Superficial Structures Final

Posterior to bladder

Location of seminal vesicles?

Orchitis

A 27 year old male presents with scrotal pain. He has a history of chlamydia and epididymitis. Currently he has an elevated white blood cell count. His ultrasound showed bilateral hypoechoic testicles with hyperemic flow. What is the most likely diagnosis?

Subacute granulomatous thyroiditis

A 32 year old female presents for a thyroid ultrasound. She has a history of PCOS and thyrotoxicosis. Today her lab values show an elevation in TSH levels. The ultrasound shows a diffusely enlarged hypoechoic thyroid that is hypovascular. What is the best diagnosis.

Embryonal carcinoma

A 32 year old male presents with increased hCG and a hypoechoic mass with irregular borders. The radiologist says this patient has a poor prognosis. What would this be characteristic of?

Prostatic abscess

A 35 year old female is in for a transrectal ultrasound, his lab values show increased WBC count. The ultrasound demonstrates a cystic area within the central zone that contains low level echoes. What's the best diagnosis?

5 mm

Parathyroid glands greater than what size should be considered abnormal?

Pyramidal lobe

Extra lobe of the thyroid gland?

Calculi

Foul smelling urine is a secondary result from which bladder pathology?

Secretion is testosterone

Function of scrotal contents:

4

How many parathyroid glands are there?

Maintain proper and steady level of serum calcium in the blood

What are the functions of the parathyroid?

Gonadal arteries

What arteries supply the blood to the penis?

Phimosis

What can be corrected by getting a circumcision?

transurethral resection of the prostate (TURP) and it's used to treat BPH

What does TURP stand for & what is it used to treat?

Fluid collection between the layers of the tunica vaginalis

What is a hydrocele?

The shape, intraluminal echoes, capacity, and wall thickness are all areas of interest to the sonographer when imaging a urinary bladder.

What is a true statement regarding the bladder protocol?

Graves disease

What is associated with exophthalmos?

Chronic cystitis

What is associated with the formation of a Brunn's nest?

Opening of the male urethra on the ventral side of the penis

What is hypospadia?

UTI

What is most associated with retrograde filling of the bladder?

Prostate is inferior to urinary bladder

What is the anatomical relationship between the prostate and the urinary bladder?

B. areola

What is the area around the nipple with different pigmentation? A. ampulla B. areola C. mammary layer d. secondary fascia

acute prostatitis

What is the least likely cause of chronic cystitis?

Prostate specific antigen velocity

What is the method that evaluates the prostate by calculating the change in PSA over time?

Anaplastic carcinoma

What is the most aggressive of the thyroid neoplasms?

Fibroadenoma

What is the most common benign tumor of the breast in females between ages 25-40 years old?

Goiter

What is the most common cause of diffuse hyperplasia of the thyroid?

Prostate enlargement

What is the most common cause of elevated psa levels?

Iodine deficiency

What is the most common cause of thyroid disorders world wide?

Palpable lump

What is the most common clinical sign of breast carcinoma?

D. polythemia

What is the most common congenital anomaly of the breast? A. athelia B. amazia C. amastia D. polythelia E. polymastia

invasive ductal carcinoma

What is the most common form of breast cancer?

Trigone

What is the most common location for a papilloma?

Transitional cell carcinoma

What is the most common malignant neoplasm of the bladder?

Painless hematuria

What is the most common symptom of transitional cell carcinoma?

Hutch's diverticula

What is the name of a common type of diverticula in the bladder where the ureter is inserted into a weak area of the bladder?

A. small, oviod structure with a hypoechoic rim and echogenic hilum

What is the normal appearance of a lymph node in the breast? A. small, oviod structure with a hypoechoic rim and echogenic hilum B. small, rounded nodule with homogeneous hypoechoic echotexture C. small nodule with microlobulations and heterogeneous echotexture D. large, round structure with a hyperechoic rim and hypoechoic hilum E. small ellipsoid nodule frequently containing cystic areas and microcalcifications

D. biopsy

What is the only reliable method for determining whether or not a breast mass is malignant? A. MRI B. mammography C. sonography D. biopsy E. radioisotope imaging

Peyroines disease

What is the painful curvature of the penis during erection?

Tail of Spence

What is the portion of mammary tissue that extends laterally into the region of the axilla?

Thyroxine

What is the primary hormone secreted by the thyroid?

C. TDLU's are found typically in the subcutaneous layer

Which of the following regarding terminal ductolobar units is incorrect? a. Most benign breast diseases arise here b. Most malignant breast disease originate here c. TDLUs are found typically in the subcutaneous layer d. TDLUs are the functional unit of the breast

Emphysematous cystits

Which of the following types of cystitis are usually associated with E. coli?

Simple ureterocele

Which pathology would present with a cyst within a cyst appearance?

Benign prostatic hypertrophy

Which prostate problem is found mostly in the transitional zone of the prostate?

Apex

Which section of the prostate is closest to the penis?

Posterior urethral valve syndrome

Which syndrome is characterized sonographically as a "keyhole" appearance?

Urachal sinus

Which urachal abnormality can be described as the urachus being closed at the bladder but remains patent at the umbilicus?

Pampiniform plexus

Which vein drains the testes and becomes the spermatic veins superiorly?

B. axillary tail

What is the projection of breast tissue that extends from the upper outer quadrant into the axilla called? A. papillary projection B. axillary tail C. ectopic gland D. Montgomery's gland E. cystosarcoma phylloides

Junction of the ejaculatory ducts with the urethra

What is the verumontanum?

Urogenital diaphragm

What muscular structure divides the prostate from the penile structure?

Corpus spongiosum

What portion of the penis occupies the ventral aspect?

B. estrogen

What stimulates breast tissue development? A. FSH B. estrogen C. hCG D. oxytocin E. prolactin

Esophagus

What structure can be demonstrated posterior and slightly left to the trachea?

Endocrine

What type of gland is the thyroid gland?

Space of Retzius

What would you find anterior to the bladder in a male patient?

5th-6th week of embryonic life

When do the salivary glands arise?

Convuluted seminferous tubules

Where does spermatogenesis occur?

E. upper outer quadrant

Where is a mass annotated as 1:00 in the left breast located? A. area posterior to the nipple B. upper inner quadrant C. lower outer quadrant D. lower inner quadrant E. upper outer quadrant

In the retromandibular fossa

Where is the parotid gland located?

A. coopers ligamnets

Which are the suspensory ligaments of the breast? a. Cooper's ligaments b. Cowper's ligaments c. Brewster's ligaments d. lactostromal ligaments e. retromammary ligaments

Spermatocele

Which cannot be caused by trauma to the testicles?

Pain similar to prostatitis

Which does not describe prostatodynia?

MRI can look for tumor enhancement in regions of DCIS that are often associated with suspicious calcifications on mammogram

Which is best associated with MRI of the breast?

C. Short menstrual cycles

Which is not a risk factor for breast malignancy? A. Increasing age B. Early menarche C. Short menstrual cycles D. High socioeconomic status E. 1st pregnancy after age 35

Testosterone levels

Which is not a screening tool for prostatic cancer?

Hematuria

Which is not a symptom of benign prostatic hypertrophy?

A. Decreased serum calcium

Which is not associated with hyperparathyroidism? A. Decreased serum calcium B. Renal stones C. Hypophosphatasia D. Parathyroid hyperplasia

C. a 13 mhz linear transducer with a 1 cm standoff pad

Which is the best way to visualize a breast nodule that is near the surface of the skin? A. A 3.5 MHz unfocused sector transducer B. A 5 MHz linear transducer with a deep focus C. A 13 MHz linear transducer with a 1 cm standoff pad D. A 7.5 MHz linear transducer with a 3-inch standoff pad

Hematuria

Which is the most common symptom of transitional cell carcinoma?

Detrusor areflexia

Which is the most likely cause of an acquired bladder diverticulum?

As clinical symptoms that include urinary frequency and urgency

Which is true of prostatitis?

Benign

Which is usually true regarding calcifications of the prostate?

Epididymis and testicles

Which of the following are structures within the scrotum?

B. homogenously dense tissue

Which of the following breast tissue types has the highest chance of masking malignancy? a. Fatty tissue b. Homogenously dense tissue c. Scattered fibroglandular tissue d. Heterogeneously dense tissue

Sublingual

Which of the following glands is located between the muscles of the oral cavity floor?

B. Number of masses

Which of the following is not a factor when staging malignancy? A. Tumor size B. Number of masses C. Presence of matastasis D. Lymph node involvement

A. A simple cyst will appear as a "bulls eyes" pattern

Regarding elastography in conjunction with B-mode ultrasound, which of the following are correct? A. A simple cyst will appear as a "bulls eye" pattern B. Invasive cancer is usually less stiff C. Benign lesions are usually more stiff D. A stiff rim is a feature of benign lesions

Arterial sinusoidal fistula

A 46 year old male who has just spent the weekend mountain biking with his friends has just presented to the ER for a penile ultrasound. He has complaints of painful erection lasting more than 6 hours, on ultrasound you notice a hypoechoic area extending into the cavernousal tissue & has a high velocity flow on Doppler analysis. What is the best choice for what is noted in your ultrasound findings?

Tuberculosis

A 47-year-old male arrives with the complaint of painful swelling of the scrotum. On the scan, you see that the epididymis is bilaterally enlarged as well as a slight enlargement in both testis. Based on lab results in conjunction with the scan, the doctors are leaning towards a diagnosis of granulomatous disease of the testes and epididymis. What infection causes granulomatous disease?

Direct hernia

A 50-year-old patient presents for a scrotal ultrasound due to lower abdominal pain & scrotal swelling. Sonographically you see an extra testicular, echogenic mass but you notice peristalsis within. What is the likely diagnosis?

Benign prostatic hyperplasia

A 56-year-old man presents for Sonographic examination of his prostate. He reports that he has been having issues urinating, including straining, retention, and nocturia. His prior ultrasounds reveal a history of hydronephrosis and his penile ultrasound came back normal. Upon completing his exam, you note an enlarged prostate, as well as a smooth mass located on the posterior bladder base. What is the most likely diagnosis?

Prostatic abscess

A diabetic male patient presents with urinary urgency, hematuria, lower back pain, and chills. The sonographic evaluation of the bladder scan was difficult to tell if anything was definitely wrong with the prostate, however the bladder looked normal. This led the doctors to order a prostate ultrasound which showed complex areas throughout the gland with hyperemia. What is the diagnosis for this patient?

Mastitis

A female patient presents with a fever and complaining of a tender, red, swollen breast. The most likely clinical diagnosis is?

D. secondary tubules

A function of the alveoli of the breast is to secrete milk into the ___ of each lobule which converge to form a lactiferous duct. A. lobular pit B. ampulla ducts C. mammary ducts D. secondary tubules E. Montgomery gland

Parathyroid adenoma

A patient comes into your clinic with a history of hypertension and chronic pancreatitis. A homogenous and very small lesion is found on one of the parathyroids. It is hypoechoic with some calcifications. What is the most likely pathology?

Prostatodynia

A patient comes to your clinic with suspected adenocarcinoma of the prostate. Which of the following would not be a reasonable differential diagnosis?

Infected hematoma

A patient presents for an ultrasound of the kidneys and bladder due to a persistent fever, polyuria, and hematuria. The patient informs you that she recently had a baby, but that her scars were healing. Laboratory testing showed that the patient had a decreased hematocrit, and an increased WBC. A fixed, complex mass is seen at the edge of the bladder upon examination. What is the most likely diagnosis?

Abscess

A patient presents to your clinic with fever, scrotal pain, & swelling. You find a complex mass with hyperemic flow in the periphery, but no flow within the mass itself. What is the most likely diagnosis?

Sialadentitis

A patient presnets with bilateral swelling of the neck and pain after eating. Lab work shows that they test positive for mono. What pathology is the most likely describing?

A. baseline imaging test before age of 40

All of the following are indications for a breast ultrasound EXCEPT: A. baseline imaging test before the age of 40 B. differentiating between a cystic and solid mass C. evaluation of an abnormal finding on mammography D. guidance during an interventional procedure such as aspiration or biopsy

Hashimotos

An 8-year-old female comes to the ER with a painless palpable area of the neck. The doctor orders a thyroid ultrasound, and the following is reported: asymmetric enlargement of the left lobe of her thyroid, hypoechoic micronodules measuring between 1-6 mm, small calcifications and normal vascularity. What will most likely by the diagnosis.

B. branches of the axillary arteries

Arterial blood supply to the breast consist of all of the following EXCEPT ___. A. anastomoses beneath the areola B. branches of the axillary arteries C. branches of the intercostals arteries D. branches of the lateral thoracic arteries E. branches of the internal mammary arteries

Differentiation of cystic from solid nodules

Chief contribution of ultrasound in the investigation of thyroid nodules

Provide suitable means of fluid transport for sprem

Chief function of the prostate gland?

Peyronie's disease

Dense hyperechoic areas near the peripheral margins of the corpus cavernosum is what diagnoses?

None

Early stages of prostate cancer present with elevated PSA and what symptoms

C. lower outer quadrant

If the mammographic findings on a right beast study demonstrate an area of concern that is below the nipple on the MLO image and lateral on the CC image, where would you expect to locate this in the breast? A. upper outer quadrant B. upper inner quadrant C. lower outer quadrant D. lower inner quadrant E. retroareolar area

corpus spongiosum

In the penis, what is the Cylindrical mass of tissue that contains urethra?

C. fatty replacment of the glandular portion

Increasing age and pregnancies causes what change is the breast? A. dilation of ducts B. decrease in fat in glandular portion C. fatty replacement of the glandular portion D. increase in echogenicity of the stromal tissue E. decrease in echogenicity of the stromal tissue

Lymphoma

Most common testicular mass in 60 year old men?

Seminoma

Most common testicular neoplasm?

Santorini plexus

Name of the prostate vessel that travels between pubic bones but does not actually penetrate the prostate gland?

Sialosis

Non-inflammatory recurrent salivary disease that usually involves the parotid bilaterally and is associated with swelling.

Low frequency transducer is used

Not true when scanning transrectally?

Medial

On a transverse scan of the prostate, where are the vas defrens located in respect to the seminal vesicles?

D. Corpus spongiosum

Portions of the penis important in erectile function include all except? A. Emissary veins B. Tunica albuginea C. Copora cavernosa D. Corpus spongiosum

Trigone

The urethra usually inserts into the bladder where?

Chronic bacterial prostatitis

This condition is associated with older men and the flu would likely make the patient more susceptible. Sonographically, there may be capsular irregularity and ejaculatory duct calcifications. Which of the following pathologies best fits this description?

Varicocele

Valsalva maneuver used to aid in the diagnosis of what pathology/condition?

Galactocele

While performing a breast ultrasound on a pregnant woman, you find a round, unilocular cyst with internal echoes. The mass is firm but mobile & slightly tender with rim calcifications and no flow seen on Doppler. What is this most characteristic of?

At the axillary tail

While scanning a male breast, where are you most likely to find gynecomastia?

Behind the nipple

While scanning a male breast, where are you most likely to find gynecomastia?

Diverticula

While scanning a patient you see an anechoic, thin walled, round structure posterior to the bladder. Color Doppler shows bidirectional flow within this structure. What is the possible diagnosis?

African American men

Who has a higher risk of prostate cancer?

Upper outer quadrant midway between the nipple and outer edge of the breast near the chest wall

You are asked to correlate findings with a mass who's location is given as left breast, 2:00 2 C. Where would you expect to find this mass?

Bullous cystitis

You are performing a renal ultrasound on a 50-year-old male, who has a diagnosis of neurogenic bladder dysfunction, complains of incontinence and a recent recurring UTI. Upon scanning the patients bladder, you notice difuse bladder wall thickening and internal echoes are present. Which of the following is the best diagnosis for the patient?

These are normal findings

You are scanning a 55 year old patient. You notice the prostate measures about 25 g, homogenous texture with a hyperechoic band between the peripheral zone and the central zone of the prostate. What is a possible diagnosis?

Antiradial

You are scanning a patient and you have your probe in the LUOQ. The probe is perpendicular to the nipple. How is the probe position annotated?

Squamous cell carcinoma

You are scanning a patient with a history of schistosomiasis that has recently resolved. While scanning you see a hyperechoic non mobile mass on the bladder wall. What would be the most likely pathology present?

A. scar

Your next patient has a recent history of breast surgery. You find an area of irregularity and posterior shadowing, but it is eliminated with probe pressure. What does this most likely represent? a. scar b. abscess c. lymph node d. fat necrosis

urethral strictures

Your patient presents with a history of gonococcal urethritis and an abnormally narrowed urethra found during ultrasound examination. What pathology is present?