Case study clinic term 2, Clinical guide to sonography ch 1-12 final set, Clinical guide to sonography ch.27, Clinical guide to sonography ch.28

Incidental bilateral thyroid nodules noted on 75yo man getting carotid exam. Thyroid exam reveals Nodule in Rt lobe is mostly cystic but contains debris, nodule in the left lobe contains multiple microcystic spaces separated by thin septa. Finding suggest...

Bilateral benign thyroid nodules

A 3 week old infant presents w/ persistent jaundice, dark urine, and enlarged girth. A fasting sono is requested. An enlarged liver with an echogenic area superior to the portal vein bifurcation is demonstrated in the RUQz No GB ID'D. Likely diagnosis. A. Hemangioendothelioma B. Hepatoblastoma C. Choledocal cyst D. Biliary atresia

Biliary atresia

The most common clinical symptoms demonstrated in pts with intussusception include all of the following except? A. Abdominal pain B. Bloody stool C. Dehydration D. Vomiting

C. Dehydration

The appendix arises from the inferior tip of the _____, located near the junction of the terminal ilium of the small intestine, and the proximal ascending colon. A. Descending colon B. transverse colon C. Sigmoid D. Cecum

Cecum

In what way does the vascular system of the spleen differ from other organ circulation?

Intrasplenic arteries do not anastomose or communicate

An 8yo girl w/ history of cystic fibrosis is seen with nonspecific abdominal pain and diarrhea. Sono evaluation of pts abdomen reveals a mass in RUQ similar in appearance to a kidney. What is the most likely diagnosis? A. Abdominal abscess B. Diverticulitis C. Intussusception D. Pyloric stenosis

Intussusception

53yo woman is sent for a breast sono b/c of abnormality seen only on one view of her recent mammo. Sono shows area of distortion with thickened cooper's ligaments and lymphadenopathy but does not show a discrete mass. The findings are most consistent with...

Invasive Lobular Carcinoma

38yo pregnant woman presents w/rapid enlarging m, retroareolar, palpable mass. Sono shows, microlobulated mass w/internal blood flow. Findings consistent with

Invasive ductal carcinoma

65 yo man presents for mammogram and sono of a palpable retroareolar RNA's. Likely diagnosis?

Invasive ductal carcinoma

65yo man presents with palpable Rt upper outer quadrant breast mass. Sonographically, a solid mass with post shadowing is seen at 10:00 3 CMFN. Findings consistent with

Invasive ductal carcinoma

A 38-year-old pregnant woman presents to the sonography department with a rapidly enlarging, retroareolar, palpable mass. Sonographically, a microlobulated mass with internal blood flow is identified. The findings are most consistent with which of the following?

Invasive ductal carcinoma

A 65-year-old man presents to the sonography department with a palpable right upper outer quadrant breast mass. Sonographically, a solid mass with posterior shadowing is seen at 10:00 3 CMFN. These findings are most consistent with which of the following?

Invasive ductal carcinoma

A 53-year-old woman is sent for a breast sonogram because of an abnormality seen only on one view of her recent mammogram. The sonogram reveals an area of distortion with taking to coopers ligament and lymphadenopathy but does not show a discrete mass. The findings are most consistent with which of the following?

Invasive lobular carcinoma

55yo woman undergoes sono, revealing a retroareolar, Solis mass within dilated ducts. She has evidence of skin edema and complains of unilateral pink nipple discharge. What would be the likely diagnosis?

Papillary carcinoma

A 55-year-old woman undergoes a sonogram that reveals a retroareolar, solid mass within dilated ducts. She has evidence of skin Adema and complains of unilateral pink nipple discharge. What would be the most likely diagnosis?

Papillary carcinoma

a 10yo boy is referred for scrotal sono b/c on clinical exam only one of his testicles was palpable within the scrotal sac. A homogenous ovoid mass is id'd w/in the lt inguinal canal. Surgical repair is recommended b/c this condition is associated with an increased risk for which of the following.

cancer

a 30yo man with gynecomastia, elevated hCG, and no palpable scrotal mass presents for a sono. The most significant sono finding includes a 1.5 cm heterogeneous mass within the rt testicle. After orchiectomy, the prognosis remains poor because this type of cancer does not respond well to chemotherapy. The clinical and sonographic findings suggest which type of cancer?

choriocarcinoma

a 28yo man undergoes clinical evaluation for a palpable mass in the lt testicle. Sono reveals a solid, mostly hypoechoic mass including a shadowing calcification within the lt testicle. A small amount of fluid also surrounds the lt testicle. Findings are mostly suggestive of

embryonal cell carcinoma

a 52 yo man is diagnosed with epididymo-orchitis after sono eval. His clinical signs and symptoms most likely include which of the following?

painful enlargement of the scrotum

a 30yo man undergoes sono exam for a painless mass in the rt hemiscrotum. Sono reveals multiple punctate huperechoic nonshadowing foci and a hypoechoic mass within the right testis. Likely diagnosis?

seminoma with microlithiasis

a 43yo man is seen with a mobile painless mass at the upper pole of his right testis. Sono reveals a 1.5cm, round anechoic lesion that demonstrates acoustic enhancement. No other abnormalities are apparent. This probably represents a

spermatocele

a 15yo boy is seen in the ER after falling and straddling a bicycle cross-bar. He has pain and swelling of the scrotum. The sono demonstrates heterogeneity of the right testicle and hype vascularity on color doppler exam. An area of echogenic material is seen just outside the upper margin of the right testicle. What is the most likely diagnosis?

testicular rupture

The appendix can be hidden from the anterior peritoneum_____% of the time A. 15 B. 30 C. 45 D. 60

30

Repair of an AAA is indicated when the aneurysm becomes greater than___cm in diameter or grows more than___ per year

5.5cm; 0.6-0.8 cm

High BP and current smoking increase the growth rate of aneurysms, and the resultant risk of rupture sharply increase with aneurysms of more than: A. 1.5 cm in diameter B. 3cm in diameter C. 4.5 cm in diameter D. 6 cm in diameter

6cm in diameter

A pt presents with a. History of alcohol abuse and ascites. Images of the spleen reveals enlargement with dilation of the vessels at the hilum. This is most likely consistent with which one of the following A. Mets B. Splenic rupture C. Splenic aneurysm D. Portal hypertension

Portal hypertension

A newborn boy is seen for renal sono as followup of abd ob sono that showed a markedly distended bladder, hydronephrosis, dilated and tortuous ureters, and keyhole appearance of the proximal urethra. These findings are most consistent with which of the following congenital obstructive disorders? A. UPJ obstruction B. Posterior Urethral valves C. Renal agenesis D eagle- Barrett syndrome

Posterior urethral valves

Which of the following would be most worrisome sonographic findings

A 4 cm, smooth, oval mass with cystic areas in the breast of a 55-year-old woman

The risk of rupture increases significantly when appendicitis is not treated within_____ hours of the onset of symptoms A. 36 B. 24 C. 12 D. 2

A. 36

The diagnosis of IHPS can be determined with confidence via sonography when which of the following diagnostic criteria are demonstrated? A. >3.0mm muscle wall, > 17mm channel length B. < 3.0 mm muscle wall, < 17 mm channel length

A. >3.0mm muscle wall, > 17mm channel length

The classic sono appearance of intussusception includes all of the following except? A. Cervix B. Doughnut C. Pseudokidney D. Sandwich

A. Cervix

Rebound tenderness in the RLQ found in pts with appendicitis is associated with: A. Peritoneal irritation B. Elevated WBC count C. Ascites D. Foreign bodies

A. Peritoneal irritation

When performing a scan to rule out AAA, the abdominal aorta should be measured

AP in long plane

A prenatal sono reveals the presence of bilateral enlarged kidneys with a loss of corticomedullary differentiation. Hepatomegaly, mildly increased hepatic echogenicity, dilated intrahepatic biliary ducts, and poorly visualized peripheral portal veins are also noted. After delivery, the infant is referred for renal sono, which displays the same characteristic large echogenic kidneys with poor corticomedullary differentiation; macrocysts are not present. Liver abnormalities noted on prenatal sono no longer evident. Like cause? A. Unilateral renal agenesis B. Neuroblastoma C. ARPKD D. MCDK

ARPKD

A neonate is referred for echocardiography and abdominal sono. Echo revealed both atria to have features of the rt atrium. Abdominal sono revealed a partial situs inversus of the abdominal organs. What would the expectation be for the spleen?

Absence of splenic tissue

An 8mo old boy with a history of new onset irritability presents with lethargy, abdominal distinction, and fever. A moderate amount of blood is found to be present in the infants stool. What is the most likely diagnosis? A. Gastric upset B. Intussusception C. Peritonitis D. Pyloric stenosis

B. Intussusception

Rebound tenderness in the RLQ is called: A. Appendicolith B. Mcburneys sign C. Pericecal sign D. Graduated sign

B. Mcburneys sign

Sonographic imaging of the appendix includes using a technique called: A. Gradual compression B. Graduated compression C. Graded compression D. Grated compression

C. Graded compression

What is the imaging method of choice for diagnosing IHPS? A. CT B. Nuclear medicine C. Sonography D. UGI

C. Sonography

An endoleak occurs when blood is allowed to flow into the aneurysm sac after endograft placement. Based on the endoleak classifications, flow into the aneurysm owing to an inadequate seal between components of the device or a tear in the fabric of the graft would be given which of the following designations? A. Type 1 B. Type 2 C. Type 3 D. Type 4

C. Type 3

An elevated____ can be an indicator for appendicitis; however, the accuracy of this test alone is limited. A. Temp B. Hematocrit C. WBC count D. RBC count

C. WBC count

A 10-year-old boys referred For scrotal sonography because on clinical examination only one of his testicles was probable within the srotal sac. A homogenous ovoid mass is identified within the left inguinal canal. Surgical repair is recommended because this condition is associated with an increased risk for which of the following?

Cancer

A 30-year-old man with gynecomastia elevated hCG, and no palpable scrotal mass presents for a sonogram. The most sonographic findings includes a 1.5 cm heterogeneous mass with in the right testicle. After orchiectomy, the prognosis remains poor because this type of cancer does not respond well to radiation and chemo therapy. The clinical and sonographic findings suggest which type of cancer?

Choriocarcinoma

A young woman presents with a painless, diffusely enlarged thyroid gland on physical examination. Sono appearance confirms diffuse enlargement with a micronodular pattern and increased vasculrity. What is the likely condition

Chronic thyroiditis

Which of the following would be most worrisome? A. Hypoechoic oval mass with a hyperechoic center found in the breast of a 45yo woman B. Microcalcified mass seen on the breast of a 38yo woman C. Hard, mostly cystic mass seen 2 mo post op, posterior to mastectomy scar D. 4-cm, smooth, oval mass with cystic areas in the breast of a 55yo woman

D. 4-cm, smooth, oval mass with cystic areas in the breast of a 55yo woman

A linear transducer with a range of ____ MHz is used during sono eval of the appendix A. 1-2 B. 4-5 C. 6-7 D. 7-12

D. 7-12

All but which of the following must be evaluated when using ultrasonography to image the pylorus? A. Channel length B. Muscle thickness C. Gastric peristalsis D. Duodenum

D. Duodenum

A 46 yo man presents with a history of stomach ulcers, electrolyte imbalance, and persistent vomiting. Likely diagnosis A. Bowel perforation B. Cholecystitis C. Intussusception D. Pyloric stenosis

D. Pyloric stenosis

Classic symptoms of appendicitis include periumbilical pain, followed by nausea, _____ pain, and subsequent vomiting with fever. A. LUQ B.LLQ C. RUQ D.RLQ

D. RLQ

All but which of the following might occur with IHPS? A. Dehydration B. Metabolic alkalosis C. Projectile vitamin D. Wt gain

D. Wt gain

A patient with a history of celiac disease and a compromised immune system is brought in for sono eval of the spleen. The clinical concern is hypospenism. What sono findings might be expected

Decreased or normal size

The sono technique used in the diagnosis of dissection varies depending on the location of the dissection. Which section of the aorta May benefit from transabdominal sono? A. Descending aorta B. Ascending aorta C. Aortic arch Ascending and descending aorta

Descending aorta

Rupture of the intima of the aorta, which then separates from the media with a column of blood between 2 layers, is the definition of: A. Dissection B. Endograft failure C. Aneurysm D. Thrombus

Dissection

A 28-year-old man undergoes a clinical evaluation for a palpable mass in the left testicle. A sonogram of those a solid, mostly hypoechoic mass including a shadowing calcification with in the left testicle. A small amount of fluid also surrounds the left testicle. These findings are mostly just of of

Embryonal cell carcinoma

Which of the following best describes the conventionally accepted definition of AAA? A. Focal dilation 1.5 times its normal diameter; an infrarenal diameter of 3 cm or larger B. Focal Dilation 1.7 times normal diameter C. General dilation 3 times normal diameter D. General dilation 1.8 times normal diameter

Focal dilation 1.5 times its normal diameter; an infrarenal diameter of 3 cm or larger

a 32yo man undergoes eval for infertility and is ordered for sono exam. Sono shows a collection of vessels measuring 2.0-2.5mm in the left hemiscrotum. What doppler findings within this collection of vessels would suggest a primary vericocele?

Further Dilation and increased blood flow during valsalva maneuver

832-year-old man undergoes evaluation for infertility, and his physician orders a sonogram. The examination shows a collection of vessels measuring 2.0- 2.5 mm in the left hemiscrotum. What Doppler findings within collection of vessels would suggest a primary varicocele?

Further dilation and increased blood flow during Valsalva maneuver

A 16-year-old girl presents to the sonography department with a breast mass that has been palpable for six months. Sonographically, a 7 cm, smooth, oval, gently lobulated mass seen. The findings are most consistent with which of the following?

Giant fibroadenoma

A 16uo girl presents w/breast mass that has been palpable for 6mo. Sonographically, a 7cm, smooth, oval, gently Lou later mass is seen. Findings consistent with

Giant fibroadenoma

A 35yo man presents with symptoms consistent with hyperthyroidism. Neck sono reveals diffusely hypoechoic with a lobulated contour. No discrete modules are seen. Color D. Shows a dramatic increase in flow throughout the gland. Likely cause for findings

Graves' disease

A 31yo woman is referred for sono after bilateral neck fullness is noted during a routine physical exam. Sono appearance of thyroid gland is diffuse, hypoechoic enlargement of both lobes and the isthmus and "coarse" parenchyma. The sono features of the mass along with patients gender and age are suspicious for

Hashimoto's thyroiditis

A 2 day old infant is referred for an abdominal sonogram b/c an echogenic liver nodule seen on the prenatal ob sono. Additionally, the infant has a a strawberry- colored mass on the rt side of her neck. The sono is most likely to reveal which kind of liver mass? A. Hepatoblastoma B. Choledocal cyst C. Congenital hepatic fibrosis D. Hemangioendothelioma

Hemangioendothelioma

An asymptomatic pt undergoes sono For possible enlargement of the spleen on physical exam. Sono reveals splenic length of 11.7 cm and 1.5 cm round hyperechoic nodule in the superior aspect. These findings are most likely consistent with which of the following A. Accessory spleen B. Hemangioma C.angiosarcoma D. Harmartoma

Hemangioma

A 1yo boy is referred for an abdominal sono. History- delivered prematurely with hepatomegaly and elevated alpha fetoprotein levels. A 9cm hepatic mass with calcification is noted. Mass appears to have invaded the adjacent portal vein. What do the clinical history and features of this mass suggest? A. Neuroblastoma B. Hepatoblastoma C. Hemangioendothelioma D. Biliary atresia

Hepatoblastoma

The classic presentation of a ruptured AAA includes the triad of

HypOtension, abdominal or back pain, pulsation abdominal mass

Which of the following is not considered a mass of the breast tissue

Inclusion cyst

Which of the following is not considered a mass of the breast tissue? Oil cyst Inclusion cyst Lipoma Hematoma Galactocele

Inclusion cyst

A 10yo girl presents with a very tender, high- midline neck mass. Her parents report feeling a small lump in this location since she was a baby, but it has enlarged and is now painful. The sono reveals an oval, 1.0 cm x1.5 cm cystic mass with a thin wall and some internal debris. It is located approximately 3cm superior to the thyroid isthmus. What is most likely cause I'd cystic mass?

Infected thyroglossal duct cyst

A 50-year-old woman palpates a compressible, molar mass in her left breast. So graphically, the mass, although probable, is indistinguishable from the surrounding breast tissue. What would be the most likely diagnosis?

Lipoma

A 50yo woman palpates a compressible minke mass in her lt breast . Somographically, the mass, although palpable, is indistinguishable from the surrounding breast tissue. Likely diagnosis?

Lipoma

A 19yo woman presents with enlarged cervical lymph nodes, fatigue, and leukopenia. Before her scheduled bone marrow biopsy, an abdominal sono was performed, revealing diffuse, hypoechoic lesions within the spleen. This describes A.infarct B. Lymphoma C. Harmaroma D. Metastasis

Lymphoma

A 1 yo girl is referred for abdominal sono after a palpable mass is noted for in the rt side. The child has no significant clinical signs or symptoms of disease. Sono reveals multiple, noncommunicating cysts in the rt renal bed. Likely cause? A. UPJ obstruction B. UVJ obstruction C. MCDK D. ARPKD

MCDK

An elderly man with painless, palpable thyroid nodule is referred for thyroid sono. Precious imaging studies have reported a thyroid nodule with calcification. A 2nd sono is done and reveals 2x3 cm solid, hypoechoic nodule with a hypoechoic halo and disruption of peripheral, egg shell calcification. These findings make this nodule suspicious for

Malignant nodule

Guidelines recommend a one-time screening with sonography for AAA in

Men 64-75 years old who have ever smoked

A young man is referred for sono eval of lateral neck mass that is nontender. Sono reveals a solitary thyroid nodule and multiple rounded masses that follow the carotid jugular areas. Both the intrathyroidal and extrathyroidal masses contain microcalcifications. This should represent

Metastatic thyroid cancer

A 63yo man in apparent good health is seeking a second opinion for a thyroid nodule that was diagnosed elsewhere. He was told that the nodule contained "psammoma bodies" this findings refers to

Microcalcifications in a nodule

A 1mo old infant is referred for sono eval of palpable abdominal mass. No other clinical signs or symptoms have been noted. Labs- elevated catechikamine levels. Sono reveals 5cm homogeneous lt suprarenal mass; calcification within the mass are noted. Doppler reveals moderate blood flow within the mass. Likely represents? A. Neuroblasotma B. Adrenal hemorrhage C. Wilms tumor D. MCDK

Neutoblastoma

A___ appendix must be ID'd to rule out appendicitis completely. A. Perforated B. Normal C. Pelvic D. Retroperitoneal

Normal

830-year-old woman with a history of breast reduction is sent to the sonogram department for imaging of palpable masses along the surgical scar. It's on account of those three round, smooth, and a cord masses. This phone is a most consistent with which of the following?

Oil cyst

30yo woman w/hx of breast reduction sent for sono for palpable masses along surgical scar. Sono reveals 3 round, smooth, anechoic masses. Findings are most consistent with which of the following?

Oil cysts

A 52-year-old man is diagnosed with epididymo - orchitis after a sonographic evaluation. His clinical signs and symptoms most likely include which of the following?

Painful enlargement of the scrotum

What are the two most common indications for breast sonography

Palpable breast and the need for more information regarding a lesion seen with another method

A 19yo man w/no significant medical history is seen with a palpable nodule in the region of the right inferior lobe of the thyroid. On sono exam, corresponding nodule is found to be slightly less echogenic than the surrounding thyroid parenchyma. There is a wide , irregular halo surrounding the nodule and fine punctuate internal calcification throughout the nodule. What is the most likely diagnosis

Papillary thyroid cancer

A postmenopausal pt with hypercalcemia and hypophosphatasia is referred for sono of the neck. An oval shaped, hypoechoic mass is seen posterior to the mid-lower right lobe of the thyroid. The clinical findings of hypercalcemia and hypophosphatasia along with the shape and location are most suggestive of

Parathyroid adenoma

A 4wk old girl with projectile vomiting for 2 days is seem. She is jaundice, and the physician is able to palpate an olive shaped mass in the RUQ on physical examination. What is the most likely diagnosis? A. Intussusception B. Pyloric stenosis C. Reflux D. Ulcer

Pyloric stenosis

What is the preferred method of labeling scam plans for breast sonography

Radial and antiradial

A 50-year-old woman with augmented breasts presents to the sonography department complaining of newly occurring asymmetry of breast size, right smaller than left. Sono graphically, the right breast has long, echogenic lines within the internal portion of the implant. Shadowing, resembling bowel gas, is also seen along the external periphery of the implant. The findings are most consistent with which of the following?

Right breast "stepladder" and "snowstorm" sign

50yo woman w/augmented breasts complains of newly occurring asymmetry of breast size, Rt smaller than lt. Sono shows: Rt has long echogenic lines w/in the internal portion of the implant. Shadowing resembling bowel gas is also seen along external periphery of implant. Findings consistent with..

Rt breast "stepladder" and "snowstorm" signs

A 30-year-old man undergoes a sonograph examination for painless mass in the right hemiscrotum. The sonogram reveals multiple punctate hyperechoic non-shadowing Foci and a hyperechoic mass within the right testis. What is the most likely diagnosis?

Seminoma with microlithiasis

An adult pt presents with mild lt- sided pain. On a sono, the spleen appeared to be of normal echogenicity. In a normal patient, what is the expected echogenicity of the spleen compared with the liver.

Slightly increased

The preferred method of evaluations and screening for AAA is:

Sonography

A 43-year-old man is seen with a mobile painless mass at the upper pole of his right testis. Sonograph examination reveals a 1.5 cm, round anechoic lesion that demonstrates acoustic enhancement. No other abnormalities are a parent. This probably represents a

Spermatocele

A 35 yo man with a history of HIV presents with severe LUQ pain, decreased hematocrit, and hypotension. Clinical assessment and CT imaging confirmed confirmed rupture of the spleen. A consequence of splenic rupture is A. Granuloma B. Infection C. Splenosis D. Malignancy

Splenosis

A 15-year-old boy seen in the emergency department after falling and straddling a bicycle crossbar. He has pain and swelling of the scrotum. The sonogram demonstrates heterogeneity of the right testicle and hypervascularity on color Doppler examination. An area of echogenic material seen just outside the upper margin of the right testicle. What is the most likely diagnosis?

Testicular rupture

A 25 yo man has a sudden onset of scrotal pain during a soccer game. During examination in the ER, the right hemiscrotum is still painful. Sono reveals slight enlargement of right testicle, and on color doppler examination, no blood flow can be found in the right testicle. Likely diagnosis?

Testicular torsion

A 25-year-old man has a sudden onset of scrotal pain during a soccer game. During examination in the emergency department, do you write him he scrotum is still painful. I sonogram reveals slight enlargement of the right testicle, and on Doppler examination, no bloodflow can be found in the right testicle. What is the most likely diagnosis?

Testicular torsion

An elderly pt who is a poor clinical historian presents for abdominal sono. Splenic images reveal multiple diffuse, small, echogenic foci without posterior shadowing. Which of the following illnesses may the patient have had in the past? A. Lymphoma B.malignancy C. Pyogenic abscess D. Tuberculosis

Tuberculosis

A 61-year-old man is seen with intermittent pain and swelling of the right scrotum, radiating to the right inguinal canal. A sonogram is ordered because a scrotal hernia is suspected. Which of the following sonographic findings is suggestive of a scrotal hernia?

Tubular structures that demonstrate peristalsis within the scrotum

A 3yo girls is referred for renal sono following a 6mo history of recurrent UTIs. Sono reveals a duplicated collecting system on the Rt kidney. Mild to moderate hydronephrosis is evident. A mildly dilated rt ureter can be followed to its insertion into the bladder where a ureterocele is noted. What condition does this describe? A. UPJ obstruction B. UVJ obstruction C. Posterior urethral valves D. MCDK

UVJ obstruction

A newborn boy after prolonged labor and breech delivery presents with a questionable RUQ mass. At physical examination, a swollen and bluish discolored scrotum is noted. Lab reveals anemia. Sono of RUQ and scrotum is requested. Sono reveals crescent- shaped, slightly hyperechoic Rt suprarenal mass. Most likely cause? A. Unilateral adrenal hemorrhage B. MCDK C. Wilms tumor D. Mrs oblast is nephroma

Unilateral adrenal hemorrhage

A 43yo woman presents with abdominopelvic pain. Images reveal normal liver and kidneys, spleen absent in LUQ. Sono images of abdomen and pelvis reveal a homogeneous, medium gray , mass like lesion in superior left adnexa. This finding is consistent with

Wandering spleen

A 3yo boy with abdominal pain is seen w/ large, firm, palpable mass in LUQ. Abd sono reveals large, spherical, heterogeneous LUQ mass. Organ of origin is the kidney. Eval of IVC and lt renal vein reveals presence of tumor thrombus. What does thus likely represent. A. Neiroblastoma B. Wilms tumor C. MCDK D. Mesoblastic nephroma

Wilms tumor

a 61yo man is seen with intermittent pain and swelling of the rt scrotum, radiating to the rt inguinal canal. Sono is ordered b/c a scrotal hernia is suspected. Which of the following sono findings is suggestive of scrotal hernia?

tubular structures that demonstrate peristalsis within the scrotum