CH. 3 The Gallbladder - Review Questions

The middle layer of the gallbladder wall is the: a.Fibromuscular layer b.Mucosal layer c.Serosal layer d.Muscularis layer

a.Fibromuscular layer

At which level of the gallbladder is the junctional fold found? a.Neck b.Fundus c.Body d.Phrygian cap

a.Neck

Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with: a.Acute cholecystitis b.Acalculous cholecystitis c.Adenomyomatosis d.Gallbladder perforation

c.Adenomyomatosis

With which of the following is Courvoisier gallbladder associated? a.A pancreatic head mass b.A stone in the cystic duct c.Cholecystitis d.Chronic diverticulitis

a.A pancreatic head mass

The diffuse polypoid appearance of the gallbladder referred to as strawberry gallbladder is seen with: a.Cholesterolosis b.Adenomyomatosis c.Cholangitis d.Kawasaki disease

a.Cholesterolosis

Diabetic patients suffering from acute cholecystitis have an increased risk for developing: a.Emphysematous cholecystitis b.Gangrenous cholecystitis c.Chronic cholecystitis d.Gallbladder torsion

a.Emphysematous cholecystitis

The sequela of acute cholecystitis that is complicated by gas within the gallbladder wall is: a.Emphysematous cholecystitis b.Membranous cholecystitis c.Chronic cholecystitis d.Gallbladder perforation

a.Emphysematous cholecystitis

Which structure is a useful landmark for identifying the gallbladder? a.Main lobar fissure b.Hepatoduodenal ligament c.Falciform ligament d.Ligamentum venosum

a.Main lobar fissure

Which statement is not true of cholelithiasis? a.Men have an increased likelihood of developing cholelithiasis. b.Patients who have been or are pregnant have an increased occurrence of cholelithiasis. c.A rapid weight loss may increase the likelihood of developing cholelithiasis. d.Patients who have hemolytic disorders have an increased occurrence of cholelithiasis.

a.Men have an increased likelihood of developing cholelithiasis.

Focal tenderness over the gallbladder with probe pressure describes: a.Murphy sign b.Strawberry sign c.Courvoisier sign d.Hydrops sign

a.Murphy sign

Which part of the gallbladder is involved in Hartmann pouch? a.Neck b.Fundus c.Body d.Phrygian cap

a.Neck

The most common variant of gallbladder shape is the: a.Phrygian cap b.Hartmann pouch c.Septated gallbladder d.Junctional fold

a.Phrygian cap

Which of the following is not a risk factor for the development of gallstones? a.Phrygian cap b.Pregnancy c.Total parenteral nutrition d.Oral contraceptive use

a.Phrygian cap

Which of the following is associated with cholelithiasis and is characteristically found in Africans or people of African descent? a.Sickle cell disease b.Gallbladder torsion c.Cholesterolosis d.Arland-Berlin syndrome

a.Sickle cell disease

The diameter of the gallbladder should not exceed: a.8 cm b.5 cm c.7 mm d.3 cm

b.5 cm

What hormone causes the gallbladder to contract? a.Estrogen b.Cholecystokinin c.Bilirubin d.Biliverdin

b.Cholecystokinin

The spiral valves of Heister are found within the: a.Gallbladder neck b.Cystic duct c.Gallbladder fundus d.Gallbladder wall

b.Cystic duct

Tumefactive sludge can resemble the sonographic appearance of: a.Cholelithiasis b.Gallbladder carcinoma c.Cholecystitis d.Adenomyomatosis

b.Gallbladder carcinoma

Empyema of the gallbladder denotes: a.Gallbladder hydrops b.Gallbladder filled with pus c.Gallbladder completely filled with air d.Gallbladder completely filled with polyps

b.Gallbladder filled with pus

What is/are cholelithiasis? a.Inflammation of the gallbladder b.Gallstones c.Hyperplasia of the gallbladder wall d.Polyps within the biliary tree

b.Gallstones

Acute cholecystitis that leads to necrosis and abscess development within the gallbladder wall describes: a.Emphysematous cholecystitis b.Gangrenous cholecystitis c.Chronic cholecystitis d.Gallbladder perforation

b.Gangrenous cholecystitis

The innermost layer of the gallbladder wall is the: a.Fibromuscular layer b.Mucosal layer c.Serosal layer d.Muscularis layer

b.Mucosal layer

5.WES sign denotes: a.The presence of a gallstone lodged in the cystic duct b.Multiple biliary stones and biliary dilatation c.A gallbladder filled with cholelithiasis d.The sonographic sign of a porcelain gallbladder

c.A gallbladder filled with cholelithiasis

Which of the following would be least likely to cause focal gallbladder wall thickening? a.Gallbladder polyp b.Adenomyomatosis c.Ascites d.Adhered gallstone

c.Ascites

31.Which of the following would be the least likely finding of acalculous cholecystitis? a.Gallbladder wall thickening b.Pericholecystitic fluid c.Cholelithiasis d.Positive Murphy sign

c.Cholelithiasis

Intermittent obstruction of the cystic duct by a gallstone results in: a.Emphysematous cholecystitis b.Gangrenous cholecystitis c.Chronic cholecystitis d.Acute cholecystitis

c.Chronic cholecystitis

A 71-year-old patient presents to the emergency department with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for: a.Acute cholecystitis b.Chronic cholecystitis c.Courvoisier gallbladder d.Porcelain gallbladder

c.Courvoisier gallbladder Courvoisier gallbladder—the clinical detection of an enlarged, palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head; typically caused by a pancreatic head mass

The gallbladder is connected to the biliary tree by the: a.Common hepatic duct b.Common bile duct c.Cystic duct d.Right hepatic duct

c.Cystic duct

The champagne sign is associated with: a.Adenomyomatosis b.Cholangiocarcinoma c.Emphysematous cholecystitis d.Acalculous cholecystitis

c.Emphysematous cholecystitis

Hepatization of the gallbladder occurs when the gallbladder: a.Perforates b.Becomes hydropic c.Fills with sludge d.Undergoes torsion

c.Fills with sludge (GB completely filled with sludge and is isoechoic to liver)

A nonmobile, nonshadowing focus is seen within the gallbladder lumen. This most likely represents a: a.Gallstone b.Gallbladder carcinoma c.Gallbladder polyp d.Sludge ball

c.Gallbladder polyp

Calcification of the gallbladder wall is termed: a.Concrete gallbladder b.Heister syndrome c.Porcelain gallbladder d.Hyperplastic cholecystosis

c.Porcelain gallbladder

The cystic artery is most often a direct branch of the: a.Main pancreatic artery b.Celiac artery c.Right hepatic artery d.Left hepatic artery

c.Right hepatic artery

The outermost layer of the gallbladder wall is the: a.Fibromuscular layer b.Mucosal layer c.Serosal layer d.Muscularis layer

c.Serosal layer

The gallbladder wall should measure not more than: a.5 mm b.6 mm c.4 mm d.3 mm

d.3 mm

A 32-year-old female patient presents to the sonography department with vague abdominal pain. The sonographic investigation of the gallbladder reveals a focal area of gallbladder wall thickening that produces comet tail artifact. These findings are consistent with: a.Gangrenous cholecystitis b.Gallbladder perforation c.Acalculous cholecystitis d.Adenomyomatosis

d.Adenomyomatosis

Which of the following would not be a laboratory finding typically analyzed with suspected gallbladder disease? a.ALP b.ALT c.Bilirubin d.Alpha-Fetoprotein

d.Alpha-Fetoprotein

Which of the following is the most likely clinical finding of adenomyomatosis? a.Murphy sign b.Hepatitis c.Congestive heart failure d.Asymptomatic

d.Asymptomatic

The direct blood supply to the gallbladder is the: a.Cholecystic artery b.Common hepatic artery c.Main portal vein d.Cystic artery

d.Cystic artery

All of the following are sources of diffuse gallbladder wall thickening except: a.Acute cholecystitis b.AIDS c.Hepatitis d.Gallbladder polyp

d.Gallbladder polyp