ARRT ABD Review - Penny Ch 1-14

What systemic disease results in the development of granulomas within the spleen and throughout the body?

Sarcoidosis. Histoplasmosis and tuberculosis can also result in granulomas in the spleen

Which pancreatic enzyme neutralizes stomach acid?

Sodium bicarbonate

The splenic hamartoma may be discovered more often in individuals with a history of:

Tuberous sclerosis

What is a substance produced by a cancerous tumor or organ or structure in response to cancer?

Tumor marker

What are the clinical findings of HCC?

Unexplained weight loss Fever Cirrhosis Elevated AFP Possible abnormal liver function tests Chronic hepatitis Hepatomegaly Ascites Palpable mass

Which of the following is considered to be a malignant testicular neoplasm? a. neuroblastoma b. Hepatoma c. Yolk sac tumor d. hamartoma

c. yolk sac tumor

Which if the following would be the least helpful laboratory value to analyze in patients with suspected biliary tract disease? a. ALT b. ALP c. GGT d. Creatinine

d. Creatinine

What is a hepatoma?

A MALIGNANT tumor of the liver

Epstein-Barr infection is best described as:

A herpes virus that can lead to infectious mononucleosis

Which cells perform the exocrine function of the pancreas?

Acinar cells

What is the most common cause of ARF?

Acute tubular necrosis

What are the causes of ARF?

Acute tubular necrosis Renal artery stenosis Renal infection UTI Polycystic kidney disease Amyloidosis Henoch-Schonlein purpura

What is the most common cause of cirrhosis?

Alcoholism

Which cells perform the endocrine function of the pancreas?

Alpha, beta, and delta cells of the islets of Lagerhans

What do the acinar cells of the pancreas produce?

Amylase, lipase, sodium bicarbonate, and tripsin, chymotrypsin, & carboxypolypeptidase

What is Henoch-Schonlein purpura?

An autoimmune disorder and form of vasculitis associated with purple spots on the skin, gastrointestinal complications, joint pain, and possibly renal failure - mostly occurs in childhood

What is the triangular cord sign?

An avascular, echogenic, triangular or tubular structure anterior to the portal vein represents replacement of the extrahepatic duct with fibrous tissue in the portahepatis

What is a courvoisier gallbladder?

An enlarged, palpable gallbladder caused by a pancreatic head mass

What is Zollinger-Ellison syndrome?

An excessive secretion of stomach acid caused by the presence of a functional gastroma within the pancreas

What is ascariasis?

An infection of the small intestine that is caused by a parasitic roundworm

What is a gastrinoma of the pancreas?

An islet cell tumor of the pancreas

The right portal vein divides into:

Anterior and posterior branches

What are the clinical findings for chronic pancreatitis?

Asymptomatic; persistent epigastric pain; jaundice; back pain; possible elevation in amylase, lipase, or ALP; Anorexia, vomiting, weight lose, constipation

What are the functions of the spleen?

Blood reservoir Stores iron Defense against disease Hematopoiesis Destruction of flawed RBCs

A 32-year old female patient presents to the sonography department with a hx 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

What is biliary atresia?

Congenital narrowing or obliteration of all or a portion of the biliary tree (associated with triangular cord sign)

What is the most common cause of CRF?

Diabetes mellitus

What are the sonographic features of chronic pancreatitis?

Dilated pancreatic duct with possible stones within, calcifications within the pancreas, pancreatic pseudocyst, heterogeneous, hyperechoic, possible portosplenic vein thrombosis

What type of fluid within the abdomen is associated with cancer?

EXUDATE ascites

What are the clinical findings or ARF?

Elevated BUN and creatinine Oliguria Hypertension Leukocytosis Hematuria Edema Hypovolemia

What are the clinical findings of pancreatic adenocarcinoma?

Elevated amylase and lipase, loss of appetite, weight loss, jaundice, courvoisier gallbladder, epigastric pain, elevated ALP

What are the specific lab markers for acute pancreatitis?

Elevated amylase within 24 hours, elevated lipase within 72 hours

What are the clinical finding of acute pancreatitis

Elevated amylase, lipase, or ALT; leukocytosis; abdominal pain especially in supine position; back pain; fever; nausea and vomiting

What is the protective layer surrounding the kidneys called?

Gerota fascia or renal capsule

What do alpha cells secrete? What does it do?

Glucagon - raises blood glucose level by promoting the release of glucose from the liver

What is considered the most common benign childhood hepatic mass?

Hemangioendothelioma

What is associated with splenomegaly?

Hemolytic abnormalities (sickle cell) Trauma Infection Cirrhosis Leukemia or Lymphoma Elevated WBC count

Which hepatic mass is associated with E. granulosus?

Hydatid liver cyst aka echinococcal cyst

What is the most common echogenicity of an acutely inflamed pancreas?

Hypoechoic

What is the characteristic clinical finding of an insulinoma?

Hypoglycemia

What do beta cells secrete? What does it do?

Insulin - stimulates the body's use of glucagon

What is the most common islet tumor?

Insulinoma

The aorta originates at the:

Left ventricle

What is Mirizzi syndrome?

Lodged stone in the cystic duct causing compression of the common duct Pt presents with jaundice, pain, and fever

What is sodium bicarbonate responsible for in the digestive system?

Neutralizes stomach acid

What is tuberous sclerosis?

Noncancerous growths (benign tumors), in parts of the body, most commonly in the brain, eyes, kidneys, heart, lungs and skin, although any part of the body can be affected.

The Whipple procedure is performed on patients who have:

Pancreatic carcinoma

Which part of the pancreas is located right lateral to the SMV, anterior to the IVC, and inferior to the portal vein?

Pancreatic neck

The presence of purulent material within the renal collecting system is termed:

Pyonephrosis

What is the charcot triad? What is it associated with?

RUQ pain, jaundice and fever; associated with cholangitis

What are the clinical findings of glomerulonephritis?

Recent throat infection Smoky urine Hematuria Proteinuria Fever Hypertension Azotemia - excess urea in the bloodstream

What type of tissue is responsible for phagocytic functions in the spleen?

Red pulp

What do delta cells secrete? What does it do?

Restrains insulin and glucose level

What are the sonographic features of acute pancreatitis?

(May appear normal) Diffusely enlarged, hypoechoic pancreas, focal hypoechoic area; unencapsulated free fluid, pseudocyst, abscess, biliary obstruction

A renal scar most likely appears as:

A echogenic area that extends from the renal sinus through the renal parenchyma

What is Beckwith-Wiedemann syndrome?

A growth disorder synonymous with enlargement of several organs including the skull, tongue, and liver

What is von Hippel-Lindau disease?

A hereditary disease that involves the development of cysts within the pancreas and kidneys and tumors in the CNS, orbits, and adrenal glands

What is amyloidosis?

Accumulation of proteins in the form of abnormal, insoluble fibers, known as amyloid fibrils in the kidneys and other organs that can lead to renal failure

What are the extrinsic causes of hydronephrosis?

Benign prostatic hypertrophy Neurogenic bladder Pelvic masses (uterine leiomyoma, ovarian masses, tubo-ovarian abscess, and bowel masses) Pregnancy Retroperitoneal fibrosis Surgery Trauma Urethritis - inflammation of urethra

What is the typical appearance of kidneys affected by ARPKD?

Bilateral enlarged echogenic kidneys Loss of corticomedullary differentiation

What disorder is associated with the triangular cord sign?

Biliary atresia

A 64-year old male patient presents to the sonography department. He complains of abdominal pain, weight loss, and pruritus. You visualize an area of dilated ducts that abruptly end. What is the most likely diagnosis?

Cholangiocarcinoma

What malignant testicular tumor consists of trophoblastic cells?

Choriocarcinoma

What are the clinical findings of CRF?

Diabetes mellitus Malaise Elevated BUN and creatinine Fatigue Hypertension Hyperkalemia

What does amylase do?

Digests carbohydrates

What are the layers of the gallbladder wall?

From inner to outer: mucosal, fibromuscular, serosal

Which hepatic mass is closely associated with oral contraceptive use?

Hepatic adenoma

What is the most common reason for a liver transplant?

Hepatitis C

What does lipase do?

It breaks down fats into fatty acids and glycerol

What is the white pulp of the spleen responsible for?

Lymphatic function - produces lymphocytes to aid the immune system

The left portal vein divides into:

Medial and lateral branches

Sonographic findings of ARF:

Normal appearance Echogenic kidneys Hydronephrosis

What kind of artifact will pneumobilia cause?

Ring-down

Sonographic findings of CRF:

Small, echogenic kidneys Cortical thinning Loss of corticomedullary differentiation Renal cysts (possible)

A 15-year-old male patient presents to the sonography department with a history 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 posterior shadowing. What is the most likely diagnosis?

Splenic hematoma

What is the implantation of ectopic splenic tissue secondary to splenic rupture termed?

Splenosis

Where is the benign pheochromocytoma commonly located?

The adrenal gland

Where is a neuroblastoma most commonly found?

The pediatric adrenal gland

Where would an angiosarcoma most commonly be found?

The spleen

What is pitting?

The splenic process of cleaning RBCs of unwanted material

What is culling?

The splenic process of removing irregular RBCs from the bloodstream

What are the intrinsic causes of hydronephrosis?

Urolithiasis Congenital abnormality (vesicourethral reflux, posterior urethral valves, and ureterovesicular junction obstruction) Hematoma (blood clot) Neoplasm Ureteropelvic junction obstruction or ureteral stricture Ureterocele

Which vessel would be shortest in length? a. Right renal vein b. Right renal artery c. Left renal vein d. Left renal artery

a. Right renal vein

Which of the following would have a pulsatile triphasic blood flow pattern? a. Renal veins b. Hepatic veins c. Gonadal veins d. Common iliac veins

b. Hepatic veins (due to proximity to the heart)

Which of the following is a tumor marker that may be used in cases of suspected testicular malignancy? a. BUN b. Creatinine c. Human gonadotropin (beta-hCG) d. Calcitonin

c. beta-hCG

All are associated with Conn syndrome except: a. adrenal adenoma b. hypertension c. excessive thirst d. thinning arms & legs

d. thinning arms & legs

The arterial blood supply to the head of the pancreas is via the:

gastroduodenal artery

What is Zollinger-Ellison syndrome?

rare condition characterized by gastrin-producing tumors (gastroma) in the duodenum and/or pancreas that lead to oversecretion of gastrin, which lead to gastric and duodenal ulcers

The inherited disorder associated with the development of tumors in the central nervous system, orbits, renal cysts, and adrenal tumors is:

von Hippel-Lindau syndrome