Red Penny Book- Chapter 4: The Bile Ducts
The biliary duct wall should never measure more than: 2 mm 9 mm 4 mm 5 mm
2 mm
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
The merging point of the pancreatic duct and the commone bile duct at the level of duodenum is referred to as the: Sphincter of Oddi Ampulla of Vater Common bile duct Cystic duct
Ampulla of Vater
The presence of an echogenic dot in the nondependent part of a dilated duct representing small fibrovascular bundles is seen with: Caroli disease Mirizzi syndrome Choledochal cysts Biliary atresia
Caroli disease
Ascariasis is: A form of biliary tree carcinoma A congenital disorder characterized by segmental dilation of the intrahepatic ducts Caused by a parasitic roundworm A type of ringworm that invades the liver
Caused by a parasitic roundworm
Primary biliary tree cancer is referred to as: Gallbladder carcinoma Biloma Cholangiocarcinoma Lymphangioma
Cholangiocarcinoma
Which of the following is typically found in pediatric patients and is described as the cystic dilation of the common bile duct? Biliary atresia Mirizzi syndrome Caroli disease Choledohcal cyst
Choledochal cyst
Which of the following is not a plausible cause of common bile duct obstruction in adults? Choledocholithiasis Chronic pancreatitis Choledochal cyst Pancreatic carcinoma
Choledochal cyst (this is primarily found in newborns/children)
A gallstone located within the biliary tree is referred to as: Cholecystitis Choledocholithiasis Cholangitis Cholangiocarcinoma
Choledocholithiasis
Which of the following could accidentally introduce bacteria into the biliary tree and thus cause cholangitis? Computed tomography Endoscope retrograde cholangiopancreatography Magnetic resonance imaging Radiography
Endoscope retrograde cholangiopancreatography
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 common bile duct
Intrahepatic ducts
For patients older than age 60, or those who have had a cholecystectomy, a maximum diameter of __________ may be considered normal. 1 cm 12 mm 14 mm 1.5 cm
1 cm
The Klatskin tumor is located: At the junction of the right and left hepatic ducts At the junction of the cystic and common bile duct At the junction of the common bile duct and common hepatic duct Between the pancreatic head and the duodenum
At the junction of the right and left hepatic ducts
A congenital disease in which there is narrowing, or obliteration, of the bile ducts refers to: Caroli disease Mirizzi disease Choledohcal cysts Biliary atresia
Biliary atresia
Which of the following disorders is associated with the sonographic triangular cord sign? Cholangitis Choledocholithiasis Biliary atresia Ascariasis
Biliary atresia
The yellowish pigment found in bile that is produced by the breakdown of old red blood cells by the liver is: Bilverdin Bilirubin Cholesterol Chyme
Bilirubin
A 64 year old man presents to the sonography department for a right upper quadrant sonogram. He is complaining of abdominal pain, weight loss, and pruritus. Sonographically, you visualize an area of dilated ducts that abruptly end. What is the most likely diagnosis? Biliary atresia Choledocholithiasis Caroli syndrome Cholangiocarcinoma
Cholangiocarcinoma
A Klatskin tumor is a form of: Lymphocytic carcinoma Cholangiocarcinoma Pancreatic carcinoma Gallbladder Carcinoma
Cholangiocarcinoma (it is a tumor found at or near the junction of the left and right hepatic ducts)
Which of the following is not associated with the development of pneumobilia? Cholangiopneumonia Gastric surgery Acute cholecystitis Fistula formation
Cholangiopneumonia
Inflammation of the bile ducts is referred to as: Pneumobilia Choledocholithiasis Cholelithiasis Cholangitis
Cholangitis
Which of the following is associated with Charcot triad? Cholangitis Cholesterolosis Klatskin tumor Choledohcal cyst
Cholangitis
An abdominal sonogram is ordered for an infant in the intensive care unit who is suffering from jaundice and fever. Sonographically, you visualize a cystic mass within the common bile duct that is causing a focal enlargement. This is most suggestive of: Cholangiocarcinoma Mirizzi syndrome Choledochal cyst Biliary atresia
Choledochal cyst
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 most distal portion of the biliary tree? Common bile duct Common hepatic duct Gallbladder Intrahepatic radicles
Common bile duct
Which of the following would be the lease helpful laboratory value to analyze in patients with suspected biliary tract disease? ALT LP GGT Creatinine
Creatinine
The spiral valves of Heister are located within the: Common bile duct Pancreatic duct Common hepatic duct Cystic duct
Cystic duct
All of the following are clinical findings consistent with cholangiocarcinoma except: Pruritus Weight loss Elevated bilirubin Dilation of the intrahepatic ducts
Dilation of the intrahepatic ducts
The most common level for biliary obstruction to occur is the: Junction of the right and left hepatic ducts Proximal common hepatic duct Distal common bile duct Cystic duct
Distal common bile duct
Clinical findings of choledocholithiasis include all of the following except: Jaundice Elevated bilirubin Elevated blood urea nitrogen Elevated ALP
Elevated blood urea nitrogen
Which segment of the biliary tree tends to dilate first with obstruction? Intrahepatic Extrahepatic
Extrahepatic
Which of the following is considered the most proximal portion of the biliary tree? Intrahepatic radicles Intrahepatic ducts Cystic duct Common bile duct
Intrahepatic radicles
The yellowish staining of the eyes and skin secondary to a liver disorder or biliary obstruction is referred to as: AIDS Cholangitis Pruritis Jaundice Bilirubinemia
Jaundice
A 32-year old female patient presents to the sonography department with a history of fever, leukocytosis, and right upper quadrant pain. Sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. What is the most likely diagnosis? Choledocholithiasis Cholangitis Mirizzi syndrome Biliary atresia
Mirizzi syndrome
A patient presents with jaundice, pain, and fever secondary to an impacted stone in the cystic duct. This is referred to as: Caroli syndrome Mirizzi syndrome Choledochal cysts Biliary atresia
Mirizzi syndrome
All of the following are forms of cholangitis except: Acute bacterial AIDS Oriental Parabolic
Parabolic
Air within the biliary tree is referred to as: Pneumobilia Cholangitis Choledocholithiasis Cholesterolosis
Pneumobilia
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
Pneumobilia will produce: Through transmission Ring down artifact Acoustic shadowing Edge artifact
Ring down artifact
Which of the following is characterized by fibrotic thickening of the bile ducts, found most often in young males, and is associated with inflammatory bowl disease or ulcerative colitis? Ulcerative biliary atresia Oriental cholangitis Sclerosing cholangitis AIDS biliary atresia
Sclerosing cholangitis
The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the: Cystic duct Ampulla of Vater Sphincter of Oddi Common bile duct
Sphincter of Oddi
