Abdomen Review Questions

The diameter of the portal vein should not exceed

13mm

the GB wall should not measure more than

3mm

The diameter of the Gb should not exceed

5cm

Which of the following would not be a lab finding typically analyzed with suspected GB disease *ALP *ALT *Bilirubin *AFP

AFP

A 32 yr old female patient present to the US department with vague abdominal pain. The US investigation of the GB reveals a focal area in the GB wall thickening and produced comet tail artifact. These findings are consistent with:

Adenomyomatosis

Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with:

Adenomyomatosis

The two most common causes of fatty liver infiltration are

Alcoholic Liver disease and obesity

Which of the following is typically transmitted through contaminated water found in places such as Mexico, Central America, South America, Asia, India, and Africa?

Amebic Liver Abscess

Which of the following would be least likely to cause focal GB wall thickening: *Gb Polyp *Adenomyomatosis *Ascites * Adhered gallstone

Ascites

Which of the following is the most likely clinical finding of adenomyomatosis

Asymptomatic

Normal flow within the hepatic artery should demonstrate a

B. Low-resistance wave form pattern, with a quick upstroke, and gradual deceleration with diastole

The portion of the liver which is not covered by peritoneum is called

Bare Area

The TIPS shunt is placed

Between the portal vein and hepatic vein

Fatty infiltration of the liver is associated with all of the following except: * Diabetes Mellitus * Alcohol Abuse *Obesity *Biliary Obstruction

Biliary Obstruction

The subcapsular hematoma of the liver has the following sonographic characteristics except: * Anechoic mass * Echogenic Mass * Well defined boarder * Bright Echogenic foci

Bright Echogenic foci

What form of hepatic abnormality are immunocompromised patients more prone to develop?

Candidiasis

What hormone causes the GB to contract

Cholecystokinin

Which of the following would be the least likely finding of acalculous cholecystitis *GB wall thickening *Pericholecystic fluid *Cholelithiasis *Positive Murphy sign

Cholelithiasis

The diffuse polypoid appearance of the GB referred to as strawberry gallbladder

Cholesterolosis

Intermittent obstruction of the cystic duct by a gallstone results in

Chronic Cholecystitis

A 71 yr old patient present the the ER with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for:

Courvoisier Gallbladder

The GB is connected to the biliary tree by the

Cystic duct

A sheep herder is at most risk for what liver disease

Echinococcal Cyst

Clinical findings of fatty infiltration of the liver include

Elevated LFT

Diabetic patients suffering form acute cholecystitis have an increased risk for developing

Emphysematous Cholecystitis

The champagne sign is associated with

Emphysematous Cholecystitis

The sequela of acute cholecystitis that is complicated by gas within the GB wall is

Emphysematous Cholecystitis

Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of

Fatty liver disease

Which of the following is not a symptom of metastatic disease of the liver: * Jaundice * Ascites * Fever * Hepatomegaly

Fever

Hepatization of the gallbladder occurs when the gallbladder:

Fills with sludge

Which of the following benign liver masses is typically isoechoic and contains a central scar * Hepatoblastoma * Cavernous Hemangioma *Hamartoma *Focal Nodular Hyperplasia

Focal Nodular Hyperplasia

A 30 yr old women has an abdominal sonogram that demonstrates gallstones and a hypoechoic area in the liver. The patient discontinues her oral contraceptive and has a repeat sonogram in 6 months. the Hypoechoic area in the liver has decreased in size - the hypoechoic area probably represents:

Focal nodular hyperplasia

All of the following are sources of diffuse GB wall thickening except: * Acute Cholecystitis *AIDS * Hepatitis * GB Polyp

GB Polyp

A nonmobile, nonshadowing focus is seen within the gallbladder lumen. This most likely represents:

GB polyp

Empyema of the GB denotes:

Gallbladder is filled with pus

Acute Cholecystitis that leads to necrosis and abscess development within the GB wall describes:

Gangrenous cholechytitis

Tumefactive sludge can resemble the sonographic appearance of:

Gb Carcinoma

The covering of the liver is referred to as

Glisson capsule

Which of the following is considered the most common benign childhood hepatic mass * Hepatoblastoma *Hepatoma *Hematoma *Hemangioendothelioma

Hemangioendothelioma

A highly vascular benign tumor of the liver is

Hemangioma

Cystic structure in the liver includes all of the following except: * Hepatic artery aneurysm * Biloma *Caroli's Disease *Hemangioma

Hemangioma

Most common benign tumor of the liver

Hemangioma

A 22 year old man present to the ER with a knife wound to the RUQ. A sonogram reveals fluid around the liver and down the right flank. Finding are compatible with

Hemoperitoneum with rupture of the liver capsule

Which of the following is the most common reason for a liver transplant * Hepatocellular Carcinoma * Hep. C * Hep. B *Hepatic Mets

Hep. C

Which hepatic mass is closely associated with oral contraceptive use?

Hepatic Adenoma

All of the following are sequela of cirrhosis except *Portal Vein thrombosis *Hepatic Artery Contraction *Portal Hypertension *Splenomegaly

Hepatic Artery Contraction

Budd-Chiari syndrome leads to a reduction in the size of the

Hepatic Veins

Causes of liver abscesses include all the following except: * Diverticulitis *Cholecystitis * Ascending cholangitis *Hepatitis

Hepatitis

A 2 year old present with abdominal pain and hepatomegaly. A sonogram of the liver may detect a

Hepatoblastoma

The childhood syndrome Bechwith-Weidemann is associated with an increased risk for developing

Hepatoblastoma

Normal flow toward the liver in the portal veins is termed:

Hepatopetal

Which of the following is associated with E. Granulosus

Hydatid Liver Cyst

Which of the following masses would be most worrisome for malignancy? * Echogenic mass * Cystic mass with posterior enhancement * Isoechoic mass with central scar * Hyperechoic mass with hypoechoic ring

Hyperechoic mass with hypoechoic ring

The caudate lobe drains its venous blood into the

IVC

Right-Sided heart failure offend leads to the enlargement of the

IVC and Hepatic Veins

Sonographic characteristics of hepatis include

Increased echogenicity of the portal triad

Shortly after birth, the ductus venosus collapses and becomes the

Ligamentum Venosum

The remnant of the fetal ductus venosus which separates the caudate lobe from the left lobe is the

Ligamentum Venosum

Hyperechoic areas of the liver can include all the following except: *Hemangioma *ligamentum teres *Metastatic disease *lymphoma

Lymphoma

Which of the following are not used to divided the medial and lateral segments of the left lobe of the liver *Main lobar fissure *Left hepatic vein *Ligamentum teres *Ascending portion of Left Portal Vein

Main Lobar Fissure

Which structure is a useful landmark for identifying the Gb

Main Lobar Fissure

Which vessel supplies 70-80% of the blood to the liver

Main Portal Vein

The ligamentum teres can be used to separate the

Medial and Lateral segments of the left lobe

Which of the following is the most common form of liver cancer * HCC * Adenocarcinoma *Metastatic Liver Disease *Hepatoblastoma

Metastatic Liver Disease

ALl of the following are located within the porta hepatis except: *Main Portal Vein *Common Bile duct *Hepatic Artery *Middle Hepatic Vein

Middle Hepatic Vein

The left lobe of the liver can be separated from the right lobe by the

Middle Hepatic Vein

Focal tenderness over the gallbladder with probe pressure describes:

Murphy Sign

The inner most layer of the gallbladder wall is the

Muscosal Layer

At which level of the Gb is the junctional fold found

Neck

Which part of the GB is involved in Hartmann pouch

Neck

The inferior extension of the caudate lobe is referred to as

Papillary Process

Clinical findings of hepatitis include all of the following except: *Jaundice *Fever *Chills *Pericholecystic Fluid

Pericholecystic Fluid

The most common variant of the GB shape is the

Phrygian Cap

Which of the following is not a risk factor for the development of gallstones *Phrygian cap *Pregnancy *Total parenteral nutrition *Oral contraceptive use

Phrygian cap

Which of the following is true about the portal veins *portal veins carry deoxygenated blood away from the liver *Portal veins have brighter walls than the hepatic veins *Portal veins should demonstrate hepatofugal flow *Portal veins increase in diameter as they approach the diaphragm

Portal veins have brighter walls than the hepatic veins

Which of the following lab values is associated with bleeding dysfunction * Prothrombin Time * Alk Phos *AST *Indirect Bilirubin

Prothrombin Time

Which of the following statements concerning primary malignant liver masses is TRUE * Rare in USA *More common in USA * Prone to invade the hepatic Artery *Tend to invade the IVC

Rare in USA

All of the following are clinical findings of HCC except: * Reduction of AFP * Unexplained weight loss * Fever *Cirrhosis

Reduction of AFP

A tonguelike extension of the right lobe of the liver is termed:

Riedel Lobe

Cystic artery is most often a direct branch of the

Right Hepatic Artery

The right intersegmental fissure contains the

Right Hepatic Vein

The right lobe of the liver is divided into segments by the

Right Hepatic Vein

A 29 year old female on oral contraceptive represents with RUQ pain. A sonogram of the liver may detect a

Ruptured Liver Adenoma

The outermost layer of the GB wall is

Serosal Layer

Which of the following is associated with cholelithiasis and is characteristically found in Africans or people of African descent

Sickle Cell Disease

Normal flow within the hepatic veins is said to be

Triphasic

Patients with liver cell disease may be unresponsive to vitamin...

Vitamin K

WES sign denotes

a gb filled with cholelithiasis

The most common cause of cirrhosis is

alcoholism

The right portal vein divides into

anterior and posterior branches

The right lobe of the liver can be divided into

anterior and posterior segments

The Direct blood supply to the GB is the

cystic artery

The middle layer of the gb wall is the

fibromucosal layer

What is/are cholelithiasis?

gallstones

The main portal vein divides into

left and right portal veins

The left umbilical vein after birth becomes the

ligamentum teres

The left portal vein divides into:

medial and lateral branches

The left lobe of the liver can be divided into

medial and lateral segments

Which statement is not true of cholelithiasis *men have an increased likelihood of developing cholelithiasis *Patients who have been or are pregnancy have an increased occurrence of cholelithiasis *A rapid weight loss may increase the likelihood of developing cholelithiasis *Patients who have hemolytic disorders have an increased occurrence of cholelithiasis

men have an increased likelihood of developing cholelithiasis

The main lobar fissure contains the

middle hepatic vein