chapter 4 bile ducts

For patients older than 60 or those who have a cholecystectomy, a max diameter of ... is considered normal

1cm

the biliary duct wall should never measure more than

2mm

which of the following disorders is associated with the sonographic triangular cord sign? -cholangitis -choledocholithiasis -biliary atresia -ascariasis

biliary atresia

the most common level for biliary obstruction to occur is the

distal CBD

a patient presents with jaundice, pain, and fever secondary to an impacted stone in the cystic duct. this is referred to as?

mirizzi syndrome

all of the following are forms of cholangitis except -acute bacterial -AIDS -oriental -parabolic

parabolic

air within the biliary tree is referred to as

pneumobilia

sonographically, you visualize scattered echogenic linear structure within the liver parenchyma that produce ring-down artifact. what is the most likely DX?

pneumobilia

pneumobilia will produce?

ring-down artifact

which of the following is characterized by fibrotic thickening of the bile ducts, found most often in young males, and is associated with inflammatory bowel disease or ulcerative colitis? -ulcerative biliary atresia -oriental cholangitis -sclerosing cholangitis -AIDS biliary atresia

sclerosing cholangitis

the klatskin tumor is located

at the junction of the right and left hepatic ducts

the yellowish pigment found in bile that is produced by the breakdown of old RBC by the liver is

bilirubin

a gallstone located within the biliary tree is referred to as

choledocholithiasis

which of the following would be the most common cause of obstructive jaundice? -klatskin tumor -cholangiocarcinoma -biliary atresia -choledocholithiasis

choledocholithiasis

what is the most distal portion of the biliary tree?

common bile duct

the spiral valves of heister are located within the

cystic duct

Which segment of the biliary tree tends to dilate first with obstruction

extrahepatic

what considered to be the most proximal portion of the biliary tree?

intrahepatic radicles

the muscle that controls the emptying of the bile and pancreatic juices into the duodenum is the

sphincter of oddi

Ascariasis is caused by

a parasitic roundwarm

If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate? -CBD -GB -Common hepatic duct -All the above

all the above

the merging point of the pancreatic duct and common bile duct at the level of duodenum is referred to as the

ampulla of Vater

a congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as

biliary atresia

the presence of an echogenic dot in the nondependent part of a dilated duct representing small fibrovascular bundles is seen with

caroli disease

a 64 year old man presents to the sono department for a RUQ sonogram. he is complaining of abdominal pain, weight loss, and pruritus. sonographically, you visualize an area of dilated ducts that abruptly end. what is the most likely DX?

cholangiocarcinoma

a klatskin tumor is a form of

cholangiocarcinoma

primary biliary tree cancer is referred to as

cholangiocarcinoma

which of the following is not associated with the development of pneumobilia? -cholangiopneumonia -gastric surgery -acute cholecystitis -fistula formation

cholangiopneumonia

a 32 year old female patient presents to the sono department with a hx of fever, leukocytosis, and RUQ pain. sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. what is the most likely dx?

cholangitis

inflammation of the bile ducts is referred to as

cholangitis

which of the following is associated with charcot triad? -cholangitis -cholesterolosis -Klatskin tumor -choledochal cyst

cholangitis

An abdominal sonogram is ordered on an infant in the intensive care unit who is suffering from jaundice and fever. You see a cystic mass within the cbd that is causing a focal enlargement. This is most suggestive of

choledochal cyst

which of the following is not a plausible cause of CBD obstruction in adults? -choledocholithiasis -chronic pancreatitis -choledochal cyst -pancreatic carcinoma

choledochal cyst

which of the following is typically found in pediatric patients and is described as the cystic dilation of the CBD? -biliary atresia -mirizzi syndrome -caroli disease -choledochal cyst

choledochal cyst

which of the following would be the least helpful laboratory value to analyze in patients with suspected biliary tract disease? -ALT -ALP -GGT -creatinine

creatinine

all of the following are clinical findings consistent with cholangiocarcinoma except: -pruritus -weight loss -elevated bilirubin -dilation of the intrahepatic ducts

dilation of the intrahepatic ducts

clinical findings of choledocholithiasis include all of the following except: -jaundice -elevated bilirubin -elevated ALP -elevated blood urea nitrogen

elevated blood urea nitrogen

which of the following could accidentally introduce bacteria into the biliary tree and thus cause cholangitis? -CT -MRI -radiography -endoscopic retrograde cholangiopancreatography

endoscopic retrograde cholangiopancreatography

If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated?

intrahepatic ducts

the yellowish staining of the whites of the eyes and then skin secondary to a liver disorder or biliary obstruction is referred to as

jaundice