exam 2

The gallbladder wall should measure no more than:

3mm

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. Acalculouscholecystitis d. Adenomyomatosis

Adenomyomatosis

A fusiform dilation of the common bile duct that causes obstruction is known as: a. Choledochal cyst b. Adenomyomatosis c. Cholangitis d. Phrygian cap

Choledochal cyst

Which of the following is the least likely cause of common bile duct obstruction in adults? Choledocholithiasis Chronic pancreatitis Choledochal cyst Pancreatic carcinoma

Choledochal cyst

What is the most likely diagnosis? Medical terms only.

Choledocholithiasis

The most common echogenicity of an acutely inflamed pancreas is: a. Anechoic b. Hyperechoic c. Hypoechoic d. Calcified

Hypoechoic

The spreading process of diffuse inflammatory edema of soft tissue that may proceed to necrosis and suppuration is:

Phlegmon

What is the most likely diagnosis. Medical terms only.

WES sign

The most common cause of acute pancreatitis is: a. Biliary calculi b. Alcohol intake c. Cholecystitis d. Colitis

a. Biliary calculi

Which of the following would be the most distal portion of the biliary tree? a. Common bile duct b. Common hepatic duct c. Gallbladder d. Intrahepatic ducts

a. Common bile duct

The most common location of adenocarcioma of the pancreas is within the: a. Head of the pancreas b. Neck of the pancreas c. Body of the pancreas d. Tail of the pancreas

a. Head of the pancreas

Which of the following is considered the most proximal portion of the biliary tree? a. Intrahepatic ducts b. Cystic duct c. Common hepatic duct d. Common bile duct

a. Intrahepatic ducts

The most common tumor of the gastrointestional tract in children under 10 years of age is: a. Lymphoma b. Polyp c. Leiomyoma d. Fecalith

a. Lymphoma

A gallstone located within the biliary tree is referred to as: a. Cholecystitis b. Choledocholithiasis c. Cholangitis d. Cholangiocarcinoma

b. Choledocholithiasis

Small bowel obstruction is associated with: a. Dilation of the bowel loops distal to the site of obstruction b. Dilation of bowel loops proximal to the site of obstruction c. Collapsed bowel loops proximal to the site of obstruction d. Polypoid masses throughout the obstruction

b. Dilation of bowel loops proximal to the site of obstruction

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

c. A gallbladder filled with stones

Clinical findings of choledocholithiasis include all of the following except: a. Jaundice b. Elevated bilirubin c. Elevated blood urea nitrogen d. Elevated alkaline phosphatase

c. Elevated blood urea nitrogen

A non-mobile, non-shadowing 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

If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated: a. Common bile duct only b. Gallbladder only c. Intrahepatic ducts d. All of the above

c. Intrahepatic ducts

Primary tumors that may metastasize to the spleen include all of the following except: a. Melanoma b. Ovary c. Lung d. Brain

d. Brain

Sonographic findings of Crohn's disease may include all the following except: a. Symmetrically swollen bowel pattern b. Uniformly increased wall thickness c. Matted-loop pattern d. Calcification

d. Calcification

Nonshadowing, low-amplitude echoes in a dependent gallbladder is most characteristic of: a. Stones b. Porcelain gallbladder c. Cholecystitis d. Sludge

d. Sludge

What is the most likely diagnosis? Medical terms only.

sludge

What is the most likely diagnosis? Medical terms only.

sludge ball

The image above was taken from the LUQ of the abdomen. What is the most likely diagnosis? Medical terms only.

splenomegaly

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

Hematuria

The yellowish staining of the whites of the eyes and the skin secondary to a liver disorder or biliary obstruction is referred to as:

Jaundice

What is the early sonographic appearance of acute pancreatitis:

Normal

Acute appendicitits may be seen on ultrasound examination as a:

Target lesion

Inflammation of the gallbladder is: a. Cholecystitis b. Choledocholithiasis c. Cholesterosis d. Adenomyomatosis

a. Cholecystitis

Gallstone appearance on ultrasound examination is: a. Dependent, mobile, echogenic b. Dependent, immobile, echogenic c. Dependent, float, immobile d. Independent, mobile, hypoechoic

a. Dependent, mobile, echogenic

Which of the following is an embryonic mistake? a. Duplication cyst b. Gastric bezoar c. Polyp d. Leiomyoma

a. Duplication cyst

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

a. Emphysematous cholecysitis

Courvoisier gallbladder is found in the presence of: a. Head of the pancreas b. Neck of the pancreas c. Body of the pancreas d. Tail of the pancreas

a. Head of the pancreas

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 of the following statements about gastric carcinoma is false? a. Ninety percent of malignant tumors of the stomach are lymphomas. b. Ninety percent of malignant tumors of the stomach are carcinomas. c. One half of these malignant tumors occur in the pylorus. d. One fourth of these malignant tumors occur in the body.

a. Ninety percent of malignant tumors of the stomach are lymphomas.

Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma that produce ring-down artifact. What is the most likely diagnosis? a. Pneumobilia b. Choledocholithiasis c. Sludge balls d. Cholesterolosis

a. Pneumobilia

Progressin of acute appendicitis to frank perforation is more rapid in: a. Preschool children b. Young Adults c. Adults d. Senior citizens

a. Preschool children

All of the following are characteristic signs of lymphoma of the stomach except: a. Relatively large and hypoechoic appearance b. Marked thickening of the gastric walls c. Relatively large and highly echogenic appearance d. Spoke wheel pattern

a. Relatively large and hypoechoic appearance

If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate? a. Common bile duct b. Gallbladder c. Common hepatic duct d. All of the above

all above

A patient who presents with jaundice, weight loss, and a palpable right upper quadrant mass should be evaluated for: a. Cholecystitis b. Adenocarcinoma of the pancreas c. Pancreatitis d. Pancreatic pseudocyst

b. Adenocarcinoma of the pancreas

A 32-year-old female patient presents to the sonography department with a history of fever, leukocytosis, and RUQ pain. Sonographically, you visualize dilated bile ducts that have thickened wall and contain sludge. What is the most likely diagnosis? a. Choledocholithiasis b. Cholangitis c. Mirizzi syndrome d. Biliary atresia

b. Cholangitis

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

All of the following are benign neoplasms in the spleen except: a. Cavernous hemangiomas b. Infarctions c. Cystic lymphangiomas d. Hamartomas

b. Infarctions

Thickening of the gallbladder wall may be caused by all of the following except: a. Hepatitis b. Pancreatitis c. Adenomyomatosis d. Cholecystitis

b. Pancreatitis

Clinical signs and symptoms in acute pancreatitis include all of the following except: a. Severe abdominal pain radiating to the back b. Severe abdominal pain radiating to the right shoulder c. Elevated amylase d. Nausea and vomiting

b. Severe abdominal pain radiating to the right shoulder

Which of the following about Crohn's disease is false? a. Crohn's disease is regional enteritis. b. The reaction involves only the mesothelium of the bowel wall. c. Clinical symtoms include diarrhea, fever, and RLQ pain. d. Crohn's disease affects the terminal ileum and/or colon.

b. The reaction involves only the mesothelium of the bowel wall.

Which of the following is associated with development of cysts within the pancreas? a. Autosomal recessive polycystic disease b. Von Hippel-Lindau disease c. Zollinger-Ellison syndrome d. Endospopic retrograde cholangiopancreatography

b. Von Hippel-Lindau disease

The ultrasound appearance of a gallbladder neoplasm is: a. Hydrops b. Wall thickening, wall mass c. Normal wall, internal echoes d. Wall thickening

b. Wall thickening, wall mass

What is/are cholelithiasis? a. inflammation of the gallbladder b. gallstones c. hyperplasia of the gallbladder wall d. stones within the biliary tree

b. gallstones

Which of the following describes a bladder diverticulum? a. A cystic enlargement of the bladder orifice b. An echogenic mass of the bladder wall c. A herniation of the bladder wall d. A focal thickening of the bladder wall

c. A herniation of the bladder wall

A condition causing RUQ pain in which small polypoid masses arise from the gallbladder wall is: a. Choledocholithiasis b. Cholesterosis c. Adenomyomatosis d. Pruritus

c. Adenomyomatosis

Symptoms of appendiceal mucoceles may include all of the following except: a. Asymptomatic b. Urinary symptoms c. Bloating d. Sepsis

c. Bloating

Mucinous cystadenocarcinomas of the pancreas are most often located within which parts of the pancreas? a. Uncinate process and neck b. Head and neck c. Body and tail d. Fundus and neck

c. Body and tail

An abdominal sonogram is ordered on an infant in the ICU who is suffering from jaundice and fever. Sonographically, you visualize a cystic mass within the common bile duct that is causing focal enlargement. This is most suggestive of: a. Cholangiocarcinoma b. Mirizzi syndrome c. Choledochal cyst d. Biliary astresia

c. Choledochal cyst

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

In the case of a porcelain gallbladder, all of the following facts are true except: a. Associated with gallbladder carcinoma b. Similar appearance to WES sign c. Dense wall without shadowing d. Hyperechoic semilunar structure with shadowing

c. Dense wall without shadowing

Gastrointestional leiomyosarcoma most commonly occur in the: a. Duodenum b. Jejunum c. Ileum d. Ascending colon

c. Ileum

Which of the following is the most common islet cell tumor? a. Granuloma b. Gastrinoma c. Insulinoma d. Cystadenoma

c. Insulinoma

The most common sign for carcinoma of the gallbladder is: a. Shadowing posterior to the gallbladder b. Gallbladder wall thickening c. Irregular mass that contains low-intensity echoes within the gallbladder d. Mass changing with position changes

c. Irregular mass that contains low-intensity echoes within the gallbladder

The most common clinical finding involving trauma to the spleen is: a. Left flank pain b. Dizziness c. LUQ pain d. Nausea/ vomiting

c. LUQ pain

A common cause of enzyme destruction via the pancreas is accumulation in the: a. Greater omentum b. Lesser omentum c. Lesser sac d. Greater sac

c. Lesser sac

The most frequent cause of metastatic disease to the biliary system is: a. Pancreatitis b. Pancreatic carcinoma c. Melanoma d. Hepatocellular carcinoma

c. Melanoma

Gallbladder perforation may appear in patients with any of the following diseases except: a Gangrenous cholecystits b. Acute cholecystitis c. Negative Murphy's sign d. Gallbladder abscess

c. Negative Murphy's sign

Nonparasitic cysts of the spleen are: a. Infectious b. Common c. Of no clinical significance d. Usually acquired

c. Of no clinical significance

Metastatic disease to the stomach is rare; it may be secondary to all of the following except: a. Breast b. Lung c. Prostate d. Melanoma

c. Prostate

Name the disease process involving hemoglobin deficiency and abnormal RBC shape. a. Polycythemia vera b. Anemia c. Thalassemia d. Niemann-Pick disease

c. Thalassemia

All of the following are classic clinical features of acute pancreatitis except: a. Leukocytosis b. Back pain c. Weight gain d. Fever

c. Weight gain

What is the most likely diagnosis? Medical terms only.

cholangitis

The maximum outer diameter of the normal appendix can measure up to: a. 3mm b. 4mm c. 5mm d. 6mm

d. 6mm

Gallstones are present in 40% to 60% of patients with; a. Chronic pancreatitis b. Annular pancreas c. Cystic fibrosis d. Acute pancreatitis

d. Acute pancreatitis

The most common form of malignancy of the pancreas is: a. Cystadenocarcinoma b. Islet cell tumors c. Cystadenoma d. Adenocarcinoma

d. Adenocarcinoma

Inflammation of the bile ducts is referred to as: a. Pneumobilia b. Choledocholithiasis c. Cholelithiasis d. Cholangitis

d. Cholangitis

Shadowing from cholelithiasis is characterized on ultrasound as: a. Fuzzy margins b. Low-level echoes beyond the stone c. Shaggy borders of the margin d. Clean shadow with distinct margin

d. Clean shadow with distinct margin

An extrahepatic mass compressing the common bile duct can produce an enlarged gallbladder. This sign is known as: a. Murphy's sign b. Camper's tissue sign c. Christian's sign d. Courvoisier's sign

d. Courvoisier's sign

All of the following are sources of diffuse gallbladder wall thickening expect: a. Benign ascites b. Hepatitis c. Congestive heart failure d. Gallbladder polyp

d. Gallbladder polyp

The pseudokidney sign may be seen in: a. Chronic appendicitis b. Meckel's diverticulum c. Gastric bezoar d. Gastric carcinoma

d. Gastric carcinoma

On ultrasound, acute pancreatits may appear: a. Homogeneous b. Echogenic c. Calcified d. Hypoechoic

d. Hypoechoic

One of the most common locations for a pancreatic pseudocyst is within the: a. Paracolic gutter b. Groin c. Spleen d. Lesser sac

d. Lesser sac

The appendix is located on the abdominal wall under: a. The iliac crest b. The bladder c. Morrison's pouch d. McBurney's point

d. McBurney's point