Abdomen Practice Tests

In older patients the prostate glands considered enlarged:

> 40 grams

------------- is capable of being replaced in a normal position; the visceral contents can be returned to normal intraabdominal location.

A reducible hernia

A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for:

Adenocarcinoma of the pancreas

The most common site for focal fat sparing is:

Anterior to the gallbladder

Large parathyroid adenomas displace the thyroid gland:

Anteriorly

Dissecting aneurysms typically originate at the:

Aortic arch

You are scanning a patient with Marfan syndrome. Ultrasound findings reveal a linear band .Throughout the length of the abdominal aorta that is mobile in relation to the cardiac cycle. What pathology is most likely present?

Aortic dissection

Which of the following best describes a spermatocele?

A simple-appearing cyst, found within the head of the epididymis

You are scanning a patient in the emergency room with severe nausea and abdominal pain. When you press with the transducer over the gallbladder, the patient has increased pain. What did you do?

A sonographic Murphy's sign

A round, echo-free mass seen high in the midline of the neck, above the thyroid, is MOST likely:

A thyroglossal duct cyst

De Quervain's disease results from:

A viral infection of the gland

Most common cause of acute abdomen is?

Appendicitis

What is the most common clinical finding of a simple renal cyst?

Asymptomatic

A 42-year-old man is found to have a 14-mm parathyroid gland on ultrasound evaluation. Based on this finding, the sonographer should look:

At the kidneys for calcifications

What disease begins as fibro-fatty plaque on the intima of large arteries?

Atherosclerosis

What is the most common etiology of Graves's disease?

Autoimmune disorder

Cerebral aneurysms are associated with

Autosomal dominant polycystic kidney disease

Which of the following is usually diagnosed in early childhood or in utero?

Autosomal recessive polycystic disease

Which of the following would NOT be a typical clinical finding of a patient with pancreatic adenocarcinoma?

Autosplenectomy

The congenital disease characterized by the narrowing or obliteration of all or a portion of the biliary tree is:

Biliary atresia

The "too many tubes" sign is associated with:

Biliary obstruction

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

Biliary tract disease

Hepatitis can lead to all of following, except:

Beckwith-Wiedemann syndrome

The majority of extra-testicular masses are:

Benign

Where is a hydrocele located?

Between the two layers of the tunica vaginalis

All of the following are sonographic indications of chronic rejection in a transplanted kidney EXCEPT:

Bladder distension

Many pancreatic islet cell tumors are commonly located in the:

Body & tail

What does secondary hyperparathyroidism result in?

Bone demineralization

What is an ileus?

Bowel moving slowly

A cystic mass noted at the mandibular angle (lateral side if the neck) is most likely

Brachial Cleft Cyst

Gas-forming bacteria in the gallbladder appear on ultrasound as:

Bright echo with a comet tail artifact

Hepatomas that invade the hepatic veins causing narrowing of the hepatic veins, with subsequent tumor invasion into the inferior vena cava can produce symptoms of:

Budd-Chiari syndrome

In cases of choledocholithiasis, stones tend to lodge in the:

Common bile duct

A 56-year-old female patient presents to the ultrasound department for a renal sonogram with a history of microscopic hematuria. She had her left kidney removed two years earlier for renal cell carcinoma. Sonographically, the right kidney appears enlarged and measures greater than 14 cm. What is the most likely explanation for this finding?

Compensatory hypertrophy

What sonographic finding contributes to a diagnosis of a perforated appendix?

Complex fluid collection

____ is used to create the "twinkle artifact" characteristic of renal calculi.

Compound imaging

Nutcracker syndrome results most commonly from the

Compression of the left renal vein between the abdominal aorta and SMA

Which of the following techniques is used to sonographically identify bowel abnormalities?

Compression sonography

Which of the following results from high levels of aldosterone secretion by the adrenal cortex?

Conn syndrome

When hypertrophic pyloric stenosis is delineated in short axis the abnormally hypertrophied pyloric diameter usually measures:

Diameter > 15 mm

What is the sonographic appearance of bowel wall inflammation?

Diffuse thickening >5mm

A patient with ampullary (ampulla of vater) carcinoma most likely will demonstrate all of the following, except:

Dilated HVs

Onion ring pattern is the classic appearance of:

Epidermoid cyst

The most frequent cause of an acute scrotal pain in the post puberty male is?

Epididymitis

Which of the following clinical findings is not consistent with the diagnosis of autosomal dominant polycystic kidney disease?

Epilepsy

Neoplasm of which origin comprise the largest group of pancreatic tumors?

Exocrine

Renal cysts that project away from the kidney are termed as:

Exophytic

A disease process characterized by mucinous ascites is called:

Exudative ascites

A 34-year-old obese, asymptomatic male patient presents to the ultrasound department with a history of elevated liver function labs. Sonographically, the liver appears diffusely echogenic, and the borders of the vessels are difficult to visualize. Which of the following would be the most likely diagnosis?

Fatty infiltration

One of the following is NOT an indication for liver transplant.

Fatty liver

A patient presents with severe abdominal pain, nausea, vomiting, abdominal distention, increased amylase levels, and decreased hematocrit. What should the sonographer suspect?

Hemorrhagic pancreatitis

A 32-year-old female patient presents with a liver mass. She states that she has been using oral contraceptives for over 13 years. Which of the following would be most likely associated with oral contraceptive use?

Hepatic adenoma

The most important vascular structure to image after a liver transplant is:

Hepatic artery

Which of the following would be considered a potential complication of a liver transplant?

Hepatic artery thrombosis

What hepatic abnormality may be discovered in the immunocompromised patient?

Hepatic candidiasis

Which of the following is a result of a fungal disease invading the liver?

Hepatic candidiasis

Which of the following hepatic masses would be least likely to appear sonographically as a "halo" or "bulls-eye" lesion?

Hepatic lipoma

Which of the following typed of hepatitis has the highest risk for development of hepatocellular carcinoma?

Hepatitis C

A 14-month-old male patient presents to the ultrasound department for a liver sonogram with Beckwith-Wiedemann syndrome and a clinical history of a palpable abdominal mass, elevated alpha-fetoprotein level, and anorexia. Which of the following liver masses would most likely be discovered in this patient?

Hepatoblastoma

Which of the following is the malignant pediatric form of liver disease and is considered to be the most common malignant tumor of childhood?

Hepatoblastoma

Which of the following is the most common type of malignant liver tumor in adults?

Hepatocellular carcinoma

What Doppler signal would be expected in the portal vein of a patient with portal hypertension?

Hepatofugal flow

A patient presents with a history of weight loss and elevation in his liver function tests. The patient is presently afebrile. Based on this clinical history, the sonographic finding is most suspicious for which of the following pathologies?

Hepatoma

All of the following mass lesions are benign, except:

Hepatoma

You are performing an ultrasound exam on a patient who has been on dialysis for 4 years. All of the following can be seen except:

Hypertrophied kidneys

Early stage of splenic infarction seen by ultrasound as:

Hypoechoic

The ultrasound appearance of leiomyoma of the stomach is?

Hypoechoic

What is the most common ultrasound appearance of pancreatic adenocarcinoma?

Hypoechoic mass

The best sonographic characteristic for a thyroid The best sonographic characteristic for a thyroid cancer is:cancer is:

Hypoechoic solid mass with irregular margins

A cold nodule in the thyroid is:

Hypofunctioning and does not take up radioisotope

What can be excluded when the patient presents with a normal thyroid-stimulating hormone (TSH) level?

Hypothyroidism

A 1 year old comes in for an ultrasound due to a distended abdomen. The ultrasound reveals distended fluid filled loops of bowel and an abrupt termination point of the distended bowel is identified. Most probably the abnormality is?

Ileus

What is the most common location of aneurysms associated with the continuation of an abdominal aortic aneurysm?

Iliac artery

Which one of the following describes the sonographic appearance of chronic pyelonephritis?

Inability to distinguish the cortex from the medullary regions

An abnormal bowel signs include all EXCEPT:

Increase of peristalisis

The lab values with parathyroid adenomas will reveal:

Increased PTH levels

Which of the following is NOT a feature of hepatic cysts?

Increased attenuation

You are scanning an obese patient to rule out fatty liver. Which of the following describe a common sonographic appearance of this condition?

Increased echogenicity of the liver compared to the normal kidney

Which of the following would be the least likely clinical feature of a patient with a history of blunt trauma to the kidney?

Increased hematocrit

Which is a finding associated with hydronephrosis?

Increased intraperenchymal resistive index

A 1-week-old patient presents with laboratory tests indicate hematuria and proteinuria. The patient is afebrile. Sonography depicts enlarged echogenic kidneys. Which of the following is the MOST likely diagnosis?

Infantile polycystic kidney disease

Enlarged lymph nodes demonstrating smooth wall margins are most consistent with an underlying:

Infection

Mycotic aneurysms are associated with:

Infection

You are performing an ultrasound to rule out the presence of abdominal aortic aneurysm (AAA). What is the most common location of AAA?

Infrarenal

A 13-year-old African American boy presents to the ultrasound department with a new onset of sickle cell crisis. What would be the most likely sonographic manifestation of sickle cell crisis?

Initial splenomegaly

Which of the following neoplasm is commonly located in the tail of the pancreas?

Insulinoma

Sonographic findings associated with acute hepatitis may include all of the following, except:

Irregular liver contour

Which one of the following describes the most common sonographic appearance of gallbladder carcinoma?

Irregular solid mass projecting from the gallbladder wall

Which of the following is not true of the neuroblastoma?

Is a malignant pediatric renal tumor

The clinical findings for pyloric stenosis includes all except

Jelly red stool

The sonographic appearance of the valvular conniventes located in the jejunum & ileum can be described as:

Key board sign

An 85-year-old male patient presents to the ultrasound department for a right upper quadrant sonogram. He is complaining of pruritus, unexplained weight loss, and abdominal pain. Sonographically, dilated intrahepatic ducts are noted and appear to abruptly terminate at the level of a hypoechoic mass. Which of the following is most likely present based on these patients clinical and sonographic findings?

Klatskin tumor

Which form of cholangiocarcinoma causes intrahepatic but NOT extrahepatic duct dilatation?

Klatskin tumor

Which of the following is NOT common in children and neonates?

Klatskin tumor

Which of the following is a type of cholangiocarcinoma?

Klatskin tumor

What areas have to be examined after splenic capsule rupture?

LLQ Pelvis Morison's pouch

Varicoceles occur more often on the _____ side.

Left

A benign tumor composed of fat is referred to as a:

Lipoma

A 35-year-old female patient from Cambodia presents for an ultrasound examination. She has leukocytosis, fever, abdominal pain, nausea and vomiting. Upon examination, the sonographer visualizes a large mass in the right lobe with ill-defined borders, mixed echogenicity, some posterior enhancement and dirty shadowing originating from within the mass. Which of the following conditions is the MOST probable cause?

Liver abscess

Which hepatic mass is associated with the use of oral contraception and glycogen storage disease?

Liver cell adenoma

One clinical sign of an insulinoma is the presence of:

Low level sugar symptoms

You are scanning a patient with right flank pain and known polycystic kidney disease. You suspect the presence of hemorrhage within one of the renal cysts. What is the sonographic appearance of this finding?

Low-level echoes within the cyst

Which of the following forms of metastatic liver disease would most likely appear as a "target" or "bull's eye" lesion?

Lung metastasis

The most common primary retroperitoneal tumor is:

Lymphoma

On which of the following blood vessel calculating the resistive index is not required:

Main renal vein

Focal bowel thickening is suspicious for ___

Malignancy

Which of the following renal disorders it thought to be caused by an early first trimester obstruction of the ureter?

Multicystic dysplastic renal disease

What is medullary carcinoma associated with?

Multiple endocrine neoplasia syndromes

In the course of a sonographic examination, the ultrasound technologist visualizes a patent lumen within the umbilical vein. This condition may be associated with and indicative of:

Portal hypertension

Which of the following is the most common cause of splenomegaly?

Portal hypertension

You are performing an ultrasound examination on a patient with acute cholecystitis. Complications of acute cholecystitis that you should look for include all of the following, except:

Portal hypertension

The amebic abscess may reach the liver through the:

Portal vein

Cavernous transformation of the portal vein is associated with:

Portal vein thrombosis

Which of the following is NOT true about chronic cholecystitis?

Positive Murphy's sign

What is performed to rule out pneumothroax?

Post-procedure chest x-ray

Following splenic rupture, splenic cells may implant through the peritoneal cavity and increase in size, resulting in ectopic spleen which is called:

Posttraumatic splenosis

A 44-year-old female patient presents to the ultrasound department for a renal sonogram complaining of decreased renal function. Sonographically, both kidneys appear enlarged and there appears to be multiple anechoic masses that have good through transmission bilaterally. Which of the following would be most likely?

Potter III

You are scanning patient with sickle cell anemia and note the presence of gallstones and gallbladder wall thickening. What else should you do to determine if acute cholecystitis is present?

Press with the ultrasound probe over the gallbladder to determine if it is painful Look carefully to see if a gallstone is lodged in the gallbladder neck Check for the presence of pericholecystic fluid

What are the clinical implications for a 52-year-old man with a liver sonography examination suggesting long standing liver disease and the presence of alpha-fetoprotein?

Primary carcinoma (HCC)

Which of the following is not true about cystitis?

Primary tumor of the bladder

Which of the following is not clinical signs and symptoms appendicitis?

Projectile vomiting

What is the most common primary tumor to metastasize to the testis?

Prostate

Acute tubular necrosis demonstrates on ultrasound as:

Renal enlargement with hyperechoic renal pyramids

You are performing an abdominal ultrasound scan and detect a hyperechoic lesion within the spleen. This is the typical appearance of which of the following entities?

Splenic hemangioma

A 64-year-old male patient presents to the ultrasound department for an abdominal sonogram with a sudden onset of LUQ pain. Sonographically, a wedge-shaped hypoechoic mass is discovered within the splenic parenchyma. Which of the following would be most likely?

Splenic infarct

A history of histoplasmosis, tuberculosis, or sarcoidosis inflammatory diseases would increase the likelihood of discovery what splenic abnormality?

Splenomegaly

Which of the following is best described as a renal stone that completely fills and takes on the shape of the renal pelvis?

Staghorn calculus

Testicular microlithiasis within the testes is associated with

Sterility

----------------- is an incarcerated hernia with vascular compromise.

Strangulated hernia

What is the most common symptom of renal artery stenosis?

Sudden onset of hypertension

What is the treatment of primary hyperparathyroidism?

Surgical excision of the parathyroid adenoma

Leydig cell tumors produce -------------------causing----------------.

Testosterone, precocious puberty

What does medullary carcinoma usually secrete?

The hormone calcitonin

The most common location for the Crohn's disease Is?

The ileum

A 34-year-old patient with carcinoma of the colon has had hepatomegaly and weight loss over the past 2 months. What malignant pattern would most likely be seen in the liver?

The liver most likely will be enlarged, with diffuse abnormalities throughout the parenchyma.

If cholelithiasis is discovered on ultrasound, the sonographer should determine:

The mobility of the stone(s)

In a pediatric patient, the renal pelvis is dilated but the ureter is normal. Which of the following is the MOST likely diagnosis?

Ureteropelvic junction obstruction

A 19-year-old patient presents to the ultrasound department for a renal sonogram with a history of recurring urinary tract infections. Sonographically, the kidneys appear normal. However, within the urinary bladder, an anechoic, balloon-like structure is noted within the lumen of the urinary bladder near the ureterovesicular junction. Which of the following is most likely?

Uretrocele

A 2-day-old baby boy presents to the ultrasound department for a renal sonogram for suspected posterior urethral valves. In the presence of this disorder, which of the following would most likely be distended?

Urinary bladder, both kidneys, both ureters

Which sonographic technique is used to document a varicocele?

Valsalva maneuver

The appearance of an inflamed appendix includes all EXCEPT:

The muscular wall should be < 1 - 2 cm

You are scanning a patient in ICU and notice low-level echoes within the gallbladder consistent with sludge. The gallbladder wall is not thickened. Which statement below is true?

The patient has sludge most likely due to bile stasis

Clinical signs and symptoms in acute pancreatitis include all of the following, except:

Severe abdominal pain radiating to the right shoulder

The clinical signs for pleural effusion include all except

Shoulder pain

Which of the following diseases would result in splenic atrophy?

Sickle-cell anemia

Non shadowing, low-amplitude echoes in a dependent GB is most characteristic of:

Sludge

Which one of the following genitourinary problems is commonly associated with the prune-belly syndrome?

Small bladder

Sonographically, the fasting superior mesenteric artery exhibits high-resistance flow and the postprandial superior mesenteric artery yields a high-resistance waveform. Which of the following should be suspected?

Small bowel ischemia

On sonographic examination, a seminoma appears as:

Solid hypoechoic mass

You are scanning a patient with liver cirrhosis and suspected portal hypertension. In this study, assessment of the size of which of the following is most important?

Spleen

Intestinal pathology creates a sonographic pattern "gut signature" known as what?

"Pseudo kidney" sign

A thyroid isthmus that measures greater than ____ is indicative of thyroid enlargement.

10 mm

The diameter of the main portal vein can vary with respiration, though typically it measure less than:

13 mm in the anteroposterior dimension

What is the congenital anomaly where the testicle is no attached to the tunica vaginalis and rotates freely on spermatic cord?

A bell clapper deformity

An 8-year-old patient presents with mid-abdominal pain and an elevated serum amylase level after blunt trauma to her abdomen. The abdominal sonogram demonstrates a cystic mass around the tail of the pancreas. The mass MOST likely represents?

A pancreatic pseudocyst

An ultrasound exam reveals a solid, hyperechoic mass in a 46-year-old patient with tuberous sclerosis. This most likely represents:

Angiomyolipoma

A post surgical patient presents with abdominal tenderness, and leukocytosis. A sonogram demonstrates a superficial ill-defined mass beneath the surgical incision. Based on the clinical history, the sonographic findings are most suspicious for:

Abscess

Which Doppler finding indicates a thrombosis and occlusion following a transjugular intrahepatic port systemic shunt?

Absent flow

Which cystic renal disease can result from chronic hemodialysis?

Acquired renal cystic disease

A 31-year-old female patient presents to the ultrasound department for a renal sonogram. She is suffering from pyuria, dysuria, and leukocytosis. Which of the following would be most likely?

Acute pyelonephritis

Which of the following would be considered to be the most common cause of acute renal failure?

Acute tubular necrosis

Ascites can be caused by all of the following except:

Adenomyomatosis

Upon sonographic examination of the RUQ in a 32-year-old female patient complaining of generalized abdominal pain, you visualize an anechoic mass with posterior enhancement superior to the right kidney. This most likely represents a /an:

Adrenal cyst

Which of the following adrenal abnormality would be the most likely cause of hypotension and a decreased hematocrit in the newborn?

Adrenal hemorrhage

Which one of the following conditions occurs when the fetus is stressed during a difficult delivery or during a hypoxia insult?

Adrenal hemorrhage

Anaplastic carcinoma rapidly invades surrounding tissues, causing what?

Airway obstruction

The most common cause of cirrhosis is:

Alcoholism

A patient is referred for a sonogram of the liver to rule out metastatic disease. Which of the following describes the sonographic appearance of liver metastasis?

All of the above appearances of liver metastasis may be encountered

What is the sonographic appearance of tumefactive sludge within the gallbladder?

An avascular mass with low-level echoes

Type I glycogen storage disease produces:

An echogenic enlarged liver

There are 4 major types of thyroid cancer. The pathology report concluded that the patient had the fastest growing thyroid cancer. It is the worst kind because patients tend to die within months of diagnosis. Which cancer does the patient has?

Anaplastic

Which of the following is the biggest risk factor for rupture of an AAA?

Aneurysm size

Acute pyelonephritis is most often the result of:

Bacteria that is spread to the kidney from the lower urinary tract

An irreversible inflammatory disease that disrupts normal liver structure and function and is characterized by diffuse hepatocellular fibrosis and nodular regeneration is:

Cirrhosis

Hemochromatosis is a rare disorder that may lead to:

Cirrhosis

The double-duct sign represents the:

CBD & PD

A patient presents with a history of a Whipple procedure one year earlier. The sonographer expects to visualize:

CBD attached to the duodenum

Mrs. Gall presented to the ER with RUQ pain, nausea and vomiting. She also exhibited a positive Murphy's sign. The ultrasound exam revealed an enlarged, thick walled GB containing echoes that shadow. Pericholecystic fluid was also demonstrated. The most likely diagnosis would be:

Calculous cholecystitis

Extrinsic causes of hydronephrosis include all of the following EXCEPT:

Calculus

What is the most common cause of acute cholecystitis?

Calculus obstruction of the gallbladder neck or cystic duct

The most common cause of fungal urinary tract infections is:

Candida albicans

The most common benign tumor in the liver is:

Cavernous hemangioma

A 44-year-old female patient presents to the ultrasound department for a right upper quadrant sonogram with a complaint of epigastric pain. The sonographic evaluation of the liver reveals an isoechoic mass within the right lobe that is difficult to image and discern its borders. You suspect that the mass is focal nodular hyperplasia. Which of the following sonographic findings would be most indicative of focal nodular hyperplasia?

Central scar

Cancer of the biliary tree is termed:

Cholangiocarcinoma

A 29-year-old female patient presents to the ultrasound department for a liver sonogram complaining of right upper quadrant pain and fever. Her laboratory findings include evidence of leukocytosis and an elevated bilirubin. She had a cholecystectomy 1 year earlier. Sonographically, the common bile duct appears enlarged, measuring 11 mm at the porta hepatis. Also, the walls of the bile duct measure 6 mm. Based on the clinical and sonographic findings, what is the most likely diagnosis?

Cholangitis

Prominent walls of the biliary tree that measure greater than 5 mm is indicative of:

Cholangitis

What is the likely diagnosis for a 5-year-old who presents with recurrent fever, right upper quadrant pain, jaundice, and a sonogram demonstrating a 2-cm cyst that is medial and separate from the gallbladder and is communicating with the common bile duct?

Choledochal cyst

Which biliary pathology is more prevalent in the Asian population?

Choledochal cyst

Patients who have hepatocellular carcinoma are likely to have had:

Cirrhosis

A 35-year-old male patient presents to the ultrasound department following a cholecystectomy for gallstones. He complains of epigastric pain and nausea, and has an elevated bilirubin and alkaline phosphatase. Sonographically, the common duct measures 10 mm at the level of the porta hepatis. Which of the following is the most likely cause of these sonographic and clinical findings?

Choledocholithiasis

A patient is referred for ultrasound with jaundice, pain, nausea and vomiting and a history of cholecystectomy. Which of the following findings is most likely?

Choledocholithiasis

Carcinoma of the gallbladder is most likely to be associated with which disease?

Cholelithiasis

A contracted gallbladder is a common sonographic finding in which of the following conditions?

Chronic cholecystitis

A patient reports with post prandial RUQ pain, frequent belching, and upon investigation by ultrasound you notice a contracted GB and the WES sign. What is the differential diagnosis?

Chronic cholecystitis

Diminished vascular structures within the liver parenchyma most likely represent:

Chronic cirrhosis

Severe sound attenuation is associated with which pathology?

Chronic cirrhosis

A 56-year-old male patient presents to the ultrasound department for a screening sonogram of his abdominal aorta. Incidentally noted during the examination is a small, heterogeneous pancreas that contains multiple calcifications and a prominent main pancreatic duct. Which of the following is the most likely explanation for these findings?

Chronic pancreatitis

A 58-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of an elevation in AST, ALT, and indirect bilirubin. He also has jaundice and complains of fatigue. Sonographically, there is ascites within the abdomen and the right lobe of the liver appears small and echogenic. Which of the following is the most likely diagnosis?

Cirrhosis

In the patient who presents with painless jaundice, which of the following clinical findings is most worrisome for pancreatic adenocarcinoma?

Courvoisier gallbladder

The syndrome associated hypertension, hyperglycemia, obesity and adrenal mass is:

Cushing syndrome

Which of the following is associated with Caroli's disease?

Cystic dilatation of intrahepatic bile ducts

What is the most common cause of GB hydrops?

Cystic duct stone

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

Cystic fibrosis

What is the most common cause of a hyperechoic pancreas in a child?

Cystic fibrosis

What developmental cyst occurs because of a congenital modification in the cervical lymphatic system?

Cystic hygroma

Which of the following abnormality is often seen in utero?

Cystic hygroma

Typical symptoms a patient may have with an abscess formation include all of the following, except:

Decreased white blood count

What can symptoms of a Baker's cyst be mistaken for, due to pain and swelling behind the knee and in the upper calf?

Deep venous thrombosis

Which of the following is the most common cause of chronic renal failure?

Diabetes

Intrahepatic pneumobilia (air in biliary tree) results from:

ERCP

The "water lily" sign is associated with which of the following abnormalities?

Echinococcal cyst

The ultrasound appearance of a shunt is:

Echogenic

What area is carefully scanned on a follow-up examination on a patient with a history of cavernous transformation?

Porta hepatis

Which of the following is NOT true of hepatic cysts?

Elevated liver function tests are often caused by hepatic cysts

Which of the following renal infections is found most often in the diabetic or immune compromised patient?

Emphysematous pyelonephritis

Which of the following is not a common fluid collection following a renal transplant?

Empyema

All of the following cause splenomegaly, except:

End stage sickle-cell anemia

The exam of the right lobe of the thyroid in a 40-year-old female demonstrates a solid mass with a "halo" effect. This is highly suggestive of a (an).

Endemic goiter

What do patients with non-palpable papillary thyroid cancer commonly present with?

Enlarged cervical nodes

Which of the following is not the sonographic appearance of Crohn's disease?

Focal bowel wall thickness

A single large, well-defined mass with smooth walls and homogeneous low-level echoes is seen within the anterior right lobe of the liver in a 28-year-old female. No Doppler signals could be obtained within the mass. Which of the following conditions is the most likely etiology of this mass?

Focal nodular hyperplasia

Which of the following tumors is considered to be the second most common benign liver tumor after hemangioma?

Focal nodular hyperplasia

Which of the following tumors of the liver is often termed the "stealth" lesion of the liver?

Focal nodular hyperplasia

A 35-year-old patient presents to the ultrasound department with a history of testicular cancer. Which of the following is not typically a primary cancer of the testicle?

Follicular carcinoma

Which of the following is considered to be the most common shape of an abdominal aortic aneurysm?

Fusiform

An 83-year-old female patient presents to the ultrasound department for a right upper quadrant sonogram with a history of unexplained weight loss, vomiting, right upper quadrant pain, and jaundice. The sonographic findings include a hypoechoic mass partially filling the gallbladder lumen that measures approximately 3 cm. Which of the following is the most likely diagnosis based on these sonographic and clinical findings?

Gallbladder carcinoma

What are the most common tumors of the hand and wrist?

Ganglion cysts

A 19-year-old female patient presents to the emergency department with severe right upper quadrant pain and leukocytosis. A gallbladder sonogram is ordered to investigate for signs of gallbladder disease. The patient complains of pain directly over the gallbladder. Sonographically, the gallbladder wall appears striated and measures 8 mm. There is a small amount of fluid adjacent to the gallbladder as well. The common bile duct measures 7 mm. Which of the following is the most likely diagnosis?

Gangrenous cholecystitis

Which of the following is associated with Zollinger-Ellison syndrome?

Gastrinoma

Which of the following forms of metastatic liver disease would most likely appear as a calcified mass?

Gastrointestinal metastasis

Hypoglycemia is an indication for which pathology?

Glycogen storage disease

Which of the following is the most common thyroid abnormality?

Goiter

What may be demonstrated in the spleen and liver in patients with AIDS?

Granulomas

Exophthalmos is associated with which pathology?

Grave's disease

What disease is clinically similar to toxic multinodular goiter?

Grave's disease

Chronic thyroiditis is another name for:

Hashimoto thyroiditis

What is the most common cause of hypothyroidism?

Hashimoto thyroiditis

A painless, diffuse enlargement of the thyroid in young or middle aged women with the lab value increase in TSH is:

Hashimoto's

Which of the following tumors consists of a group of small blood vessels?

Hemangioma

A_______is a collection of blood which is usually confined to an organ, tissue or space, a decreased hematocrit level indicates it's presence.

Hematoma

What is the most common clinical presentation of transitional cell carcinoma?

Hematuria

What idiopathic condition most commonly affects first-born male infants?

Hypertrophic pyloric stenosis

___ forms when the abdominal wall muscles are weakened, thus allowing the viscera to protrude into the weakened abdominal wall.

Hernia

Which of the following is not typically a clinical feature of Conn syndrome?

Hirsutism

In patients with suspected lymphoma, the presence of Reed-Sternberg cells indicates:

Hodgkin lymphoma

Casoni test is done to confirm:

Hydatid disease

Which of the following is associated with echinococcus granulosus?

Hydatid liver cyst

The most common cause of painless scrotal swelling is?

Hydrocele

The most important diagnosis to exclude in patients with acute renal failure by ultrasound is:

Hydronephrosis

Which of the following is the ultrasound appearance of focal fatty infiltration?

Hyperechoic focal areas of fat present within a background normal echo texture

A 40-year-old female long-time smoker presents to the ultrasound department for a renal sonogram with a palpable left upper quadrant mass, weight loss, and gross hematuria. A hypoechoic mass is noted in the upper pole of the left kidney. Which of the following is the most likely?

Hypernephroma

What pathology is most likely demonstrated on a 64-year-old man with an elevated prostate-specific antigen level and the endorectal sonogram documenting an 8.9 mm hypoechoic mass in the right peripheral zone?

Malignancy

Primary neoplasm of the retroperitoneum are rare, this tumors are generally:

Malignant

The majority of intratesticular masses are:

Malignant

Which of the following would be most likely to predispose a patient to develop an abdominal aortic aneurysm, and is described as a disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency?

Marfan syndrome

Aortic dissection is associated with:

Marfan syndrome Pregnancy Hypertension

The anatomical landmark most often used to locate the appendix is:

McBurney's point

-----------------------is a pouch on the wall of the lower part of the bowel.

Meckel's diverticulum

A 38-year-old patient presents to the ultrasound department for a renal sonogram with a history of urinary tract infections and renal calculi. Sonographically, the kidneys appear to have echogenic renal pyramids. Which of the following is the most likely explanation for these sonographic findings?

Medullary nephrocalcinosis

The median arcuate ligament syndrome symptoms are similar to:

Mesenteric ischemia

Which of the following is described as a clinical condition in which the patient presents with jaundice, pain, and fever secondary to a lodged stone in the cystic duct?

Mirizzi syndrome

The sonographic appearance of cholelithiasis is best described as:

Mobile, hyperechoic focus demonstrating posterior shadowing

The ultrasound appearance of metastatic tumor to the spleen can be seen by ultrasound as:

Mostly hypoechoic to the spleen

A _________ designates gross enlargement of the appendix from accumulation of mucoid substance within the lumen.

Mucocele

Which of the following will cause a thin-walled gallbladder?

Mucocele GB

Which of the following is usually diagnosed in early childhood or in utero?

Multicystic dysplastic kidney

An 88-year-old immunocompromised patient presents to the ultrasound department for a liver sonogram with a history of right upper quadrant pain, fever, and hepatomegaly. Sonographically, multiple hyperechoic masses with hypoechoic borders are noted throughout the liver. Which of the following would be most likely?

Multiple fungal candidiasis

You are performing an abdominal ultrasound on a patient with lymphoma. What findings of the spleen are commonly seen with this condition?

Multiple hypoechoic masses throughout the spleen

You have detected compensatory hypertrophy of the right kidney in a 35-year-old male. This finding is associated with which of the following EXCEPT?

Nephrectomy of one kidney

Which of the following is a malignant pediatric renal tumor that may also be referred to as a Wilms' tumor?

Nephroblastoma

A hypernephroma is a solid renal mass It is known as all of the following except:

Neuroblastoma

Patients who have Von Hippel-Lindau syndrome have a propensity to develop all of the following except:

Neuroblastoma

What nodules should FNA is considered in?

Nodule >1.0 cm with micro calcifications

An abrupt increase in alkaline phosphatase levels is suggestive of:

Obstructive jaundice

Inflammatory processes of the parotid glands is called:

Parotitis

Which of the following would be least likely to increase the likelihood of developing renal cell carcinoma?

Oral contraceptive

Yolk sac tumors are also called what?

Orchidoblastoma

Infection of the testicle is known as:

Orchitis

Which of the following is not considered an intrinsic cause of hydronephrosis?

Ovarian mass

Which one of the following genitourinary problems is commonly associated with the prune-belly syndrome?

PUV

A TIPS procedure involves creating a pathway through the liver that connects:

PV to a hepatic vein

A 54-year-old patient whose clinical history includes a long history of smoking presents to the ultrasound department for an abdominal sonogram. His order states that he has a palpable gallbladder and jaundice. Which of the following is most likely?

Pancreatic adenocarcinoma

An increase in CEA (carcinoembryonic antigen) is an indication for:

Pancreatic cystadenocarcinoma

A patient presents with a pancreatic carcinoma. Which location will most likely have a better prognosis?

Pancreatic head

What is the predominant type of thyroid carcinoma in children and young adults?

Papillary carcinoma

A surgical puncture of the peritoneum for removal of fluids; usually done by using a large bore needle is called:

Paracentesis

A round anechoic mass in the renal pelvis is most likely a;

Parapelvic cyst

What anomalous condition occurs when the tubular structure that extends from the umbilicus to the apex of the bladder canal remains open and results in a communication channel between the bladder and the umbilicus?

Patent or persistent urachus

To exclude a false-positive diagnosis of hydronephrosis, the sonographer should:

Perform post void images of the kidneys

What type of calcification is the most reliable feature of a benign nodule?

Peripheral

The largest percentage of cancer originates from which are of the prostate:

Peripheral zone

A scrotal hernia occurs when bowel protrudes through the inguinal canal into the scrotal sac. The presence of which of the following confirms the diagnosis?

Peristalsis

What does perforation of acute appendicitis lead to?

Peritonitis

Which of the following masses would most likely be discovered in the adrenal gland?

Pheochromocytoma

A 41-year-old patient presents to the ultrasound department for an abdominal sonogram with a history of hypertension, headaches, tachycardia, and excessive sweating. A 4 cm hypoechoic mass in the area of the right adrenal gland is discovered. Which of the following is the most etiology of this mass?

Pheocromocytoma

A 44-year-old female patient with a history of recent gastric surgery presents to the ultrasound department complaining of right upper quadrant pain, nausea, and vomiting. Sonographically, echogenic linear structures are seen scattered throughout the liver. Obvious ring-down artifact is noted posterior to these structures as well. Which of the following is the most likely diagnosis?

Pneumobilia

Patients who undergo long term use of hemodialysis have an increased risk of developing all of the following except:

Polycystic kidney disease

Blood disorder resulting in uncontrolled RBC production causing hyperviscosity, hypercoagulation and cause splenomegaly is called:

Polycythemia Vera

A calcified gallbladder wall describes which one of the following conditions?

Porcelain gallbladder

Which of the following is the best indicating marker for diagnosing prostate cancer?

Prostate-specific antigen

What pathology is most likely demonstrated on a patient with fever, a painfully swollen prostate gland, an elevated prostate-specific antigen level, and the endorectal sonogram documenting several irregular, hypoechoic areas in the periurethral area?

Prostatitis

Tuberous sclerosis is associated with all of the following except:

Prune belly syndrome

The US appearance of intussusception includes:

Pseudo kidney" sign

A 52 year old female with complaints of abdominal pressure, increasing abdominal girth, 'crampy' abdominal pain and decreased ability to eat was referred for an abdominal ultrasound by her physician. Medical history includes mucinous cystadenocarcinoma of the appendix. U/S: A complex mucinous mass with hypoechoic internal echoes was identified in the abdomen compressing the intra-abdominal structures. Most probably the abnormality is:

Pseudomyxoma peritonei

Follow-up abdominal sonogram. The previous ultrasound report indicates that empyema was present. What is empyema?

Pus in the GB

The olive sign is a feature of:

Pyloric stenosis

A 24-year-old female patient presents to the ultrasound department for a renal sonogram with a history of leukocytosis, pyuria, fever, and flank pain. Within the dilated collecting system, there is evidence of dependent, layering, low-level echoes. Which of the following is the most likely explanation for these sonographic findings?

Pyonephrosis

Which of the following is NOT a typical sonographic finding of Budd-Chiari syndrome?

Reduced visualization of the portal veins

A renal sonogram is ordered on a 6-month-old infant in the critical care unit with a history of fever, chills, and long-term indwelling catheter use. Sonographically, several echogenic, mobile, non-shadowing structures are noted within the dilated right renal collecting system. Which of the following is most likely?

Renal fungal disease

A 32-year-old male patient with a history of renal stones within the left kidney presents to the ultrasound department following lithotripsy. He is complaining of hematuria and left flank pain. Sonographically, there appears to be a complex appearing fluid surrounding the left kidney. Which of the following is the most likely explanation for this finding?

Renal hematoma

Transitional cell carcinoma of the kidney is most often located:

Renal pelvis

Parapelvic cysts are located in the:

Renal sinus

What is the treatment of choice for end stage renal disease?

Renal transplantation

Renal cell carcinoma commonly invades the IVC via the:

Renal vein

A patient with a renal transplant (10 days postoperative) was scanned sonographically to rule out rejection. All of the following areas should the sonographer evaluate except?

Renal vein RI

A complication generally occurring within days of a renal transplant:

Renal vein thrombosis

In sickle cell disease over time the spleen becomes small and not visible because of:

Repeated attack

What process contributes to an acquired aplasia and hypoplasia of the spleen?

Repeated infarction

Which of the following is most likely to be associated with migraine medication use?

Retroperitoneal fibrosis

35yr old white male presents with acute right flank pain. Bladder imaging identifies only a left urine jet. What is the most likely diagnosis?

Right ureter stone

You are performing a follow-up ultrasound exam in a patient with a known AAA. You cannot obtain a clear image of the aorta in a midline sagittal view due to overlying bowel gas. What should you do?

Roll the patient into either decubitus position or image the aorta from a coronal plan

A patient presents with clinical findings highly suggestive of cirrhosis. The liver appears diffusely echogenic, but no ascites is seen. Which of the following would be most helpful in confirming the presence of cirrhosis?

Scanning the liver surface with a high-frequency linear transducer

Calcifications that arise from the surface of the tunica vaginalis are called?

Scrotal "pearls"

You have performed a study to R/O appendicitis in a young female with RLQ pain. No evidence of appendicitis was detected. What should you do?

Search for other causes of RLQ pain

A 50 year old male is seen by his MD for a painless scrotal mass and hardening of his testicle. His blood work revealed an increase in HCG. An ultrasound showed a hypoechoic, solid, intratesticular mass in his right testicle. The most likely diagnosis is:

Seminoma

The most important sonographic land mark for determining hernia is:

The transversalis fascia

Sonographically, cystitis is diagnosed when:

The urinary bladder wall is thickened

The procedure used to remove the fluid around the lung is called:

Thoracenthesis

What is a possible explanation for a 63-year-old patient who presents with multiple low-level echoes within the aorta that persist with gain and sensitivity changes?

Thrombus within the aorta

What is the best diagnosis if the sonographic features include an irregular, solid, uneven, vascular, hypoechoic mass with internal echoes within the walls of a normal-sized thyroid gland?

Thyroid carcinoma

A patient presents with osteoporosis. A hyperplastic parathyroid gland is seen on ultrasound examination. Your differential diagnosis includes all except which of the following?

Thyroid cyst

A 17-year-old boy presents in the emergency room with scrotal pain. The sonogram reveals an enlarged testicle, decreased echogenicity, thickening of the scrotal wall, a hydrocele, and no flow. These findings are consistent with:

Torsion

Clinical findings of sudden scrotal pain and swelling are suggestive of:

Torsion

95% of all BPH arises in the:

Transitional zone

Proteinuria would be least likely associated with:

Trauma

Which of the following is the considered to be the most common cause of medullary nephrocalcinosis?

Tuberous sclerosis

A 60 year old male is sent for an ultrasound because of a painless palpable mass in his right testicle. He was seen the week before for epididymitis. US show numerous small tubular cystic structures within the rete testis. The most likely diagnosis is:

Tubular ectasia

Ultrasound imagining reveals left-sided hydronephrosis in a 38-year-old woman with vague abdominal pain. You should tailor your exam to rule out which of the following?

Ureteral calculi

What pathology is best demonstrated by use of Doppler for evaluating ureteral jets?

Ureteral obstruction with unilateral calculi

Bladder outlet obstruction can be caused by all of the following except:

Ureteral stone

A patient with a history of splenomegaly and portal hypertension demonstrates multiple tubular structures around the splenic hilum. These tubular structures are most suspicious for:

Varices

A dilated group of veins found within the scrotum is defined as:

Varicocele

Which of the following is a common cause of infertility in men?

Varicoceles

A 57-year-old woman has been referred for abdominal ultrasound with a history of an abdominal bruit. What pathology are you searching for?

Vascular compromise involving the aorta or its branches

How does follicular carcinoma of the thyroid tend to spread?

Via the blood stream

Bowel obstruction due to twisting is a called:

Volvulus

Conditions in the newborn associated with renal abnormalities include all of the following except:

Vomiting

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

Von Gierke

Which of the following is best described as a hereditary disease that leads to the development of cysts within the pancreas and other organs?

Von Hippel-Lindau disease

Grave's disease is characterized by the following features except:

Weight gain

Which of the following is NOT considered a common clinical feature associated with metastatic liver disease?

Weight gain

Which malignant tumor is most common in children aged 1-8?

Wilm's tumor

_____ is a renal infection that is associated with staghorn calculus and hydronephrosis.

Xanthogranulomatous pyelonephritis