URR Clinical Spleen, Urinary, Vasc.

you are performing a renal artery doppler exam for renal stenosis. the mid aortic peak velocity is 70cm/s the rra peak velocity is 140cm/s and the lra peak velocity is 240 cm/s what is the rar for the right kidney

2.0

the length measurements of the adult kidneys should be within ____ of each other

2cm

What is the top normal post-residual volume in the bladder, if measured within 5 minutes of voiding?

<100ml

which of the following correctly describes peritoneal dialysis

a cleansing fluid flows is injected through an intraperitoneal catheter

a pt presents with an order for an abdomen us ro rule out upj obstruction of the left kidney. what are the expected finding if the exam is positive

a normal ureter will be identified but the left renal calyces and renal pelvis will be chronically dilated with or without the bladder distended.

a pt presents for an abdominal us due to new onset of hematuria, proteinuria and increased serum bun and creatinine he complains of recent fever, sore throat, joint pain, and peripheral edema. these clinical findings are most suggestive of

acute glomerulonephritis

sudden onset of hematuria, azotemia, and proteinuria is an indication of

acute glomerulonephritis

which of the following frequently occurs as a late complication of pharyngitis (throat infection)

acute glomerulonephritis

a 45yo pt presents with increased serum bun and creatinine, a recent history of oliguria and bilateral flank pain the us exam demonstrates bilateral hydronephrosis and hydroureter but the bladder is nearly empty. which of the following statement is true regarding this pt and the findings

acute postrenal failure is present and the radiologist should review the case immediately

which of the following correctly describes hemodialysis

an arteriovenous fistula is created by connecting an artery and a vein usually in the arm

a pt presents for an abdominal sonogram due to a history of marfan syndrome. what structures should be closely evaluated for related findings

aorta

hypovolemic shock is a common symptom of

aortic rupture

Where is the Doppler cursor placed in the aorta to obtain the velocity used in the renal aortic ratio?

at the level of the renal artery origins

a pt arrives with an order that reads t/o fluid in morison pouch. where do you need to scan to answer this question

between the liver and right kidney

a pt presents for his annual renal scan due to a long history of dialysis treatment he does not currently have any related complaints what are the expected findings on the exam

bilaterally atrophied kidneys with little to no visible parenchyma and multiple cyst formation

what equation is used to calculate post void risidual urine volume

bladder length x width x height x 0.52

renal function lab testing includes serum levels of

blood urea nitrogen

which of the following is a fungal infection that can affect the kidney

candidiasis infection

when the superior mesenteric artery is in view in a transverse plane the probe must be angled ___ to see the celiac axis

cephalad

If renal calculi are identified in the kidney:

color Doppler should be used to evaluate the urinary bladder

placing the patient in an oblique position and using a lateral transducer position on the lower abdoment would best demonstrate what vessels

common iliac arteries

hematocrit levels are determined by

counting red blood cells

which of the following is normally identified in the urine

creatinine

what modality is commonly used in the characterization of a renal angiomyolipoma

ct scan

increased hematocrit levels are associated with which of the following

dehydration

which of the following is the most likely cause for renal vein thrombosis

dehydration

elevated hematocrit levels are associated with

dehydration and polycythemia vera

what is the best way to explain a renal doppler exam to a 9yo female?

demonstrate the gel on the probe and how you will slide it around on her belly to obtain pictures for the doctor

a pt presents with fever flank pain dehydration electrolyte imbalance and positive serum and urine bacterial cultures for e coli these clinical findings are most suggestive of

emphysematous pyelonephritis

which type of kidney infection is considered a critical finding

emphysematous pyelonephritis

Note the Doppler measurement on the image. What other Doppler measurement should be taken to calculate the resistive index?

end diastolic velocity

which of the following should be performed on a pt with suspected acute renal failure

eval the resistive index of the parenchymal arteries

while scanning the luq you identify multiple dilated vessels at the hilum of the spleen which of the following describes the best way to identify a cause for the findings

evaluate the liver vasculature for sign of portal htn

a pt presents for a post biopsy scan of the right kidney. a lymphocele is suspected what will the appearance of this abnormality on the image

fluid collection with debris and septations located adjacent to the kidney

a pt presents for a post biopsy scan of the right kidney. a subcapsular hematoma is suspected what will be the appearance of this abnormality on the image

free fluid beneath the renal capsule that distorts the contour of the parenchyma

a pt presents for a post biopsy scan of the right kidney. an extracapsular hematoma is suspected. what will be the appearance of this abnormality on the image

free fluid with debris levels found within morrison pouch

what lab test is used to eval the success of a renal transplant

glomerular filtration rate

the following image was taken from a pt with acute right flank pain which of the following pt history questions is most pertinent to your findings

have you experienced any trauma to your right side recently

The masses demonstrated on the image were biopsied and the samples consisted of a high concentration normal vascular tissues. Which of the following describes the type of mass?

hemangioma

a pt presents with lyq pain and a history of mva 3 days ago, a cystic structure is seen in the spleen with layered debris within it. this most likely represents

hematoma

what is the most common symptom of renal cell carcinoma

hematuria

a pt presents with a history of a chronic uti for over 3 weeks with little resolve from antibiotic treatment. the finding on the image are most suggestive of

hydronephrosis- moderate to severe

a pt presents for an abdominal us due to suspected displacement of the greenfield filter where should you look to find the filter in the normal position

in the ivc just below the level of the renal veins

which of the following would be associated with the finding on the image

increased serum creatinine

which of the following is the preferred method for obtaining the most accurate measurement of the length of the spleen

intercostal coronal view that demonstrates the hilum

which of the following correctly lists the equation for the splenic volume index?

length x width x height /27=SVI

which of the following describes how to correctly measure the ap diameter of iliac artery

longitudinal view, outer wall to outer wall

while scanning a pts ruq you identify the aorta on the right side of the spine, duplicated ivc and a horseshoe kidney along the midline where should you look next for an associated abnormality

luq to determine the presence or absence of the splee

which renal arteries are evaluated with doppler in an us exam that is used to perform a direct eval for renal artery stenosis

main renal artery

all of the following are contraindications for a renal transplant except

marked increase in serum creatinine

a pt presents with a history of gaucher disease what do you expect to see on the abdominal us exam

massive splenomegaly

a pt presents with an order for a renal us due to increased serum bun an creatinine levels and bilateral decreased renal size identified on a recent ct scan. what are the expected findings on the us exam

medical renal disease

a 55yo female pt presents for an abdominal sonogram due to a history of weight loss and recurrent pain just after eating what structures should be closely evaluated

mesenteric arteries and celiac axis

____ causes abdomen pain 20-30 minutes after eating, while ____usually causes abdomen pain several hours after eating

mesenteric ischemia, cholelithiasis

which of the following is the least likely cause for bilateral pedal edema

mesenteric vein thrombosis

which of the following is a risk factor for the formations of splenic artery aneurysms

multigravida

which of the following is a common symptom of renal transplant rejection

oliguria

IF a pt forgets to take their hypertension medication before a renal duplex exam, what effect can this have on the findings ?

overstimation of renal artery stenosis

when evaluating a pt with an aortic aneurysm, which of the following must be reported

position related to the renal artery origins

which of the following defines renal colic

recurrent flank pain that radiates to the groin

a pt presents for an abdominal sonogram due to a history of acute onset of malignant htn. what structures should be closely evaluated

renal arteries

a pt presents for an abdominal us due to a history of median arcuate ligament syndrome what structures should be closely evaluated for related findings?

renal arteries

Which exam would be improved by the administration of Simethicone prior to the ultrasound evaluation?

renal artery duplex

elevated blood urea nitrogen levels are associated with ______while decreased blood urea nitrogen levels are associated with _____

renal failure, liver failure

a pt presents for a renal us due to high serum levels of anti diuretic hormone, low urine output and a recent pulmonary embolism these clinical findings are most suggestive of

renal vein thrombosis

If a solid renal mass is identified in the kidney on an US exam, which of the following should also be closely evaluated for associated findings?

renal veins

a pt is referred for a renal us due to suspected right renal agenesis which of the following is not an expected finding associated with right renal agenesis

right kidney located in the right lower quadrant

you are performing a renal doppler exam. what is the best pt position to visualize the ful length of the left renal artery

right lateral decubitus

while performing an us of the abdominal aorta the mid and distal portions of the vessel are partially obscured by bowel gas. which of the following techniques can be used to improve your visualization of the aorta

roll the pt into an oblique or decubitus position and rescan the aorta

you are attempting to scan the spleen with the pt in the right lateral decubitus position and using a coronal view the spleen is obscured by the left lung. what can you do to obtain a better view of the spleen

scan the pt at full expiration

which of the following are commonly associated with retroperitoneal fibrosis

scrotal swelling and pedal edema

which renal arteries are evaluated with doppler in an us exam that is used to perform an indirect eval for renal artery stenosis

segmental and parenchymal arteries

doppler eval of the parenchymal arteries is required in pt with

significant hydronephrosis

which of the following correctly describes the lab values identified in a pt with acquired hemolytic anemia

significantly increased serum bilirubin and decreased hemoglobin levels

a 6yo is referred for an abdominal us due to a history of epstein barr infection what organ should be closely evaluated for associated findings

spleen

a pregnant female presents with lateral luq pain and a bruit in the same area what is the most likely finding on the abdominal us exam

splenic artery aneurysm

a 60yo presents with a history of sickle cell anemia what do you expect to find on the us eval of the spleen

splenic enlargement or atrophy

a 3yo pt present with a history of sicle cell anemia what do you expect to find on the us eval of the spleen

splenomegaly

what is the preferred position of a pt having a transplant kidney biopsy

supine

the following image was taken from a pt with acute right flank pain following a liver biopsy. which of the following describes the finding on this image of the right flank

the fluid within morison pouch is consistent with intraperitoneal blood

a pt is referred for a renal ultrasound due to suspected horseshoe kidney what is the expected us finding for this condition

the lower poles of the kidneys are joined across the midline, usually anterior to the mid aorta

hematuria is defined as

the presence of red blood cells in uring

when an organ transplant is being evaluated by us

the resistive index should be assessed at several locations in the allograft

a pt presents for a renal us with a history of increased serum bun and creatinine and htn. right renal artery occlusion was documented on an us eval performed last year what are the expected findings on the us exam to day

the right kidney will be atrophied and hyperechoic and the left kidney may demonstrate a mild increase in size since the last exam

which of the following correctly describes how us is used to guide treatment of a pseudoaneurysm of the external iliac artery

the technologist uses us to guide the probe placement during compression therapy applied in 30 minute intervals

a pt presents with midline pelvic pain for 3 days. visible hematuria presented 2 days ago which of the following statements is true regarding the findings displayed on the image

the ureter is dilated with at least one calculus present in the lumen

a pt presents with persistent flank pain for 3 days following his weekly flag football game. lab testing demonstrated a small decrease in hematocrit levels which statement below best describes the abnormality on the us image

there is a hematoma formation within morrison pouch, adjacent to the right kidney

a pt presents with abdominal pain after MVA the pt was in the passenger seat of a car that was hit on the right front door. which statement is true regarding the images from the pts exam

these findings should be communicated to the radiologist immediately because the spleen has ruptured

anemia is least likely to be related to abnormalities of which of the following organs

thyroid

a pt presents for a bladder us due to recent onset of visible hematuria. which of the following conditions is commonly associated with this symptom?

transitional cell carcinoma

which of the following abnormalities is commonly associated with painless hematuria

transitional cell carcinoma of the bladder

which of the following describes how to correctly measure the width of the iliac artery

transverse view, outer wall to outer wall

which of the following is incorrect regarding the eval of a pt with a suspected abdominal aortic aneurysm

transverse views are preferred for the most accurate diameter measurement

a 30yo pt present with an order for a renal us due to suspected multicystic kidney disease what are the expected finding on the us exam if the abnormality is present

unilateral formation of multiple renal cysts consuming the renal parenchyma