chapter 4 bile ducts
For patients older than 60 or those who have a cholecystectomy, a max diameter of ... is considered normal
1cm
the biliary duct wall should never measure more than
2mm
which of the following disorders is associated with the sonographic triangular cord sign? -cholangitis -choledocholithiasis -biliary atresia -ascariasis
biliary atresia
the most common level for biliary obstruction to occur is the
distal CBD
a patient presents with jaundice, pain, and fever secondary to an impacted stone in the cystic duct. this is referred to as?
mirizzi syndrome
all of the following are forms of cholangitis except -acute bacterial -AIDS -oriental -parabolic
parabolic
air within the biliary tree is referred to as
pneumobilia
sonographically, you visualize scattered echogenic linear structure within the liver parenchyma that produce ring-down artifact. what is the most likely DX?
pneumobilia
pneumobilia will produce?
ring-down artifact
which of the following is characterized by fibrotic thickening of the bile ducts, found most often in young males, and is associated with inflammatory bowel disease or ulcerative colitis? -ulcerative biliary atresia -oriental cholangitis -sclerosing cholangitis -AIDS biliary atresia
sclerosing cholangitis
the klatskin tumor is located
at the junction of the right and left hepatic ducts
the yellowish pigment found in bile that is produced by the breakdown of old RBC by the liver is
bilirubin
a gallstone located within the biliary tree is referred to as
choledocholithiasis
which of the following would be the most common cause of obstructive jaundice? -klatskin tumor -cholangiocarcinoma -biliary atresia -choledocholithiasis
choledocholithiasis
what is the most distal portion of the biliary tree?
common bile duct
the spiral valves of heister are located within the
cystic duct
Which segment of the biliary tree tends to dilate first with obstruction
extrahepatic
what considered to be the most proximal portion of the biliary tree?
intrahepatic radicles
the muscle that controls the emptying of the bile and pancreatic juices into the duodenum is the
sphincter of oddi
Ascariasis is caused by
a parasitic roundwarm
If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate? -CBD -GB -Common hepatic duct -All the above
all the above
the merging point of the pancreatic duct and common bile duct at the level of duodenum is referred to as the
ampulla of Vater
a congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as
biliary atresia
the presence of an echogenic dot in the nondependent part of a dilated duct representing small fibrovascular bundles is seen with
caroli disease
a 64 year old man presents to the sono department for a RUQ sonogram. he is complaining of abdominal pain, weight loss, and pruritus. sonographically, you visualize an area of dilated ducts that abruptly end. what is the most likely DX?
cholangiocarcinoma
a klatskin tumor is a form of
cholangiocarcinoma
primary biliary tree cancer is referred to as
cholangiocarcinoma
which of the following is not associated with the development of pneumobilia? -cholangiopneumonia -gastric surgery -acute cholecystitis -fistula formation
cholangiopneumonia
a 32 year old female patient presents to the sono department with a hx of fever, leukocytosis, and RUQ pain. sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. what is the most likely dx?
cholangitis
inflammation of the bile ducts is referred to as
cholangitis
which of the following is associated with charcot triad? -cholangitis -cholesterolosis -Klatskin tumor -choledochal cyst
cholangitis
An abdominal sonogram is ordered on an infant in the intensive care unit who is suffering from jaundice and fever. You see a cystic mass within the cbd that is causing a focal enlargement. This is most suggestive of
choledochal cyst
which of the following is not a plausible cause of CBD obstruction in adults? -choledocholithiasis -chronic pancreatitis -choledochal cyst -pancreatic carcinoma
choledochal cyst
which of the following is typically found in pediatric patients and is described as the cystic dilation of the CBD? -biliary atresia -mirizzi syndrome -caroli disease -choledochal cyst
choledochal cyst
which of the following would be the least helpful laboratory value to analyze in patients with suspected biliary tract disease? -ALT -ALP -GGT -creatinine
creatinine
all of the following are clinical findings consistent with cholangiocarcinoma except: -pruritus -weight loss -elevated bilirubin -dilation of the intrahepatic ducts
dilation of the intrahepatic ducts
clinical findings of choledocholithiasis include all of the following except: -jaundice -elevated bilirubin -elevated ALP -elevated blood urea nitrogen
elevated blood urea nitrogen
which of the following could accidentally introduce bacteria into the biliary tree and thus cause cholangitis? -CT -MRI -radiography -endoscopic retrograde cholangiopancreatography
endoscopic retrograde cholangiopancreatography
If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated?
intrahepatic ducts
the yellowish staining of the whites of the eyes and then skin secondary to a liver disorder or biliary obstruction is referred to as
jaundice
