Chapter 10 The Gastrointestinal tract and abdominal wall

An adult patient presents to the sonography department with left lower quadrant pain, fever and bouts constipation and diarrhea. Which of the following would be the most likely etiology? A. Diverticulitus B. Intussusception C. Midgut malrotation D. Appedicitis

A. Diverticulitus

The situation when bowel protrudes into the groin is referred to as an? A. Inguinal hernia B. Linea alba hernia C. Unbillical hernia D. Spigelian hernia

A. Inguinal hernia

Which of the following types of obstruction refers to the bowel being physically blocked by something? A. Mechanical B. Nonmechanical C. Obsterperous D. Bezoarine

A. Mechanical

All of the following are true of normal intestinal findings with sonography except? A. Normal bowel does not compress B. Normal bowel should have observable peristalsis C. Intestinal wall should measure less than 5 mm D. Normal bowel has little to no color doppler signals

A. Normal bowel does not compress

Which of the following is not a layer of gut identified with sonography? A. Visceral B. Serosa C. Submucosa D. Mucosa

A. Visceral

Gastric cancer is most often in the form of? A. Cystadenocarcinoma B. Adenocarcinoma C. Rhabdomyocarcinoma D. Angiosarcoma

B. Adenocarcinoma

Which of the following would be most likely a cause of colitis? A. Gastroesophageal reflux disease B. Antibiotic therapy C. Dehydration D. Rectus sheath hematoma

B. Antibiotic therapy

Upon sonographic evaluation of the right lower quadrant in a patient complaining of focal abdominal pain in that area, you visualize a hyperemic blind ended tubular structure that contains shadowing focus, what is the most likely etiology of the shadowing focus? A. Ureteral stone B. Appendicolith C. Gallstone D. Herniated omentum

B. Appendicolith

All of the following are sonographic findings of acute appendicitis except? A. Appendicolith B. Compressible blind ended tube C. Periappendieal fluid collection D. Hyperemic flow

B. Compressible blind ended tube

All of the following are common clinical findings in infants who present with intussusception except? A. Vomiting B. First born male infant C. Red currant jelly stools D. Leukocytosis

B. First born male infant

Which of the following best describes the location of McBurney point? A. Left lateral B. Halfway between the anterior superior iliac spine and the umbilicus C. Midway between the umbilicus and the symphysis pubis D. Medial to the superior iliac spine

B. Halfway between the anterior superior iliac spine and the umbilicus

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

B. McBurney point

Which of the following is not associated with a rectus sheath hematoma? A. Palpable abdominal mass B. increased hematocrit C. Child birth D. Sneezing

B. increased hematocrit

The olive sign is best described as? A. the palpation of the inflamed appendix with rebound tenderness B. An area of pain halfway between the anterior superior iliac spine and the umbilicus C. An enlarged palpable pyloric sphincter D. The sonographic appearance of pyloric stenosis

C. An enlarged palpable pyloric sphincter

A patient presents to the sonography department with a painful superficial abdominal mass located within a prior cesarean scar. What clinical feature would be most consistent with scar endometriosis? A. Hematuria B. Chronic headaches C. Clinical pain D. Bloody diarrhea

C. Clinical pain

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

C. Constipation

Which of the following is the development of small outpouchings within the sigmoid colon? A. Diverticulitis B. Crohn disease C. Diverticulosis D. Midgut malrotation

C. Diverticulosis

What anatomic structure may be noted as a bulls eye structure anterior to the abdominal aorta and posterior to the left lobe of the liver in the sagittal scan plane? A. Pyloric sphincter B. Duodenal antrum C. Gastroesophageal junction D. Distal jejunum

C. Gastroesophageal junction

Pediatric patients could suffer from bowel obstructions that are caused by a buildup of ingested hair. The mass associated with this type of obstruction is termed a? A. Phytobezoar B. Lactobezoar C. Trichobezoar D. Permabezoar

C. Trichobezoar

Which of the following would be the most likely clinical feature of colitis? A. Inguinal herniation of the bowel B. Right shoulder pain C. Watery diarrhea D. Midline hematoma

C. Watery diarrhea

What are the diagnostic criteria for pyloric stenosis? A. 17mm in thickness and 2 mm in length B. 17mm in thickness and 3 mm in length C. 3 mm in thickness and 10 mm in length D. 3 mm in thickness and 17 mm in length

D. 3 mm in thickness and 17 mm in length

Pseudomyxoma peritonei can result from? A. Intussusception B.Pyloric stenosis C. Chrohn disease D. Appendix cancer

D. Appendix cancer

All of the following are common clinical findings in infants who present with pyloric stenosis except? A. Weight loss B. Dehydration C. Olive sign D. First born female

D. First born female

Other abnormalities that can present much like pyloric stenosis include all of the following except? A. Midgut malrotation B. Pylorospasm C. Gastroesophageal reflux disease D. Intussusception

D. Intussusception

A patient presents to the sonography department with bilious vomiting. While investigating the pediatric patient for pyloric stenosis, you note that while the pyloric sphincter appears normal, the SMA is abnormally located to the right of the SMV. What is the most likely diagnosis? A. Pylorospasm B. Intussusception C. Crohn disease D. Midgut herniation

D. Midgut herniation

The situation when bowel protrudes into a weakened area in the lower one fourth of the rectus muscle is referred to as an? A. Inguinal hernia B. Linea alba hernia C. Umbilical hernia D. Spigelian hernia

D. Spigelian hernia

Traditionally treatment for intussusception is by means of? A. Surgery B. External manipulation C. Compression sonography D. Therapeutic enema

D. Therapeutic enema

Which of the following would be useful to employ during a sonographic evaluation of a suspected abdominal wall hernia? A. Upright positioning B. Prone positioning C. Graded compression D. Valsalva

D. Valsalva

The sonographic finding of fluid filled distended loops of bowel is consistent with? A. Meckel diverticulum B. Diverticulitis C. Gastroesophageal reflux disease D. intestinal obstruction

D. intestinal obstruction

Rebound tenderness is associated with? A. Appendicitis B. Intussusception C. Diverticulitis D. Gastric carcinoma

A. Appendicitis

All of the following are sonographic criteria in the diagnosis of pyloric stenosis except? A. Wall of the pylorus is focally thinned B. Length of the pylorus measures more than 17mm C. Doughnut appearance in transverse D. Cervix appearance in longitudinal

A. Wall of the pylorus is focally thinned

The most common cause of intestinal obstruction in children less than 2 years of age is? A. intussusception B. Midgut malrotation C. Pyloric stenosis D. Acute appedicitis

A. intussusception

What abnormality associates red currant jelly stools? A. Diverticulitis B. Appendicitis C. Intussusception D. Pyloric stenosis

C. Intussusception

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

A. Crohn disease

Clinical findings of a patient with Crohn disease include all of the following except? A. Palpable abdominal mass B. Rectal bleeding C. Abdominal pain D. Weight loss

A. Palpable abdominal mass

In what position is the infant often placed for better sonographic visualization of the pyloric sphincter? A. Right lateral decubitus B. Left lateral decubitus C. Prone D. Upright

A. Right lateral decubitus

HPS is most often found in infants between? A. 1 and 10 days of age B. 2 and 6 weeks of age C. 10 and 24 weeks of age D. 2 and 4 years of age

B. 2 and 6 weeks of age

The most common location of the vermiform appendix is in the are of the? A. Jejunum B. Descending colon C. Cecum D. Sigmoid colon

C. Cecum

Which o the following is not a sonographic finding consistent with crohn disease? A. Bowel wall thickening B. Non compressible bowel that has a target appearance C. Increased peristalsis D. Hyperemic wall

C. Increased peristalsis

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

C. Intussusception