-, and sclerosing.)