Sonography exam review chapter 11 spleen

A 13-year-old female patient presents to the ultrasound department complaining of vague left upper quadrant plane she admits to wrestling with her brother a week early she denies blunt force trauma laboratory tests are pending. Based on this clinical history the sonographic findings are most suspicious for which of the following conditions

A cystic mass in a patient with a history of abdominal trauma most likely represents an intraparenchyl l hematoma.

Which of the following benign neoplasm is composed of lymphoid tissue

A hamartoma Is a benign neoplasm composed of lymphoid tissue. A lipoma is composed of fatty tissue. Adenoma is an Epithelial a neoplasm. A cavernous hemangioma is a benign tumor consisting of a mass of blood vessels

A hemangiosarcoma located in the spleen on ultrasound would appear as

A hemangiosarcoma is located in the spleen appears on ultrasound as a hyper a coworker or complex math. Frequently my testicle lesions are discovered in the liver

A patient presents with a history of liver function test showing elevated levels. Based on this clinical history the sonogram is most likely demonstrating

A smooth solid mass is identified in the medial to inferior portion of the spleen and left kidney. This mass demonstrates an echo pattern similar to the spleen. These sonographic findings are most consistent with an accessory spleen.

A hematoma located below the splenic capsule most commonly appears on ultrasound as a

A sub capsular hematoma is located between the splenic capsule and Parenchyma. It most commonly appears on ultrasound as a crescent shaped fluid collection inferior to the diaphragm

The most common location of an accessory spleen is near the

Accessories liens are commonly Located medial to the splenic Hilum. The tail of the pancreas may extend towards the splenic or left renal Hilum

A 50-year-old patient with a long history of alcohol abuse presents to the ultrasound department complaining of left upper quadrant pain. This sonogram of the left upper quadrant is most consistent with which of the following conditions

Alcohol abuse is associated with cirrhosis. Chronic insult to the liver cells leads to a decrease in liver function leading to spleno megaly. This sonogram demonstrates an in large spleen measuring 19.4 cm in length. Lympho may demonstrate splenomegaly but is not the most likely differential in this case

Splenic infarct Chin is most commonly associated with an embolism originating from which of the following structures

An embolism originating in the heart is the most common source of a splenic infarction

The most common clinical findings associated with A hemangosarcoma is

Anemia is the most common clinical findings associated with a hemangiosarcoma involving the spleen. Other symptoms may include left upper quadrant pain weight loss and leukocytosis

Which of the following splenic regions is Identify by Arrow A

Arrow a identifies the superior medial portion of the spleen

Which of the following splenic regions is identified by Arrow b

Arrow b identity the midpoint of the spleen known as the splenic Hilum

Which of the following splenic regions is identified by Arrow C

Arrow c Identifies the inferior lateral portion of the spleen

And a symptomatic middle aged patient presents with a history of liver function test showing elevated levels on an annual physical examination. And abdominal ultrasound is ordered to rule out liver disease. A sonogram of the left upper quadrant demonstrates a hyperechoic mass in the splenic parenchyma on this history the master Denna five most likely represents

Caverness hemangios are commonly begin masses that may develop in the splenic Parenchyma They are the most common Benign solid mass and they are most likely diagnosis of this hyperechoic intraparenchyma mass. Lipoma is a differential consideration but not a common finding with in the splenic parenchyma

Which of the following conditions is most likely to demonstrate an elevated hematocrit

Elevation in Hematocrit may be related to infection do you hydration shock and Polycythemia vera

Patients with a history of portal hypertension have an increased risk of developing a splenic

Factors associated with an increased risk for developing an aneurysm of the splenic artery include female pervalance trauma atherosclerosis infection and portal hypertension

Which of the following splenic abnormalities is the most commonly lead to infective Endocarditis

Formation of a splenic abscess is most commonly associated with infective Endocarditis.Infarction of the spleen may be caused by emboli from the heart sub acute bacterial endocarditis leukemia sickle cell anemia metastasis or pancreatitis.

Which of the following splenic pathology is associated with granulomatosis

Granulomatosis is defined as an abnormal increase in the total number of granulocytes in the blood.

Hemangiosarcoma involving the spleen frequently metastasize to which of the following organs

Hemangiosarcoma Is a rare primary malignant neoplasm of the spleen that frequently metastasizes to the liver

Hematocrit is defined as the percentage of

Hematocrit is the percentage of red blood cells in the blood. Hemoglobin is the oxygen carrying pigment of the red blood cells. Platelets are formed in the bone marrow and some are stored in the spleen

Which of the following structures carries carbon dioxide back to the lungs

Hemoglobin carries carbon dioxide from the self back to the lungs. Platelets are essential for the coagulation of blood and the maintenance of hemostasis. Hematocrit is the percentage of red blood cells in the blood. Lymphocytes and leukocytes are associated with infection

A retroperitoneal ultrasound is ordered on an older patient with a history of elevated creatine levels hyperechoic foci are identified in the splenic Parenchyma these foci are most suspicious for

Hyperechoic foci with in the parenchyma are most suspicious for splenic calcification. Calcifications are generally an incidental finding commonly associated with granulomatosis. Other ideologies may include splenic infarction calcified cyst or abscess.

A patient with a history of leukemia presents to the ultrasound department complaining of left upper quadrant pain a sonogram of the spleen demonstrates hypoechoic nodules with in the splenic parenchyma These nodules most likely represent

In a patient with a history of leukemia the Parenchyma nodules most likely represent primary malignant tumors. Leukemia may demonstrate Hypoechoic or hyperechoic splenic mass is on ultrasound. Metastatic disease to the spleen most commonly originates from melanoma or malignancy of the breast lung or pancreas.

Which of the following is an indication for an ultrasound of the spleen

Indications for an ultrasound of the spleen may include chronic liver disease infection leukocytosis leukopenia abdominal or left upper quadrant mass fatigue leukemia lymphomia trauma

Leukocytosis Is defined as white blood cell count

Leukocytosis is defined as a white blood count up above 20,000. Normal serum levels range between 4500 and 11,000 MM3

Metastasis to the spleen most commonly originates from which of the following malignancies

Metastasis to the spleen is rare. Disease involving the spleen most commonly originates from melanoma. Other primary neoplasm metastasizing to the spleen may arise from the breast long ovary stomach: kidney and prostate

Multiple splenic infection is a predisposing factor for which of the following conditions

Patients with a history of multiple splenic infections are at an increased risk for developing candidiasis. This condition is most commonly found in auto immune compromised patients. An embolism originating from the heart is the most common cause of splenic infarct Chin. Calcifications in the spleen are more commonly caused by granulomatosis or infarction

A congenital abnormality of the spleen associated with gastrointestinal cardiovascular and biary abnormally is most consistent with

Polysporin union is associated with multiple small spleens to the left lung is a congenital abnormalities of the Gastro intestinal track cardiovascular system and by Bilary system. Asplenia syndrome is associated with two right lung Gastro intestinal and urinary a normal cheese and a midline placement of the liver. Accessory spleen and wondering spleen are not associated with additional anomaly

And asymptomatic patient presents to the ultrasound department with a history of hepatitis B an incidental finding is identified in the superior portion of the spleen. This finding is most consistent with a

Smooth thin walled margins are identified along with posterior acoustic enhancement this is most consistent with a splenic cyst.

Based on the clinical history the sonographic findings are most likely considered

Splenic calcifications are generally an incidental finding. Follow up is typically recommend it only if clinically indicated. Splenic calcifications are most commonly associated with granulomatosis or in response to infection

Which of the following pathologies is associated with a wheel within a wheel appearance on ultrasound

Splenic candidiasis and metastatic lesions most commonly demonstrated a wheel within a wheel or target pattern on ultrasound. A hemangiosarcoma generally appears on ultrasound as a hyperechoic or complex mass. Infarction May appear hypoechoic when acute or hyperechoic chronic cases.

Based on this history and sonogram the sonographers should also evaluate for which of the following pathologies

Splenomegaly in a patient with a long history of alcohol abuse should be evaluated for liver disease

A patient presents with a history of portal hypertension the spleen is expected to demonstrate

Splenomegaly is the most common sonographic findings associated with portal hypertension. Other findings may include hepato-megaly diameter in large meant of the main portal splenic and or superior mesenteric vein's development of Puerto splenic collaterals and changes in the flow or direction pattern of the portal circulation.

The most common benign neoplasm of the spleen is a

The Caverness hemangioma is the most common benign neoplasm of the spleen.

The splenic artery is a branch of which of the following structures

The celiac access/trunk is the first branch of the abdominal aorta. The Celiac access trifurcates into the splenic left gastric and common hepatic artery's. Branches of the superior mesenteric artery supply the head of the pancreas and portions of the small and large intestine

A clinical findings associated with splenic infarction may include

The majority of patients with a history of splenic infarction are asymptomatic but may develop left upper quadrant pain

The normal adults lien measures approximately

The normal adult spleen measures approximately 10 to 12 cm in length 7 cm in width and 3 to 4 cm in thickness

Gain settings should be placed to demonstrate the normal spleen as

The normal spleen is isoechoic to slightly hyperechoic when compared to the normal liver. The normal renal cortex is hypoechoic to the liver and spleen

Which of the following scanning Plains is most likely demonstrated in this sonogram

The sonogram demonstrates the length of the left kidney the spleen and kidney like closest to the transducer footprint and this spinous process lies further from the transducer footprint. These findings are most consistent with a coronal plane.

The spleen is predominately located in which of the following quadrants

The spleen is an intraperoneal Organ perdominantly located in the left hypochondriac region with the superior aspect extending into the epigastric region

The location of the spleen is best described as

The spleen is in intraperineal structure located lateral to the pancreas anterior to the left kidney inferior to the left hemidiaphragm and lateral to the stomach and left adrenal gland

A patient presents with a history of increased abdominal girth and liver function test showing elevated levels. Which of the following findings is most likely demonstrated in this sonogram of the left upper quadrant

anechoic free fluid is Identify inferior to the diaphragm and superior to the spleen as well as inferior to the spleen. These sonographic findings are most suspicious for ascites