207 ABD PATH final

The IVC is considered dilated when its dimension exceeds:

2.5 cm

an abdnormal aortic aneurysm is presents when the diameter of the abdominal aorta exceeds:

3 cm

Gallbladder enlargement is suggested once the transverse diameter exceeds: A. 3 mm B. 7 cm C. 5 cm D. 4 cm

5 cm

Increased pressure in the portal vein can be a consequence of: (Multiple answers allowed) A. Vein obstruction B. Liver fibrosis D. Dilated intrahepatic ducts

A & B vein obstruction & liver fibrosis

With what condition is the "starry sky" appearance of the liver associated? A. Acute hepatitis B. Metastatic disease C. Granulomatous disease D. Echinococcal cyst

A. Acute hapatitis

A rare malignant tumor of the spleen that consists of blood vessels is a/an: A. Angiosarcoma B. Granuloma C. Hemangioma D. Lymphoma

A. Angiosarcoma

What extrahepatic anechoic collection of bile is located within the peritoneal cavity? A. Biloma B. Hematoma C. Lymphocele D. Seroma

A. Biloma

_____ is caused by thrombus in the hepatic veins or IVC. A. Budd-Chiari syndrome B. Cirrhosis C. Arnold-Chiari syndrome D. All options listed are correct

A. Budd-Chiari syndrome

The most common benign liver tumor is: A. Cavernous Hemangioma B. Hepatic adenomas C. Hamartoma D. Hemangioendothelioma

A. Cavernous Hamangioma

Hemochromatosis is a rare disorder that may lead to: A. cirrhosis B. cholangitis C. schistosomiasis D. hepatitis

A. Cirrhosis

What is the most common cystic lesion found within or near the pancreas? A. Pancreatic pseudocyst B. Mucinous cystic adenoma C. Microcystic adenoma D. Polycystic disease of the pancreas

A. Pancreatic pseudocyst

________ is an inflammation that often result in abscess formation that extends beyond the borders of the pancreas. A. Phlegmon B. Pseudocyst C. Chocolate cyst D. None of the options are correct

A. Phlegmon

A 4-week-old girl with projectile vomiting for 2 days is seen. She is jaundiced, and the physician is able to palpate an olive-shaped mass in the RUQ on physical examination. What is the most likely diagnosis? A. Pyloric stenosis B. Intussusception C. Ulcer D. Reflux

A. Pyloric stenosis

Which of the following is NOT a cause of hepatomegaly? A. All options listed may cause hepatomegaly B. Lymphoma C. Multiple masses D. Chronic passive congestion

A. all options listed may cause hepatomegaly

A patient presents to the ER with right lower quadrant pain with rebound tenderness, fever, and leukocytosis. The ultrasound exam reveals an incompressible echo free mass in the right lower quadrant with irregular borders. Most likely diagnosis would be: A. Appendicitis B. Adenocarcinoma C. Fistula D. Diverticulitis

A. appendicitis

A congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as: A. Biliary atresia B. Mirizzi disease C. Caroli disease D. Choledochal cysts

A. biliary atresia

A middle-age patient presents with a history of vague right upper quadrant pain. Laboratory values reveal an increase in nonconjugated bilirubin levels. A sagittal image of the gallbladder demonstrates which of the following? A. biliary sludge B. gangrenous cholecystitis C. gallbladder carcinoma D. acute cholecystitis

A. biliary sludge

Which of the following would be the most distal portion of the biliary tree? A. Common bile duct B. Intrahepatic radicles C. Gallbladder D. Common hepatic duct

A. common bile duct

Which of the following is NOT a sonographic finding of acute appendicitis: A. Compressible, blind-ended tube B. Hyperemic flow C. Periappendiceal fluid collection D. Appendicolith

A. compressible, blind-ended tube

Clinical findings of acute appendicitis include all of the following except: A. Constipation B. Right lower quadrant pain C. Rebound tenderness D. Leukocytosis

A. contipation

If a mass is detected in the pancreatic head what other organ should be evaluated? A. Gallbladder B. Stomach C. Duodenum D. Left kidney

A. gallbladder

A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence in the stomach rugae. These findings are most suspicious for which of the following conditions? A. gastritis B. gastric ulcer C. carcinoma D. Crohn's disease

A. gastritis

The most common cause of acute renal failure is:

Acute Tubular Necrosis (ATN)

A patient presents with severe abdominal pain after a big night out on the town. The pain had remained intense and constant over the past 36 hours a cystic mass is seen in the region of the pancreatic tail. This condition most likely represents?

Acute pancreatitis

What is the most prevalent benign kidney tumor with a similar sonographical appearance to renal cell carcinoma?

Adenoma

A benign fatty tumor of the kidney that appears very hyperechoic and has been seen in patients with tuberous sclerosis is most likely:

Angiomyolipoma

An outpatient with a history back pain and hypertension presents to the ultrasound department for abdominal aortic sonogram. Sonographically, you visualize a 6 cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis?

Aortic dissection

What could account for decreased pulsations of the abdominal aortic walls and hyperechoic aortic wall echoes?

Arteriosclerosis

Over load of nitrogen, uric acid, and creatnine, which occur with renal failure

Azotemia

Inflammation of the bile ducts is referred to as: A. Cholelithiasis B. Cholangitis C. Choledocholithiasis D. Pneumobilia

B. Cholangitis

A 65-year-old man presents with elevated liver function tests. Your examination reveals a shrunken, echogenic right lobe and a relatively enlarged caudate lobe. The liver contour is irregular. What is the most likely diagnosis? A. Acute hepatitis B. Cirrhosis C. Hepatocellular carcinoma D. Chronic hepatitis

B. Cirrhosis

An autoimmune disease characterized by periods of inflammation of the gastrointestinal tract describes: A. Pyloric stenosis B. Crohn disease C. Intussusception D. Meckel diverticulitis

B. Crohn disease

Clinical findings of choledocholithiasis include all of the following except: A. Jaundice B. Elevated blood urea nitrogen C. Elevated alkaline phosphatase D. Elevated bilirubin

B. Elevated blood urea nitrogen

A nonmobile, nonshadowing focus is seen within the gallbladder lumen. This most likely represents a: A. Gallstone B. Gallbladder polyp C. Gallbladder carcinoma D. Sludge ball

B. Gallbladder polyp

An examination of the liver reveals a well-defined, highly echogenic mass in the posterior liver. An artifact is present, causing the portion of the diaphragm directly posterior to the mass to appear discontinuous with the remainder of the diaphragm. What is the most likely diagnosis of the mass? A. Hepatic adenoma B. Hepatic lipoma C. Cavernous hemangioma D. Hepatoma

B. Hepatic lipoma

The most common granulomatous disease of the spleen is: A. Staphylococcal infection B. Histoplasmosis C. Abscesses D. Echinococcal cyst

B. Histoplasmosis

The area of pain and rebound tenderness with acute appendicitis is most likely at: A. Olive point B. McBurney point C. Meckel point D. Murphy point

B. McBurney point

Rebound tenderness in the RLQ is called: A. Pericecal sign B. McBurney's sign C. Graduated sign D. Appendicolith

B. McBurney's sign

a 38 year old woman presents post cholecystectomy with RUQ pain, fever and an elevated white count. Your examination reveals an irregular, hypoechoic mass with posterior enhancement in the region of the porta hepatis. What is the most likely diagnosis? A. Hepatocelluar carcinoma B. Pyogenic abscess C. Focal fatty sparing D. Hematoma

B. Pyogenic abscess

A 58-year-old patient presents with a history of elevated liver function tests. Based on this clinical history, the sonogram of the left upper quadrant is most likely demonstrating which of the following abnormalities? A. harmartomas B. splenic calcifications C. candidiasis D. splenic infarctions

B. Splenic calcifications

Which of the following is not a possible cause of right upper quadrant pain? A. Right renal calculous B. Splenic infarct C. Duodenal ulcer D. Emphysematous gallbladder

B. Splenic infarct

A patient arrives for an abdominal ultrasound to rule out gallstones. A sonogram of the liver demonstrates which of the following? A. metastatic disease B. cavernous hemangioma C.hepatic adenoma D. adrenal hemorrhage

B. cavernous hemangioma

Which of the following is not a plausible cause of common bile duct obstruction in adults? A. Pancreatic carcinoma B. Choledochal cyst C. Chronic pancreatitis D. Choledocholithiasis

B. choledochal cyst

A sagittal sonogram medial to the porta hepatis is demonstrating which of the following abnormalities? A. chronic cholecystitis B. dilated common bile duct C. portal vein thrombosis D. cholangitis

B. dilated common bile duct

A sonogram reveals a hypoechoic, wedge-shaped lesion at the periphery of the spleen. The most likely diagnosis is: A. Lymphoma B. Splenic infarction C. Splenic rupture D. Splenic abscess

B. splenic infarction

A 15-year-old female patient presents with a history of left upper quadrant pain. Based on this clinical history, the sonogram is most likely demonstrating which of the following abnormalities? A. splenic infarction B. splenomegaly C. splenic rupture D. leukemia

B. splenomegaly

In glycogen storage disease, Type I is the most common. This is also known as: A. von Gussel's disease B. von Gierke's disease C. von Slurpie's disease D. von Gerpe's disease

B. von Gierke's disease

Blood test that evaluates the amount of nitrogenous waste in the blood and serves as a measure of kidney function

BUN

A 42-year-old man with significant RUQ pain, diarrhea, and fever undergoes a sonographic evaluation of the liver. Laboratory test results are pending. The patient reports that he spent 1 month in Africa last year participating in a medical mission mission trip. The sonogram reveals a hypoechoic lesion measuring 4.8 cm in the right lobe of the liver with acoustic enhancement. Which of the following diagnoses is most likely? A. Pyogenic abscess B. Complex cyst C. Amebic abscess D. Hematoma E. Neoplasm

C. Amebic abscess

Cases of gallbladder carcinoma frequently demonstrate coexisting: A. cholecystitis B. adenomyomatosis C. cholelithiasis D. pleural effusion

C. Cholelithiasis

A 71-year-old patient presents to the emergency department with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for: A. Chronic cholecystitis B. Porcelain gallbladder C. Courvoisier gallbladder D. Acute cholecystitis

C. Courvoisier gallbladder

The most common cause of intestinal obstruction is: A. Cancer B. Crohn's disease C. Diverticulitis D. Adhesions

C. Diverticulitis

A patient presents with a history of right upper quadrant pain and leukocytosis. On further questioning the patient states he had recently returned from India. Based on this clinical history, the sonogram is mostly likely displaying a(n): A. hepatic abscess B. hemorrhagic cyst C. echinococcal cyst D. hepatocellular carcinoma

C. Echinococcal cyst

The most common primary neoplasm of the spleen is the: A. Hemangiosarcoma B. Cystic lymphangioma C. Hemangioma D. Hamartoma

C. Hemangioma

In adults, the primary malignant tumor of the liver is: A. Hamartoma B. Hepatoblastomas C. Hepatoma D. Cystic hemangioma

C. Hepatoma

The most common islet cell tumor is the: A. Glucogonoma B. Cystadenoma C. Insulinoma D. Gastrinoma

C. Insulinoma

Elevation of serum bilirubin results in: A. Ascites B. Hepatocellular disease C. Jaundice D. Hemolysis

C. Jaundice

All of the following are sources of diffuse gallbladder wall thickening except: A. AIDS B. Hepatitis C. Malignant ascites D. Adenomyomatosis

C. Malignant ascites

What symptom describes tenderness over the gallbladder with probe pressure? A. Courvoisier's gallbladder B. Douglas's sign C. Murphy's sign D. Morrison's pouch

C. Murphy's sign

An asymptomatic patient with a history of hepatitis B arrives for an abdominal ultrasound. Based on this clinical history, the sonogram is most likely demonstrating which of the following abnormalities? A. clonorchiasis B. choledocholithiasis C. pneumobilia D. Klatskin tumor

C. Pneumobilia

What causes recanalization of the umbilical vein? A. Pancreatitis B. Hepatocelluar carcinoma C. Portal hypertension D. Cirrhosis

C. Portal hypertension

While scanning the spleen, you notice multiple enlarged tortuous vessels in the splenic hilum. Color Doppler confirms that they are vascular in nature. Dilated vessels are also noted within the splenic parenchyma. What is the most likely cause of these findings? A. Lymphoma with metastases B. Splenic rupture with bleeding outside the capsule C. Portal hypertension with collateral varices D. Accessory spleen near the splenic hilum

C. Portal hypertension with collateral varices

While performing an abdominal sonogram for RUQ pain, you notice a single, well-circumscribed anechoic lesion in the right lobe of the liver. The lesion exhibits posterior enhancement. The remainder of the examination is normal. What is the most likely diagnosis? A. Hematoma B. Polycystic liver disease C. Simple liver cyst D. Cavernous hemangioma

C. Simple liver cyst

If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate? A. Common bile duct B. Common hepatic duct C. All of the options listed are correct D. Gallbladder

C. all of the options listed are correct

Focal hypoechoic areas in an otherwise fatty liver usually found near the porta hepatis that do not disturb anatomy are most likely: A.Metastases B. Cysts C. Focal sparing D. Hepatoma

C. focal sparing

A 60-year-old man with a history of alcoholic cirrhosis presents with increasing abdominal girth and jaundice. The sonographic examination reveals ascites and multiple hyperechoic lesions seen throughout the liver. Tumor is noted within the portal vein. What is the most likely diagnosis? A. Hepatic adenomas B. Hepatic metastases C. Hepatocellular carcinoma D. Karposi's sarcoma

C. hepatocellular Carcinoma

A patient presents with a history of cardiovascular disease and vague left upper quadrant pain. He denies any recent trauma or illness. Based on this clinical history, the sonogram is most likely demonstrating a splenic: A. candidiasis B. hamartoma C. infarction D. rupture

C. infartion

A patient presents with elevated liver function tests and a prior history of lung cancer. Based on this clinical history, the sonogram is most likely displaying: A. hepatocellular carcinoma B. candidiasis C. metastatic lesions D. focal nodular hyperplasia

C. metastatic lesions

If cholelithiasis is discovered on an ultrasound, the sonographer must determine the: A. composition of the stone(s) B. size of the stone(s) C. mobility of the stone(s) D. contour of the stone(s)

C. mobility of the stones

A patient in the intensive care unit because of a spinal cord injury with a long hospitalization complains of intermittent RUQ pain, and a sonographic evaluation of the RUQ is ordered. Sonography reveals a gallbladder containing low-level echoes that layer and are gravity-dependent. This finding is most consistent with which of the following? A. Emphysematous cholecystitis B. Abscess C. Sludge D. Cholecystitis E. Cholelithiasis

C. sludge

An abdominal ultrasound is ordered for an asymptomatic patient to evaluate a splenic mass identified on a recent CT scan. Based on this clinical history, the sonogram is most likely demonstrating which of the following abnormalities? A. splenic infarction B. splenic rupture C. splenic cyst D. splenic abcess

C. splenic cyst

Another term for a cortical renal abscess is:

Carbuncle

Blood test along with BUN used to measure the kidney's ability to remove waste in the blood

Creatnine

A patient presents with a history of autoimmune deficiency syndrome, jaundice, and marked elevation in bilirubin and alkaline phosphatase. Based on this clinical history, the sonographic findings are most consistent with: A. cholangiocarcinoma B. clonorchiasis C. ascariasis D. cholangitis

D. Cholangitis

A gallstone located within the biliary tree is referred to as: A. Cholangitis B. Cholangiocarcinoma C. Cholecystitis D. Choledocholithiasis

D. Choledocholithiasis

Intermittent and repeated obstruction of the cystic duct by a gallstone results in: A. Gangrenous cholecystitis B. Emphysematous cholecystitis C. Acute cholecystitis D. Chronic cholecystitis

D. Chronic cholecystitis

The "water lily" sign is associated with which of the following abnormalities? A. polycystic liver disease B. hydronephrosis C. hepatic cystadenoma D. echinococcal cyst

D. Echinococcal cyst

Acute cholecystitis that leads to necrosis and abscess development within the gallbladder wall describes: A. Gallbladder perforation B. Chronic cholecystitis C. Emphysematous cholecystitis D. Gangrenous cholecystitis

D. Gengrenous cholecystitis

Which of the following is not a diffuse liver disease? A. Hepatitis B. Fatty infiltration C. Cirrhosis D. Hepatoma

D. Hepatoma

A stone lodged in the cystic duct is associated with: A. Budd-Chiari syndrome B. No options listed are correct C. Meigs syndrome D. Mirizzi syndrome

D. Mirizzi syndrome

Which of the following is associated with development of cysts within the pancreas? A. Zollinger-Ellison syndrome B. Autosomal recessive polycystic kidney disease C. Endoscopic retrograde cholangiopancreatography D. Von Hipple-Lindau disease

D. Von Hipple-Lindau disease

What is the surgical procedure of choice for a patient who has pancreatic cancer? A. Pancreatectomy and cholecystectomy B. Wirsung procedure C. Pancreatic transplant D. Whipple procedure

D. Whipple procedure

A splenic rupture below the splenic capsule will appear on ultrasound as a: A. hypoechoic parenchymal mass B. loculated mass anterior to the left kidney C. lateral anechoic mass D. crescent-shaped fluid collection inferior to the diaphragm

D. crescent- shaped fluid collection inferior to the diaphragm

A 76-year-old patient presents for an abdominal sonogram with chronic abdominal pain. An irregular mass is seen projecting into the gallbladder lumen. Color Doppler detects flow within the mass. Gallstones are also seen. What is the most likely diagnosis? A. Courvoisier gallbladder B. Gallbladder sludge and stones C. Adenomyomatosis D. Gallbladder carcinoma

D. gallbladder carcinoma

A patient with a history of cirrhosis presents for an annual abdominal ultrasound. A hyperechoic tubular structure is present within the liver. This is consistent with which of the following? A. surgical clips B. portal vein thrombosis C. recanalized hepatic vein D. hepatic stent

D. hepatic stent

The telescoping of one segment of bowel into another is referred to as: A. Crohn disease B. Volvulus C. Pyloric stenosis D. Intussusception

D. intussusception

A patient presents 2 days post motor vehicle accident with left upper quadrant pain. A crescent shape fluid collection that conforms to the spleen is identified. This most likely represents: A. Perisplenic abscess B. Perisplenic hematoma C. None of the options listed are correct D. Subcapsular hematoma

D. subcapsular hematoma

Increased production of urine that can occur with diabetes mallitus, acute renal failure, or increased fluid intake

Diuresis

Painful urination

Dysuria

Which statement is the best description of the sonographic appearance of a bladder tumor?

Echogenic structures protruding into anechoic bladder lumen

Slight widening of the aorta throughout its entire length is referred to as:

Ectatic aorta

What is an aneurysm that is uniform in nature called?

Fusiform

Also known as the renal fascia; dense connective tissue that surrounds and helps anchor the kidney, adipose capsule, and the adrenal gland

Gerota's fasica

An afebrile 64 years old patient presents with a history of right flank pain. He states a right renal lithotripsy was preformed 2 weeks prior. Based on this clinical history, the sonogram is most suspicious for which of the following complication?

Hematoma

Blood in the urine

Hematuria

In small bowel ischemia, the postprandial superior mesentric artery will yield what flow pattern?

High resistance

Another term for renal cell carcinoma

Hypernephroma

What is the most common clinical symptom of renal artery stenosis?

Hypertension

The classic presentation of a ruptured AAA includes the triad of:

Hypertension, abdominal or back pain, and pulsatile abdominal mass

The sonographic appearance of the pancreases and other related organs in a patient with cystic fibrosis may reveal:

Hypoechoic pancreas with uneven echo texture, splenomegaly, gallbladder with sludge and thickened walls, portal hypertension

A 25 year old pregnant patients presents in her third trimester with mild right flank pain. Which of the following would you expect to find in this patient?

Mild to moderate hydronephrosis

An aneurysm associated with infection is termed:

Mycotic

Surgical removal of the kidney

Nephrectomy

Kidney disease

Nephropathy

Low output of urine that is the result of many possible causes including dehydration, renal failure, or urinary obstruction

Oliguria

What is a cyst that originates in the renal parenchyma and protrudes into the renal sinus called?

Parapelvis cyst

A patient presents to the ultrasound department for a renal exam due to decreased renal function. The exam reveals multiple bilateral cysts of varying size in the cortex region. The renal contour is distorted. Multiple cysts were also detected in the liver. The most likely diagnosis would be:

Polycystic disease

Which of the following abnormalities is associated with the development of abdominal varicosities in the area of the splenic hilum, renal hilum, and gastroesophageal junction?

Portal hypertension

The most common cause of urinary obstruction in male infants is:

Posterior Urethral Valves (PUV)

What states presents when the Doppler spectral analysis of the normal superior mesenteric artery demonstrates reduced or absent reversal of flow during the diastolic phase of the cardiac cycle?

Postprandial state

Protein in the urine; sign of kidney disease

Proteinuria

What type of aneurysm may occur after a heart catherization?

Pseudoaneurysm

which type of aneurysm typically has a neck and demonstrates a swirling pattern on color doppler?

Pseudoaneurysm

Pus in the urine

Pyuria

What is the most common cause of IVC obstruction?

Right-sided heart failure

Sonographically, compared to normal kidneys, those affected by chronic renal failure will appear:

Smaller in size and more echogenic

A 44-year-old man with a history of diarrhea and weight loss is seen for an abdominal ultrasound scan. Ultrasound examination reveals multiple hypoechoic lesions in the liver, kidneys, and spleen (Figure 4,A and B). Lymphadenopathy is also noted. These results are most consistent with which diagnosis? True or False - This is likely lymphoma. True False

True

The presence of an appendicolith, regardless of the diameter of the appendix, is usually diagnostic of appendicitis. True False

True

The circular structure(s) seen in the bladder image bladder image below most accurately represents which of the following:

Ureterocele

Bacterial infection in the bloodstream as a result of a urinary tract infection

Urosepsis

Courvoisier gallbladder is found in the presence of:

adenocarcinoma in the head of the pancreas

Enlargement of the pancreatic head may cause:

biliary obstruction

________ is used to create the "twinkle artifact" characteristic of renal calculi.

color doppler

Which of the following is not a cause of cystitis:

insulinoma

What is the medical term for kidney stones?

nephrolithiasis

_________ is the most common solid malignant renal abnormal

renal cell carcinoma

When a patient has an abdominal aortic aneurysm , what is the greatest concern?

rupture

A sonogram of the right kidney demonstrates which of the following abnormalities

sinus lipomatosis

The most common site of obstruction in adults by kidney stones is the:

ureterovesical junction

The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors:

von Hipple- Lindau syndrome