spleen

leukopenia is defined as a white blood cell count:

below 4,000

all of the following are considered functions of the spleen except:

breaks down old white blood cells

which of the following splenic pathologies is associated with granulomatosis?

calcifications

you are performing an ultrasound study on a patient with a history of recent blunt left-sided trauma in a motor vehicle accident. which finding below is not associated with this history?

calcified splenic cyst

multiple splenic infections is a predisposing factor of which of the following conditions?

candidiasis

which of the following pathologies is associated with a "wheel with a wheel" appearance on ultrasound?

candidiasis

an asymptomatic middle aged patient presents with a history of liver function tests showing elevated levels on an annual physical examination. an abdominal ultrasound is ordered to rule out liver disease. a sonogram of the LUQ demonstrates a hyperechoic mass in the splenic parenchyma. based in this history, the mass identified most likely represents a:

cavernous hemangioma

the most common benign neoplasm of the spleen is a:

cavernous hemangiomoma

the splenic artery is a branch of which of the following vascular structures?

celiac axis

the splenic artery originates at the :

celiac axis

which of the following scanning planes is most likely demonstrated in this sonogram?

coronal

the spleen removes irregular cells from the blood stream and retains them through a process called:

culling

an asymptomatic patient presents to the ultrasound department with a history of hepatitisB . an incidental finding is identified in the superior portion of the spleen. this finding is most consistent with a:

cyst

all of the following are functions of the spleen except:

destruction of phagocytic cells

what is the most common sonographic appearance of a splenic hemangioma?

echogenic

indications for an ultrasound of the spleen may include all of the following except?

elevated serum amylase

a patient presents with a history of portal hypertension. the spleen is expected to demonstrate:

enlargement

the process of making red blood cells is termed:

erythropoiesis

during abdominal sonography of a patient with portal hypertension and splenomegaly, you detect a calcified ring at the splenic hilum. what should you do?

evaluate the area with color doppler

which of the following would be most helpful in improving diagnostic confidence in the case described the above question?

evaluate the lesion with color doppler

in the question above, considering the ultrasound findings, what additwionslinformation should you provide?

evaluate the liver and portal vein

which of the following benign neoplasms is composed of lymphoid tissue?

hamartoma

splenic infarction is most commonly associated with an embolism originating from which of the following structures?

heart

a 32 year old female patient presents to the ultrasound department for an abdominal sonogram. an evaluation of the spleen reveals a 1 cm, rounded, echogenic mass that does not produce acoustic shadowing. what is the most likely diagnosis?

hemangioma

an afebrile 13 year old female patient presents to the ultrasound department complaint of vague left upper quadrant pain. she admits to "wrestling" with her brother a week ago. she denies blunt force trauma. laboratory tests are pending.base on this clinical history, the sonographic findings are most suspicious for which of the following conditions?

hematoma

which of the following structures carries carbon dioxide back to the lungs?

hemoglobin

which of the following structures is recycled into iron by the spleen?

hemoglobin

a patient arrives at the emergency department following a motor vehicle accident . an abdominal ultrasound is most likely ordered to evaluate for which of the following conditions?

hemoperitoneum

in a patient with suspected lymphoma , the presence of reed-sternberg cells indicates:

hodgkin lymphomaall

which term can be used to describe the normal sonographic appearance of the splenic parenchyma?

homogeneous with mid-to-low-level echogenicity

a complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the:

hydatid cyst

when compared to the liver, the echogenicity of the normal splenic parenchyma is described as:

hypoechoic or isoechoic

enlargement of the spleen may be associated with all of the following conditions except?

hypotension

based on the clinical history, these sonographic findings are most likely considered:

incidental findings

which of the following is not a feature you would detect in a splenic cyst?

increased attenuation

which of the following conditions is most likely to demonstrate an elevated hematocrit?

infection

which of the following splenic regions is identified by arrow C?

inferior portion

you have been asked to evaluate the tail of the pancreas. what is the relationship of the pancreatic tail to the spleen?

inferomedial

you are examining the spleen during routine sonography. what view provides the best long axis image of the spleen?

intercostal coronal view with patient supine

which of the following is a pitfall you might encounter in ultrasound scanning of the spleen?

intercostal scanning may produce rib shadows obscuring the splenic parenchyma, in hepatomegaly the left lobe of the liver may be mistaken for the spleen, a mass in the tail of the pancreas may be confused with a splenic mass, an accessory spleen may be confused with an enlarged lymph node

the spleen is a:

intraperitoneal organ

the location of the spleen is best described as:

lateral to the stomach

in cases of portal hypertension, the splenic vein is most likely to shunt blood directly into the:

left renal vein

you are performing an abdominal ultrasound and are having difficulty identifying the spleen. which of the following structures is in contact with the spleen?

left semi diaphragm, stomach, pancreas, splenic flexure of the colon

leukemia may be associated with all of the following except:

leukopenia

hemangiosarcoma involving the spleen frequently metastasizes to which of the following organs?

liver

which of the following conditions is most likely associated with decrease leukocytes?

lymphoma

predisposing factors for developing an aneurysm of the splenic artery may include all of the following except?

male prevalence

metastasis to the spleen most commonly originates from which of the following malignancies?

melanoma

you are performing an ultrasound study on a patient with malignant melanoma. your ultrasound findings reveal multiple hyperechoic masses within the spleen. this most likely represents:

metastasis

you are imaging the spleen of a 27 year old male with AIDS. what is the most common finding in the spleen in patients with AIDS?

moderate splenomegaly

you are performing a abdominal ultrasound on a patient with histoplasmosis. what findings of the spleen are commonly seen with this condition?

multiple focal, bright echogenic granulomatous lesions throughout the spleen

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?

multiple granulomas

a patient with an accessory spleen will most likely present with which of the following symptoms?

no symptoms

from the list below, what is the most likely clinical finding of a patient who has a splenic hemangioma?

none

all of the following can be associated with splenomegaly except:

pancreatitis

a congenital anomaly of the spleen associated with gastrointestinal, cardiovascular, and biliary anomalies is most consistent with:

polysplenia syndrome

based on this history and sonogram, the monographer should also evaluate for which of the following pathologies?

portal hypertension

during splenic sonography, you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum. what condition do you suspect?

portal hypertension

the most common cause of splenomegaly is:

portal hypertension

you are scanning a patient with moderate splenomegaly. which of the following is a cause of mild to moderate splenomegaly?

portal hypertension, infection, aids

the splenic vein drains into what vein?

portal vein

the splenic vein joins the superior mesenteric vein to form the:

portal vein

the splenic vein marks the:

posterior aspect of the pancreatic body and tail

a hematoma located below the splenic capsule most commonly appears on ultrasound as a ?

present shaped fluid collection inferior to the diaphragm

an a febrile patient with a history of leukemia presents to the ultrasound department complaining of LUQ pain. a sonogram of the spleen demonstrates hypoechoic nodules within the splenic parenchyma. these nodules most likely represent:

primary malignant tumors

hematocrit is defined as the percentage of:

red blood cells in the blood

the type of tissue within the spleen that is responsible for its phagocytic function is the:

red pulp

what systemic disease results in the development of granulomas within the spleen and throughout the body?

sarcoidosis

a retroperitoneal ultrasound is ordered on an elderly patient with a history of elevated creatine levels. hyperechoic foci are identified in the splenic parenchyma. these foci are most suspicious for:

splenic calcifications

a 14 year old male patient presents to the ultrasound department after falling from his bicycle. an abdominal sonogram reveals a complex appearing mass within the spleen. this most likely represents a :

splenic hematoma

the most common location of an accessory spleen is near the ?

splenic hilum

where is the most common location of an accessory spleen?

splenic hilum

which of the following splenic regions is identified by arrow B?

splenic hilum

a 48 year old male patient with history of severe , sudden onset of left upper quadrant pain without trauma presents to the ultrasound department for a sonogram the spleen. you visualize a wedge shaped hypoechoic area within the spleen. this most likely represents a:

splenic infarct

an area within the spleen that has become necrotic because of a lack of oxygen is referred to as a :

splenic infarct

you are performing an abdominal ultrasound scan and detect a hypoechoic, wedge- shaped lesion within the spleen. this is the typical appearance of which of the following entities?

splenic infarction

which structure will you detect at the splenic hilum?

splenic vein

a 50 year old patient with a long history of alcohol abuse presents to the ultrasound department complaining of left upper quadrant pain. this sonogram of the left upper quadrant is most consistent with which of the following conditions?

splenomegaly

diffuse involvement of lymphoma or leukemia of the spleen will often lead to:

splenomegaly

sickle cell disease will often lead to:

splenomegaly

the splenic artery marks the:

superior aspect of the pancreatic body and tail

which of the following splenic regions is identified by arrow A?

superior portion

all of the following are true of the spleen except:

the spleen has a convex inferior margin and concave superior border

which of the following statements is not true regarding the spleen?

the spleen is a retroperitoneal structure

the type of tissue within the spleen that is responsible for its lymphatic function is the?

white pulp

the normal adult spleen measures approximately:

11cm in length, 7cm in width, and 4 cm in height

in a 400 year old patient , splenomegaly is suggested once the length of the spleen exceeds:

13 cm

normal hemoglobin levels should not exceed?

20 g /dl

an average sized male patient has been referred for ultrasound evaluation of splenomegaly. what transducer would provide the highest resolution images of the spleen?

5 MHz curved linear

the splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?

SMV

epstein-barr infection is best described as:

a herpes virus that can lead to infectious mononucleosis in children

leukocytosis is defined as a white blood cell count:

above 20,000

which of the following splenic abnormalities is most commonly linked to ineffective endocarditis?

abscess

a 25byear old female patient presents to the ultrasound department for a complete abdominal sonogram. she complains of right lower quadrant pain and nausea. the Right upper abdomen appears normal. a small mass is noted in the area of the splenic hilum. this mass appears isoechoic to the spleen what does this most likely represent?

accessory spleen

a patient presents with a history of liver function tests showing elevated levels. the arrows in this sonogram are most likely identifying a:

accessory spleen

during routine sonographic evaluation of the spleen, you detect a small, rounded mass at the splenic hilum that is homogeneous and isoechoic with the spleen. you have most likely detected?

accessory spleen

the most common clinical finding associated with a hemangiosarcoma is:

anemia

a rare malignant tumor of the spleen that consists of blood vessels is a/n?

angiosarcoma

a patient presents with a history of increased abdominal girth and liver function test showing elevated levels. which of the following findings most likely demonstrated in this sonogram of the left quadrant?

ascites