Chapters 4-6

Fora patient older than the age of 60, or who have had a cholecystectomy, a maximum diameter of ____ may be considered normal

10 mm/1 cm

The biliary duct wall should never measure more than

5 mm

Epstein-Barr infection is best described as

A herpes virus that can lead to infectious mononucleosis in children

A 25-year-old female patient presents to the ultrasound appointment for a complete abdominal sonogram. She complains of right lower quadrant pain and nausea. The right upper quadrant appears normal. A small mass is located in the area of the splenic hilum. This mass appears isoechoic to the spleen. What is most likely to represent

Accessory spleen

Which cells carry out the exocrine function of the pancreas

Acinar cells

All of the following are forms of cholangitis

Acute bacterial, AIDS, oriental

The most common form of malignancy in the pancreas is

Adenocarcinoma

Courvoisier gallbladder is found in the presence of

Adenocarcinoma in the head of the pancreas

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

Ampulla of Vater

A rare malignant tumor of the spleen consisting of blood vessels is a

Angiosarcoma

The Klatskin tumor is located

At the junction of the right and left to hepatic ducts

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

Biliary atresia

The yellow pigment found in bile that is produced by the breakdown of old red blood cells by the liver is

Bilirubin

Mucinous cystadenocarcinomas of the pancreas are most often located in which part of the pancreas

Body and tail

The splenic artery originates at the

Celiac trunk

A 64-year-old man presents to the sonography department for right upper quadrant sonogram. He's complaining of abdominal pain, weight loss, and puritis. Sonographically, you visualize an area of dilated ducts it abruptly end. What is most likely the diagnosis

Cholangiocarcinoma

A klatskin tumor is a form of

Cholangiocarcinoma

Primary biliary tree cancer is referred to as

Cholangiocarcinoma

A 32-year-old female patient presents to the sonography department with a history of fever, leukocytosis, and right upper quadrant pain. Sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. What is the most likely diagnosis

Cholangitis

Inflammation of the bile ducts is referred to as

Cholangitis

An abdominal sonogram is ordered on an infant in the intensive care unit who is suffering from jaundice and fever. Sonographically, you visualize a cystic mass with in the common bile duct that is causing a focal enlargement. This is most suggestive of

Choledochal cyst

What kind of biliary cyst is common within children

Choledochal cyst

A gallstone located within the biliary tree is referred to as

Choledochalithiasis

Which of the following would be the most distal portion of the biliary tree

Common bile duct

If an obstructive biliary calculus located with in the distal common duct, which of the following could be ultimately dilated

Common bile duct, gallbladder, common hepatic duct

The spleen removes irregular cells from the bloodstream and retains them through a process called

Culling

The spiral valves of Heister are located within the

Cystic duct

All of the following are sonographic features of chronic pancreatitis

Dilated pancreatic duct, calcifications with in the pancreas, pancreatic pseudocyst

The most common level for biliary obstruction to occur is the

Distal common bile duct

Coexisting obstruction of the common bile duct and pancreatic duct maybe referred to as

Double duct sign

What is the name for the main pancreatic duct

Duct of Wirsung

What is a additional name for the accessory duct of the pancreas

Duct of santorini

What is the most common sonographic appearance of a splenichemangioma

Echogenic/hyperechoic

Clinical findings associated with pancreatic adenocarcinoma

Epigastric pain, weight loss, jaundice

The process of making red blood cells is termed

Erythropoiesis

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

Extrahepatic

What is associated with the development of pneumobilia

Gastric surgery, acute cholecystitis, fistula formation

The arterial blood supply to the head of the pancreas is via the

Gastroduodenal artery

Which part of the pancreas is located right lateral to the superior mesenteric vein, anterior to inferior vena cava, and inferior to the portal vein

Head

Most common location of adenocarcinoma of the pancreas is within the

Head of the pancreas

The most common location of focal pancreatitis

Head of the pancreas

A 32-year-old female patient presents to the ultrasound apartment for an abdominal sonogram an evaluation of the spleen reveals a 1 cm, rounded, echogenic mass that does not produce acoustic shadowing. What is most likely the diagnosis

Hemangioma

You will see a decreased ____ in a patient who has a splenichemangioma

Hematocrit

In a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates

Hodgkin lymphoma

A complex cyst that results from the parasitic infection of the spleen by tape worm

Hydatid cyst

The most common echogenicity of an acutely inflamed pancreas is

Hypoechoic

Which of the following is the hormone released by the pancreas that encourages the bodies use of glucagon

Insulin

Which of the following is the most common islet cell tumor

Insulinoma

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

Intrahepatic ducts

Which of the following is considered to be the most proximal portion of the biliary tree

Intrahepatic radicals

Is the spleen and intraperitoneal or retroperitoneal organ

Intraperitoneal

The yellow staining of the whites of your eyes in the skin secondary to a liver disorder or biliary obstruction is referred to as

Jaundice

Clinical findings with choledochalithiasis include

Jaundice, elevated bilirubin, elevated alkaline phosphatase

The spleen is the _____ structure of the _____ system

Largest, reticuloendothelial

One of the most common locations for pancreatic pseudocyst is within the

Lesser sac

Classic clinical features of acute pancreatitis

Leukocytosis, back pain, fever

Which laboratory value listed below appears to be more specific for acute pancreatitis

Lipase

One clinical sign of an insulinoma is the presence of

Low blood sugar

This spleen is considered the largest _____ organ

Lymphatic

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

Mirizzi syndrome

Small echogenic foci scattered throughout the spleen most likely represents

Multiple benign granulomas

A 35-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen

Multiple granulomas

What is the early sonographic appearance of acute pancreatitis

Normal

Courvoisier gallbladder is

Palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head

Which part of the pancreas is located anterior to the portal confluence

Pancreatic neck

The primary objective of the spleen is to filter the _____ blood

Peripheral

Air within the biliary tree

Pneumobilia

Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma the produce ring down artifact. What is most likely the diagnosis

Pneumobilia

The most common cause of splenomegaly is

Portal hypertension

The splenic vein marks the

Posterior aspect of the pancreatic body and tail

All of the following are part of the exocrine function of the pancreas

Production of lipase, Amylase, and sodium bicarbonate

Clinical findings consistent with cholangiocarcinoma

Puritis, weight loss, elevated bilirubin

The type of tissue with the spleen that is responsible for phagocytic function is the

Red pulp

Is the pancreas and intraperitoneal or retroperitoneal organ

Retroperitoneal

What systemic disease results in the development of granulomas with in the spleen and throughout the body

Sarcoidosis

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

Sphincter of Oddi

A 14-year-old male patient presents to the ultrasound apartment after falling from his bicycle. And I'm normal sonogram reveals a complex of hearing mass with in the spleen. This most likely represents a

Splenic hematoma

Where is the most common location of an accessory spleen

Splenic hilum

A 48-year-old male patient with a history of severe, sudden onset of left upper quadrant pain without trauma presents to the ultrasound department for sonogram of the spleen. You visualize a wedge shaped, hypoechoic area within the spleen. This most likely represents a

Splenic infarct

An area within the spleen that has become a necrotic because of lack of oxygen is referred to as

Splenic infarct

Diffuse involvement of lymphoma or leukemia of the spleen more often lead to

Splenomegaly

Sickle cell disease will often lead to

Splenomegaly

The functions of the spleen

Storage of iron, defense against disease, blood reservoir

The splenic artery marks the

Superior aspect of the pancreatic body and tail

The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein

Superior mesenteric vein

The gallbladder is connected to the biliary tree by

The cystic duct

The portion of the bowel that encompasses the head of the pancreas is

The duodenum

The pancreatic tail is outline posteriorly by what vascular structure

The splenic vein

Things associated with splenomegaly

Trauma, hemolytic abnormalities, mononucleosis

Which of the following is associated with the development of cysts with in the pancreas

Von Hippel-Lindau disease

The type of tissue within the spleen that is responsible for its lymphatic function is the

White pulp

A gastrinoma of the pancreas can produce

Zollinger-Ellison syndrome