Abdomen mock review 1-14
patient presents with RUQ pain, weight loss, jaundice, and hepatomegaly. What is the most likely diagnosis in the presence of an asymmetrically thickened gallbladder wall? Gallstones Acalculous cholecvstitis Gallbladder carcinoma Gangrenous cholecystitis
Gallbladder carcinoma
Which of the following should the sonographer carefully examine in the urinary bladder of a patient who has undergone a pancreatic transplant? Pancreatic abscess commonly extends to the urinary bladder in cases of rejection. Ascites is commonly demonstrated around the urinary bladder if there is a failed anastomosis. Acute pancreatic rejection can cause ureteral obstruction leading to bladder atrophy. Formation of an urinoma secondary to a bladder anastomosis.
Formation of an urinoma secondary to a bladder anastomosis.
If a patient's lab results indicate increased amylase, increased lipase, and increased bilirubin, which of the following organs is likely diseased? Liver Gallbladder Kidney Thyroid gland
Gallbladder
Arterial blood supply to the pancreas is supplied by which of the following arteries? Gastroduodenal artery Splenic artery Superior mesenteric artery Gastroduodenal artery, splenic artery, and superior mesenteric artery
Gastroduodenal artery, splenic artery, and superior mesenteric artery
What is the most common cause of hyperthyroidism? Graves disease Hashimoto thyroiditis Elevated iodine levels in the body Pituitary adenoma
Graves disease
What thyroid disorder presents with bulging eyes, nervousness, weight loss, and hair loss? Hashimoto thyroiditis Graves disease Goiter Colloid cysts
Graves disease
Which of the following is a benign mass found in the liver parenchyma found in patients taking oral contraceptives? Hepatic lipoma Hepatic hematoma Hepatocellular carcinoma Hepatocellular adenoma
Hepatocellular adenoma
A decreased hematocrit indicates which of the following? Active infection Renal insufficiency Biliary obstruction Internal bleeding
Internal bleeding
A patient presents with fever, leukocytosis, and rebound tenderness. What should the sonographer expect to find on the sonogram? Bull's eye appearance of bowel in area of right lower quadrant (RLQ) measuring <6 mm. Noncompressible blind-ended tubular structure in the RLQ measuring >6 mm. Compressible tubular structure in left lower quadrant (LLQ) measuring > 10 mm. Noncompressible echogenic structure within the LLQ measuring <5 mm.
Noncompressible blind-ended tubular structure in the RLQ measuring >6 mm.
If a breast mass is annotated as LT 4:00 1 C, what does this tell you about its location? Left breast, lower inner quadrant, close to the nipple, periareolar Left breast, upper outer quadrant, close to midaxillary line, periareolar Left breast, lower inner quadrant, periareolar, deep to pectoral muscle Left breast, lower outer quadrant, midway from nipple deep to the pectoral muscle
Left breast, lower outer quadrant, midway from nipple deep to the pectoral muscle
Which of the following best describes a mucinous cystadenocarcinoma? Large benian cystic mass in the pancreatic head with CBD dilation Small cystic mass in the tail of the pancreas Multilocular cystic mass with mural nodules and internal echoes with dilation of the duct of Wirsung Microscopic cystic mass in the head of the pancreas with dilation of the pancreatic duct
Multilocular cystic mass with mural nodules and internal echoes with dilation of the duct of Wirsung
Which of the following falsely describes an accessory spleen? Polysplenia Splenule Splenunculus Supernumerary spleen
Polysplenia
What is the most common complication of a wandering spleen? Splenic cleft Polysplenia Splenosis Splenic torsion
Splenic torsion
What is the term used to describe an enlarged spleen? Hepatomegaly Splenomegaly Splenosis Polysplenia
Splenomegaly
What is the cause of gallbladder sludge? Stasis of bile in the gallbladder Overproduction of bile in the gallbladder Portal hypertension Fatty liver
Stasis of bile in the gallbladder
What is a tumor marker? Substances produced by cancer cells or organs when cancer is present A group of sonographic findings that are all consistent with cancer A group of symptoms used to stage a cancer A blood test used to determine a patient's genetic predisposition to cancer
Substances produced by cancer cells or organs when cancer is present
What posterior landmark can the sonographer use to aid in delineation of the pancreas? C-loop of duodenum Superior mesenteric vein and splenic vein Left lobe of liver Splenic artery
Superior mesenteric vein and splenic vein
Why should the gallbladder be imaged in multiple patient positions? To provide proof of pathology mobility/nonmobility To decrease the effects of bowel contents overlaying the gallbladder To make it easier to get a gallbladder wa measurement To evaluate for cholecystectomy
To provide proof of pathology mobility/nonmobility
What is the term used to describe the inner layer of the aorta wall? Tunica adventitia Tunica media Tunica intima Lumen
Tunica intima
whats the most common scrotal mass? spermatocele seminoma Embryonal cell tumor Choriocarcinoma
spermatocele
A breast sonogram on a lactating female demonstrated a focal fluid collection with internal echoes and enlarged lymph nodes. What is the most likely diagnosis? Mastitis Breast abscess Gynecomastia Galactocele
Breast abscess
What is the term used to describe a fluid collection around the lung? Pleural effusion Pericardial effusion Ascites Cardinal effusion
Pleural effusion
What part of the testicle produces sperm? Tunica albuginea Seminiferous tubules Rete testis Epididymis
Seminiferous tubules
What is the normal diameter of the proximal abdominal aorta? 2.5 cm or less Greater than 1.8 cm but no larger than 2.5 cm 2.0 cm or less Less than 3.0 cm
2.5 cm or less
Which lab results will be elevated when gallbladder disease is present? Alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and red blood cells Platelets, ALP, and alanine aminotransferase (ALT) Bilirubin, ALP, and alpha-fetoprotein ALT, ALP, GGT, and white blood cells
ALT, ALP, GGT, and white blood cells
A male athlete presented with pain between the heel and the calf. The area was warm to the touch. Sonogram demonstrated a focal thickened hypochoic area within the tendon with hyperemic flow. What is the most likely diagnosis? Ruptured iliotibial tendon Achilles tendonitis Gastrocnemius tendonitis Soles tear
Achilles tendonitis
A patient presents with a palpable enlarged thyroid gland, dysphagia, and intermittent coughing. Sonogram demonstrated an enlarged heterogeneous gland with multiple focal nodules. What is the most likely diagnosis? Hashimoto thyroiditis Graves disease Adenomatous goiter Hypoplastic thyroid gland
Adenomatous goiter
A 3-day-old patient presented with jaundice, an acute drop in hematocrit, and a broken clavicle. What is the most likely diagnosis for a triangular shaped mass in the area of the adrenal gland? Adrena adenoma Adrenal cyst Neuroblastoma Adrenal hemorrhage
Adrenal hemorrhage
What is the most common cause of acute pancreatitis? Alcohol abuse Trauma Post endoscopic retrograde cholangiopancreatography (ERCP) Cholangitis
Alcohol abuse
What disorder is characterized by neonatal jaundice, cirrhosis, portal hypertension, and the triangular cord sign? Hepatoblastoma Cholangiocarcinoma Biliary atresia Choledochal cyst
Biliary atresia
Which of the following typically presents in a patient whose history includes chronic bladder UTI and sonographic appearance of diffusely thickened bladder wall with septations and internal debris? Neurogenic bladder Cystitis Bladder lithiasis Bladder diverticulum
Bladder diverticulum
What sonographic feature gives an adrenal cyst concern for malignancy? Round shape Produces acoustic enhancement Presence of hemorrhage within cyst Calcified cyst wall
Calcified cyst wall
What are the complications associated with choledochal cyst? Cholelithiasis, portal hypertension, and Mirizzi syndrome Dilated bile ducts within the liver resulting in reverse flow in the portal vein Cholangitis, portal hypertension, pancreatitis, and liver failure Pancreatic head mass, cholangiocarcinoma, and liver failure
Cholangitis, portal hypertension, pancreatitis, and liver failure
What is the least common cause of bile duct obstruction? Cholelithiasis Pancreatic head tumor Mirizzi syndrome Choledocholithiasis
Cholelithiasis
If the gallbladder wall is demonstrated as symmetrically thickened, what is the most likely pathologic cause? Postprandial patient Chronic cholecystitis Gallbladder polyp Gallbladder carcinoma
Chronic cholecystitis
How does chronic cholecystitis differ from acute cholecystitis? Patients with acute cholecystitis complain of pain whenever they ingest fatty foods over a period of years. Chronic cholecystitis presents with a WES sign but no Murphy's sign. Dirty shadowing or reverberation artifact emanates from the gallbladder wall with chronic cholecystitis. Chronic cholecystitis demonstrates the champagne sign.
Chronic cholecystitis presents with a WES sign but no Murphy's sign.
A patient presents with a history of chronic alcohol abuse and hyperparathyroidism. The sonogram demonstrates a small pancreas with a complex cystic mass demonstrated along the border of the pancreatic tail. What is the most likely diagnosis? Acute pancreatitis Chronic pancreatitis Choledocholithiasis Pancreatic adenocarcinoma
Chronic pancreatitis
What organs should be closely interrogated if the common bile duct is dilated? Liver, gallbladder, pancreas, and spleen Complete biliary tree, liver, gallbladder, and pancreas Gallbladder, complete biliary tree, and pancreas Complete biliary tree, liver, and pancreas
Complete biliary tree, liver, gallbladder, and pancreas
What term describes a lesion with cystic and solid components? Complex Heterogeneous Hypochoic Hyperechoic
Complex
How is pelvocaliectasis diagnosed with sonography? Dilation of the calices, renal pelvis, and proximal ureter Dilation of the calices Dilation of the calices and renal pelvis Dilation of the renal pelvis
Dilation of the calices and renal pelvis
Which vessel in the liver normally demonstrates a pulsatile low-resistant waveform? Middle hepatic vein Portal vein Hepatic artery Left hepatic vein
Hepatic artery
A patient presents with elevated liver function tests and the sonogram reveals diffuse increase in echogenicity, hepatomegaly, and a poorly visualized diaphragm. Which of the following conditions is most likely? Portal hypertension Cirrhosis Hepatitis Hepatic steatosis
Hepatic steatosis
A 3-week-old infant presented with projectile vomiting, dehydration, weight loss, and insatiable appetite. Sonography demonstrated a cervix sign in the long axis. What is the most likely diagnosis? Constipation Appendicitis Intussusception Hypertrophic pyloric stenosis
Hypertrophic pyloric stenosis
What is the normal sonographic appearance of a muscle? Bull's eye appearance in transverse Hyperechoic tissue with hypochoic stranding pattern Hypoechoic tissue with linear echogenic strands Echogenic fibrous structures
Hypoechoic tissue with linear echogenic strands
What feature allows the sonographer to distinguish porcelain gallbladder from WES sign? Echogenic curvilinear structure within the gallbladder fossa with shadowing Chronic cholecystitis Gallstones Identification of the calcified back wall of the gallbladder
Identification of the calcified back wall of the gallbladder
Which patient population is most prone to developing hepatic candidiasis? Immunocompromised patients Elderly Children Farmers
Immunocompromised patients
How does the function of the spleen differ in infants/children and adults? In infants/children, its primary function is defense against infection, whereas in adults, it is production of lymphocytes and monocytes. In infants/children, the primary function is erythropoiesis, whereas in adults, it is defense against infection. In infants/children, the primary function is production of lymphocytes and monocytes, whereas in adults, it is erythropoiesis The function of the spleen is the same for all age groups; it includes erythropoiesis, defense against infection, and production of erythrocytes and monocytes
In infants/children, its primary function is defense against infection, whereas in adults, it is production of lymphocytes and monocytes.
Which of the following best describes the location of the spleen? Intraperitoneally located in the left upper quadrant (LUQ) Intraperitoneally located in the left lower quadrant (LLQ) Retroperitoneally located in the LUQ Intraperitoneally located in the LLQ
Intraperitoneally located in the left upper quadrant (LUQ)
What is a common complication of Wilms tumor, renal transitional cell carcinoma, and Budd-Chiari syndrome? Mets Enlargement of the IVC Invasion of the IVC Need for IVC filter
Invasion of the IVC
What laver of the breast tissue contains the ducts and glandular tissue? Subcutaneous layer Retromammary layer Pectoral layer Mammary layer
Mammary layer
What is the proper method for measuring the common bile duct? Measure the segment on the intrahepatic side of the cystic duct with an inner-to-inner measurement Measure the segment on the extrahepatic side of the cystic duct with an inner-to-inner measurement Measure the segment on the intrahepatic side of the cystic duct with an outer-to-outer measurement Measure the segment on the extrahepatic side of the cystic duct with an outer-to-outer measurement.
Measure the segment on the extrahepatic side of the cystic duct with an inner-to-inner measurement
What area of the adrenal gland produces epinephrine and norepinephrine? Medulla Gerota fascia Zona fasciculata Zona glomerulosa
Medulla
What hepatic pathology demonstrates the sonographic findings of multiple target lesions within the liver parenchyma? Focal nodular hyperplasia Multiple hemangiomas Pseudocirrhosis Metastatic disease from lung or colon cancer
Metastatic disease from lung or colon cancer
How do you measure the true lumen of an AAA? Inner to inner excluding wall thrombus Outer to outer including wall thrombus Outer to outer excluding wall thrombus Inner to inner including wall thrombus
Outer to outer including wall thrombus
A patient presents with hypercalcemia. Sonography demonstrated a hypochoic mass adjacent to the thyroid gland. What is the most likely diagnosis? Parathyroid adenoma Exophytic thyroid adenoma Hemorrhagic thyroglossal duct cyst Normal esophagus
Parathyroid adenoma
What is a subluxated hip? Dislocation of the hip Partial dislocation of the hip Hip with missing acetabular rim Absent femoral head
Partial dislocation of the hip
How is an aortic rupture diagnosed? Presence of intimal flap with thrombus on the aorta wall adiacent to it Presence of an AAA with adjacent hematoma. You must demonstrate color images of the active bleeding site. To-fro flow must be demonstrated at the rupture site
Presence of an AAA with adjacent hematoma.
What is the function of the white pulp in the spleen? Phagocytosis Hematopoiesis Culling and pitting Production of lymphocytes
Production of lymphocytes
A 60-year-old male patient presents with elevated prostate-specific antigen (PSA), macroscopic hematuria, and a decrease in the amount of ejaculated fluid. Sonogram de monstrates a hypervascular enlarged prostate gland. What is the most ikely diagnosis? Prostate cancer Benign prostatic hypertrophy Prostatitis Seminoma
Prostate cancer
What is the function of the bile ducts? Produce bile Produce cholecystokinin Storage of bile Provide a conduit for bile to get from the liver to the digestive system
Provide a conduit for bile to get from the liver to the digestive system
If a patient presents with elevated blood urea nitrogen (BUN) and elevated creatinine, what disease process is most likely? Renal failure Chronic nephritis Dehydration Parenchymal disease
Renal failure
A hemophiliac patient presents with low hematocrit and RT back pain. A complex mass is demonstrated in the muscle between the kidney and the spine. What is the most likely diagnosis? Lymphoma Retroperitoneal fibrosis Retroperitoneal hematoma Renal cell carcinoma
Retroperitoneal hematoma
Which of the following best describes the adult kidney? Retroperitoneal location with cortex responsible for blood filtration and medulla responsible for absorption Intraperitoneal location with right kidney typically measuring up to 2 cm larger than left responsible for homeostasis Retroperitoneal location covered by Gerota fascia with the main function being the regulation of blood pressure by producing renin Intraperitoneal location typically down in the pelvis responsible for detoxification and filtration of the blood
Retroperitoneal location with cortex responsible for blood filtration and medulla responsible for absorption
Which of the following best describes the location of the left adrenal gland? Retroperitoneal, located medial to the superior pole of the LT kidney Intraperitoneal, posterior to the lesser sac Retroperitoneal, medial to the right lobe of the liver Intraperitoneal, lateral to the crus of the diaphragm
Retroperitoneal, located medial to the superior pole of the LT kidney
A patient presents with a painless scrotal mass and elevated hG levels. On sonographic examination, a solid, hypochoic mass is demonstrated within the testicle. What is the most likely diagnosis? Testicular adenoma Yolk sac tumor Teratoma Seminoma
Seminoma
A diagnosis of chronic cirrhosis is consistent with which of the following sonographic findings? Enlarged caudate, hypochoic parenchyma, and starry sky appearance Shrunken echogenic right lobe, nodular contour, hepatofugal flow in the portal veins, and ascites Nodular contour, hepatopedal flow in the portal vein, and retrograde flow in the hepatic veins Ascites, smooth contour, and recanalization of paraumbilical vein
Shrunken echogenic right lobe, nodular contour, hepatofugal flow in the portal veins, and ascites
What are the criteria of a simple cyst? Smooth borders, through transmission, and hypoechoic Anechoic, smooth walls, and round shape Smooth borders, anechoic, through transmission, and round shape Hyperechoic walls, anechoic, and through transmission
Smooth borders, anechoic, through transmission, and round shape
What is the typical sonographic pattern demonstrating an intussusception? Blind-ended pouch in the RLQ Target shaped mass in the transverse plane and pseudokidney sign in the longitudinal plane Cervix sign Olive sign
Target shaped mass in the transverse plane and pseudokidney sign in the longitudinal plane
When assessing the sonographic appearance of an adult kidney, what echogenicity comparisons are typically used? Triangular shaped pyramids should be demonstrated within the cortex hyperechoic to the medulla. The cortex should be hyperechoic to the medulla measuring at least 1 cm in thickness. Glisson capsule should be echogenic and demonstrate a lobular contour. The cortex should be hypochoic or isoechoic to the liver or spleen.
The cortex should be hypochoic or isoechoic to the liver or spleen.
Why are radial and anti-radial planes preferred for breast imaging? Because the breast tissue is very superficial. it is better imaged in these planes. The lactiferous ducts are arranged in a radial pattern, so will be better demonstrated if scanned along the same planes. When the patient is positioned in an oblique position the tissue lies perpendicular to the longitudinal plane. It is just a convention; there is no physiologic or anatomic rationale for it.
The lactiferous ducts are arranged in a radial pattern, so will be better demonstrated if scanned along the same planes.
Which statement below is true with respect to the liver ligaments? Recanalization of the paraumbilical vein in the ligamentum venosum can occur with portal hypertension The ligamentum venosum divides the left lobe from the caudate lobe The right branch of the umbilical vein becomes the ligamentum teres after birth. The left branch of the umbilical vein becomes the ligamentum venosum after birth.
The ligamentum venosum divides the left lobe from the caudate lobe
How does acute renal failure differ from chronic renal failure? Both present as small kidneys with cortical thinning. The most common cause of chronic renal failure is acute tubular necrosis and it presents with a normal renal appearance on sonography whereas acute renal failure is most commonly caused by diabetes mellitus and presents as small kidneys with cortical thinning. The most common cause of chronic renal failure is diabetes mellitus and it presents with a normal renal appearance on sonography whereas acute renal failure is most commonly caused ov acute tubular necrosis and presents as small kidneys with cortical thinning The most common cause of chronic renal failure is diabetes mellitus and it presents as small kidneys with cortical thinning on sonography whereas acute renal failure is most commonly caused by acute tubular necrosis and presents as normal appearing kidneys
The most common cause of chronic renal failure is diabetes mellitus and it presents as small kidneys with cortical thinning on sonography whereas acute renal failure is most commonly caused by acute tubular necrosis and presents as normal appearing kidneys
How does blood drain from the testicles? LT and RT testicular veins drain into the inferior vena cava (IVC) The pampiniform plexus empties into the RT and LT testicular veins which then empty into the IVC The pampiniform plexus empties into the RT and LT testicular veins; then the RT testicular vein drains into the IVC and the IT drains into the IT renal vein. The pampiniform plexus empties into the RT and LT testicular veins; then the RT testicular vein drains into the RT renal vein and the LT drains int the IVC.
The pampiniform plexus empties into the RT and LT testicular veins; then the RT testicular vein drains into the IVC and the IT drains into the IT renal vein.
How is testicular echotexture described? The testicles are isoechoic to each other, but hypochoic to thyroid tissue. The RT testicle is slightly more echogenic than the LT. The testicles are isoechoic to each other and similar to that of the thyroid gland. The testicle is slightly hypochoic to the epididymis and isoechoic to the thyroid gland.
The testicles are isoechoic to each other and similar to that of the thyroid gland.
In what image is the crus of the diaphragm typically demonstrated on sonography? Transverse image of the kidney Sagittal image of the distal inferior vena cava (IVC) Transverse image of pancreas Transverse image of LT lobe of liver
Transverse image of the kidney
What is the normal Doppler waveform appearance of the distal aorta? Biphasic, low-resistant pattern with flow reversal in late diastole Triphasic, low-resistant pattern with no flow reversal at any point in cycle Monophasic, high-resistant pattern with flow reversal in systole Triphasic, high-resistant pattern with flow reversal in early diastole
Triphasic, high-resistant pattern with flow reversal in early diastole
What is a possible role of sonography in the evaluation of lung masses? Diagnosis of consolidation masses caused by asthma Ultrasound-guided biopsy Evaluation for inhaled foreign body Differentiation of benign from malignant lung masses
Ultrasound-guided biopsy
What term is used to describe dilation of the ureter as it enters the bladder? Hydroureter Urachus Ureterocele Vesicoureteral obstruction
Ureterocele
What technique can be used to help define an abdominal wall hernia? Valsalva maneuver Deep inspiration Deep expiration Water enema
Valsalva maneuver
Which of the following is most likely a malignant tumor? Hamartoma Pheochromocvtoma Adenomyomatosis Choriocarcinoma
choriocarcinoma
Which portion of the pancreas lies in the C-loop of the duodenum? Pancreatic head Pancreatic body Pancreatic duct Pancreatic tail
Pancreatic head
What is the function of the parathyroid glands? Regulation of calcium levels Produce thyroid-stimulating hormone Produce saliva Regulation of growth hormone
Regulation of calcium levels
A complex cystic mass is demonstrated in the spleen with posterior dirty shadow in a febrile patient. What is the most likely diagnosis? Splenic abscess Hydatid cyst Splenic metastasis Pancreatic pseudocyst
Splenic abscess
