Chapters 4-6
Fora patient older than the age of 60, or who have had a cholecystectomy, a maximum diameter of ____ may be considered normal
10 mm/1 cm
The biliary duct wall should never measure more than
5 mm
Epstein-Barr infection is best described as
A herpes virus that can lead to infectious mononucleosis in children
A 25-year-old female patient presents to the ultrasound appointment for a complete abdominal sonogram. She complains of right lower quadrant pain and nausea. The right upper quadrant appears normal. A small mass is located in the area of the splenic hilum. This mass appears isoechoic to the spleen. What is most likely to represent
Accessory spleen
Which cells carry out the exocrine function of the pancreas
Acinar cells
All of the following are forms of cholangitis
Acute bacterial, AIDS, oriental
The most common form of malignancy in the pancreas is
Adenocarcinoma
Courvoisier gallbladder is found in the presence of
Adenocarcinoma in the head of the pancreas
The merging of the pancreatic duct and common bile duct at the level of the duodenum is referred to as
Ampulla of Vater
A rare malignant tumor of the spleen consisting of blood vessels is a
Angiosarcoma
The Klatskin tumor is located
At the junction of the right and left to hepatic ducts
A congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as
Biliary atresia
The yellow pigment found in bile that is produced by the breakdown of old red blood cells by the liver is
Bilirubin
Mucinous cystadenocarcinomas of the pancreas are most often located in which part of the pancreas
Body and tail
The splenic artery originates at the
Celiac trunk
A 64-year-old man presents to the sonography department for right upper quadrant sonogram. He's complaining of abdominal pain, weight loss, and puritis. Sonographically, you visualize an area of dilated ducts it abruptly end. What is most likely the diagnosis
Cholangiocarcinoma
A klatskin tumor is a form of
Cholangiocarcinoma
Primary biliary tree cancer is referred to as
Cholangiocarcinoma
A 32-year-old female patient presents to the sonography department with a history of fever, leukocytosis, and right upper quadrant pain. Sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. What is the most likely diagnosis
Cholangitis
Inflammation of the bile ducts is referred to as
Cholangitis
An abdominal sonogram is ordered on an infant in the intensive care unit who is suffering from jaundice and fever. Sonographically, you visualize a cystic mass with in the common bile duct that is causing a focal enlargement. This is most suggestive of
Choledochal cyst
What kind of biliary cyst is common within children
Choledochal cyst
A gallstone located within the biliary tree is referred to as
Choledochalithiasis
Which of the following would be the most distal portion of the biliary tree
Common bile duct
If an obstructive biliary calculus located with in the distal common duct, which of the following could be ultimately dilated
Common bile duct, gallbladder, common hepatic duct
The spleen removes irregular cells from the bloodstream and retains them through a process called
Culling
The spiral valves of Heister are located within the
Cystic duct
All of the following are sonographic features of chronic pancreatitis
Dilated pancreatic duct, calcifications with in the pancreas, pancreatic pseudocyst
The most common level for biliary obstruction to occur is the
Distal common bile duct
Coexisting obstruction of the common bile duct and pancreatic duct maybe referred to as
Double duct sign
What is the name for the main pancreatic duct
Duct of Wirsung
What is a additional name for the accessory duct of the pancreas
Duct of santorini
What is the most common sonographic appearance of a splenichemangioma
Echogenic/hyperechoic
Clinical findings associated with pancreatic adenocarcinoma
Epigastric pain, weight loss, jaundice
The process of making red blood cells is termed
Erythropoiesis
Which segment of the biliary tree tends to dilate first with obstruction
Extrahepatic
What is associated with the development of pneumobilia
Gastric surgery, acute cholecystitis, fistula formation
The arterial blood supply to the head of the pancreas is via the
Gastroduodenal artery
Which part of the pancreas is located right lateral to the superior mesenteric vein, anterior to inferior vena cava, and inferior to the portal vein
Head
Most common location of adenocarcinoma of the pancreas is within the
Head of the pancreas
The most common location of focal pancreatitis
Head of the pancreas
A 32-year-old female patient presents to the ultrasound apartment for an abdominal sonogram an evaluation of the spleen reveals a 1 cm, rounded, echogenic mass that does not produce acoustic shadowing. What is most likely the diagnosis
Hemangioma
You will see a decreased ____ in a patient who has a splenichemangioma
Hematocrit
In a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates
Hodgkin lymphoma
A complex cyst that results from the parasitic infection of the spleen by tape worm
Hydatid cyst
The most common echogenicity of an acutely inflamed pancreas is
Hypoechoic
Which of the following is the hormone released by the pancreas that encourages the bodies use of glucagon
Insulin
Which of the following is the most common islet cell tumor
Insulinoma
If a gallstone, causing obstruction, is located with in the distal common hepatic duct, which of the following would become dilated
Intrahepatic ducts
Which of the following is considered to be the most proximal portion of the biliary tree
Intrahepatic radicals
Is the spleen and intraperitoneal or retroperitoneal organ
Intraperitoneal
The yellow staining of the whites of your eyes in the skin secondary to a liver disorder or biliary obstruction is referred to as
Jaundice
Clinical findings with choledochalithiasis include
Jaundice, elevated bilirubin, elevated alkaline phosphatase
The spleen is the _____ structure of the _____ system
Largest, reticuloendothelial
One of the most common locations for pancreatic pseudocyst is within the
Lesser sac
Classic clinical features of acute pancreatitis
Leukocytosis, back pain, fever
Which laboratory value listed below appears to be more specific for acute pancreatitis
Lipase
One clinical sign of an insulinoma is the presence of
Low blood sugar
This spleen is considered the largest _____ organ
Lymphatic
A patient presents with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct. This is referred to as
Mirizzi syndrome
Small echogenic foci scattered throughout the spleen most likely represents
Multiple benign granulomas
A 35-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen
Multiple granulomas
What is the early sonographic appearance of acute pancreatitis
Normal
Courvoisier gallbladder is
Palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head
Which part of the pancreas is located anterior to the portal confluence
Pancreatic neck
The primary objective of the spleen is to filter the _____ blood
Peripheral
Air within the biliary tree
Pneumobilia
Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma the produce ring down artifact. What is most likely the diagnosis
Pneumobilia
The most common cause of splenomegaly is
Portal hypertension
The splenic vein marks the
Posterior aspect of the pancreatic body and tail
All of the following are part of the exocrine function of the pancreas
Production of lipase, Amylase, and sodium bicarbonate
Clinical findings consistent with cholangiocarcinoma
Puritis, weight loss, elevated bilirubin
The type of tissue with the spleen that is responsible for phagocytic function is the
Red pulp
Is the pancreas and intraperitoneal or retroperitoneal organ
Retroperitoneal
What systemic disease results in the development of granulomas with in the spleen and throughout the body
Sarcoidosis
The muscle that controls the emptying of bile and pancreatic juices in the duodenum is
Sphincter of Oddi
A 14-year-old male patient presents to the ultrasound apartment after falling from his bicycle. And I'm normal sonogram reveals a complex of hearing mass with in the spleen. This most likely represents a
Splenic hematoma
Where is the most common location of an accessory spleen
Splenic hilum
A 48-year-old male patient with a history of severe, sudden onset of left upper quadrant pain without trauma presents to the ultrasound department for sonogram of the spleen. You visualize a wedge shaped, hypoechoic area within the spleen. This most likely represents a
Splenic infarct
An area within the spleen that has become a necrotic because of lack of oxygen is referred to as
Splenic infarct
Diffuse involvement of lymphoma or leukemia of the spleen more often lead to
Splenomegaly
Sickle cell disease will often lead to
Splenomegaly
The functions of the spleen
Storage of iron, defense against disease, blood reservoir
The splenic artery marks the
Superior aspect of the pancreatic body and tail
The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein
Superior mesenteric vein
The gallbladder is connected to the biliary tree by
The cystic duct
The portion of the bowel that encompasses the head of the pancreas is
The duodenum
The pancreatic tail is outline posteriorly by what vascular structure
The splenic vein
Things associated with splenomegaly
Trauma, hemolytic abnormalities, mononucleosis
Which of the following is associated with the development of cysts with in the pancreas
Von Hippel-Lindau disease
The type of tissue within the spleen that is responsible for its lymphatic function is the
White pulp
A gastrinoma of the pancreas can produce
Zollinger-Ellison syndrome