Abdomen registry questions

Results from bilateral adrenal gland hemorrhage Characterized by acute adrenal gland insufficiency What adrenal path

WATERHOUSE-FRIDERICHSEN SYNDROME

Pt has - a large nonfunctioning kidney and a staghorn calculus what renal path

Xanthogranulomatous pyelonephritis

A ureteropelvic junction obstruction is associated with: Select one: autosomal recessive polycystic kidneys autosomal dominant polycystic kidneys a multicystic dysplastic kidney a duplex kidney

a multicystic dysplastic kidney A ureteropelvic junction obstruction can be a contralateral finding associated with multicystic dysplastic kidney.

Traumatic laceration of the splenic capsule may result in: Select one: a subcapsular hematoma ascites a perisplenic hematoma an intraparenchymal hematoma

a perisplenic hematoma Correct. Laceration of the splenic capsule results in a perisplenic hematoma.

If patient looks like they have a mass in pancreas, check if they have symptoms & if they have abnormal labs if they do it =

acute pancreatitis and not a mass

Adrenal cortex atrophies- Insufficient secretion of adrenocortical hormones Cortisol & Aldosterone occurs What adrenal path

addisons disease

Increased sodium retention Tissue edema Increased plasma volume Increased potassium excretion Fatigue Muscle and bone weakness Hyperpigmentation of the skin Mild alkalosis clinical symps of what disease

addisons disease

~80% of nodular thyroid disease is caused by -____

adenomatous hyperplasia

Hirsutism is associated with which organ? Select one: adrenal gland parathyroid gland ovary thyroid

adrenal gland Correct. Hirsutism is the result of excessive cortisol secretion of the adrenal gland (Cushing's Syndrome)

Cushing's syndrome is the excessive secretion of cortisol due to what 3 things

adrenal hyperplasia, adenoma or carcinoma

Elevated labs for cholestasis and fatty liver

alkaline phos direct bilirubin

what type of abscess is Contracted by ingesting the cysts through contaminated water and food

amebic

Grows rapidly Invades surrounding neck structures It usually causes death by compression and asphyxiation as a result of invasion of the trachea what thy path

anaplastic (undifferentiated) ca

Epididymitis and orchitis Treatment

antibiotics

The testicular artery is a branch of the: Select one: external iliac aorta hypogastric artery internal iliac

aorta. Correct. The testicular arteries branch directly from the aorta.

All of the following are elevated with biliary obstruction except: Select one: alkaline phosphatase gamma glutamyl transpeptidase aspartate aminotransferase conjugated bilirubin

aspartate aminotransferase Gamma glutamyl transpeptidase, alkaline phosphatase and conjugated bilirubin are all laboratory values that may be elevated in association with a biliary obstruction.

Polycystic liver disease is an ____ ____ disease

autosomal dominant 1/500 ppl

Increased BUN and Creatinine =

azotemia

Typically, the testicle is attached to the tunica vaginalis, Without this attachment, the testicle can rotate freely on the spermatic cord. This is called the "____ ____ deformity". This congenital anomaly allows the testicle to twist, causing testicular torsion.

bell clapper

Do prostate calcs indicate malignant or benign process

benign

Is nephrocalcinosis bilateral or unilateral

bilateral

is medullary sponge kidney unilateral or bilateral?

bilateral

In juvenile polycystic renal disease, there is what 4 things

bile duct proliferation periportal fibrosis portal hepatic varices nephromegaly

Bilious vomiting, abdominal cramps, diarrhea, volvulus, whirlpool sign - which is twists of mesentery around SMA waht peds path

bowel rotation

In MCDK, the kidney does not function and may transform to ____ if kidney is not removed

cancer

Most common benign tumor of the liver, common in women

cavernous hemangioma

which prostate zone borders the seminal vesicles

central

The spermatic cord consists of all the following except: Select one: cremasteric artery centripetal artery testicular artery vas deferens pampiniform plexus of veins

centripetal artery Correct. The spermatic cord consists of the vas deferens, cremasteric artery, deferential artery, testicular artery, pampiniform plexus of veins, lymphatices and nerves.

clinical of waht Steatorrhea (Fatty Stools) Abdominal pain Epigastric Pain Back pain Weight loss Jaundice Flatulence Malabsorption

chronic pancreatitis

In 80% of cases HCC is caused by

cirrhosis

An anechoic with tiny echogenic focus cyst on thyroid is called a

colloid cyst

While imaging a patient with dilated loops of bowel you detect the presence of haustra. This is an identifying feature of which part of the gastrointestinal tract? Select one: duodenum stomach colon smal intesines

colon

Which of the following is normally found in urine? Select one: conjugated bilirubin unconjugated bilirubin alpha fetoprotein albumin

conjugated bilirubin Correct. Conjugated bilirubin is excreted from the biliary tree and released into the intestines. From the intestines, the conjugated bilirubin is absorbed into the bloodstream then filtered by the kidneys.

Calcification commonly seen within the prostate are called: Select one: corpora amylacea corpus callosum corpus albicans microcalcifications

copora amylacea Correct. Corpora amylacea are small hyaline masses, sonographically appearing as calcifications, in the prostate.

Which of the following is inversely related to glomerular filtration rate. Select one: sedimentation rate prothrombin time creatinine hematocrit

creatinine As glomerular filtration rate decreases, creatinine increases.

The _______ artery branches from the inferior epigastric artery

cremasteric

The _______ vein drains into tributaries of the epigastric and deep pudendal veins

cremasteric

von Hippel-Lindau Disease forms ____ and ____ on many organs

cysts and neoplasms

Parathyroid hormone is secreted when there is a ____ in the blood calcium level

decrease

Patient with secondary hyperparathyroidism due to chronic renal failure have: Select one: decreased serum calcium increased serum calcium increased serum potassium increased serum calcium level

decreased serum calcium Correct. Patients with secondary hyperparathyroidism are unable to synthesize vitamin D and therefore have chronic hypocalcemia.

The ____ artery arises from the vesical artery Branches off the internal iliac artery

deferential

Which artery Supplies the epididymis and vas deferens

deferential artery

Emphysematous Cholecystitis: 50% of patients will have ____

diabetes

Acquired Cystic Kidney Disease (ACKD) pt is undergoing ____

dialysis

Which of the following is not associated with sclerosing cholangitis? Select one: obstructive liver chemistries ulcerative colitis diverticulosis intrahepatic duct wall thickening

diverticulosis Correct. Sclerosing cholangitis presents with thick-walled intrahepatic ducts causing an increase in alkaline phosphatase and bilirubin. 50% of patients with sclerosing cholangitis have ulcerative colitis.

Most common cause of acute scrotal pain

epididymitis. Most patients have UTI's

Orchitis is also called

epididymoorchitis

Pheochromocytomas secrete: Select one: cortisol aldosterone epinephrine ACTH

epinephrine Correct. Pheochromocytomas are hyperfunctioning tumors that secrete norepinephrine and epinephrine into the blood. It is the excess secretion of these catecholamines that produces hypertension.

Pheochromocytomas secrete: Select one: cortisol aldosterone epinephrine ACTH

epinephrine. Pheochromocytomas are hyperfunctioning tumors that secrete norepinephrine and epinephrine into the blood. It is the excess secretion of these catecholamines that produces hypertension.

An _____ pelvis is a common variant in which the renal pelvis protrudes out of the renal hilum.

extrarenal

Propagation speed artifacts are associated with the ___ component of a mass.

fatty

What age and gender is porcelain GB mostly found in

females >60

Name the anterior zone of the prostate. Select one: central zone peripheral zone transitional zone fibromuscular stroma

fibromuscular stroma Correct. Fibromuscular stroma is the non-glandular anterior portion of prostate; thus, it is not affected by cancer, prostatitis or hyperplasia.

2nd most common thy cancer

follicular carcinoma

Where does GB perforation typically occur?

fundus

"Wheel within a wheel" is a lesion with a peripheral hypoechoic zone, an inner echogenic wheel and a hypoechoic center. This is the earliest manifestation of a ______ infection and most recognizable

fungal

Emphysematous Cholecystitis: Less than 50% of patients will have ____

gallstones

Zollinger-Ellison syndrome is associated with: Select one: pancreatic adenocarcinomas gastrinomas Insulinomas microcystic cystadenomas

gastrinomas Correct. Gastrinomas, which produce the Zollinger-Ellison syndrome, are the second most common islet-cell tumors.

WATERHOUSE-FRIDERICHSEN SYNDROME TREATMENT: Immediate intervention administration of _____ therapy is necessary or death will occur very fast!

glucocorticoid

Hypertrophic pyloric stenosis is sonographically characterized by a pyloric wall thickness: Select one: greater than 2 mm greater than 4 mm greater than 7 mm greater than 9 mm

greater than 4 mm Correct. Hypertrophic pyloric stenosis is indicated when the wall of the pylorus is greater than 4mm in thickness.

Hyperbilirubinemia with normal levels of aminotransferase and alkaline phosphatase indicates: Select one: cholangiocarcinoma hemolysis choledocholithiasis hepatocellular disease

hemolysis Hyperbilirubinemia without elevation in levels of aminotransferase and alkaline phosphatase would suggest hemolysis.

Liver Cell Adenoma AKA

hepadenoma

Which hepatic mass is associated with the use of oral contraception and glycogen storage disease? Select one: cavernous hemangioma focal nodular hyperplasia hepatic adenoma hepatic lipoma

hepatic adenoma Hepatic adenomas are associated with the use of oral contraseption and glycogen storage disease.

Wheel within wheel appearance, Bulls eye appearance, Multiple small hypoechoic lesions sono of what?

hepatic candidiasis

With a patent TIPS, the right and left portal branches are ______ in flow direction

hepatofugal

Hepatocellular Carcinoma is aka

hepatoma

Daughter cysts, Septations may occur (Water Lily sign), may have calcs sono of what

hydatid/echinococcal cysts

A complete duplication of the renal collecting system demonstrates all of the following except: Select one: a ureterocele hydronephrosis of the lower pole two ureters and two renal sinuses two renal sinuses separated by renal cortex a hydroureter

hydronephrosis of the lower pole With a complete duplication of the renal collecting system the upper pole of the kidney is typically hydronephrotic due to obstruction from a ureterocele.

There is a high correlation between _____ (what echotexture) metastases and colon cancer

hyperechoic

The sonographic appearance of an acute hematoma would be: Select one: anechoic hypoechoic hypervascular hyperechoic

hyperechoic Correct. Directly after blood has spilled from a vessel, fibrin infiltrates the hematoma resulting in a hyperechoic mass. As time passes, the hematoma will liquefy appearing anechoic. This acute hyperechoic appearance is why ultrasound is not the modality of choice for evaluate early bleeds.

Renal insufficiency and intestinal malabsorption cause ______ leads to stimulation of PTH

hypocalcemia

Both Hodgkin's and non-Hodgkin's lymphomas appear as ____ masses in liver

hypoechoic. non-hodgkins there can be TARGET hypoechoic masses

Azotemia is: Select one: increased serum phosphates increased serum white blood cells decreased serum red blood cells increased serum nitrogen

increased serum nitrogen

What is the most common location of a cryptorchid testis? Select one: inguinal canal above the level of the groin abdomen pelvis

inguinal canal Correct. The most common location of the cryptorchid testis is in the inguinal canal (groin) or prescrotal position. Less than 10% of undescended testis are located in the abdomen.

currant jelly stools, vomiting or colickly abdominal pain is what peds path

intussesception

Goiter Affects large groups of people in a specific geographic area with low ____

iodine

Production of thyroid hormones occurs via _____ metabolism

iodine

A _____ _______ defect is seen as a triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney.

junctional parenchymal

The falciform ligament, ligamentum teres, left hepatic vein and the ascending portal vein are landmarks of the ______ _____ fissure.

left intersegmental

What part of the liver is the quadrate lobe located? Select one: left medial segment left lateral segment right posterior segment right anterior segment

left medial segment The quadrate lobe is an old term which defines the inferior aspect of the left medial segment. On the inferior suface of the liver, this area looks like a square or a "quadrant".

Most common type of mesenchymal tumor

lipoma

The "mantle sign" is associated with: Select one: lymphadenopathy fibromuscular dysplasia retroperitoneal fibrosis subcapsular hematomas

lymphadenopathy The "sandwich" or "mantle" sign indicates the presence of perivessel lymphadenopathy.

What divides the anterior segment of the right lobe from the medial segment of the left lobe? Select one: caudate lobe main lobar fissure falciform ligament coronary ligament

main lobar fissure The main lobar fissure divides the anterior segment of the right lobe from the medial segment of the left lobe

Is PHEOCHROMOCYTOMA a cortical or medullary tumor

medullary

Medical history of Multiple Endocrine Neoplasia (MEN) Type 2 & hyperparathyroidism - most likely to be what thyroid cancer

medullary ca

Echogenic medullary parenchyma May have calcifications sono of waht

medullary sponge kindey

Metastatic to the gallbladder is usually a result of what other cancer_____

melanoma

WATERHOUSE-FRIDERICHSEN SYNDROME: Hemorrhage is caused by ______ infections

meningococcal

Sono of ARPKD

microscopic cysts (linked to chromosome 6)

Found above the base of the prostate between the bladder and rectum mullerian or utricle cysts

mullerian

All of the following are associated with renal cell carcinoma except: Select one: von Hippel-Lindau disease multiple endocrine neoplasia acquired cystic kidney disease tuberous sclerosis

multiple endocrine neoplasia Von Hippel-Lindau disease, tuberous sclerosis, and acquired cystic kidney disease are associated with a higher incidence of renal cell carcinoma.

Alkaline phophatase increases with all of the following except: Select one: bone growth myocardial infarction pregnancy diseases that impair bile formation (cholestasis)

myocardial infarction Alkaline phosphatase comes from liver, bone and placenta. It increasing with bone growth, pregnancy and cholestatsis (intra and extrahepatic)

treatment for emphysematous pyellonephritis

nephrectomy! these pts do not show response to antibiotics

A 20 year old patient presents with an acute onset of right testicular pain. The right testicle is enlarged, hypoechoic and hypervascular as compared to the left. What is the most likely diagnosis? Select one: torsion of the testicular appendix testicular torsion scrotal hernia orchitis

orchitis

Venous drainage of the scrotum occurs through the veins of the ___ ____

pampiniform plexus

Occurs when the cells at the apex of the renal pyramids are destroyed what renal diseae

papillary necrosis

Most common cause of primary hyperparathyroidism

parathyroid adenoma

does orchitis involve the testicle and epi?

yes

what size are parathyroid adenomas

<3 cm

size of parathyroid

<4 mm

Normal PSA number

<4.0 ng/ml

Focal Nodular Hyperplasia (FNH) is common in females ____ years of age

<40

Primary hyperparathyroidism Occurs when increased amounts of PTH are produced by Medical Hx of what 3 pathologies

Adenoma Parathyroid hyperplasia Carcinoma

CONN'S SYNDROME TREATMENT:

Adenoma - removal of the adenoma

A hyperplastic change in the inner gallbladder wall Diverticula of mucosa called Rokitansky-Aschoff sinuses comet tail artifact

Adenomyomatosis

Non functioning cortical tumors consisting of lipid filled cells

Adrenal adenoma

what is the medical hx for a pt with emphysematous pyellonephritis

E coli infection and/or diabetes

Iron metabolism disease characterized by excess iron deposits throughout the body Can deposit in the liver

Hemochromatosis

Pancreatic Pseudocysts: An encapsulated collection of fluid due to loculation of: 3

Hemorrhage Inflammatory processes Necrosis

The state in which the thyroid is producing the right amount of thyroid hormone. Normal functioning thyroid is called?

Euthyroid

5 cholelithiasis clincal F factors

Fat Female Fertile Forty Fair-skinned

what is the path polycystic liver disease takes through diff organs

First appears in kidneys, then liver, then can go to pancreas, spleen and testes

Primary adrenal ca _____ tumors are small and homogenous _____ tumors are large and heterogeneous Nonfunctional or functional

Functional Nonfunctional

Flat elevations located in body of gallbladder, usually near the fundus Does not change with position No shadowing

GB adenomas

Porcelain Gallbladder- Patients are at an increased risk for developing what?

GB cancer.

most common site for mets to come FROM from TO the liver?

GI/colon

Occurs in women greater than 30 years of age Autoimmune disorder Characterized by thyrotoxicosis The most frequent cause of hyperthyroidism

Graves disease

______ sonographically appears as a diffusely enlarged thyroid with extensive hypervascularity.

Graves' disease

What is the sign for discoloration of the flanks after panc hemorrhagic called?

Grey Turners

Hepatic Candidiasis occurs in immunocompromised and ___ patients

HIV

Hyperthyroidism- Labs will show High __ & ___ and low ___

HYPER High = T3 & T4 Low = TSH

Hypothyroidism- Labs will show High __ and low ___ & __

HYPO High = TSH Low = T3 & T4

thyrotropin-releasing factor (TRH) iis produced by pituitary or hypothalamus

HYPOTHALAMUS. TRH tells pituitary to make TSH

What does an adenoma look like with color doppler?

Increased peritumoral and intratumoral vascularity on color

Contralateral ureteropelvic junction (33% of patients) is seen in what kidney disease

MCDK

Multiple cysts of varying sizes No renal parenchyma around the cysts Enlarged kidney in children Small calcified renal in adults sono of what

MCDK

Cysts form in the collecting tubules in the medullary portion of the kidney

Medullary sponge kidney

is NEUROBLASTOMA a cortical or medullary tumor

Medullary tumor Malignant mass found in children

It is the most common palpable abdominal mass found in neonates

Multicystic Dysplastic Kidney (MCDK)

________ is seen in (40-80% of cases) of medullary sponge kidney

Nephrocalcinosis

what are the 3 primary causes of chronic renal failure

Nephron Vascular Interstitial abnormalities

Normal or small renals cysts(<2cm) located in the renal medulla Increased parenchymal echogenicity sono of what

Nephronophthisis

______ Occurs due to cortical tubular atrophy and interstitial fibrosis

Nephronophthisis

salt-wasting nephropathy. What kidney path

Nephronophthisis

ACKD kidneys sono

Normal or small echogenic simple cysts located in cortex

Why does courvoisier gallbladder occur

Occurs due to prolonged obstruction of the CBD Most often due to pancreatic head CA

Hypoechoic Well defined mass spoke wheel patterns of enhancement with a central scar sono of what kidney path

Oncocytoma

Risk factor of Focal Nodular Hyperplasia (FNH)?

Oral contraceptives

Parathyroid medical history 5

Osteopenia/Osteoporosis Nephrolithiasis Nephrocalcinosis Pancreatitis Peptic Ulcer Disease

testicular arteries PSV - ranges from __-__ cm/s EDV - ranges from __-__ cm/s

PSV 4-19 EDV 2-7

Prominent round or triangular cystic areas within the medullary region of the kidney would suggest: Select one: papillary necrosis medullary sponge kidney acute glomerulonephritis multicystic dysplastic kidney

Papillary necrosis may sonographically present as rounded or triangular cystic medullary pyramids.

Analgesic drug abuse, diabetes or sickle cell disease are just a few conditions that may cause calcification or sloughing of the medullary pyramids. This condition is called: Select one: medullary sponge kidney papillary necrosis medullary cystic disease multicystic dysplastic kidney

Papillary necrosis or sloughing of the papilla of the medullary pyramids is associated analgesic drug abuse, diabetes and sickle cell disease.

Precursor to TCC and may have a ferm or polypoid appearance bladder path

Papilloma - benign

what are the 4 stages of ARPKD according to the age of the patient at onset of clinical symptoms:

Perinatal Neonatal Infantile Juvenile

Large echogenic kidneys in the fetus is indicative of _______

Perinatal ARPKD

The bull's eye or target pattern of metastatic disease has been associated with: Select one: melanoma colon cancer lung cancer hepatocellular cancer

lung cancer The bull's eye or target pattern of metastatic disease has been associated with lung cancer.

Testicular Torsion: After 12 hours only ___% are saved

20

Positive for hypertrophic pyloric muscle Wall thickness of ___ mm or greater

3.5, xzone says 4mm

Ruptured/fractured testicle: If surgery is performed after 72 hours after injury, only ___% can be saved

45

Medical Hx of ADPKD: HTN Renal Insufficiency By age 60, ~_____% of patients will have end stage renal disease (ESRD)

50

Panc pseudocyst rupture occurs in 5% of pts, shock & peritonitis occurs. what is the mortality rate?

50%

An outer diameter > __ mm = appendicitis

6

Testicular Torsion: If surgery is performed within __-__ hours of the onset of pain - save rate is 70%

6-12

Ruptured/fractured testicle: If surgery is performed within ____ hours after injury, up to 90% of testes can be saved

72

Testicular Torsion: If surgery is performed within __-__ hours of the onset of pain - 80% to 100% of testes can be saved

0-6

Tuberous Sclerosis Patients may have Medical HX of 3

1 Hamartomas: Cutaneous, retinal, and cerebral 2 Multiple renal cysts 3 Angiomyolipomas

There are two kinds of polycystic renal disease:

1 Infantile autosomal recessive (ARPKD) 2 Adult autosomal dominant (ADPKD)

Panc pseudocysts are acquired process usually from: 2

1 Pancreatitis - acute and chronic 2 Trauma

Emphysematous Cholecystitis: SURGICAL EMERGENCY Fatal in ___% of patients

15

Positive for hypertrophic pyloric muscle Canal length___ mm or greater

17

An increased amount of cortical tissue between medullary pyramids is called: Select one: a parenchymal junctional defect compensatory hypertrophy a column of Bertin a duplex kidney

A column of Bertin is seen sonographically as an increased cortical thickness between medullary pyramids.

Bilateral renal enlargement Kidneys may be echogenic Multiple cysts bilaterally may replace normal kidney parenchyma Kidneys lose their bean shape appearance sono of waht

ADPKD

Excessive secretion of sex hormone due to tumor or hyperplasia. Newborn girls have ambiguous external genitalia - resembles boys what adrenal path

ADRENOGENITAL SYNDROME

Has masculinizing effects on adult women Clinically: Hirsutism Baldness Acne Deepening of the voice Atrophy of the uterus Decreased breast size Clitoral hypertrophy Increased muscularity What adrenal path

ADRENOGENITAL SYNDROME

Elevated labs in HCC

AFP Alk Phos ALT AST

Pneumocystitis Carinii is seen in pts with ____

AIDS

Elevated labs for hepatitis

ALT AST Bilirubin

Enlarged echogenic kidneys Lack of corticomedullary differentiation Macroscopic cysts (1-2mm) may be present sono of what

ARPKD Sonographic appearance

Elevated labs for cirrhosis, which one will be decreased

AST ALT LDH Bilirubin Alk Phos DECREASED: Albumin

Increased cortical echogenicity Enlarged mottled kidneys sono of what

Acute Interstitial Nephritis

Scarlet fever Diphtheria are ass with what renal disease

Acute Interstitial Nephritis

Enlarged kidneys bilaterally with hyperechoic pyramids that can revert to normal appearance sono of what? - its not nephrocalcinosis

Acute tubular necrosis

The most common cause of acute rejection in a transplanted kidney is: Select one: renal artery stenosis renal vein thrombosis acute pyelonephritis acute tubular necrosis

Acute tubular necrosis is the most common cause of acute rejection of a transplanted kidney.

Hemangiosarcoma Risk Factors/medical hx 2

Advanced age Exposure to toxic chemicals/carcinogens

Medical conditions (HX) that may lead to papillary necrosis: 6

Analgesic abuse Sickle cell disease Diabetes mellitus Hydronephrosis Pyelonephritis Renal transplant

Primary Causes of addisons disease 5

Autoimmune process TB Inflammatory process Primary neoplasm Mets

Cerebral aneurysms are associated with: Select one: multicystic dysplasitc kidney autosomal recessive polycystic kidney disease acquired cystic kidney disease autosomal dominant polycystic kidney disease

Autosomal dominant (adult) polycystic kidney disease is associated with cerebral aneurysms.

6 medical hx associations of medullary sponge kindey

Beckwith-Wiedemann Syndrome Polycystic Kidney Disease Caroli's disease of the liver Hepatic Fibrosis Nephrocalcinosis (40-80% of cases) Hydronephrosis

Tuberous Sclerosis is aka

Bourneville disease

Muscle weakness Hypertension Abnormal EKG clinical symps of what adrenal path

CONN'S SYNDROME

Hemochromatosis is also called

Celtic curse

Abnormal cholesterol deposits in the outer GB wall "Strawberry gallbladder"

Cholesterolosis

Transient right upper quadrant pain without + Murphy's sign. Path?

Chronic Cholecystitis

What disease is Children dominant & Pt has a medical hx of recurrent respiratory infections

Chronic Granulomatous Disease

Hashimoto's Thyroiditis is also called

Chronic lymphocytic thyroiditis

What does color doppler look like with FNH?

Color Doppler demonstrates a hypervascular stellate arterial pattern

Adenoma Associated with:

Common in females of childbearing age Increased incidence with Oral contraceptives use in females Anabolic steroids in males Glycogen storage disease (von Gierke's)

Hyperaldosteronism due to an adrenal adenoma is called: Select one: Cushing Disease Conn Syndrome Cushing Syndrome Addison Disease

Conn Syndrome Correct. Conn's syndrome typically results from an adrenal adenoma producing hyperaldosteronism.

Aldosteronism is also called

Conn's syndrome

Excessive cortisol secretion due to increase in adrenocorticotropic hormones (ACTH) from a pituitary tumors is called. Select one: Cushing's disease Conn's disease Cushing's syndrome Adrenalgenital syndrome Addison's disease

Cushing's disease Correct. Cushing's disease is the excessive cortisol secretion due to increase in adrenocorticotopic hormones (ACTH) from a pituitry tumor.

Excessive secretion of glucocorticoids due to: Adrenal hyperplasia Cortical adenoma Adrenal cancer Pituitary adenoma what adrenal path

Cushings syndrome

Truncal obesity Pencil thin extremities Hypertension Renal stones Irregular menses Psychiatric disturbances Which adrenal path

Cushings syndrome

Usually caused by a infection (viral) Thyroid becomes Diffusely enlarged Tender to palpation Gradual to Abrupt onset occurs Causes transient hyperthyroidism Weeks or months later, the edema and pain subside and normal thyroid function will occur what path

De Quervains

ARPKD Sonographic appearance

Enlarged echogenic kidneys Lack of corticomedullary differentiation Macroscopic cysts (1-2mm) may be present

Hepatocytes contain areas of: Bile stasis Focal hemorrhage Necrosis this happens with?

Hepadenomas

The most common cause of intrahepatic cholestasis (obstructive jaundice) is: Select one: pancreatic carcinoma hepatitis Courvoisier gallbladder periportal lymphadenophathy

Hepatitis is the most common cause of intrahepatic obstruction (obstructive jaundice).

Echinococcal Cyst AKA

Hydatid cyst. Parastic infectious cyts

Primary Hyperparathyroidism- women in menopause. Characterized by Medical Hx of: (labs) 3

Hypercalcemia Hypercalciuria Hypophosphatasia

Renal Cell Carcinoma (RCC) is aka 3

Hypernephroma Adenocarcinoma Grawitz tumor

Conn's syndrome: Adrenal hyperplasia - more common in ____ Adrenal adenoma - more common in ____

Hyperplasia = MALES Adenoma = FEMALES

rcc medical hx 4

Hypertension von Hippel-Lindau disease Acquired cystic disease (dialysis) Tuberous Sclerosis

4 PHEOCHROMOCYTOMA SYMPTOMS:

Intermittent HTN Headaches Sweating Tachycardia

Gallbladder Carcinoma -Adenocarcinoma clinical symps 4

Jaundice Weight loss malaise Change in appetite

The sonographic image is a "parallel channel" or "shotgun" sign. This indicates intahepatic ductal dilatation. Of the four choices, only a ______ ____, which is a cholangiocarcinoma, causes intrahepatic ductal dilatation.

Klatskin tumor

In ADPKD cysts may be found in waht 4 other places

Liver Pancreas Spleen Testes

3 Common primary of metastases to kidney include:

Lung Ca Breast CA RCC on contralateral kidney

Catecholamines are secreted by the: Select one: thyroid testicle pituitary gland adrenal gland

Pheochromocytomas originating in the adrenal glands are hyperfunctioning tumors that secrete norepinephrine and epinephrine into the blood. It is the excess secretion of these catecholamines that produces hypertension.

Risk Factors Leading to Gallstones 7

Pregnancy Oral contraceptives Hormone Replacement Diet induced weight loss Total parenteral nutrition Hemolytic disease Diabetes

Chronic Pancreatitis cases can cause what 4 things

Pseudocysts Dilated CBDs Thrombosis of the SV extending into the PV increased risk for pancreas CA

Acquired Cystic Kidney Disease (ACKD) pt is at increased risk of developing what 3 things

Renal cysts Adenoma Cancer

Secondary Hyperparathyroidism: Chronic hypocalcemia caused by what 3 things?

Renal failure Vitamin D deficiency (rickets) Malabsorption syndromes

Where does the right testicular vein drain? Where does the left?

Right- IVC Left- Left renal vein

Associated with contaminated water Patient drinks contaminated water → Parasitic eggs get absorbed in small intestine → Travel to the portal venous system → Invades the portal vein

Schistosomiasis

Enlarged portal tracts with echogenic walls Initially liver enlarges, decreases in size as disease progresses Periportal fibrosis occurs Presinusoidal PHTN occurs sono of whht

Schistosomiasis

Granulomatous portal vein reaction to parasitic invasion. path called?

Schistosomiasis

This laboratory value is synthesized by the liver, used to transport unconjugated bilirubin, and decreased amounts can be associated with the formation of ascites. Select one: blood urea nitrogen alkaline phosphatase albumin gamma glutamyl transpeptidase

Serum albumin is a plasma protein produced in the liver which transports unconjugated bilirubin to the liver for conjugation. Hypoalbuminemia is associated with the development of ascites (which is why the sometims hang albumin through IV after paras)

Large bulky renal pelvis mass Invades Renal vein and IVC sono of what

Squamous cell carcinoma

Treatment for addisons disease

Steroid replacement therapy

_________ artery present in half the population It courses through the mediastinum toward the testicular capsule

Transmediastinal (or transtesticular)

What does the TURP surgery for prostate stand for? what portion of the prostate does surgeon remove?

Transurethral Resection of the Prostate. central zones

ADPKD Lab Results 4

Uremia Hematuria Proteinuria Elevated Creatinine

Nephronophthisis is aka

Uremic Medullary Cystic Disease

Which of the following is not associated with tuberous sclerosis? Select one: pheochromocytoma angiomyolipoma renal cysts renal cell carcinoma

pheochromocytoma There is an increased incidence of angiomyolipomas, renal cell carcinomas and renal cysts associated with tuberous sclerosis.

A _____ is a diffuse soft tissue inflammatory edema that may produce pus and tissue necrosis

phlegmon

Parathyroids are located ____ & ___ on thyroid

posterior and medial

what are the 3 things Alk Phos is elevated with

pregnancy (placenta), bone growth (children), biliary obstruction

All of the following have the same sonographic appears except: Select one: Mycetoma (fungal balls) papillary necrosis blood clots angiomyolipoma renal cell carcinoma

renal cell carcinoma Mycetoma (fungal balls), angiomyolipomas, blood clots and papillary necrosis all may sonographically present as a hyperechoic mass. A renal cell carcinoma typically is seen as a hypoechoic mass.

What is the correct sequence of structures at the renal hilum from anterior to posterior? Select one: renal vein, renal artery, ureter renal artery, ureter, renal vein ureter, renal vein, renal artery renal vein, ureter, renal artery

renal vein, renal artery, ureter At the renal hilum, the renal vein is the most anteriorly place structure, the ureter is the most posteriorly place structure, and the renal artery is situated between the renal vein and ureter.

All 4 parathyroid glands are usually affected in ____ hyperparathyroidism

secondary

The most common testicular cancer is Select one: teratoma embryonal cell carcinoma seminoma mixed germ cell tumors

seminoma Correct. Seminoma is the most common testicular cancer.

Which laboratory values will increase with the presence of prostate cancer? Select one: serum alkaline phosphatase and testosterone serum alkaline phosphatase and prostate specific antigen serum acid phosphatase and serum alkaline phosphatase serum acid phosphatase and prostate specific antigen

serum acid phosphatase and prostate specific antigen

A ______ is sonographically seen as an extratesticular cystic mass.

spermatocele

which rcc stage spreads to the renal vein and ivc

stage 3

Stage __ or __ of prostate cancer is when it extends through the capsule

stage c or III

De Quervains thyroiditis is also called

subacute granulomatous thyroiditis

Blunt abdominal trauma of the left upper quadrant with an intact splenic capsule may result in a: Select one: intraperitoneal hematoma perihepatic hematoma subcapsular hematoma perisplenic hematoma

subcapsular hematoma

The curs of the diaphragm is located in all of the following locations except: Select one: posterior to the inferior vena cava superior to the celic axis anteior to the aorta superior to the diaphragm

superior to the diaphragm Correct. The crus of the diaphragm is located: anterior to the aorta, superior to the celiac axis and posterior to the inferior vena cava.

Empyema (pus in gb) also called

suppurative cholecystitis

Testicular artery pathway

testicular artery --> capsular artery --> centripetal artery --> recurrent remi (centrifugal artery)

The arcuate line is: Select one: the point at which the posterior rectus sheath ends at the level of the renal arteries the point at which the anterior rectus sheath ends the separation between the rectus abdominal muscles

the point at which the posterior rectus sheath ends Correct. The arcuate line is the point which the posterior rectus sheath ends. The arcuate line is somewhere between the umbilicus and the symphysis pubis.

How does an amebic abscess get to the liver

through the portal vein

What size are peribilary cysts usually

tiny. 0.2-2.5 cm

adenomatous hyperplasia is also called

toxic multinodular goiter

Benign prostatic hyperplasia commonly originates in the ____ zone.

transitional

Which cyst is located midline of prostate and Close to the verumontanum mullerian or utricle cysts

utricle

are utricle or mullerian duct cysts endodermal?

utricle. Mullerian = Mesodermal

what does the spermatic cord consist of 7

vas deferens, cremasteric artery, deferential artery, testicular artery, pampiniform plexus of veins, lymphatices and nerves.

Nephrocalcinosis is associated with hypercalcemic states. Which of the following in not associated with hypercalcemia? Select one: hyperparathyroidism vitamin D excess vitamin K excess malignancies

vitamin K excess