DMS 340 Quizzes before and after MT

Splenomegaly in an adult is diagnosed when the spleen measures greater than:

13cm

The transducer typically selected for an ultrasound examination of the abdomen is the:

2.25-7MHz curvilinear

The normal size of the pancreatic duct is less than ____ mm.

3

The normal bladder wall should be smooth and thin and measure between ____________ millimeters (mm).

3-6

The thickness of the gallbladder wall in a normal fasting patient should not exceed:

3mm

The diameter of the common hepatic duct is approximately ______.

4mm

Neuroblastoma commonly presents at what age?

5 years or less

An appendicitis is described as a non-compressible tubular structure measuring great than ___ millimeters (mm).

6

How long should the patient fast, prior to an abdominal ultrasound?

8 hours

Approximately 60% of acute viral hepatitis in the United States is Type_____.

B

Fatty infiltration appearance may be observed on sonography in all patients EXCEPT those with: Severe hepatitis Chronic alcoholism Severe hepatitis Budd Chiari Syndrome

Budd Chiari syndrome

Which of the following best describes the sonographic appearance of chronic kidney disease:

Echogenic kidney with loss of normal anatomy, typically smaller in size

Complication of cholecystitis that occur in older diabetic patients and is characterized by the presence of gas forming bacteria in the gallbladder wall:

Emphasematous Cholecystitis

Hydronephrosis may be best demonstrated sonographically by which one of the following patterns?

Fluid-filled pelvocaliceal collecting system

A patient lying on their side, with the right side up- 90 degrees from the table, is in the:

LLD

The right kidney is in contact with:

Liver, colon, and right adrenal gland

A patient presents to the emergency room with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct causing obstruction of the common hepatic duct. This condition is known as:

Mirrizzi Syndrome

The sonographic appearance of cholelithiasis is best described as:

Mobile, hyperechoic focus demonstrating posterior shadowing

Massive splenomegaly is most likely the result of:

Myelofibrosis

Sonographic evidence of acute hepatitis includes:

Portal vein borders may be more echogenic than usual, with normal to slightly increased liver parenchyma

The portal confluence is formed by the splenic vein and the ___________________.

SMV

Granulocytopoietic abnormalities can result from of all of the following EXCEPT: Histoplasmosis TB Urinary Tract Infection Sarcoidosis

UTI

In glycogen storage disease, type I is the most common and is also known as ____ disease.

Von Gierkes

A gastrinoma of the pancreas can produce:

Zollinger-Ellison syndrome

The situation when bowel or fat protrudes through a weakened area in the abdominal wall is termed:

abdominal hernia

Patients on dialysis tend to develop:

acquired cystic disease

Acute tubular necrosis is the most common cause of:

acute renal failure

Courvoisier gallbladder is found in the presence of:

adenocarcinoma in the head of the pancreas

What benign liver tumor has been found in patients with type I glycogen storage disease?

adenoma

Which one of the following is the most common of the primary ADRENAL tumors? -carcinoma -adenoma -pheochromocytoma -cyst

adenoma

Results from hyperplastic changes of the gallbladder wall and may cause "comet tail" artifact which can display a focal or diffuse pattern:

adenomyomatosis

A dirty shadow is likely the result from:

air in the duodenum

A severe increase in this laboratory value can be seen with obstructive liver disease:

alkaline phosphatase (ALP)

Which of the following should be included on a physicians order? All answers are correct Reason for exam Ordering Physician information and signature Type of Exam

all answers are correct

The liver converts _____________________ to urea to be excreted by the kidneys

ammonium

Another term for sonolucent is:

anechoic

An echo free structure is described as:

anechoic or sonolucent

Which of the following describes the internal characteristics of a simple cyst?

anechoic or sonolucent

Inflammatory or malignant ascites demonstrates all the following characteristics EXCEPT: -Fine or course internal echoes -Matting of bowel loops -Loculations of fluid -Anechoic patterns with smooth borders

anechoic patterns with smooth borders

A benign vascular fatty tumor of the kidney is called:

angiomyolipoma

The body of the pancreas lies _________________ to the splenic vein?

anterior

Rebound tenderness is associated with:

appendicitis

What is first identified, in normal situations after IV administration of ultrasound contrast agent?

arterial phase

Fluid in the abdominal/peritoneal cavity is called:

ascites

A Klatskin tumor is located:

at the junction of the right and left hepatic ducts

The typical sonographic appearance of the kidneys in a patient with autosomal recessive polycystic kidney disease is:

bilateral enlarged, echogenic kidneys

An excretory product of the liver that is stored in the gallbladder aids in the digestion of fats:

bile

The most common cause of acute pancreatitis in the United States is:

biliary tract disease

An extrahepatic loculated fluid collection that may develop because of spontaneous rupture of the biliary tree is called:

biloma

All of the following are true regarding the ligamentum teres EXCEPT: -Could be confused as a mass in the left lobe -Can recanalize with portal hypertension -Can be seen between the portal vein and neck of the gallbladder -Is the obliterated portion of the umbilical vein

can be seen between the portal vein and neck of the GB

Which of the following pathologies of the spleen is identified sonographically as having a "wheel within a wheel" appearance?

candidiasis

Splenic infarction is most commonly the result of:

cardiac emboli

All of the following are possible common causes of gallbladder wall thickening EXCEPT; Right sided heart failure hypoalbuminemia cholyecystitis Caroli's disease

caroli's disease

The most common benign tumor of the liver is:

cavernous hemangioma

Which one of the following tumors consists of large blood-filled spaces?

cavernous hemangioma

Inflammation of the common bile duct:

cholangitis

A fusiform dilation of the common bile duct that causes obstruction is known as:

choledochal cyst

A stone located in the bile duct is termed:

choledocholithisasis

Condition of the gallbladder that has a "strawberry gallbladder" appearance on gross pathology:

cholesterolosis

Condition that results from multiple bouts of acute cholecystitis:

chronic cholecystitis

Patients who have hepatocellular carcinoma are likely to have had:

cirrhosis

What is the most common cause of intrahepatic portal hypertension?

cirrhosis

All of the following are benefits of using ultrasound contrast agent EXCEPT: -improved detection of blood flow -classification of breast cysts -improved detection of tumors in abdomen -improved characterization of tumors in abdomen

classification of breast cysts

Mural Thrombus refers to:

clot attached to the wall of a blood vessel

Diverticulum is most common in the:

colon

A renal sonogram is performed. An area of cortical tissue that extends inward and separates the renal sinus is most consistent with:

column of bertin

The main pancreatic duct joins the ______ before entering the second part of the duodenum.

common bile duct

The gastroduodenal artery is a branch of the:

common hepatic artery

The aorta bifurcates into the:

common iliac arteries

Which of the following would not produce a complex sonographic pattern? -Hematoma -Congenital simple cyst -Hemorrhagic cyst -Abscess

congenital simple cyst

Water soluble bilirubin is also known as:

conjugated (AKA direct bilirubin)

Beta cells of the pancreas release insulin which stimulates the body to:

convert glucose to glycogen

The most common collateral pathways that occur with portal hypertension are the:

coronary (gastric) and esophageal veins

Which one of the following syndromes is a result of excessive secretion of cortisol?

cushing

A condition that causes increased secretion of abnormal mucus by the exocrine glands is:

cystic fibrosis

Typical symptoms a patient has with an abscess formation include all of the following EXCEPT: Decreased WBCs Increased WBCs Fever Pain

decreased WBC's

Fluid collects in the most ________________ areas of the abdomen and pelvis.

dependent

All of the following are normal functions of the spleen EXCEPT: -Production of lymphocytes -Storage of iron -Production of plasma cells -Destruction of normal red blood cells

destruction of normal red blood cells

Ectasia implies:

diffuse dilation of an artery/vessel

All of the following are sonographic features of chronic pancreatitis EXCEPT: -Diffusely hypoechoic pancreas -Calcifications within the pancreas -Dilated pancreatic duct -Atrophic pancreas

diffusely hypoechoic pancreas

Small bowel obstruction is associated with:

dilation of bowel loops proximal to the site of obstruction

A cortical bulge in the lateral border of the kidney is called a(n):

dromedary hump

All of the following are causes of hydronephrosis EXCEPT -Dromedary hump -Calculus -Bladder tumors -Normal pregnancy

dromedary hump

The portion of the bowel that encompasses the head of the pancreas is the:

duodenum

Where does most of the digestion of food take place?

duodenum

The keyboard sign can be seen in the:

duodenum and jejunum

During which stage of life is the spleen active in blood formation (hematopoiesis):

during the initial part of fetal life

What is the only parasite that forms splenic cysts?

echinococcus

Which one of the following infections caused by E-Coli may cause an emergency nephrectomy?

emphysematous pyelonephritis

In the early stages of sickle cell anemia, the spleen generally appears:

enlarged

The mesenteric "sandwich" sign represents:

enlarged lymph nodes anterior and posterior to the mesenteric vessels

The mesenteric "sandwich sign" represents:

enlarged lymph nodes anterior and posterior tot eh mesenteric vessels

A central cystic region near the renal hilum, that extends beyond the renal parenchyma is called:

extrarenal pelvis

The liver is suspended from the diaphragm and anterior abdominal wall by the:

falciform ligament

This landmark serves as a division between the medial and lateral portions of the left lobe:

falciform ligament

T/F? Culling is the process of removing the nuclei from the red blood cells.

false- its pitting

T/F? The spleen is often the site of primary disease:

false- the 10th

All of the following are examples of a sonolucent structure, except: simple cyst fat urinary bladder gallbladder

fat

All of the following are common clinical findings in infants with pyloric stenosis EXCEPT: -Dehydration -Projective vomiting -Weight loss -Female

female

Fatty infiltration that only affects parts of the liver is known as:

focal fatty infiltration

A subtle mass in the liver that may be hard to differentiate in echogenicity from the liver parenchyma and can be diagnosed with the observation of a central stellate scar:

focal nodular hyperplasia

What is the most common presentation of an abdominal aortic aneurysm?

fusiform of infrarenal aorta

The three most common primary sites of metastatic disease of the liver include all of the following EXCEPT: colon gallbladder breast lung

gallbladder

The artery commonly seen in the anterior lateral head of the pancreas is called:

gastroduodenal artery

The blood supply to the head of the pancreas is via the ________, which gives rise the the superior pancreaticoduodenal arteries.

gastroduodenal artery

Which artery courses along the anteriorlateral border of the head of the pancreas?

gastroduodenal artery

Which of the following structures is located in the anterolateral border of the pancreas:

gastroduodenal artery

The left lateral extension of the greater omentum that connects the gastric greater curvature to the superior splenic hilum is called the _____________________ ligament.

gastrosplenic

Which of the following lies freely over the intestines similar to an apron?

greater omentum

The colon is divided into sections called:

haustra

The most common location of Adenocarcinoma of the pancreas is within the _________ of the pancreas:

head

The most common benign lesion of the spleen is:

hemangioma

A complex, subcapsular, avascular mass noted in the Right lobe of the liver on a 37 year old male involved in a recent motor vehicle accident most likely represents:

hematoma

A 27 year old female presents with sudden onset of RUQ pain, history of von Gierke's disease and long history of oral contraceptive use. An ultrasound of the abdomen shows a hyperechoic mass with central cystic component. The mass is most likely a:

hepatic adenoma

Patients who are immuno-compromised are at a greater risk for what type of infectious liver disease?

hepatic candidiasis

The most common site for abdominal abscess formation is:

hepatic recess

Hepatocellular disease can be defined as a process that affects the:

hepatocytes and interferes with liver function

The term that denotes reversal of flow in the main portal vein:

hepatofugal

Normal flow into the liver by the portal vein is termed:

hepatopedal

Which one of the following describes a bladder diverticulum?

herniation of the bladder wall

A complex mass is described as:

heterogeneous

A completely uniform echotexture is termed:

homogeneous

Fusion of the lower pole of the kidneys is called a:

horseshoe kidney

Clinical findings of glomerulonephritis include all of the following except: -Strep throat -Hypercalcemia -Azotemia -Proteinuria

hypercalcemia

Which one of the following clinical findings is the most common reason for a renal artery duplex examination?

hypertension

In cases of acute pancreatitis, when the pancreas become edematous, the parenchyma of the pancreas appears ____________ on ultrasound.

hypoechoic

What type of bilirubin would you expect to see elevated in cases of increased RBC destruction?

indirect bilirubin (AKA unconjugated)

If the celiac axis is well visualized and the seagull sign is seen in the transverse plane, the sonographer should move the transducer in the __________ direction to see the pancreas

inferior

A diffuse disease process is described as:

infiltrating

Which of the following is the most common functioning islet cell tumor:

insulinoma

What transducer position refers to the placement of the transducer in between the ribs?

intercostal

Red currant jelly stools are associated with what abnormality?

intussusception

All of the following are true regarding focal fatty sparing EXCEPT: -Is commonly seen anterior to the gallbladder -Appears as a focal hypoechoic area that can be mistaken for a mass -Is also know as geographical fatty sparing -Is an area of the liver that is spared from fatty infiltration

is also known as geographical fatty sparing

All of the following are true about cirrhosis of the liver EXCEPT: -Is caused by thrombus in the hepatic veins -a nodular border may be seen -Ascites may be present -Hepatomegaly is seen in the early stage

is caused by thrombus in the hepatic vein

An echogenic triangular-shaped lesion on the peripheral border of the kidney most likely represents a(n):

junctional parenchymal defect

The portal venous system receives blood from all of the following except the: Spleen Gallbladder Kidneys Pancreas

kidneys

The location of the spleen is best described as:

lateral to the stomach

What vein courses posterior to the SMA and anterior to the Aorta?

left renal vein

A double layer of peritoneum, extending from the liver to the lesser curvature of the stomach, is called the:

lesser omentum

Refers to the increase in number of white blood cells present in the blood and usually a typical finding in infection:

leukocytosis

Which laboratory value listed is most specific for acute pancreatitis?

lipase

One clinical sign of insulinoma is the presence of:

low blood sugar

The most common origin of pulmonary emboli is venous thrombosis from the:

lower extremities

Metastases to the adrenal gland are most commonly caused by primary carcinoma of the ______, _____, and ______

lung, breast, melanoma

The most common primary retroperitoneal tumor is:

lymphoma

The landmark seen as an echogenic line seen running from the neck of the GB to the PV is the:

main lobar fissure

What is the line that runs from the neck of the gallbladder and the portal vein and can serve as a landmark for the gallbladder?

main lobar fissure

An area located between the anterior superior iliac spine and the umbilicus, which can be helpful in identifying the root of the appendix, is termed:

mcburney's point

Pouch-like hernia through the distal ileum. Symptoms include intestinal obstruction, rectal bleeding and inflammation and may sometimes be mistaken for acute appendicitis:

meckel diverticulitis

In the transverse image of the lower pole of the right kidney, the psoas muscle lies:

medial

In cases of nephrocalcinosis, calcium deposits are usually located in the:

medulla

Which one of the following demonstrates an excessive secretion of epinephrine?

medulla tumor

The most common form of neoplastic involvement of the liver is:

metastases

Adrenal insufficiency is typically caused by:

metastatic lesions

The superior portion of the subhepatic space is called:

morison's pouch

A type of aneurysm that is the result of an infection is called:

mycotic

When a splenunculus is present, it is usually located:

near the hilum of the spleen

What part of the pancreas lies anterior to the Portal confluence?

neck

Which part of the pancreas is located anterior to the portal confluence?

neck

Adrenal hemorrhages are more common in:

neonates

These arteries have a high diastolic component and supply organs that need constant perfusion:

nonresistive

Which one of the following statements about gastric carcinoma is false? -50 percent of tumors occur in the pylorus -Occurs twice as often in older women -Most often in the form of adenocarcinoma -Develops from the lining of the stomach

occurs twice as often in older women

The most common primary lesions to develop peritoneal metastasis originate in the:

ovaries, stomach and colon

All of the following are risk factors for Aortic Aneurysm EXCEPT Smoking Family history Paget's disease Hypertension

paget's disease

The three types of portocaval shunts include all of the following EXCEPT: Correct! Pancorenal Mesocaval Portacaval splenorenal

pancorenal

A courvoisier's gallbladder is associated with which of the following:

pancreatic head mass

Which one of the following statements describes adrenal cysts -patients are typically asymptomatic -adrenal cysts are usually bilateral -adrenal cysts are a common finding -male patients are affected more than female patients

patients are typically asymptomatic

Acquired cystic renal disease is usually seen in which patients?

patients on dialysis

The most common location of renal ectopia is in the:

pelvis

The tissue outside the renal capsule is the:

perinephric fat

On ultrasound, a discrete linear echogenicity in the deepest layer of the anterior abdominal wall is:

peritoneal line

A smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs is the:

peritoneum

What adrenal tumor demonstrates uncontrollable hypertension and severe headaches?

pheochromocytoma

The three branches of the celiac axis include all of the following EXCEPT: Common hepatic artery Splenic artery Left gastric artery Phrenic artery

phrenic artery

Fluid in the lung space is known as:

pleural effusion

Air within the biliary tree, secondary to common bile duct stents, is called:

pneumobilia

Classic symptoms of gallbladder disease include all of the following EXCEPT: Nausea and vomiting Right shoulder pain Pneumobilia RUQ pain

pneumobilia

A calcified gallbladder wall describes which of the following conditions:

porcelain gallbladder

A 57 y/o male patients presents to the ER with a history of cirrhosis and LUQ pain. Upon evaluation of the spleen, the sonographer noted the splenic length to be 17cm. Based on these findings and the patient history, what else should the sonographer evaluate for?

portal hypertension

An amoebic abscess may reach the liver through the:

portal vein

You are scanning a patient with a history of cirrhosis. While scanning you notice enlargement of the portal and splenic veins, an enlarged spleen and biphasic flow in the portal vein. What is the likely diagnosis?

portal vein hypertension

Tenderness directly over the gallbladder when transducer pressure is applied to this area is termed:

positive sonographic murphy sign

The splenic vein courses along the ______________ of the pancreas

posteromedial border

A progression of acute appendicitis to frank perforation is more rapid in:

preschool age children

Occurs when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue or within the outer layer of the artery:

pseudoaneurysm

The presence of purulent material within the collecting system is called:

pyonephosis

All of the following can be seen with portal hypertension EXCEPT -splenomegaly -Recanalization of the umbilical artery -Collateral Pathways -Caput Medusae

recanalization of the umbilical artery

The area between the bladder and rectum is called the ______ space.

rectovesical

Renal vein thrombosis may be visualized in patients with:

renal cell carcinoma

The most common tumor to fill the IVC is:

renal cell carcinoma

The texture of the liver should be compared to that of the:

renal cortex of RT kidney

A common renal finding in people over 50 years of age is:

renal cysts

Renal sonography is NOT helpful in evaluating:

renal function

Parapelvic cysts originate from what portion of the kidney?

renal sinus

Renal cell carcinoma commonly invades the IVC via the:

renal vein

Anterior displacement of the kidney and ureter suggests a mass in the:

retroperitoneum

The cystic artery is most commonly a branch of the:

right hepatic artery

What is the vessel seen posterior to the IVC on the sagittal scan?

right renal artery

Which artery arises from the lateral portion of the Aorta and courses posterior to the IVC?

right renal artery

All of the following are true of the falciform ligament EXCEPT: -Separates the left lobe from the Caudate lobe -Contains the ligamentum teres -Composed of two peritoneal folds -Divides the left lobe into medial and lateral segments

separates the left lobe from the caudate lobe

Echinococcal cysts have the highest incidence in countries in which:

sheep grazing is common

The most echogenic portion of the kidney, sonographically, is(are) the:

sinus

Which one of the following is most characteristic of non-shadowing, layering low-amplitude echoes in the dependent portion of the gallbladder?

sludge

The left kidney is in contact with the:

spleen, pancreas, colon, and jejunum

Lymph nodes emerge from the splenic hilum and course along the:

splenic artery

Volvulus of the spleen refers to:

splenic torsion

The Portal vein is formed posterior to the pancreas by the union of the superior mesenteric vein and the:

splenic vein

Which one of the following vascular structures relates to the posteriormedial borders of the pancreatic body and tail? Hepatic artery Superior mesenteric artery Splenic vein Splenic artery

splenic vein

The inability to see the spleen in its normal location results from all of the following EXCEPT: Wandering spleen Asplenia Polysplenia Splenomegaly

splenomegaly

A stone that completely fills the renal pelvis is called:

staghorn calculus

The splenic artery is considered to course along the ____________ border of the pancreas in the majority of patients.

superior

Acute appendicitis may be seen on a transverse sonogram as a ________________ mass.

target shaped

Autosomal dominant polycystic kidney disease may be characterized by all of the following statements EXCEPT: -The disease may be associated with cysts in the liver, pancreas, and spleen. -The involved kidneys are small and extremely echogenic. -The severity of the disease varies, depending on the genotype. -The disease is latent until the fourth or fifth decade of life.

the involved kidneys are small and extremely echogenic

Which one of the following statements about the kidneys is false? -Renal pyramids are found within the medullay portion of the kidney -The kidneys become more hypoechoic with renal failure -The kidneys may become atrophic with renal insufficiency -The renal parenchyma consists of inner medulla and outer cortex

the kidneys become more hypoechoic with renal failure

All of the following are layers of the artery wall EXCEPT: The portal triad Tunica adventitia Tunica intima Tunica media

the portal triad

All of the following statements about the kidneys are true except: -The right is more inferiorly location than the left -The average length typically falls in the range of 9-12 cm -They should move with respiration -They are intraperitoneal in location

they are intraperitoneal in location

What accounts for 90% of malignancies that involve the renal pelvis, ureter and bladder?

transitional cell carcinoma

A systemic disorder characterized by the development of solid tumors in various organs, including angiomyolipomas of the kidney, and epilepsy:

tuberous sclerosis

Sonographic sign used to help identify renal stones using color doppler is:

twinkle sign

A cystic mass visualized between the umbilicus and the bladder is called a(n):

urachal cyst

A cyst like enlargement of the distal end of the ureter is called:

ureterocele

A post-transplant perinephric fluid collection can exhibit all of the following EXCEPT: -Hematoma -Ureterocele -Lymphocele -Urinoma

ureterocele

Which of the following actions should be done to image the near field/surface of the liver?

use a linear transducer with a high frequency

An inherited disorder that is associated with the development of tumors in the CNS, renal cysts, renal cell carcinoma and adrenal tumors is:

von hippel lindau syndrome

A urinoma may be defined as:

walled-off collection of extravasated urine

A spleen that has migrated from its normal location is termed:

wandering spleen

The most common solid renal mass found in childhood is:

wilm's tumor

The primary/main pancreatic duct is the duct of:

wirsung