Abdominal Sonography Final
What are the diagnostic criteria for pyloric stenosis? A) 17mm thickness and 2mm in length B) 17 mm in thickness and 3mm in length C) 3mm wall thickness and 10mm length D) 3mm wall thickness and 17mm in length
3mm wall thickness and 17mm length
The normal parathyroid glands measure less than: A) 3mm B) 4mm C) 8mm D) 6mm
4mm
how many layers does the bowel wall have? A) 2 B) 4 C) 5 D) 6
5
The approximate dimensions of the thyroid are: A) 5cm length, 2cm width, 2cm depth B) 4cm length, 5cm width, 2cm depth C) 3cm length, 5cm width, 2cm depth D) 6cm length, 3cm width, 3cm depth
5cm length, 2cm width, 2cm depth
The maximum outer diameter of the normal appendix can measure up to: A) 3mm B) 15 mm C) 10 mm D) 6mm
6mm
A 5 year old w/ hx of recent streptococcus throat infection treated w/ a 10 day course of oral antibiotics is referred for a neck US to evaluate a large, tender, palpable mass that is right sided. What is the sonographer most likely to find? A) a hypoechoic, homogeneous mass with an echogenic center lateral time the internal jugular vein B) a solid, echogenic mass in the thyroid gland surrounded by echogenic halo C) a diffusely enlarged thyroid gland D) a hyperechoic mass lateral to the common carotid artery E) a well circumscribed mass echo free adjacent to the thyroid gland
A hypoechoic, homogeneous mass with an echogenic center lateral to the internal jugular vein
Rare, undifferentiated carcinoma occurring in middle age: A) Graves' disease B) parathyroid hyperplasia C) thyroiditis D) anaplastic carcinoma
Anaplastic Carcinoma
Fecalith or calcification found in the appendiceal lumen: A) ileus B) ulcer C) appendicolith D) volvulus
Appendicolith
The entrance into the stomach is the: A) esophageal orifice B) diaphragmatic orifice C) thoracic orifice D) cardia orifice
Cardia orifice
When evaluating the appendix sonographically, what structure will help you locate it? A) cecum B) duodenum C) jenunum D) urinary bladder
Cecum
A diverticulum is most common in the: A) stomach B) small intestine C) colon D) ileum
Colon
Clinical findings of acute appendicitis include all of the following except: A) leukocytosis B) RLQP C) constipation D) rebound tenderness
Constipation
An automimmune disease characterized by periods of inflammation of the GI tract describes: A) intussusception B) Crohn's disease C) pyloric stenosis D) Meckel diverticulitis
Crohn's Disease
Which of the following thyroid diseases is a result of a viral infection that causes enlargement and tenderness? A) hashimotos B) deQuervains C) adenoma D) Graves E) more than one of the following
DeQuervain's
Small bowel obstruction is associated with: A) dilation of the bowel loops distal you the site of obstruction B) dilation of bowel loops proximal you the site of obstruction C) collapsed bowel loops proximal to the site of obstruction D) polypoid masses throughout the obstruction
Dilation of bowel loops proximal to the site of obstruction
Most of the digestion and absorption of food takes place in the: A) large intestine B) duodenum C) stomach D) colon
Duodenum
Which part of the GI tract can be seen around the pancreatic head? A) stomach B) duodenum C) jejunum D) ileum
Duodenum
What is an embryologic mistake? A) duplication cyst B) gastric bezoar C) polyp D) leiomyoma
Duplication cyst
Non-Hodgkins type lymphoma shows a hypervascular, hyperechoic mass on US T or F
False
All of the following are common clinical findings in infants that present with pyloric stenosis except: A) weight loss B) dehydration C) olive sign D) first-born female
First-born female
What is the inflammation of the stomach lining, presents a thickened stomach lining and swollen rugae? A) GERD B) enteritis C) colitis D) gastritis
Gastritis
The structure often seen on a sagittal US to the left of the midline as a "bulls-eye" or target pattern anterior to the aorta and posterior to the left lobe of the liver is the: A) pancreatic duct B) common bile duct C) ligamentum teres D) gastroesophageal junction
Gastroesophageal junction
Increased vascularity w/ Color Doppler termed the "thyroid inferno" is seen w/: A) hashimotos disease B) Graves' disease C) de quervains thyroiditis D) papillary carcinoma
Grave's disease
Which of the following is a condition that has a diffuse toxic goiter, bulging of the eyes, and thickening dermis of the feet? A) Graves B) hashimotos C) deQuervains D) thyroiditis E) multinodular goiter
Graves' disease
Which of the following best describes the location of McBurney's point? A) left lateral tot the umbilicus and medial to the left iliac spine B) halfway between the anterior superior iliac spine and the umbilicus C) midway between the umbilicus and symphysis pubis D) medial to the superior iliac spine
Halfway between the anterior superior iliac spine and the umbilicus
Chronic inflammatory disease of the thyroid is known as: A) multinodular goiter B) endemic goiter C) hashimotos disease D) follicular adenoma E) follicular adenocarcinoma
Hashimoto's disease
Which of the following is not a medical hx question that pertains prior to an US of the thyroid gland? A) hx of vascular disease B) previous imaging studies C) palpable areas in neck D) abnormal TSH
Hx of vascular disease
GI leiomyosarcoma most commonly occur in the: A) duodenum B) jejunum Ileum
Ileum
Your patient has been referred for an abdominal sonogram with a history of abdominal pain and Crohn's disease. What does Crohn's disease primarily effect? A) ileum B) duodenum C) stomach D) cecum
Ileum
Failure of the intestine to propel its contents due to diminished motility is: A) dysphagia B) ileus C) peristalsis D) volvulus
Ileus
The celiac axis, superior mesenteric artery, and ___ supply both the small and large intestines A) lumbar artery B) IMA C) splenic artery D) renal artery
Inferior mesenteric artery
The sonographic finding of fluid-filled, distended loops of bowel is consistent with: A) Meckel diverticulitis B) diverticulitis C) gastroesophageal reflux disease D) intestinal obstruction
Intestinal obstruction
What is the most common tumor of the stomach? A) leiomyoma B) lymphoma C) lipoma D) adenomyoma
Leiomyoma
The most common tumor of the GI tract in children under 10 is: A) lymphoma B) polyp C) leiomyoma D) fecalith
Lymphoma
The appendix is located on the abdominal wall under: A) the iliac crest B) McBarney's point C) McBurney's sign D) McBurney's point
McBurney's point
Rebound tenderness and pain located over the area of the appendix is referred to as a positive: A) Murphy's sign B) McBurney's sign C) McDowell's sign D) McGinnty's sign
McBurney's sign
What is an imaging study that is often used in evaluation of the thyroid gland? A) NM B) CT C) MRI D) Spiral CT
NM
Occurs as a compensatory enlargement of the thyroid gland resulting from thyroid hormone deficiency: A) adenoma B) cystic hygroma C) modular hyperplasia D) non-toxic goiter
Non-toxic goiter
All of the following are true of normal intestinal finding with US except: A) normal bowel does not compress B) normal bowel should have observable peristalsis C) intestinal wall should measure less than 5mm D) normal bowel has little to no color Doppler signals
Normal bowel does not compress
Metastatic disease to the stomach may be secondary to all of the following except: A) breast B) lung C) prostate D) melanoma
Prostate
Which of the following is related to Non-Hodgkin's type lymphoma? A) a tumor that affects younger women B) seen as a lobulated hyperechoic mass C) surrounding tissue may be homogenous D) all of the above
Seen as a lobulated hyperechoic mass
Which of the following statements regarding appendicitis is FALSE A) a noncompressible appendix greater than 6mm is considered abnormal B) a calcifies appendicolith can help ID an inflamed appendix C) an inflamed appendix will demonstrate hype remix flow with color or power Doppler D) sonography can't visualize a normal appendix
Sonography cannot visualize a normal appendix
Which of the following lab values will most likely be abnormal in a pt. w/ a multinodular goiter? A) serum calcium B) potassium C) T3 & T4 D) WBC E) TSH
TSH
Acute appendicitis may be seen on US exam as a: A) hypoechoic mass with good transmission B) hyperechoic mass with fair transmission C) target lesion D) hyperechoic mass with good transmission
Target lesion
Which of the following statements about Crohn's disease is false? A) Crohn's disease isn't regional enteritis B) the reaction involves only the endothelium of the bowel wall C) clinical symptoms include diarrhea, fever, and RLQP D) Crohn's disease affects the terminal ileum and/or the colon
The reaction involves only the mesothelium of the bowel wall
A 35 year old woman with a palpable neck mass presents for a thyroid sonogram. Three solid, slightly echogenic masses are identified surrounded by halo of hypoechoic tissue. The most likely diagnosis is: A) thyroid adenomas B) Graves' disease C) thyroid cancer D) hashimotos disease E) thyroiditis
Thyroid adenomas
Patients could suffer from bowel obstruction that are caused by a buildup of ingested hair. The mass associated with this type of obstruction is termed a: A) phytobezoar B) lactobezoar C) trichobezoar D) permabezoar
Trichobezoar
An erosion of the mucosal layer of the wall of the GI tract is: A) volvulus B) haustral C) peristalsis D) ulcer
Ulcer
Which of the following is not a layer of gut identified with US? A) visceral B) serosa C) submucosal D) mucosa
Visceral
Which of the following is not true concerning the parathyroid glands: A) they may be located posterior to the thyroid B) they may be located in the thyroid C) a parathyroid mass is often not palpable D) a normal parathyroid is 1cm
a normal parathyroid is 1cm
Which of the following statements about gastric carcinoma is false? a) Ninety percent of malignant tumors of the stomach are lymphomas b) Ninety percent of malignant tumors of the stomach are carcinomas c) One half of these tumors occur in the pylorus d) One fourth of these tumors occur in the body and fundus
a) Ninety percent of malignant tumors of the stomach are lymphomas
All of the following are indications for US eval of the neck except: A) a cold module on NM study B) difficulty swallowing C) a palpable neck mass D) abnormally low serum calcium levels E) a history of tongue carcinoma
abnormally low serum calcium levels
What can be a complication if immunosuppressive medication dosage is too low? A) toxicity B) vascular torsion C) infection D) allograft rejection
allograft rejection
The olive sign is best described as: A) the palpating of the inflamed appendix with rebound tenderness B) an area of pain halfway between the anterior superior iliac spine and the umbilicus C) an enlarged palpable pyloric sphincter D) the sonographic appearance of pyloric stenosis
an enlarged palpable pyloric sphincter
Rebound tenderness is associated with: A) appendicitis B) intussusception C) diverticulitis D) gastric carcinoma
appendicitis
What is evident in an US of a 7 year old female with leukocytosis, fever, and RLQ pain? A) gastritis B) appendicitis C) ileus D) none of the above
appendicitis
A cystic formation lateral to the thyroid gland is typically a: A) thyroglossal cyst B) brachial cleft cyst C) cystic hygroma D) sublingual cyst
brachial cleft cyst
All of the following are sonographic findings of acute appendicitis except: A) appendicolith B) compressible, blond-ended tube C) periappendiceal fluid collection D) hyperemic flow
compressible, blind-ended tube
Traditionally, treatment for intussusception is by means of: A) surgery B) external manipulation C) compression sonography D) contrast enema
contrast enema
Adenomas are 7 times more common in men T or F
false
The left lobe is usually the largest of the two lobes T or F
false
The mucosa layer of the intestine wall contains blood vessels and lymph channels T or F
false
The sternocleidomastoid muscles are large muscles posterior/lateral to the thyroid T or F
false
There are usually ___ parathyroid glands A) 3 B) 4 C) 2 D) 5
four
THe most common thyroid abnormality is: A) goiter B) hashimotos disease C) adenoma D) lymphoma
goiter
The differential diagnosis for thyroiditis includes all of the following except: A) goiter B) abscess C) hemorrhagic cyst D) multinodular goiter
hemorrhagic cyst
Sonographically, the thyroid may be described as having characteristics of all of the following except: A) inhomogenous echogenic pattern B) sternocleidomastoid, longus colli, and strap m are hypoechoic compared w/ thyroid tissue C) homogenous texture of medium echogenicity D) superior and inferior thyroid vessels are best imaged in Sagittal plane
inhomogeneous echogenic pattern
The following are differential diagnosis for acute appendicitis EXCEPT: A) ruptured ectopic pregnancy B) mittelshmerz C) ovarian torsion D) intussusception
intussusception
The telescoping of one segment o bowel into another is referred to as: A) volvulus B) Crohn's disease C) intussusception D) pyloric stenosis
intussusception
Which of the following does NOT cause an ileus? A) bowel ischemia B) spinal fx C) intussusception D) acute pancreatitis
intussusception
The most common cause of thyroid disorder worldwide is: A) hypercalcemia B) hyperthyroidism C) iodine deficiency D) calcium deficiency
iodine deficiency
the arrow is pointing to the A) longus colli m B) isthmus C) reverberation artifact D) sternothyroid m
isthmus
The parathyroid glands produce a hormone that affects: A) liver, colon, and kidneys B) kidneys, bones, and GI tract C) GU tract, breast, and scrotum D) kidneys, heart, and colon
kidneys, bones, and GI tract
Which of the following structures lies posterolateral to the thyroid gland? A) esophagus B) sternocleidomastoid C) longus colli m D) omohyoid m
longus colli muscle
What is a disease of the thyroid that results from long standing thyroiditis? A) papillary carcinoma B) follicular carcinoma C) medullary carcinoma D) anaplastic carcinoma E) lymphoma
lymphoma
Which of the following is not true regarding adenomas? A) homogenous with variable size B) slow growing C) have peripheral halo D) more common in males
more commin in males
The most common type of thyroid malignancy is: A) papillary carcinoma B) medullary carcinoma C) anaplastic carcinoma D) follicular carcinoma
papillary carcinoma
The most common cause of hyperparathyroidism is: A) thyroid adenoma B) parathyroid adenoma C) parathyroid cyst D) parathyroid hemorrhage cyst
parathyroid adenoma
What pathology is seen in the image below A) parathyroid adenoma B) thyroid cancer C) hashimotos D) thyroid cyst with foci
parathyroid adenoma
All of the following structures form neighboring structures for the thyroid gland except: A) superficial and deep fascia B) parotid muscle C) strap muscles D) sternocleidomastoid m
parotid muscle
The most common feature of a thyroid adenoma is: A) diffuse echogenecity B) hemorrhage C) peripheral sonucent halo D) inhomogeneous properties
peripheral sonolucent halo
The parathyroid gland is normally located on which part of the thyroid? A) posterior medial B) anterior lateral C) posterior lateral D) anterior medial
posterior medial
The common carotid artery and internal jugular vein are ___ to the thyroid A) anteriorlateral B)medial C) posterolateral D) posteromedial
posterolateral
Progression of acute appendicitis to frank perforation is more rapid in: A) preschool children B) elementary school children C) adults D) senior citizens
preschool children
When performing an US eval of the thyroid, colow flow Doppler may be helpful when: A) determining whether a mass is benign B) looking for calcifications in the lesion C) proving that a mass is real and not artifact D) proving that the mass is in near field
proving that a mass is real and not artifact
What pathology can occur in a 3 week old male infant? A) intussusception B) ileus C) pyloric stenosis D) duodenal ulcer
pyloric stenosis
Where do most of the gastric carcinomas occur in the stomach? A) cardia B) fund us C) body D) pylorus
pylorus
All abnormal lymph node demonstrate: A) homogeneous texture B) central echogenic complex C) oval contour D) round contour
round contour
The best sonographic characteristic for a thyroid cancer is: A) hypovascularity B) more hyperechoic than normal thyroid tissue C) solid complex mass w/ heterogeneous echo pattern and irregular margins D) normal size lymph nodes
solid complex mass with heterogeneous echo pattern and irregular margins
THe lobes of the thyroid gland are connected by: A) Ismal tissue B) the isthmus C) island tissue D) parathyroid tissue
the isthmus
A 44 year old woman is found to have a 14mm parathyroid gland on US eval. Based on this finding, the sonographer should look at: A) at the abdomen for a primary neoplasm B) at the jugular vein for tumor invasion C) at the esophagus to rule out obstruction D) along the major vessels for adenopathy E) at the kidneys for calcification
the kidneys for calcifications
A ___ presents as a palpable midline mass between the hyoid bone and isthmus of the thyroid A) Tyroma B) parathyroid adenoma C) thyroglossal duct cyst D) carotid aneurysm
thyroglossal ductal cyst
A pt. presents w/ osteoporosis. A hyperplastic parathyroid gland is seen on US exam. Your differential diagnosis includes all except: A) thyroid cyst B) hyperparathyroidism C) parathyroid adenoma D) parathyroid hyperplasia
thyroid cyst
Clinical signs of thyroid goiter are: A) lymph node enlargement B) rapidly enlarging mass C) fainting D) thyroid enlargement
thyroid enlargement
Gross enlargement of the appendix from accumulation of mucoid substance within the lumen is mucocele T or F
true
Papillary carcinoma is the most common thyroid malignancy in children T or F
true
Pouchlike herniations through the muscular wall of a tubular organ are called diverticulum T or F
true
The term euthyroid describes the thyroid as normal functioning at cellular level T or F
true
The thyroid gland consists of the following number of lobes: A) 3 B) 4 C) 2 D) 5
two
What condition results when the pt is unable to clear nitrogen-containing wastes from the body? A) glycosuria B) proteinuria C) uremia D) pyuria
uremia
