Penny Abdomen Review Questions
Occlusion of the hepatic veins describes:
Budd-Chiari syndrome
Which of the following would be the most distal portion of the biliary tree? -CBD -CHD -GB -Intrahepatic radicles
CBD
Parathyroid glands control the release & absorption of which nutrient?
Calcium
The most common location of the vermiform appendix is the area of the:
Cecum
Which of the following is not associated with the development of pneumobilia? -Cholangiopneumonia -Gastric surgery -Acute cholecystitis -Fistula formation
Cholangiopneumonia
Intermittent obstruction of the cystic duct by a gallstone results in:
Chronic cholecystitis
Clinical findings of a Baker cyst may mimic those of a(n):
DVT
With active internal hemorrhage, the patients hematocrit will:
Decrease
All of the following are clinical findings of HCC except: -Decreased AFP -Unexplained weight loss -Fever -Cirrhosis
Decreased AFP
What is the most common sonographic appearance of a splenic hemangioma?
Echogenic
Tendons sonographically appear as: -Echogenic , fibrous structures connecting muscles to bone -Echogenic, fibrous structures connecting bone to bone -Hypoechoic, linear arrangements within hyperechoic tissue -Hyperechoic tissue that contains linear, echogenic strands
Echogenic , fibrous structures connecting muscles to bone
All of the following are sonographic findings of an abnormal lymph node EXCEPT: -Rounded shape -Echogenic hilum -Calcifications -Enlargement
Echogenic hilum
The most common shape of an AAA is:
Fusiform
Used to measure the relationship of the femoral head & acetabulum by evaluating the alpha and beta angles:
Graf
Dilated veins of a varicocele will measure:
Greater than 2 mm
In a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates:
Hodgkin lymphoma
A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the:
Hydatid cyst
Which of the following masses would be most worrisome for malignancy? -Echogenic mass -Cystic mass w/posterior enhancement -Isoechoic mass w/ a central scar -Hyperechoic mass w/ a hypoechoic halo
Hyperechoic mass w/ a hypoechoic halo
The MPV divides into:
Left & right branches
The hepatic artery should demonstrate:
Low-resistance flow
Fluid located around the lungs is termed:
Pleural effusion
The most common cause of splenomegaly is:
Portal HTN
What is another name for Morrison pouch?
Posterior right subhepatic space
All of the following are part of the exocrine function of the pancreas except for the: -Production of lipase -Production of glucagon -Production of amylase -Production of sodium bicarbonate
Production of glucagon
In what position should the patient be placed to better evaluate the Achilles tendon?
Prone
What is the most common cancer found in men?
Prostate cancer
What is the most common location of a retroperitoneal hematoma in hemophiliac patients?
Psoas muscle
Which of the following muscles would be situated closest to the spine? -Rectus abdominus -Psoas muscle -Quadratus lumborum -Iliacus
Psoas muscle
Inflammation of the breast that is related to pregnancy:
Puerperal Mastitis
A separate mass of nonfunctioning lung tissue with its own blood supply describes:
Pulmonary sequestration
Psammoma bodies are:
Punctate calcific deposits
The presence of purulent material within the renal collecting system is termed:
Pyonephrosis
The superior extension of the thyroid isthmus is referred to as the:
Pyramidal lobe
What is the first branch of the external carotid artery?
Superior thyroid artery
Fluid within the synovial sheath is indicative of:
Tendosynovitis
A tumor that consists of tissue from all three germ cell layers is the:
Teratoma
What is the cause of Cushing disease?
anterior pituitary gland tumor
The splenic artery marks the:
superior aspect of the pancreatic body and tail
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 walls and contain sludge. What is the most likely diagnosis?
Cholangitis
Which vascular structure is located closest to the thyroid lobes?
Common carotid artery
Which of the following houses the male urethra? -Corpus spongiosum -Buck fascia -Bulbourethral gland -Corpus cavernosum
Corpus spongiosum
The adrenal cortex produces:
Cortisol Androgens Aldosterone
a 71-year-old patient presents to the ED with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for: -Acute cholecystitis -Chronic cholecystitis -Courvoisier GB -Porcelain GB
Courvoisier GB
palpable GB caused by a biliary obstruction in the area of the pancreatic head:
Courvoisier GB
Which of the following would be the least helpful lab value to analyze in patients with suspected biliary tract disease? -ALT -ALP -GGT -Creatinine
Creatinine
An autoimmune disease characterized by periods of inflammation of the GI tract describes:
Crohn disease
A linear muscular section of the diaphragm that attaches to the anterolateral surfaces of the upper lumbar vertebrae:
Crus of the diaphragm
Denotes that one or both testicles have not descended into the scrotum:
Cryptorchidism
The spleen removes irregular cells from the bloodstream and retains them through a process called:
Culling
Coexisting obstruction of the common bile duct and pancreatic duct may be referred to as the:
Double-duct sign
A bulge on the lateral border of the kidney is referred to as:
Dromedary hump
What is another name for the accessory duct of the pancreas?
Duct of Santorini
What is the name of the main pancreatic duct?
Duct of Wirsung
Empyema of the GB denotes:
GB filled with pus
All of the following are sources of diffuse GB wall thickening except: -Acute cholecystitis -AIDS -Hepatitis -GB polyps
GB polyps
What is/are cholelithiasis?
Gallstones
A common mass found along the dorsal aspect of the hand and wrist is the:
Ganglion cyst
A 32-year-old female patient presents to the sonography department for an abdominal sonogram. An evaluation of the spleen reveals a 1 cm, rounded, echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis?
Hemangioma
A person who has an inherited blood disorder that inhibits the control of blood clotting:
Hemophiliac
A simple fluid collection surrounding the testis is referred to as a:
Hydrocele
The most common sonographic appearance of a pheochromocytoma is a(n):
Hyperechoic mass
The vessel located anterior to the abdominal aorta & posterior to the SMA is the:
Left Renal Vein
The left gonadal vein drains directly into the:
Left renal vein
The left suprarenal vein (adrenal) drains directly into the:
Left renal vein
Suspicion of cortical thinning should occur when the renal cortex measures:
Less than 1 cm
One of the most common locations for a pancreatic pseudocyst is within the:
Lesser sac
What are the clinical features of acute pancreatitis?
Leukocytosis Back pain Fever
The tissue comprising a lung consolidation can appear sonographically isoechoic to the:
Liver
A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is: -Wilms syndrome -Meckel-gruber syndrome -Marfan syndrome -Kleinman syndrome
Marfan syndrome
The LPV divides into:
Medial & Lateral branches
Fluid located around the heart is termed:
Pericardial effusion
Clinical findings of hepatitis include all of the following except: -Jaundice -Fever -Chills -Pericholecystic fluid
Pericholecystic fluid
What systemic disease results in the development of granulomas within the spleen and throughout the body?
Sarcoidosis
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 LUQ pain without trauma presents to the sonography department for a 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 necrotic because of a lack of oxygen is referred to as a:
Splenic infarct
A patient with a wandering spleen would have: -Splenic infection -Splenic carcinoma -Splenic infarct -Splenosis
Splenic torsion
A sickle cell crisis will often lead to:
Splenomegaly
Diffuse involvement of lymphoma or leukemia of the spleen will often lead to:
Splenomegaly
The implantation of ectopic splenic tissue possibly secondary to splenic rupture:
Splenosis
What is the most common malignancy of the penis?
Squamous cell carcinoma
A stone that completely fills the renal pelvis is referred to as a:
Staghorn calculus
Which muscle does fibromatosis colli mostly affect?
Sternocleidomastoid
Which muscles are located lateral to each thyroid lobe?
Sternocleidomastoid
The arterial blood supply to the adrenal glands is accomplished by means of the:
Suprarenal arteries
The adrenal glands receive a portion of their blood supply from:
Suprarenal branches of the aorta, renal arteries, & inferior phrenic arteries
The outer wall layer of a vessel is the:
Tunica Adventitia
Which of the following occurs behind strong, granular, and irregular surfaces like crystals, calculi, or calcifications such as a kidney stone? -Twinkle artifact -Refraction -Anisotropy -Side lobes
Twinkle artifact
Which of the following is not considered an extrinsic cause of hydronephrosis? -Ureteral stricture -Pregnancy -Neurogenic bladder -Uterine leiomyoma
Ureteral stricture
Which of the following is NOT considered an intrinsic cause of hydronephrosis? -Ureterocele -Urethritis -Urolithiasis -UPJ obstruction
Urethritis
What technique is useful for providing sonographic evidence of a varicocele?
Valsalva
Which of the following would be useful to employ during a sonographic evaluation of a suspected abdominal wall hernia? -Upright positioning -Prone positioning -Graded compression -Valsalva
Valsalva
A 23-year-old male presents to the sonography department with a hx of infertility. Which of the following is associated with male infertility? -Spermatocele -Choriocarcinoma -Varicocele -Hydrocele
Varicocele
A dilated group of veins found within the scrotum:
Varicocele
What is the most common correctable cause of male infertility?
Varicocele
What scrotal abnormality is caused by incompetent valves within the pampiniform plexus?
Varicocele
A patient with cholecystitis most likely has an elevation in which of the following labs? -Alpha-Fetoprotein -WBC count -Lactate Hydrogenase (LDH) -Chromaffin
WBC count
Which of the following would be the most likely clinical feature of colitis? -Inguinal herniation of the bowel -Right shoulder pain -Watery diarrhea -Midline hematoma
Watery diarrhea
Clinical findings of nephrocalcinosis include all of the following EXCEPT: -UTIs -Urinary calculi -Hyperparahyroidism -Weight loss
Weight loss
Which of the following would NOT be a typical clinical finding of a patient with retroperitoneal hematoma? -Low hematocrit -Trauma -Weight loss -Hemophilia
Weight loss
The duct that drains the submandibular gland:
Wharton duct
Abnormal lymph nodes typically measure more than:
10mm or 1cm
The diameter of the MPV should not exceed:
13mm or 1.3 cm
A renal scar most likely appears as: -A hypoechoic mass in the renal parenchyma -A linear anechoic space in the renal cortex -A hyperechoic, rounded structure within the renal pyramid that shadows -A echogenic area that extends from the renal sinus through the renal parenchyma
A echogenic area that extends from the renal sinus through the renal parenchyma
The first main visceral branch of the abdominal aorta:
Celiac artery
The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, & adrenal tumors is: -Tuberous sclerosis -Tuberculosis -von Hippel-Lindau syndrome -MCDK
von Hippel-Lindau syndrome
The presence of an echogenic dot in the nondependent part of a dilated duct representing small fibrovascular bundles is seen with:
Caroli disease
What would be the most likely sonographic appearance of a seminoma? -Hyperechoic -Anechoic -Heterogeneous w/calcifications -Hypoechoic
Hypoechoic
What is the most common sonographic appearance of retroperitoneal fibrosis?
Hypoechoic mass surrounding the aorta
One of the clinical signs of an insulinoma is the presence of:
Hypoglycemia
What is the term for low levels of sodium in the blood?
Hyponatremia
Which of the following would NOT be a typical clinical feature of renal transplant failure? -Oliguria -Proteinuria -Hypotension -Elevated creatinine
Hypotension
The right suprarenal vein (adrenal) drains directly into the:
IVC
Subluxation denotes:
Partial hip dislocation
The type of tissue within the spleen that is responsible for its phagocytic function is the:
Red pulp
The MPV is created by the union of the:
Splenic Vein SMV
The blue dot sign is indicative of:
Torsion of the testicular appendage
A pleural effusion that is associated with infection will sonographically appear:
Varying sonographic appearances have been noted
Which of the following is NOT a layer of gut identified by sonography? -Visceral -Serosa -Submucosa -Mucosa
Visceral
All of the following are sonographic criteria in the diagnosis of pyloric stenosis EXCEPT: -Wall of the pylorus is focally thinned -Length of the pylorus measures more than 17mm -Doughnut appearance in transverse -Cervix appearance in sagittal
Wall of the pylorus is focally thinned
All of the following are diagnostic findings of a likely benign thyroid nodule EXCEPT: -Anechoic nodule -Eggshell calcification -Hyperechoic nodule -Cold nodule
Cold nodule
Which of the following would more likely be a malignant thyroid nodule? -Cold nodule -Hot nodule
Cold nodule
The fluid produced by the thyroid gland that contains thyroid hormones is referred to as:
Colloid
A type of reverberation artifact cause by several small, highly reflective interfaces, such as gas bubble:
Comet tail artifact
Which of the following would most likely yield a high-resistance flow pattern? -Celiac artery -Common iliac artery -Splenic artery -Right renal artery
Common iliac artery
Enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function is referred to as:
Compensatory hypertrophy
Which type of pancreatic transplant is more common? -Exocrine enteric drainage -Exocrine bladder drainage -Endocrine bladder drainage -Endocrine enteric drainage
Exocrine enteric drainage
Which of the following is considered the most common benign childhood hepatic mass? -Hepatoblastoma -Hepatoma -Hematoma -Hemangioendothelioma
Hemangioendothelioma
A benign tumor comprised of blood vessels:
Hemangioma
A 38-year old female patient presents to the sonography department with a hx of femoral artery puncture & back pain. What lab value would be helpful to assess the patient for active bleeding?
Hematocrit
When internal bleeding is suspected what laboratory value is useful for a sonographer to evaluate?
Hematocrit
What is a malignant tumor of the adult liver?
Hepatoblastoma
What is a malignant tumor of the liver?
Hepatoma
Normal flow toward the liver in the portal veins is termed:
Hepatopetal
The most common sonographic appearance of a neuroblastoma is:
Heterogenous mass with calcifications
What transducer would be best suited to sonographically assess for a splinter in a patient's hand?
High fx linear array
Conn syndrome results from: -low levels of cortisol -high levels of cortisol -high levels of aldosterone -low levels of epinephrine
High levels of aldosterone
What flow pattern would the postprandial SMA yield in small bowel ischemia?
High-resistance
Which of the following is associated with E. granulosus? -Candidiasis -Amebic liver abscess -Hydatid liver cyst -Hepatocellular carcinoma
Hydatid liver cyst
Clinical findings of glomerulonephritis include all of the following EXCEPT: -Proteinuria -Throat infection -Azotemia -Hypercalcemia
Hypercalcemia
Which of the following would result in buffalo hump and moon-shaped face clinical findings? -Conn syndrome -Addison disease -Adrogenism -Hypercortisolism
Hypercortisolism
All of the following are sonographic findings of malignant thyroid nodules EXCEPT: -Internal calcifications -Hyperechoic mass -Cervical node involvement -Solitary mass
Hyperechoic mass
Which of the following is considered the most proximal portion of the biliary tree? -Intrahepatic radicles -Cystic duct -Common hepatic duct -CBD
Intrahepatic radicles
The spleen is a _____ organ.
Intraperitoneal
Which of the following is another name for Wilms tumor? -Nephroblastoma -Hepatoblastoma -Neuroblastoma -Hepatoma
Nephroblastoma
What is the functional unit of the kidney?
Nephron
All of the following are most likely a benign adrenal mass EXCEPT: -Adrenal adenoma -Neuroblastoma -Pheochromocytoma -Adrenal hematoma
Neuroblastoma
The most common, extracranial, malignant mass in children is the:
Neuroblastoma
All of the following are sonographic findings consistent with torsion of the testicular appendage EXCEPT: -No intratesticular flow -Small hyperechoic mass adjacent to the testis -Reactive hydrocele -Scrotal wall thickening
No intratesticular flow
Which of the following is produced by the adrenal medulla? -Cortisol -Aldosterone -Norepinephrine Androgens
Norepinephrine
What is the early sonographic appearance of acute pancreatitis?
Normal
Which of the following are not considered retroperitoneal organs? -Abdominal lymph nodes -Adrenal glands -Kidneys -Ovaries
Ovaries
Clinical findings of a patient with Crohn disease include all of the following EXCEPT: -Palpable abdominal wall mass -Rectal bleeding -Abdominal pain -Weight loss
Palpable abdominal mass
A gastrinoma would most likely be discovered in the: -Pancreas -Adrenal gland -Stomach -Spleen
Pancreas
Which of the following has both an endocrine & exocrine function? -Adrenal glands -Spleen -Pancreas -Duodenum
Pancreas
Which of the following is not considered to be an intraperitoneal organ? -Liver -Pancreas -Gallbladder -Spleen
Pancreas
Which of the following is not a section of the IVC? -Postrenal -Pancreatic -Prerenal -Hepatic
Pancreatic
Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma that produce ring-down artifact. What is the most likely diagnosis? -Pneumobilia -Choledocholithiasis -Sludge balls -Cholesterolosis
Pneumobilia
Free air within the chest outside of the lungs is referred to as:
Pneumothorax
One complication of a thoracentesis that may require a chest radiograph for diagnosis is the development of a:
Pneumothorax
Which of the following could result from undergoing a thoracentesis? -DVT -Pneumothorax -Pericardial effusion -Ascites
Pneumothorax
The exocrine function of the testicles is to produce:
Sperm
A 14-year-old male presents to the sonography department after falling from his bicycle. An abdominal sonogram reveals a complex-appearing mass within the spleen. This most likely represents:
Splenic hematoma
What are the functions of the spleen?
Storage of Iron Defense against disease Blood reservoir
Which of the following is NOT a component of the spermatic cord? -Epididymis -Testicular artery -Cremaster muscle -Lymph nodes
Epididymis
What are the clinical findings associated with pancreatic adenocarcinoma?
Epigastric pain Weight loss Jaundice
Which of the following hormones are responsible for the "flight-or-fight" response? -Epinephrine & norepinephrine -Cortisol & androgens -Cortisol & aldosterone -ACTH & aldosterone
Epinephrine & norepinephrine
A herpesvirus that can lead to infectious mononucleiosis:
Epstein-Barr infection
The process of making red blood cells:
Erythropoiesis
All of the following are common clinical findings in infants who present with intussusception EXCEPT: -Vomiting -First-born male infant -Red currant jelly stools -Leukocytosis
First-born male infant
Also referred to as a Bible bump:
Ganglion cyst
What anatomic structure may be noted as a bulls-eye structure anterior to the abdominal aorta & posterior to the left lobe of the liver in sagittal?
Gastroesophageal junction
Which of the following would have a pulsatile, triphasic blood flow pattern? -Renal veins -Hepatic veins -Gonadal veins -Common iliac veins
Hepatic veins
The childhood syndrome Beckwith-Weidemann is associated with an increased risk for developing:
Hepatoblastoma
Transitional cell carcinoma is commonly found in all of the following locations except: -Liver -Renal Pelvis -Urinary Bladder -Ureter
Liver
The left lobe of the liver can be separated from the right lobe by the:
Middle hepatic vein
Focal tenderness over the GB with probe pressure describes:
Murphy sign
Which part of the GB is involved in Hartmann pouch?
Neck
Which part of the pancreas is located anterior to the portal confluence?
Neck
These potential spaces extend alongside the ascending and descending colon on both sides of the abdomen:
Paracolic gutters
What is the splenic process of cleaning red blood cells of unwanted material?
Pitting
Enlargement of the abdominal lymph nodes:
Retroperitoneal lymphadenopathy
The cystic artery is most often a direct branch of the:
Right Hepatic Artery (RHA)
The IVC terminates at the:
Right atrium
A 45-year-old patient presents to the sonography department with chest pain & shortness of breath. During the sonographic examination of the abdomen, an anechoic fluid collection is noted superior to the diaphragm. This most likely represents:
Pleural effusion
Which of the following most often accompanies lung consolidation? -Ascites -Retroperitoneal fibrosis -Retroperitoneal hematoma -Pleural effusion
Pleural effusion
Air within the biliary tree is referred to as:
Pneumobilia
Calcifications of the GB wall is termed:
Porcelain Gallbladder
The TIPS shunt is placed between a _____ and _____.
Portal vein Hepatic vein
Which of the following is true about the portal veins? -Portal veins carry deoxygenated blood away from the liver -Portal veins have brighter walls than the hepatic veins -Portal veins should demonstrate hepatofugal flow -Portal veins increase in diameter as they approach the diaphragm
Portal veins have brighter walls than the hepatic veins
Which of the following best describes the location of the right adrenal gland? -Posterior & lateral to the pancreas -Medial to the lower pole of the RK -Posterior & lateral to the IVC -Medial to the crus of the diaphragm
Posterior & lateral to the IVC
All of the following are potential causes of lung consolidation EXCEPT: -Pneumonia -Hemorrhage -Carcinoma -Pulmonary sequestration
Pulmonary sequestration
Which of the following can be seen posterior & lateral to the kidney? -Rectus abdominis -Psoas muscle -Quadratus lumborum -Iliacus
Quadratus lumborum
Which of the following is the space located between the pancreas & the stomach? -Morrison pouch -Lesser sac -Space of Retzius -Pouch of Douglas
Space of Retzius
A common cyst most often seen in the head of the epididymis that contains nonviable sperm is the:
Spermatocele
Which of the following benign liver masses is typically isoechoic & contains a central scar? -Hepatoblastoma -Cavernous hemangioma -Hamartoma -Focal nodular hyperplasia
Focal nodular hyperplasia
Acute cholecystitis that leads to necrosis & abscess development within the GB wall describes:
Gangrenous cholecystitis
The arterial blood supply to the head of the pancreas is via the:
Gastroduodenal artery
Which of the following is the most common islet cell tumor? -Granuloma -Gastrinoma -Insulinoma -Cystadenoma
Insulinoma
The sonographic finding of fluid-filled, distended loops of bowel is consistent with:
Intestinal obstruction
Other abnormalities that can present much like pyloric stenosis include all of the following EXCEPT: -Midgut malrotation -Pylorospasm -Gastroesophageal reflux disease -Intussusception
Intussusception
Which of the following is not a risk factor for the development of gallstones? -Phrygian cap -Pregnancy -Total parenteral nutrition -Oral contraceptive use
Phrygian cap
All of the following are clinical findings of Acute Renal Failure EXCEPT: -Hematuria -Hypertension -Oliguria -Decreased BUN & creatinine
Decreased BUN & creatinine
Which of the following is the most common cause of Chronic Renal Failure? -Hypertension -Diabetes Mellitus -ARPKD -Acute tubular necrosis
Diabetes Mellitus
All of the following are clinical findings consistent with cholangiocarcinoma except: -Pruritis -Weight loss -Elevated bilirubin -Dilation of the intrahepatic ducts
Dilation of the intrahepatic ducts
The sequela of acute cholecystitis that is complicated by gas within the GB wall is:
Emphysematous cholecystitis
What type of gland is the thyroid gland?
Endocrine
Which typed of glands release their hormones directly into the bloodstream?
Endocrine glands
What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely result in?
Endoleak
Which of the following could accidentally introduce bacteria into the biliary tree and thus cause cholangitis? -Computed tomography -Endoscopic retrograde cholangiopancreatography -MRI -Radiography
Endoscopic retrograde cholangiopancreatography
What structure may be confused for a thyroid or parathyroid mass because of its relationship to the trachea & the posterior aspect of the left thyroid gland?
Esophagus
Renal cysts that project out away from the kidney are termed:
Exophytic
Which segment of the biliary tree tends to dilate first with obstruction?
Extrahepatic
A collection of abdominal fluid within the peritoneal cavity often associated with cancer is termed:
Exudate ascites
Which of the following vessels would most likely yield a high-resistance flow pattern? -Celiac artery -CHA -Renal artery -Fasting SMA
Fasting SMA
Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of: -Portal vein thrombosis -Metastatic liver disease -Primary liver carcinoma -Fatty liver disease
Fatty liver disease
Which of the following is associated with congenital muscular torticollis? -Fibromatosis colli -Branchial cleft cysts -Pleomorphic adenoma -Sialadenosis
Fibromatosis colli
The middle layer of the GB wall is the:
Fibromuscular layer
Hepatization of the GB occurs when the GB:
Fills with sludge
All of the following are common clinical findings in infants who present with pyloric stenosis EXCEPT: -Weight loss -Dehydration -Olive sign -Fist-born female
First-born female
A partial tear of a tendon typically appears as:
Focal hypoechoic areas within the tendon
A nonmobile, nonshadowing focus is seen within the GB lumen. This most likely represents a:
GB Polyp
Tumefactive sludge can resemble the sonographic appearance of:
GB carcinoma
The adrenal glands are surrounded by a connective tissue capsule called:
Gerota Fascia
The covering of the liver is referred to as:
Glisson capsule
A tumor that consists of a group of inflammatory cells best describes the:
Granuloma
Multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most likely represents:
Granulomas
A 30-year-old patient presents to the sonography department for a thyroid sonogram with a hx of weight loss, hair loss, & hyperthyroidism. You note that the patient has bulging eyes. What is the most likely diagnosis?
Graves disease
What is the most common cause of hyperthyroidism?
Graves disease
Which abnormality is associated with the sonographic findings of a thyroid inferno?
Graves disease
Which of the following is a tumor marker that may be used in cases of suspected testicular malignancy? -BUN -Creatinine -Human chorionic gonadotropin (beta-HCG) -Calcitonin
HCG
Which of the following best describes the location of McBurney point? -Left lateral to the umbilicus & medial to left iliac crest -Halfway between the anterior superior iliac spine & the umbilicus -Midway between the umbilicus & the symphysis pubis -Medial to the superior iliac spine
Halfway between the anterior superior iliac spine & the umbilicus
What is the most common cause of hypothyroidism?
Hashimoto thyroiditis
Which part of the pancreas is located right lateral to the SMV, anterior to the IVC, and inferior to the portal vein?
Head
The most common location of adenocarcinoma of the pancreas is within the:
Head of the pancreas
The most common location of focal pancreatitis is within the:
Head of the pancreas
The Achilles tendon connects the:
Heel to the calf muscle
Which of the following laboratory values would be most helpful in evaluating a patient who has suffered from recent trauma? -WBC count -Alpha-Fetoprotein -Blood Urea Nitrogen (BUN) -Hematocrit
Hematocrit
A localized collection of blood describes a:
Hematoma
A tumor that consists of a focal collection of blood best describes the:
Hematoma
Which of the following renal findings would most likely present with a clinical finding of hematuria? -Hemorrhagic renal cyst -Milk of calcium renal cyst -Simple renal cyst -Angiomyolipoma
Hemorrhagic renal cyst
A childhood autoimmune disease that results in the development of purple spots on the skin and possible renal failure:
Henoch-Scholein Purpura
Which of the following is the most common reason for a liver transplant? -Hepatocellular carcinoma -Hep C -Hep B -Hepatic mets
Hep C
Which hepatic mass is closely associated with oral contraceptive use?
Hepatic adenoma
All of the following are sequela of cirrhosis except: -Portal vein thrombosis -Hepatic artery contraction -Portal hypertension -Splenomegaly
Hepatic artery contraction
Budd-Chiari syndrome leads to a reduction in the size of the:
Hepatic veins
The veins seen attaching to the IVC just below the diaphragm are the:
Hepatic veins
Which of the following would be the LEAST likely cause of acute pancreatitis? -Alcohol abuse -Hepatitis -Trauma -Gallstones
Hepatitis
Which of the following is not a rule of surgical asepsis? -If you recognize an item has become nonsterile, act immediately -If one sterile person must pass another, they must pass face to face -A sterile field must never be left unattended, if so it is considered nonsterile -A sterile person does not lean across the sterile field
If one sterile person must pass another, they must pass face to face
Which of the following is not associated with rectus sheath hematoma? -Palpable abdominal mass -Increased hematocrit -Child birth -Sneezing
Increased hematocrit
Which of the following is NOT a sonographic finding consistent with Crohn disease? -Bowel wall thickening -Noncompressible bowel that has a target appearance -Increased peristalsis -Hyperemic wall
Increased peristalsis
What vessel may attach to the splenic vein before reaching the portal confluence?
Inferior mesenteric vein (IMV)
Hyperemic flow within or around a structure is often indicative of:
Inflammation
The situation when bowel protrudes into the groin is referred to as a(n):
Inguinal hernia
What is the hormone released by the pancreas that encourages the body's use of glucagon?
Insulin
In what position is the infant often placed for better sonographic visualization of the pyloric sphincter?
Right lateral decubitus
In the sagittal plane, you recognize a circular, anechoic vascular structure posterior to the IVC. Which of the following would this structure be most likely? -Abdominal aorta -Left renal vein -Right renal artery -SMA
Right renal artery
Which vessel would be the shortest in length? -Right renal vein -Right renal artery -Left renal vein -Left renal artery
Right renal vein
Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen in cases of: -Budd-Chiari syndrome -Marfan syndrome -Left sided heart failure -Right sided heart failure
Right-sided heart failure
What artifact does pneumobilia produce?
Ring-down
The second main branch of the abdominal aorta is the:
SMA
Which of the following vessels show a different flow pattern after eating? -Celiac artery -Splenic artery -Renal artery -SMA
SMA
The splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein?
SMV
Characterized by fibrotic thickening of the bile ducts, found most often in young males, and is associated with inflammatory bowel disease or ulcerative colitis:
Sclerosing cholangitis
Zinner syndrome consists of unilateral renal agenesis, ejaculatory duct obstruction, and: -Prostate cancer -Seminoma -Bulbourethral stones -Seminal vesicle cysts
Seminal vesicle cysts
The most common germ cell tumor of the testis is the:
Seminoma
What is the most common malignancy of the testicles?
Seminoma
The outermost layer of the GB wall is the:
Serosal layer
What is the artifact most likely encountered posterior to a gallstone?
Shadowing
Which of the following is associated with cholelithiasis & is characteristically found in Africans or people of African descent? -Sickle cell disease -GB torsion -Cholesterolosis -Arland-Berlin syndrome
Sickle Cell Disease
An autoimmune disease that affects the glands that produce moisture, leading to dysfunction of the salivary glands, and dryness of the eyes, nose, skin, & mouth:
Sjogren syndrome
A patient presents with unexplained abdominal pain for a vascular assessment of the SMA. Sonographically you note that the patient's SMA yields a persistent high-resistive flow pattern. This is indicative of:
Small bowel ischemia
All of the following are characteristics of a complex cyst EXCEPT: -Internal echoes -Smooth walls -Mural nodules -Septations
Smooth walls
The enzyme released by the pancreas that neutralizes stomach acid:
Sodium bicarbonate
A cyst found within the head of the epididymis, that may contain debris:
Spermatocele
The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the:
Sphincter of Oddi
The situation when bowel protrudes into a weakened area in the lower 1/4 of the rectus muscle is referred to as a(n):
Spigelian hernia
An angiosarcoma would most likely be discovered in the: -Rectum -Gallbladder -Spleen -Pancreas
Spleen
Which of the following is NOT an endocrine organ or structure? -Thymus -Pancreas -Thyroid -Spleen
Spleen
What marks the posterior aspect of the pancreatic body and tail?
Splenic Vein
What vascular structure outlines the pancreas tail posteriorly?
Splenic Vein
A congenital anomaly in which the spleen is divided into two portions by a band of tissue:
Splenic cleft
A 15-year-old male patient presents to the sonography department with a hx of left sided trauma 5 years earlier. He currently has no LUQ discomfort. The sonographic findings of the spleen include a mass that contains calcification producing distinct posterior shadowing. What is the most likely diagnosis?
Splenic hematoma
Which muscles are located anterior to the thyroid gland?
Strap
Pediatric patients could suffer from bowel obstructions that are caused by buildup of ingested hair. The mass associated with this type of obstruction is termed a:
Trichobezoar
The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs, including angiomyolipomas of the kidneys is:
Tuberous Sclerosis
The splenic hamartoma may be discovered more often in individuals with a history of:
Tuberous sclerosis
During a sonographic examination of the right testis, you visualize multiple small cysts located along the mediastinum testis. What is the most likely diagnosis?
Tubular ectasia of the rete testis
What is a substance produced by a cancerous tumor or an organ or structure in response to cancer?
Tumor marker
The inner wall layer of a vessel, closest to the passing blood, is the:
Tunica Intima
The biliary duct wall should never measure more than:
2mm or 0.2 cm
The GB wall should not measure more than:
3 mm or 0.3 cm
The neuroblastoma is a malignant pediatric mass commonly found in the:
Adrenal Gland
The pheochromocytoma is a benign mass commonly located in the:
Adrenal Gland
A 45-year-old obese woman with thin arms & legs, HTN, & severe fatigue presents to the ultrasound department for an abdominal sonogram. Based on these clinical findings, you should evaluate the adrenal glands closely for signs of:
Adrenal adenoma
Which of the following would be most likely a cause of colitis? -GERD -Antibiotic therapy -Dehydration -Rectus sheath hematoma
Antibiotic therapy
What are the sonographic features of chronic pancreatitis?
-Dilated pancreatic duct -Calcifications within the pancreas -Pancreatic pseudocyst
For patients older than age 60, or those who have had a cholecystectomy, a maximum diameter of ____ may be considered normal.
1 cm
A thyroid isthmus that measures greater than _____ is indicative of thyroid enlargement -8 mm -5 mm -12 mm -10 mm
10mm
A normal lymph node will not measure more than:
10mm or 1cm
WES sign denotes:
A GB filled with cholelithiasis
Describe the normal appearance of a cervical lymph node:
A hypoechoic, oblong structure with a distinct echogenic hilum
Which hormone, secreted by the anterior pituitary gland, controls the release of hormones by the adrenal glands?
ACTH
Which of the following renal condition is associated with the development of cysts within the pancreas & liver? -ARPKD -ADPKD -MCDK -Acquired renal cystic disease
ADPKD
The "sandwich" sign denotes:
Abdominal lymphadenopathy
A 25-year-old female patient presents to the sonography department for a complete abdominal sonogram. She complains of RLQ pain and nausea. A small mass is noted in the area of the splenic hilum. The mass appears isoechoic to the spleen. What does this most likely represent?
Accessory spleen
Which cells perform the exocrine function of the pancreas?
Acinar cells
What renal cystic disease would be most likely caused by, and thus associated with hemodialysis? -MCDK -ADPKD -Acquired renal cystic disease -ARPKD
Acquired renal cystic disease
Hyperfunctioning adrenal adenomas are associated with all of the following EXCEPT: -Cushing syndrome -Conn syndrome -Hypoechoic mass in the area of the adrenal gland -Acute drop in hematocrit
Acute drop in hematocrit
Which of the following is the most common cause of acute renal failure? -Hypertension -Diabetes Mellitus -ARPKD -Acute tubular necrosis
Acute tubular necrosis
Which of the following has a clinical finding of bronzing of the skin? -Addison disease -Cushing disease -Cushing syndrome -Conn syndrome
Addison disease
Which of the following is associated with hyponatremia? -Cushing syndrome -Conn syndrome -Pheochromocytoma -Addison disease
Addison disease
Which of the following is referred to as primary adrenocortical insufficiency? -Conn sydrome -Addison disease -Cushing disease -Congenital adrenal hyperplasia
Addison disease
Gastric cancer is most often in the form of:
Adenocarcinoma
What is the most common form of malignancy of the pancreas?
Adenocarcinoma
Courvoisier GB is found in the presence of:
Adenocarcinoma of the head of the pancreas
A 32-year-old female patient presents to the sonography department with vague abdominal pain. The sonographic investigation of the GB reveals a focal area of GB wall thickening that produces comet tail artifact. These findings are consistent with:
Adenomyomatosis
An abdominal sonogram is requested for a newborn in the ICU. The newborn is suffered from brief anoxia at birth & is now suffering from jaundice. Superior to the RK, you visualize a triangular-shaped, heterogeneous mass. What is the most likely diagnosis?
Adrenal hemorrhage
The most common cause of cirrhosis is:
Alcoholism
The RPV divides into:
Anterior & Posterior branches
Rebound tenderness is associated with:
Appendicitis
A cystic mass located within the popliteal fossa is most likely a:
Baker cyst
The accumulation of synovial fluid from a weakening in the joint capsule of the knee, as seen in conditions such as rheumatoid arthritis can result in a:
Baker cyst
The lack of the normal fixation of the testis to the posterior scrotal wall is referred to as:
Bell-clapper deformity
Enlargement of the prostate in older men is most often caused by:
Benign Prostatic Hypertrophy (BPH)
The most common location of a hydrocele is:
Between the two layers of the tunica vaginalis
Which of the following best describes the sonographic appearance of a kidney affected by ARPKD? -Bilateral, enlarged echogenic kidneys -Unilateral, smooth-walled, noncommunicating cysts of varying sized located within the renal fossa -Small, echogenic kidneys -Numerous, large, complex renal cysts
Bilateral, enlarged echogenic kidneys
The term cholangiocarcinoma denotes:
Bile duct carcinoma
A congenital disease in which there is narrowing or obliteration of the bile ducts:
Biliary atresia
What disorder is associated with the sonographic triangular cord sign?
Biliary atresia
The yellowish pigment found in bile that is produced by the breakdown of old red blood cells by the liver is:
Bilirubin
Sonographically, normal muscle appears as:
Hypoechoic tissue that contains linear, echogenic strands
The most common sonographic appearance of gynecomastia:
Hypoechoic, retroareolar mass
A benign pancreatic tumor:
Insulinoma
The area of pain and rebound tenderness with acute appendicitis is most likely at:
McBurney point
Which type of obstruction refers to the bowel being physically blocked by something?
Mechanical
The ligamentum teres can be used to separate the ____ & _____ segments of the left lobe:
Medial & Lateral
All of the following are true of normal intestinal findings with sonography EXCEPT: -Normal bowel does not compress -Normal bowel should have observable peristalsis -Intestinal walls should measure less than 5mm -Normal bowel has little to no color Doppler signals
Normal bowel does not compress
A clinical test for developmental hip dysplasia that is used to evaluate the hip for the reduction or relocation of a dislocated hip:
Ortolani
The Whipple procedure is performed on patients who have:
Pancreatic carcinoma
Acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector is referred to as:
Refractive shadowing
The pancreas is a _____ organ.
Retroperitoneal
Which of the following statements about the IVC is NOT true? -The diameter of the IVC is variable -Respiration can affect the size of the IVC -The IVC is located to the left of the abdominal aorta -The IVC is considered retroperitoneal in location
The IVC is located to the left of the abdominal aorta
What patient position is typically required for a thoracentesis?
Upright
What is the most common location for a urolithiasis to become lodged?
Ureterovesicular junction
The type of tissue within the spleen that is responsible for its lymphatic function is the:
White pulp
Where is the thymus located?
Within the mediastinum
Which of the following is considered to be a malignant testicular neoplasm? -Neuroblastoma -Hepatoma -Yolk sac tumor -Hamartoma
Yolk sac tumor
A gastrinoma of the pancreas can produce:
Zollinger-Ellison syndrome
Which of the following children would least likely suffer from sickle cell anemia? -African-American -Caucasian -Middle eastern -Mediterranean
Caucasian
What does the thyroid utilize to produce its hormones?
Iodine
A tumor that is of similar echotexture to normal liver tissue is discovered in the liver of an asymptomatic patient. What is the echogenicity of the tumor?
Isoechoic
Which vascular structure may be confused for the main pancreatic duct?
Splenic artery
All of the following are true of ganglion cysts EXCEPT: -A ganglion cyst is a common mass found along the superior aspect of the hand & wrist, between the tarsals -Ganglion cysts typically appear sonographically as an incompressible, anechoic mass w/acoustic enhancement -Clincally, ganglion cysts may be hard to touch & painful -Ganglion cysts are often treated with an injection of corticosteroids
A ganglion cyst is a common mass found along the superior aspect of the hand & wrist, between the tarsals
With which of the following is Courvoisier GB associated? -A pancreatic head mass -A stone in the cystic duct -Cholecystitis -Chronic diverticulitis
A pancreatic head mass
An outpatient with a history of back pain & HTN presents to the ultrasound department for an abdominal aortic sonogram. Sonographically you visualize a 6cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis?
Aortic dissection
Upon sonographic evaluation of the RLQ in a patient complaining of focal abdominal pain in that area, you visualize a hyperemic blind-ended, tubular structure that contains a shadowing focus. What is the most likely etiology of the shadowing focus?
Appendicolith
Pseudomyxoma peritonei can result from:
Appendix cancer
Which of the following would be a common finding in a patient undergoing peritoneal dialysis? -Hemorrhage -Ascites -Renal artery stenosis -Renal vein thrombosis
Ascites
Which of the following would be least likely to cause focal GB wall thickening? -GB polyp -Adenomyomatosis -Ascites -Adhered gallstone
Ascites
From the list below, what is the most likely clinical finding of a patient who has a splenic hemangioma? -Fever -Decreased hematocrit -Elevated WBC count -Asymptomatic
Asymptomatic
What is the most common clinical finding of a simple renal cyst? -Hematuria -Quadrant pain -Elevated BUN -Asymptomatic
Asymptomatic
Which of the following is the most likely clinical finding of adenomyomatosis? -Murphy sign -Hepatitis -Congestive heart failure -Asymptomatic
Asymptomatic
The Klatskin tumor is located:
At the junction of the right & left hepatic ducts
All of the following are sonographic findings consistent with the diagnosis of testicular torsion EXCEPT: -Hyperemic flow within the testis -Hypoechoic testis -Reactive hydrocele -Decreased intratesticular flow (as compared to the asymptomatic testis)
Hyperemic flow within the testis
Common locations for abdominal lymph nodes include:
Mesentary Renal hilum Along the length of the abdominal aorta
Which of the following is the most common form of liver cancer? -Hepatocellular carcinoma -Adenocarcinoma -Metastatic liver disease -Hepatoblastoma
Metastatic liver disease
Spermatogenesis occurs within the:
Seminiferous tubules
Stones within the salivary duct:
Sialolithiasis
Hypertrophic Pyloric Stenosis (HPS) is most often found in infants between: -1 and 10 days of age -2 and 6 weeks of age -10 and 24 weeks of age -2 and 4 years of age
2 and 6 weeks of age
Which of the following is typically transmitted through contaminated water found in places such as Mexico, Central America, South America, Asia, India, and Africa: -Amebic liver abscess -Hydatid liver cyst -Candidiasis -Hepatoma
Amebic liver abscess
A Klatskin tumor is a form of:
Cholangiocarcinoma
A standoff pad is most useful in imaging: -Deep structures that produce acoustic enhancement -Deep structures that produce acoustic shadowing -Structures that produce refractive shadowing -Superficial structures
Superficial structures
Which of the following is associated with development of cysts within the pancreas? -ARPKD -von Hippel-Lindau disease -Zollinger-Ellison syndrome -Endoscopic retrograde cholangiopancreatography
von Hippel-Lindau disease
An aneurysm associated with infection is termed:
Mycotic
At which level of the GB is the junctional fold found?
Neck
The diameter of the IVC should never exceed:
2.5cm
An AAA is present when the diameter of the abdominal aorta exceeds:
3cm
What are the diagnostic criteria for pyloric stenosis?
3mm in thickness 17mm in length
Normally, how many parathyroid glands are found within the adult neck?
4
The neuroblastoma typically presents before the age of:
5
The diameter of the GB should not exceed:
5 cm
Which of the following would be most indicative of renal artery stenosis? -Decreased cortical echogenicity -A renal to aorta ratio that is greater than 3.5 -Enlarged kidney -Tardus-parvus waveform upstream to the stenosis
A renal to aorta ratio that is greater then 3.5
Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with:
Adenomyomatosis
Upon sonographic examination of the right upper quadrant in a 32-year-old female patient complaining of generalized abdominal pain, you visualize an anechoic mass with posterior enhancement superior and medial upper pole of the right kidney. This most likely represents a/an: -Adrenal metastatic lesion -Pheochromocytoma -Neuroblastoma -Adrenal cyst
Adrenal cyst
Which of the following would most likely resemble a solid intratesticular mass & be associated with Cushing syndrome? -Choriocarcinoma -Epidermoid cyst -Intratesticular varicocele -Adrenal rest
Adrenal rest
Which of the following mass-like lesions may be associated with congenital adrenal hyperplasia & found within the testes? -Adrenal adenomas -Adrenal rests -Pheocromocytomas -Neuroblastomas
Adrenal rests
The aorta originates at the:
Left ventricle
Sonographically, compared to normal kidneys, those affected by chronic renal failure will appear: -Normal in size with a decreased echogenicity -Smaller in size & hypoechoic -Larger in size & more echogenic -Smaller in size & more echogenic
Smaller in size & more echogenic
Which of the following is true about patients with a lipoma? -They often complain of pain in the area of the mass -They are often obese -They are only slightly tender in the area of the mass -They feel no pain in the area of the mass
They feel no pain in the area of the mass
All of the following are true of abnormal lymph nodes EXCEPT: -They tend to lose their echogenic hilum -Enlargement may be associated with infection or malignancy -They tend to measure less than 1 cm -The "sandwich" sign denotes abdominal nodes surrounding & compressing the aorta & IVC
They tend to measure less than 1 cm
All of the following are associated with Conn syndrome EXCEPT: -Adrenal adenoma -Hypertension -Excessive thirst -Thinning arms & legs
Thinning arms & legs
During this test the calf should be squeezed & the foot should plantarflex in a pt who does not have a complete tear of the Achilles tendon:
Thompson test
What test can be performed to determine a torn achilles tendon?
Thompson test
In this test the patient lies prone while the symptomatic calf is squeezed:
Thompson test to evaluate the Achilles tendon
The diagnostic or therapeutic procedure where fluid is removed from the pleural space:
Thoracentesis
Which of the following would be the most likely vascular complication of acute pancreatitis? -Thrombosis in the splenic vein -Pseudoaneurysm of the SMA -Thrombosis of the MPV -Stenosis of the SMA
Thrombosis in the splenic vein
Benign congenital cysts located superior to the thyroid gland near the hyoid bone are referred to as:
Thyroglossal duct cysts
Which of the following is not a salivary gland? -Thyroid gland -Parotid gland -Submandibular gland -Sublingual gland
Thyroid gland
Which of the following is the hormone that is the most abundantly produced by the thyroid? -Thyroxine -Iodine -Triiodothyronine -Calcitonin
Thyroxine
What is the most likely cause of a hip joint effusion in infants?
Transient synovitis
Normal flow within the hepatic veins is said to be:
Triphasic
Which of the following is associated with hypernatremia? -Cushing syndrome -Conn syndrome -Pheochromocytoma -Addison disease
Conn syndrome
Clinical findings of acute appendicitis include all of the following EXCEPT: -Leukocytosis -RLQ pain -Constipation -Rebound tenderness
Constipation
The syndrome associated with hypertension, hyperglycemia, obesity, and an adrenal mass is:
Cushing syndrome
A cystic mass at the mandibular angle is most likely a:
Branchial cleft cyst
A benign intratesticular mass that typically has a whorled or onion skin sonographic appearance:
Epidermoid cyst
Of the list below, which is considered to be an intraperitoneal organ? -Left Kidney -Aorta -IVC -Liver
Liver
All of the following may be discovered sonographically within the chest EXCEPT: -Bronchial infections -Pleural effusion -Lymphomas -Thymomas
Bronchial infections
Which hormone is responsible for regulating blood pressure by controlling the amounts of sodium & water in the body?
Aldosterone
Which of the following occurs when the Doppler sampling rate (PFR) is not high enough to display the Doppler frequency shift? -Doppler noise -Aliasing -Mirror image -Twinkle artifact
Aliasing
If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate? -Common bile duct -Gallbladder -Common hepatic duct -All of the above
All of the above
Typically, a hematoma appears: -Hyperechoic -Hypoechoic -Complex -All of the above have been encountered
All of the above have bee encountered
Which of the following would not be a lab finding typically analyzed with suspected gallbladder disease? -ALP -ALT -Bilirubin -Alpha-Fetoprotein
Alpha-Fetoprotein
What lab value can be assessed as a tumor marker to evaluate a patient for testicular malignancy?
Alpha-Fetoprotein (AFP)
The merging point of the pancreatic duct and CBD at the level of the duodenum is referred to as:
Ampulla of Vater
What lab value increases first in the presence of acute pancreatitis?
Amylase
The olive sign is best described as: -The palpation of the inflamed appendix with rebound tenderness -An area of pain halfway between the anterior superior iliac spine and the umbilicus -An enlarged palpable pyloric sphincter -The sonographic appearance of pyloric stenosis
An enlarged palpable pyloric sphincter
Which plays a part in the development of male characteristics? -Androgens -Cortisol -Aldosterone -Hematocrit
Androgens
Enlarged abnormal lymph nodes tend to deviate from their normal sonographic appearance and become more:
Anechoic or hypoechoic
This common tumor of the kidney consists of blood vessels, muscle and fat:
Angiomyolipoma
Which of the following would be considered the most common solid renal mass? -Renal hematoma -Angiomyolipoma -Oncocytoma -Hypernephroma
Angiomyolipoma
The most common cause of fungal urinary tract infection is:
Candida Albicans
What form of hepatic abnormality are immunocompromised patients more prone to develop? -Hepatic adenoma -Amebic abscess -Hydatid liver abscess -Candidiasis
Candidiasis
Ascariasis is: -A form of biliary tree carcinoma -A congenital disorder characterized by segmental dilatation of the intrahepatic ducts -Caused by a parasitic worm -A type of ringworm that invades the liver
Caused by a parasitic worm
What branch and its tributaries of the abdominal aorta appears as a "seagull" in the transverse plane?
Celiac artery
The splenic artery originates at the:
Celiac trunk
Inflammation & infection of the skin and subcutaneous tissue:
Cellulitis
The diagnosis of a pneumothorax is typically via a(n):
Chest x-ray
A 64-year-old man presents to the sonography department for a RUQ sonogram. He is complaining of abdominal pain, weight loss, & pruritis. Sonographically, you visualize an area of dilated bile ducts that abruptly end. What is the most likely diagnosis?
Cholangiocarcinoma
Primary biliary tree cancer is referred to as:
Cholangiocarcinoma
Inflammation of the bile ducts:
Cholangitis
Which of the following is associated with Charcot triad? -Cholangitis -Cholesterolosis -Klatskin tumor -Choledochal cyst
Cholangitis
What hormone causes the GB to contract?
Cholecystokinin
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
A patient presents to the sonography department with a painful, superficial abdominal mass located within a prior cesarean scar. What clinical feature would be most consistent with scar endometriosis? -Hematuria -Chronic headaches -Cyclical pain -Bloody diarrhea
Cyclical pain
The direct blood supply to the GB is the:
Cystic artery
The GB is connected to the biliary tree by the:
Cystic duct
The spiral valves of Heister are found within the:
Cystic duct
The spiral valves of Heister are located within the:
Cystic duct
A female patient presents with a history of leukocytosis, dysuria, lower abdominal pain, & hematuria. Sonographically the kidneys appear normal, although the bladder wall measures 6mm in the distended state. What is the most likely diagnosis? -Glomerulonephritis -Xanthogranulomatous pyelonephritis -Cystitis -TCC of the bladder
Cystitis
The most common level for biliary obstruction to occur is the:
Distal CBD
An adult patient presents to the sonography department with LLQ pain, fever, & bouts of both constipation & diarrhea. Which of the following would be the most likely etiology? -Diverticulitis -Intussusception -Midgut malrotation -Appendicitis
Diverticulitis
The development of small outpouchings within the sigmoid colon:
Diverticulosis
The portion of the bowel that encompasses the head of the pancreas is the:
Duodenum
The most common congenital anomaly of the urinary tract is:
Duplicated collecting system
Which of the following is the most likely sonographic appearance of the thymus? -Echogenic mass that contains linear & punctuate echogenicities -Anechoic structure anterior to the sternum -Complex mass anterior to the iliac crest -Homogenous mass w/posterior shadowing containing anechoic cystic structures
Echogenic mass that contains linear & punctuate echogenicities
Clinical findings of choledocholithiasis include all of the following except: -Jaundice -Elevated bilirubin -Elevated BUN -Elevated ALP
Elevated BUN
Clinical findings of fatty infiltration of the liver include: -Elevated LFTs -Fever -Fatigue -Weight loss
Elevated LFTs
Which of the following is consistent with the sonographic features of testicular abscess? -Hyperemic flow around the abscess but not within it -Onion skin sonographic appearance and hyperemic epididymis -Hyperemic flow within an anechoic mass -Hyperemic flow within the abscess but not around it
Hyperemic flow around the abscess but not within it
The most common echogenicity of an acutely inflamed pancreas is:
Hypoechoic
Right-sided heart failure often leads to enlargement of the:
IVC & hepatic veins
A patient presents to the sonography department with a history of cellulitis on his abdomen. The patient has fever, edema, and complains of focal tenderness in a specific regions affected by the cellulitis. Sonographically you identify a localized complex collection of fluid. What is most likely the diagnosis? -Superficial hemangioma -Subcutaneous carcinoma -Mastitis -Superficial abscess
Superficial abscess
Inflammation of the tendon & synovial tendon sheath is referred to as:
Tendosynovitis
Acute onset of testicular pain at rest is a common clinical finding with:
Testicular torsion
The endocrine function of the testicles is to produce:
Testosterone
All of the following are true statements about the adrenal glands EXCEPT: -The adrenal glands are easily identified in the fetus -The adrenal glands are exocrine glands -The adrenal glands are composed of a medulla & cortex -The adrenal glands may also be referred to as the suprarenal glands
The adrenal glands are exocrine glands
Traditionally, treatment for intussusception is by means of:
Therapeutic enema
The diffuse polypoid appearance of the GB referred to as strawberry GB is seen with: -Cholesterolosis -Adenomyomatosis -Cholangitis -Kawasaki disease
Cholesterolosis
A rare malignant tumor of the spleen that consists of blood vessels is a/an:
Angiosarcoma
Which of the following is an artifact that alters the echogenicity of a tendon? -Acoustic enhancement -Anisotropy -Ring-down artifact -Mirror image artifact artifact
Anisotropy
Results from the maldevelopment of the two embryologic elements of the pancreas and consequent obstruction of the duodenum:
Annular pancreas
The right lobe of the liver can be divided into:
Anterior & Posterior segments
Infantile polycystic kidney disease may also be referred to as:
Autosomal Recessive Polycystic Kidney Disease (ARPKD)
A 26-year-old patient with a long-standing history of multiple sickle cell crises and subsequent splenic infarctions presents to the sonography department for an abdominal sonogram. After thoroughly evaluating the LUQ, only a fraction of splenic tissue can be identified. This describes the process of:
Autosplenectomy
Which of the following would be the least likely complication of a pancreatic transplant? -Hematoma -Biloma -Ascites -Urinoma
Biloma
Within which parts of the pancreas are mucinous cystadenocarcinomas most often located?
Body & tail
All of the following are clinical findings of a pheochromocytoma EXCEPT: -Bradycardia -Uncontrollable HTN -Excessive sweating -Tremors
Bradycardia
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
A gallstone located within the biliary tree is referred to as:
Choledocholithiasis
A 63-year-old male patient presents to the sonography department for an examination of the abdomen. He has a hx of lung cancer and is suffering from shortness of breath. Sonographically, the liver & GB appear normal. However, you visualize a heterogeneous fluid collection superior to the right hemidiaphragm. What is the most likely diagnosis? -Pulmonary sequestration -Complex pleural effusion -Pneumothorax -Cystic adenomatoid malformation
Complex pleural effusion
All of the following are sonographic findings of acute appendicitis EXCEPT: -Appendicolith -Compressible, blind-ended tube -Periappendiceal fluid collection -Hyperemic flow
Compressible, blind-ended tube
A mass consisting of abnormal bronchial & lung tissue that develops within the fetal chest best describes:
Congenital cystic adenomatoid malformation (CCAM)
Clinical findings of an AAA include all of the following EXCEPT: -Lower extremity pain -Back pain -Abdominal bruit -Elevated hematocrit
Elevated hematocrit
Diabetic patients suffering from acute cholecystitis have an increased risk of developing:
Emphysematous cholecystitis
The champagne sign is associated with:
Emphysematous cholecystitis
Which statement is not true of cholelithiasis? -Men have an increased likelihood of developing cholelithiasis -Patients who have been or are pregnant have an increased occurrence of cholelithiasis -A rapid weight loss may increase the likelihood of developing cholelithiasis -Patients who have hemolytic disorders have an increased occurrence of cholelithiasis
Men have an increased likelihood of cholelithiasis
The main lobar fissure contains:
Middle hepatic vein
A patient presents to the sonography department with bilious vomiting. While investigating the pediatric patient for pyloric stenosis, you note that while the pyloric sphincter appears normal, the SMA is abnormally located to the right of the SMV. What is the most likely diagnosis?
Midgut malrotation
Which of the following is caused by the bending of the ultrasound beam when it passes through an interface between two tissues with vastly dissimilar speeds of sound and the angle of the approach is not perpendicular? -Comet tail -Refraction -Reverberation -Acoustic enhancement
Refraction
The hypernephroma may also be referred to as the:
Renal Cell Carcinoma (RCC)
All of the following are true statements about the adrenal glands EXCEPT: -The adrenal glands play an important role in blood pressure regulation -The adrenal glands are easily identified in the fetus -The left adrenal gland is located lateral to the upper pole of the left kidney -The right adrenal gland is located medial to the right lobe of the liver
The left adrenal gland is located lateral to the upper pole of the left kidney
Which of the following is NOT true of the abdominal aorta? -The abdominal aorta bifurcates into the common iliac arteries -The proximal aorta is situated more anterior than the distal aorta -The aorta has a thicker tunica media than the IVC -The third major branches of the abdominal aorta are the renal arteries
The proximal aorta is situated more anterior than the distal aorta
All of the following will aid in the sonographic assessment of an Achilles tendon EXCEPT: -Patient lies prone, with feet hanging off the bed -Both symptomatic & asymptomatic Achilles should be scanned for comparison -The entire tendon should be evaluated in SAG & TRANS -The pt is scanned standing, with a small amount of pressure places on the symptomatic side
The pt is scanned standing, with a small amount of pressure places on the symptomatic side
All of the following are true of the spleen EXCEPT: -It is the largest structure of the reticuloendothelial system -The primary objective of the spleen is to filter peripheral blood -The spleen has a convex inferior margin & a concave superior border -The spleen is considered the largest lymphatic organ
The spleen has a convex inferior margin & a concave superior border
Which of the following is true regarding a duplex collecting system with complete ureteral duplication? -The upper pole of the kidney suffers from reflux -The lower pole suffers from obstruction because of varicocele -The upper pole suffers from obstruction because of ureterocele -The lower pole suffers from deflux & hypertrophy
The upper pole suffers from obstruction because of ureterocele
In the presence of Hashimoto thyroiditis, the thyroid produces:
Too few thyroid hormones
A 7-year-old boy presents to the emergency department with acute testicular pain localized to the superior pole of his right testis. What is the most likely diagnosis?
Torsion of the testicular appendage
Which of the following would be the most common cause of obstructive jaundice? -Klatskin tumor -Cholangiocarcinoma -Biliary atresia -Choledocholithiasis
Choledocholithiasis
Which of the following would be the LEAST likely finding of acalculous cholecystitis? -GB wall thickening -Pericholecystic fluid -Cholelithiasis -Positive Murphy sign
Cholelithiasis
The malignant testicular tumor that consists of trophoblastic cells is the: -Choriocarcinoma -Yolk sac tumor -Teratoma -Insulinoma
Choriocarcinoma
A patient presents to the sonography department with a history of Marfan syndrome. The sonographic evaluation reveals a linear echo within the aortic lumen that extends from the celiac axis to the iliac arteries. Color Doppler reveals flow throughout the aorta on both sides of the linear echo. The patient has had no surgeries, & there is no AAA. What does the linear echo most likely represent?
Intimal flap
If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated? -Main pancreatic duct -Gallbladder only -Intrahepatic ducts -Distal CBD
Intrahepatic ducts
The most common cause of intestinal obstruction in children less than 2 years of age is:
Intussusception
The telescoping of one segment of bowel into another is referred to as:
Intussusception
What abnormality associates red currant jelly stool?
Intussusception
All of the following are hormones produced by the thyroid EXCEPT: -Thyroxine -Iodine -Triiodothyronine -Calcitonin
Iodine
Clinical findings of tendonitis include all of the following EXCEPT: -Itching in the area of the tendon -Pain -Edema -The area is warm to touch
Itching in the area of the tendon
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
A 6-year-old female patient presents to the sonography department for a hip sonogram with irritability, unwillingness to walk, & low-grade fever. Sonographically, you visualize a hypoechoic fluid collection that elevates the joint capsule. What is the most likely diagnosis?
Joint effusion
What vessel can be often noted coursing between the SMA and the abdominal aorta in the transverse scan plane?
Left renal vein
What vessel travels directly anterior to the left renal artery?
Left renal vein
The most common location for a varicocele is:
Left side of the scrotum
Secondary varicoceles are most likely associated with all of the following EXCEPT: -Left-sided location -Right-sided location -Hepatomegaly -Renal mass
Left-sided location
The left umbilical vein after birth becomes the:
Ligamentum Teres
Shortly after birth, the ductus venosus collapses and becomes the:
Ligamentum Venosum
Which of the following lab values appears to be more specific for acute pancreatitis? -Amylase -Lipase -Aspartate aminitransferase -Serum glutamic oxaloacetic transaminase
Lipase
A benign tumor comprised of fat:
Lipoma
Which muscles are located posterior to each thyroid lobe?
Longus colli
Normal flow within the hepatic artery should demonstrate a _________ waveform pattern, with a quick ______, and gradual ______ with diastole.
Low-Resistance Upstroke Deceleration
What should the postprandial flow pattern be within the SMA?
Low-resistance
Sonographically this appears as several internal echoes that radiate in a linear pattern because of air within the bronchi:
Lung consolidation
The replacement of normal air-filled alveoli with fluid, inflammation, blood, or neoplastic cells is referred to as:
Lung consolidation
Which of the following is NOT located within the mediastinum? -Heart -Thymus -Esophagus -Lungs
Lungs
A 45 year old female patient presents to the sonography department with a palpable neck mass 6 months following a thyroidectomy for papillary carcinoma. Which of the following would be the most likely etiology of the mass? -Torticollis -Lymphadenopathy -Sialadenitis -Graves disease
Lymphadenopathy
A benign lesion that is a congenital malformation of the lymphatic system:
Lymphangioma
All of the following are located within the porta hepatis except: -MPV -CBD -Hepatic artery -MHV
MHV
Which structure is a useful landmark for identifying the gallbladder?
Main lobar fissure
The left lobe of the liver can be divided into:
Medial & Lateral segments
Which of the following is included in the clinical findings of retroperitoneal fibrosis? -Hematuria -Migraine medication use -Diabetes mellitus -Diarrhea
Migraine medication use
A patient presents with jaundice, pain, & fever secondary to an impacted stone in the cystic duct. This is referred to as:
Mirizzi syndrome
Which of the following statements about the abdominal aorta is NOT true? -Most aneurysms located within the abdominal aorta are false aneurysms -The abdominal aorta is located just left of midline -The most common location of an AAA is infrarenal -The abdominal aorta is considered to be retroperitoneal in location
Most aneurysms located within the abdominal aorta are false aneurysms
The right intersegmental fissure contains the:
Right hepatic vein
The right lobe of the liver is divided into segments by the:
Right hepatic vein
All of the following are keys to identifying foreign bodies with sonography EXCEPT: -Most foreign bodies appear hypoechoic -A linear array transducer should be used -Most foreign bodies are better visualized using a standoff pad -Comet-tail artifact may be seen posterior to metallic objects
Most foreign bodies appear hypoechoic
The most common form of salivary gland cancer:
Mucoepidermoid carcinoma
The innermost layer of the GB wall is the:
Mucosal layer
Small echogenic foci scattered throughout the spleen most likely represent:
Multiple benign granulomas
A 35-year-old male patient presents to the sonography 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 results in a shortened main pancreatic duct that works to drain only the pancreatic head and not the entire pancreas?
Pancreatic divisum
All of the following can be associated with splenomegaly EXCEPT: -Trauma -Hemolytic abnormalities -Mononucleosis -Pancreatitis
Pancreatitis
A complicated baker cyst may contain a thin flap of tissue referred to as:
Pannus
The most common form of thyroid cancer:
Papillary
The inferior extension of the caudate lobe is referred to as:
Papillary process
All of the following are forms of cholangitis except: -Acute bacterial -AIDS -Oriental -Parabolic
Parabolic
A patient with HTN presents to the sonography department for a neck sonogram. What abnormality in the neck should be suspected?
Parathyroid adenoma
With which of the following is elevated serum calcium associated? -Graves disease -Thyroglossal duct cyst -Parathyroid adenoma -Thyroid adenoma
Parathyroid adenoma
Which gland is located immediately anterior to the ear?
Parotid gland
What is the most common location of an ectopic kidney?
Pelvis
The most common location of Benign Prostatic Hypertrophy (BPH) is the:
Peripheral zone
The most common location of prostatic cancer is the:
Peripheral zone
A patient presents to the sonography department for a penile sonogram. He complains of a painful curvature of the penis & impotence. What is the most likely diagnosis?
Peyronie disease
The adrenal mass often associated with uncontrollable hypertension, tachycardia, & tremors is the:
Pheochromocytoma
Which of the following is not a pediatric malignant tumor? -Hepatoblastoma -Neuroblastoms -Pheochromocytoma -Nephroblastoms
Pheochromocytoma
A peripancreatic fluid collection that results from the inflammation of the pancreas:
Phlegmon
The most common variant of GB shape is the:
Phrygian cap
A patient presents with a palpable, oozing mass at the level of the natal cleft. What is the most likely etiology of this mass? -Pannus cyst -Epidermoid cyst -Hamangioma -Pilonidal cyst
Pilonidal cyst
The protective capsule of the kidney is referred to as:
Renal capsule
What is the most likely location of TCC in the kidney? -Cortex -Medulla -Minor calyx -Renal pelvis
Renal pelvis
A 35-year-old female patient presents to the sonography department with a history of migraine medication use, weight loss, nausea, & malaise. Sonographically, you visualize a 15cm hypoechoic mass within the abdomen. Which of the following would be most likely? -Volvulus -Retroperitoneal fibrosis -Intussusception -Retroperitoneal lymphadenopathy
Retroperitoneal fibrosis
A 65-year-old patient presents to the sonography department with a history of abdominal pain and weight loss. Sonographically, you visualize multiple hypoechoic masses that extend along the anterior border of the abdominal aorta. Which of the following would be most likely? -Pulmonary sequestration -Retroperitoneal hematoma -Retroperitoneal lymphadenopathy -Encapsulated ascites
Retroperitoneal lymphadenopathy
Primary varicoceles are associated with all of the following except: -Left-sided location -Retroperitoneal mass -Infertility -Palpable extratesticular mass
Retroperitoneal mass
The kidneys are: -Intraperitoneal organs -Retroperitoneal organs -Both intraperitoneal & retroperitoneal organs -Neither intraperitoneal nor retroperitoneal organs
Retroperitoneal organs
A tonguelike extension of the right lobe of the liver is termed:
Riedel lobe
All of the following are branches of the celiac axis EXCEPT: -Right gastric artery -Hepatic artery -Splenic artery -Left gastric artery
Right gastric artery
