Abd/Sup Structures II
The parathyroid glands lie:
between the posterior borders of the medial lobes of the thyroid gland
Diminished vascular structures within the liver parenchyma most likely represent:
cirrhosis
Patients who have hepatocellular carcinoma are likely to have had?
cirrhosis
Cholelithiasis is characterized on ultrasound as:
clean shadow with distinct margins
Compared with the testis, the epididymis typically appears:
coarser in texture
Acoustic shadowing is always indicative of malignancy.
false
Th most common solid benign tumor of the breast is:
fibroadenoma
Sonographically, the thyroid may be described as having characteristics of all of the following except:
inhomogeneous echogenic pattern
Sonographically, the breast may be characterized by:
inhomogeneous parenchymal pattern
The most common type of malignancy is:
invasive breast carcinoma
Breast cancer is the ___________ leading cause of death in women.
second
Clinical findings of acute scrotal pain and swelling are suggestive of:
torsion
The ultrasound appearance of a gallbladder neoplasm is:
wall thickening, wall mass The tumor (neoplasm) arises in the body of the gallbladder or rarely in the cystic duct. The tumor infiltrates the gallbladder locally or diffusely and causes thickening and rigidity of the wall.
The most characteristic finding of a fibroadenoma is:
well-defined border
Which of the following patient preparation is required before an abdominal ultrasound examination?
Take nothing by mouth 6 to 8 hours before the examination.
Gallstone appearance on ultrasound examination is:
dependent, mobile, echogenic
The testes measure:
4 cm length, 3 cm A-P, 3 cm width
A condition causing RUQ pain in which small polypoid masses arise from the gallbladder wall is:
Adenomyomatosis a condition in which an immobile echogenic focus(i) OK is noted in the gallbladder wall demonstrating a "comet tail" posterior shadow.
All of the following are tumor markers EXCEPT:
PAS
Specific indications for a pancreas ultrasound examination include all of the following EXCEPT:
nephrolithiasis
The most common tumor to fill the IVC is:
renal cell carcinoma
The normal size of the lobar collecting ducts are:
2.0mm
What age group is most commonly affected by testicular cancer?
20-34
The maximum outer diameter of the normal appendix can measure up to:
6 mm
Which fact about an undescended testis is false?
All undescended testes are found in the inguinal canal.
How are tumor markers used during treatment?
Monitoring cancer treatment is the most common use of tumor markers. As cancer is reduced, levels decrease. Stable or increasing levels indicate the cancer is not responding to treatment.
What is the most common age group, symptoms and significance of testicular torsion?
Most common in adolescents, presents with acute pain often accompanied by nausea and vomiting, results in testicular death due to lack of blood flow unless surgical intervention.
How are tumor markers used after a diagnosis is made?
Once cancer is diagnosed, tumor marker levels help determine the amount of cancer present. Higher levels usually indicate more advanced cancer and a worse prognosis. This allows the patient and the physician to choose between more or less aggressive treatment.
What is the occurrence of benign testicular lesions?
Simple cysts are now considered common whereas microliathis and tubular ectasia of the Rete Testis are quite rare
Use this image to label the anatomy of the thyroid.
Strap muscle:#1, Thyroid gland:#2, Longus Colli:#3
Which of the following statements about varicocele is false?
They are more common on the right side.
What are Tumor Markers?
Tumor markers are substances produced by tumor cells or by the body in response to tumor cells.
Vascular supply to the testes is through the ________________and vascular drainage is through the________________. A) Vascular supply to the testicle is via testicular veins branching from the IVC passing through the spermatic cord. Vascular drainage is through the testicular arteries through the spermatic cord into the testicular veins with the right testicular vein draining into the IVC and the left testicular vein draining into the left renal vein and then into the IVC. B) Vascular supply to the testicle is via testicular arteries branching from the aorta passing through the spermatic cord. Vascular drainage is through the pampiniform plexus through the spermatic cord into the testicular veins with the right testicular vein draining into the IVC and the left testicular vein draining into the left renal vein and then into the IVC.
Vascular supply to the testicle is via testicular arteries branching from the aorta passing through the spermatic cord. Vascular drainage is through the pampiniform plexus through the spermatic cord into the testicular veins with the right testicular vein draining into the IVC and the left testicular vein draining into the left renal vein and then into the IVC.
Sonographic characteristics of the testes includes:
a homogeneous pattern with medium-level echoes
Ultrasound findings in a primary gallbladder neoplasm include all of the following EXCEPT:
a normal duct Obstruction of the cystic duct by tumor or lymph nodes occurs early in the course of the disease.
A patient who presents with jaundice, weight loss, and a palpable right upper quadrant (RUQ) mass should be evaluated for:
adenocarcinoma of the pancreas Clinical findings of adenocarcinoma include weight loss, decreased appetite, nausea and vomiting, stool changes, pain radiating to the back, painless jaundice (Courvoisier's sign), and metastasis (liver, lymph nodes).
The mediastinum testis appears sonographically as:
an echogenic linear echo through the mid testis
Which of the following is a benign fatty tumor of the kidney?
angiomyolipoma An angiomyolipoma is an uncommon benign tumor composed mainly of fat cells found in the renal cortex.
Follow-up examination of patients with microlithiasis is recommended:
annually
Microlithiasis of the testis is associated with:
both a and c Microlithiasis is associated with malignancy, varicocele, undescended testis, Klinefelter's syndrome, infertility, and testicular atrophy.
The most common benign tumor of the liver is:
cavernous hemangioma The cavernous hemangioma is the most common benign tumor of the liver.
Inflammation of the gallbladder is:
cholecystitis
Sonographic patterns of testicular neoplasms include all EXCEPT which of the following?
complex mass with internal anechoic and echogenic areas
All of the following are included in the sonographic appearance of epididymitis EXCEPT:
decreased blood flow
Typical symptoms a patient may have with an abscess formation include all of the following EXCEPT:
decreased white blood count
Breast cancer mortality rate has been __________________during the past few years.
decreasing
Gallstone appearance on ultrasound examination is:
dependant, mobile, echogenic
The most important signs to look for in determining a cystic lesion of the breast include all EXCEPT:
disruption of architecture
Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and elevated white blood cell count. He states that 3 months ago he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram. What is your differential diagnosis?
echinococcal cyst The best answer is c. An abscess is a possibility, although with a history of being a sheep herder, echinococcal cyst is most likely. A hematoma does not cause a fever.
Copper's ligaments are best characterized as:
echogenic line interfaces in the subcutaneous layer
Which of the following are typically NOT indications for an ultrasound examination of the scrotum?
fever with no pain
Clinical findings of lumpy, painful, tender breast that vary with monthly cycles usually represents:
fibrocystic disease
There are usually _____ parathyroid glands.
four
The most common thyroid abnormality is:
goiter
Budd-Chiari syndrome is a rare disorder caused by obstruction of the:
hepatic veins
Hepatocellular disease can be defined as a process that affects the:
hepatocytes and interferes with liver function
The differential diagnosis for an undescended testis includes all of the following EXCEPT?
hernia An undescended testis appears small and hypoechoic on ultrasound. It is typically found in the inguinal canal. Differential considerations could include a lymph node, collapsed bowel, or retroperitoneal neoplasm.
Characteristic sonographic findings of torsion include all of the following EXCEPT?
hyperechoic parenchyma After 4-6 hours the testis becomes swollen and hypoechoic. After 24 hours the testis becomes heterogeneous as a result of hemorrhage, infarction, necrosis, and vascular congestion.
On ultrasound, acute pancreatitis may appear:
hypoechoic
The retromammary layer is sonographically imaged as:
hypoechoic
On ultrasound, acute pancreatitis may appear:
hypoechoic Early stages of acute pancreatitis may appear sonographically normal. When swelling of the pancreas occurs, the pancreas is hypoechoic to anechoic and is less echogenic because of the increased prominence of lobulation and congested vessels.
Which of the following best describes the sonographic appearance of malignant testicular tumors?
hypoechoic solid lesions with no posterior enhancement accompanied by possible calcifications and shadowing Until proven otherwise, solid tumors WITHIN the testicle are always considered malignant. The tumors tend to be small and hypoechoic although some may include cystic areas and calcifications. Borders may be smooth or irregular. REMEMBER- as a general rule, cancer can look any way it wants to look.
A spermatocele usually lies:
in the head of the epididymis, superior to the testis Spermatoceles are cystic dilatations of the efferent ductules of the epididymis. They are always located in the epididymal head.
The most common sign for carcinoma of the gallbladder is:
irregular fungating mass that contains low-intensity echoes within the gallbladder
Elevation of serum bilirubin results in:
jaundice
The enzyme that is the most sensitive over time in laboratory tests for the diagnosis of acute pancreatitis is:
lipase
The most common site for an Echinococcal growth is the:
liver
Which of the following structures lies posterolateral to the thyroid gland?
longus colli muscle
Calcifications (microlithiasis) within the testicle are most commonly associated with what condition?
malignancy when the number of calcifications exceeds 5
A linear stripe of variable thickness and echogenicity running through the testis in a craniocaudal direction represents the:
mediastinum testis
The most frequent cause of metastatic disease to the biliary system is:
melanoma
The characteristic findings of a papilloma of the breast include all EXCEPT
no disruption of architecture
The differential diagnosis of a testicular neoplasm may include all EXCEPT which of the following?
orchitis A testicular neoplasm is typically a hypoechoic intratesticular mass. An abscess, infarction, and hemorrhage could be included as a differential diagnosis.
Metastases to the breast may be from all the primary tumors EXCEPT:
pancreatic carcinoma
An elderly man with a history of alcoholism recently was diagnosed with acute pancreatitis. He now presents with decreased hematocrit and hypotension. Your differential includes:
pancreatic hemorrhage
A hydrocele develops between:
parietal and visceral layers of the tunica vaginalis
All of the following structures form neighboring structures for the thyroid gland except:
parotid muscle The strap muscles lie anterior to the thyroid and the sternocleidomastoid muscle lie anterior and lateral to the thyroid.
The most common feature of a thyroid adenoma is:
peripheral sonolucent halo
The amoebic abscess may reach the liver through the:
portal vein
Pyonephrosis refers to the presence of:
pus in a dilated collected system
Renal cell carcinoma commonly invades the IVC via the:
renal vein Renal cell carcinoma may invade the renal vein and IVC with a tumor or thrombosis.
The most common neoplasm associated with undescended testes is:
seminoma
Clinical signs and symptoms in acute pancreatitis include all of the following EXCEPT:
severe abdominal pain radiating to the right shoulder
Echinococcal cysts have the highest incidence in countries in which:
sheep grazing is common
Nonshadowing, low-amplitude echoes in a dependent gallbladder is most characteristic of:
sludge
Label the anatomy based on the image provided
sternocleidomastoid muscle:#1, thyroid gland:#2, jugular vein:#3, common carotid artery:#4, longus colli muscle:#5, esophagus :#6, trachea:#7
Characteristic findings of malignant breast disease include all EXCEPT
strong posterior margin
Characteristic findings of malignant breast disease include all EXCEPT:
strong posterior margin
The fat, Cooper's ligaments, connective tissue, blood vessels, nerves, and lymphatics are found in which layer or zone:
subcutaneous
The epididymis is located:
superior to the upper pole of the testis The epididymis is a 6 to 7 cm tubular structure beginning superiorly and coursing posterolateral to the testis. It is divided into the head, body, and tail.
Acute appendicitis may be seen on ultrasound examination as a:
target lesion
Acute appendicitis may be seen on ultrasound examination as a:
target lesion The target-shaped lesion consists of a hypoechoic fluid-distended lumen, a hyperechoic inner ring representing mainly the mucosa and submucosa, and an outer hypoechoic ring representing the muscularis externa.
The scrotum contains:
testes, epididymis, and spermatic cord
The lobes of the thyroid gland are connected by:
the isthmus
A _____ presents as a palpable midline mass between the hyoid bone and isthmus of the thyroid.
thyroglossal duct cyst
Clinical signs of a thyroid goiter are:
thyroid enlargement
The most common cause of acute pancreatitis in children is:
trauma
In patients with multiple primary cancer, the risk increases for developing cancer in the contralateral breast.
true
The size of a breast cyst may change with the menstrual cycle.
true
The testes are covered by a fibrous capsule formed by the:
tunica albuginea The testis is completely covered by a dense, fibrous tissue termed the tunica albuginea.
The thyroid gland consists of the following number
two
Common causes of a secondary hydrocele include all of the following EXCEPT?
undescended testes
The most common location for breast masses to occur is:
upper outer quadrant
Which of the following best describes the vascular pattern associated with malignant testicular tumors?
vascular patterns are unreliable indicators of malignancy in the testicle
