Abdominal Sonography, part 3 - urinary tract, adrenal glands, abdominal vasculature, gastrointestinal tract and abdominal wall

All of the following are clinical findings of a pheochromocytoma except: a. bradycardia b. uncontrollable hypertension c. excessive sweating d. tremors

a. bradycardia

Which of the following is not considered an extrinsic cause of hydronephrosis? a. ureteral stricture b. pregnancy c. neurogenic bladder d. uterine leiomyoma

a. ureteral stricture

What renal cystic disease would be most likely caused by, and thus associated with hemodialysis?

acquired renal cystic disease

Which of the following is associated with hypernatremia? a. Cushing syndrome b. Conn syndrome c. pheochromocytoma d. Addison disease

b. Conn syndrome

Which of the following is the most likely cause of ARF? a. hypertension b. diabetes mellitus c. ARPKD d. Acute tubular necrosis

d. Acute tubular necrosis

An AAA is present when the diameter of the abdominal aorta exceeds:

3cm

The neuroblastoma typically presents before the age of:

5 years

Which hormone, secreted by the anterior pituitary gland, controls the release of hormones by the adrenal glands?

ACTH

Which of the following has a clinical finding of bronzing of the skin? a. Addison disease b. Cushing disease c. Cushing syndrome d. Conn syndrome

a. Addison disease

Which plays a part in the development of male characteristics? a. androgens b. cortisol c. aldosteronea d. hematocrit

a. androgens

Which of the following hormones are responsible for the "fight-or-flight" response? a. epinephrine and norepinephrine b. cortisol and androgens c. cortisol and aldosterone d. ACTH and aldosterone

a. epinephrine and norepinephrine

What is the cause of Cushing disease?

anterior pituitary gland tumor

Which of the following is also referred to as primary adrenocortical insufficiency? a. Conn syndrome b. Addison disease c. Cushing disease d. congenita; adrenal hyperplasia

b. Addison disease

Which of the following would be most indicative of renal artery stenosis? a. decreased cortical echogenicity b. a renal to aorta ratio that is greater than 3.5 c. enlarged kidney d. Tardus-parvus waveform upstream to the stenosis

b. a renal to aorta ratio that is greater than 3.5

Which of the following mass-like lesions may be associated with congenital adrenal hyperplasia and found within the testes? a. adrenal adenomas b. adrenal rests c. pheochromocytomas d. neuroblastomas

b. adrenal rests

The first main visceral branch of the abdominal aorta is the:

celiac artery

A bulge on the lateral border of the kidney is referred to as:

dromedary hump

Which types of glands release their hormones directly into the bloodstream?

endocrine glands

The vessel located anterior to the abdominal aorta and posterior to the superior mesenteric artery is the:

left renal vein

What vessel can be often notedcoursing between the SMA and the abdominal aorta in the transverse scan plane?

left renal vein

What is the functional unit of the kidney?

nephron

Sonographically, compared to normal kidneys, those affected by CRF will appear:

smaller in size and more echogenic

What is the most common location for a urolithiasis to become lodged?

ureterovesicular junction

Which of the following renal findings would most likely present with a clinical finding of hematuria? a. hemorrhagic renal cyst b. milk of calcium renal cyst c. simple renal cyst d. angiomyolipoma

a. hemorrhagic renal cyst

Which of the following is the most common cause of CRF? a. hypertension b. diabetes mellitus c. ARPKD d. acute tubular necrosis

b. diabetes mellitus

Which of the following is produced by the adrenal medulla? a. cortisol b. aldosterone c. norepinephrine d. androgens

c. norepinephrine

Conn syndrome results from:

high levels of aldosterone

All of the following are characteristics of a complex cyst except: a. internal echoes b. smooth walls c. mural nodules d. septations

b. smooth walls

In the sagittal plane, you recognize a circular, anechoic vascular structure posterior to the IVC. Which of the following would this structure most likely be? a. abdominal aorta b. left renal vein c. right renal artery d. SMA

c. right renal artery

Cilinical findings of nephrocalcinosis include all of the following except: a. urinary tract infections b. urinary calculi c. hyperparathyroidism d. weight loss

d. weight loss

The arterial blood supply to the adrenal glands is accomplished by means of the:

suprarenal arteries

Infantile polycystic kidney disease may also be referred to as:

ARPKD

Which of the following renal conditions is associated with the development of cysts within the pancreas and liver? a. ARPKD b. ADPKD c. MCDK d. acquired renal cystic disease

b. ADPKD

Which of the following would be considered the most common solid renal mass? a. renal hemangioma b. angiomyolipoma c. oncocytoma d. hypernephroma

b. angiomyolipoma

Which of the following is not considered an intrinsic cause of hydronephrosis? a. ureterocele b. urethritis c. urolithiasis d. ureteropelvic junction obstruction

b. urethritis

Which of the following is associated with hyponatremia? a. Cushing syndrome b. Conn syndrome c. pheochromocytoma d. Addison disease

d. Addison disease

The most common sonographic appearance of a neuroblastoma is:

heterogenous mass with calcifications

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

asymptomatic

Which of the following is true regarding a duplex collecting system with complete ureteral duplication? a. The upper pole of the kidney suffers from reflux. b. The lower pole suffers from obstruction because of a varicocele. c. The upper pole suffers from obstruction because of a ureterocele. d. The lower pole suffers from reflux and hypertrophy.

c. The upper pole suffers from obstruction because of a ureterocele.

A female patient presents with a history of leukocytosis, dysuria, lower abdominal pain, and hematuria. Sonographically, the kidneys appear normal, although the bladder wall measures 6mm in the distended state. What is the most likely diagnosis?

cystitis

The adrenal cortex produces all of the following except: a. cortisol b. androgens c. aldosterone d. adrenaline

d. adrenaline

Which of the following vessels would most likely yield a high-resistance flow pattern? a. celiac artery b. common hepatic artery c. renal artery d. fasting SMA

d. fasting SMA

Clinical findings of glomerulonephritis include all of the following except: a. proteinuria b. throat infection c. azotemia d. hypocalcemia

d. hypocalcemia

Which of the following is a childhood, autoimmune disease that results in the development of purple spots on the skin and possible renal failure? a. Henoch-Schonlein purpura b. azotemia c. von Hippel-Lindau syndrome d. Xanthogranulomatous pyelonephritis

a. Henoch-Schonlein purpura

Which of the following best describes the sonographic appearance of a kidney affected by ARPKD? a. bilateral enlarged, echogenic kidneys b. unilateral, smooth-walled, noncommunicating cysts of varying sizes located within the renal fossa c. small, echogenic kidneys d. numerous, large, complex renal cysts

a. bilateral enlarged, echogenic kidneys

The second main branch of the abdominal aorta is the:

SMA

What is the most common location of an ectopic kidney?

pelvis

The adrenal mass often associated with uncontrollable hypertension, tachycardia, and tremors is the:

pheochromocytoma

A stone that completely fills the renal pelvis is referred to as:

staghorn calculus

The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs, including angiomyolipomas of the kidneys, is:

tuberous sclerosis

A 45-year-old obese woman with thin arms and legs, hypertension, and severe fatigue presents to the ultrasound department for an abdominal sonogram, Based on these clinical findings, you should evaluate the adrenal glands closely for signs of:

adrenal adenoma

Upon sonographic examination of the right upper quadrant in a 32-year-old female patient conplaining of generalized abdominal pain, you visualize an anechoic mass with posterior enhancement superior and medial upper pole of the right kidney. This most likely represents a(n):

adrenal cyst

Which hormone is responsible for regulating blood pressure by controlling the amounts of sodium and water in the body?

aldosterone

All of the following are true statements about the adrenal glands except: a. The adrenal glands play an important role in blood pressure regulation. b. The adrenal glands are easily identified in the fetus. c. The left adrenal gland is located lateral to the upper pole of the left kidney. d. The right adrenal gland is located medial to the right lobe of the liver.

c. The left adrenal gland is located lateral to the upper pole of the left kidney.

Which of the following best describes the location of the right adrenal gland? a. posterior and lateral to the pancreas b. medial to the lower pole of the right kidney c. posterior and lateral to the IVC d. medial to the crus of the diaphragm

c. posterior and lateral to the IVC

With active internal hemorrhage, the patient's hematocrit will:

decrease

Which vascular structure may be confused for the main pancreatic duct?

splenic artery

HPS is most often found in infants between:

2 and 6 weeks of age

The diameter of the IVC should never exceed:

2.5 cm

What are the diagnostic criteria for pyloric stenosis?

3mm in thickness and 17mm in length

Occlusion of the hepatic veins describes:

Budd-Chiari syndrome

The most common cause of fungal urinary tract infection is:

Candida albicans

An autoimmune disease characterized by periods of inflammation of the gastrointestional tract describes:

Chron's disease

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

Cushing syndrome

The adrenal glands are surrounded by a connective tissue capsule called:

Gerota fascia

The right suprarenal vein drains directly into the:

IVC

A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is:

Marfan syndrome

The area of pain and rebound tenderness with acute appendicitis is most likely at:

McBurney point

The situation when bowel protrudes into a weakened area in the lower one-fourth of the rectus muscle is referred to as a(n):

Spigelian hernia

Which of the following statements about the abdominal aorta is not true? a. Most aneurysms located within the abdominal aorta are false aneurysms. b. The abdonimal aorta is located just left of the midline. c. The most common location of an AAA is infrarenal. d. The abdominal aorta is considered to be retroperitoneal in location.

a. Most aneurysms located within the abdominal aorta are false aneurysms.

An adult patient presents to the sonography department with left lower quadrant pain, fever, and bouts of both constipation and diarrhea. Which of the following would be the most likely etiology? a. diverticulitis b. intussisception c. midgut malrotation d. appendicitis

a. diverticulitis

Which of the following types of obstruction refers to the bowel being physically blocked by something? a. mechanical b. nonmechanical c. obstreperous d. bezoarine

a. mechanical

All of the following are true of normal intestinal findings with sonography except: a. normal bowel does not compress b. normal bowel should have observable peristalsis c. intestinal wall should measure less than 5mm d. normal bowel has little to no color Doppler signals

a. normal bowel does not compress

Clinical findings of a patient with Chron's disease include all of the following except: a. palpable abdominal mass b. rectal bleeding c. abdominal pain d. weight loss

a. palpable abdominal mass

All of the following are branches of the celiac axis except: a. right gastric artery b. hepatic artery c. splenic artery d. left gastric artery

a. right gastric artery

Which vessel would be the 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 is not a layer of gut identified with sonography? a. visceral b. serosa c. submucosa d. mucosa

a. visceral

All of the following are sonographic criteria in the diagnosis of pyloric stenosis except: a. wall of the pylorus is focally thinned b. length of the pylorus measures more than 17 mm c. doughnut appearance in transverse d. cervix appearance in longitudinal

a. wall of the pylorus is focally thinned

Rebound tenderness is associated with:

aappendicitis

Gastric cancer is most often in the form of:

adenocarcinoma

An abdominal sonogram is requested for a new born in the intensive care unit. The new born suffered from brief anoxia at birth and is now suffering from jaundice. Superior to the right kidney, you visualize a triangular-shaped, heterogenous mass. What is the most likely diagnosis?

adrenal hemorrhage

A renal scar most likely appears as:

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

The olive sign is best described as:

an enlarged palpable pyloric sphincter

An outpatient with a history of back pain and hypertension presents to the ultrasound department for an abdominal aortic sonogram. Sonographically, you visualize a 6 cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis?

aortic dissection

Upon sonographic evaluation of the right lower quadrant in a patient complaining of focal abdominal pain in that area, you visualize a hyperemic blind-ended, tubular structure that contains a shadowing focus. What is the most likely etiology of the shadowing focus?

appendicolith

Pseudomyxoma peritonei can result from:

appendix cancer

All of the following are true statements about the adrenal glands except: a. The adrenal glands are easily identified in the fetus. b. The adrenal glands are exocrine glands. c. The adrenal glands are composed of a medulla and a cortex. d. The adrenal glands may also be referred to as the suprarenal glands.

b. The adrenal glands are exocrine glands.

Which of the following is not true about the abdominal aorta? a. The abdominal bifurcates into the common iliac arteries. b. The proximal aorta is situated more anterior than the distal aorta. c. The aorta has a thicker tunica media than the IVC. d. The third major branches of the abdominal aorta are the renal arteries.

b. The proximal aorta is situated more anterior than the distal aorta.

Which of the following would be most likely a cause of colitis? a. gastroesophageal reflux disease b. antibiotic therapy c. dehydration d. rectus sheath hematoma

b. antibiotic therapy

Which of the following would be a common finding in a patient undergoing peritoneal dialysis? a. hemorrhage b. ascites c. renal artery stenosis d. renal vein thrombosis

b. ascites

Which of the following would most likely yield a high-resistance flow pattern? a. celiac artery b. common iliac artery c. splenic artery d. right renal artery

b. common iliac artery

All of the following are sonographic findings of acute appendicitis except: a. appendicolith b. compressible, blind-ended tube c. periappendiceal fluid collection d. hyperemic flow

b. compressible, blind-ended tube

All of the following are common clinical findings in infants who present with intussusception except: a. vomiting b. first-born male infant c. red currant jelly stools d. leukocytosis

b. first-born male infant

Which of the following best describes the location of McBurney point? a. left lateral to the umbilicus and medial to the left iliac crest b. halfway between the anterior superior iliac spine and the umbilicus c. midway between the umbilicus and the symphysis pubis d. medial to the superior iliac spine

b. halfway between the anterior superior iliac spine and the umbilicus

Which of the following would have a pulsatile, triphasic blood flow pattern? a. renal veins b. hepatic veins c. gonadal veins d. common illiac veins

b. hepatic veins

Which of the following is not associated with a rectus sheath hematoma? a. palpable abdominal mass b. increased hematocrit c. child birth d. sneezing

b. increased hematocrit

The hepatic artery should demonstrate: a. high-resistance flow b. low-resistance flow

b. low-resistance flow

All of the following are most likely a benign adrenal mass except: a. adrenal adenoma b. neuroblastoma c. pheochromocytoma d. adrenal hematoma

b. neuroblastoma

Which of the following is not a section of the IVC? a. postrenal b. pancreatic c. prerenal d. hepatic

b. pancreatic

Which of the following statements about the IVC is not true? a. The diameter of the IVC is variable. b. Respiration can affect the size of the IVC. c. The IVC is located to the left of the abdominal aorta. d. The IVC is considered retroperitoneal in location.

c. The IVC is located to the left of the abdominal aorta.

Clinical findings of acute appendicitis include all of the following except: a. leukocytosis b. right lower quadrant pain c. constipation d. rebound tenderness

c. constipation

Which of the following is the development of small outpouchings within the sigmoid colon? a. diverticulitis b. Chron's disease c. diverticulosis d. midgut malrotation

c. diverticulosis

Which of the following would not be a typical clinical feature of renal transplant failure? a. oliguria b. proteinuria c. hypotension d. elevated creatinine

c. hypotension

Which of the following is not a sonographic finding consistent with Chron's disease? a. bowel wall thickening b. noncompressible bowel that has a target appearance c. increased peristalsis d. hyperemic wall

c. increased peristalsis

Which of the following would be the most likely clinical feature of colitis? a. inguinal herniation of the bowel b. right shoulder pain c. watery diarrhea d. midline hematoma

c. watery diarrhea

The most common location of the vermiform appendix is in the area of the:

cecum

What branch and its tributaries of the abdominal aorta appears as a "seagull" in the transverse plane?

celiac artery

Enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function is referred to as:

compensatory hypertrophy

A patient presents to the sonography department with a painful, superficial abdominal mass located within a prior cesarean scar. What clinical feature would be most consistent with scar endometriosis?

cyclical pain

Which of the following vessels show a different flow pattern after eating? a. celiac artery b. splenic artery c. renal artery d. SMA

d. SMA

Hyperfunctioning adrenal adenomas are associated with all of the following except: a. Cushing syndrome b. Con syndrome c. Hypoechoic mass in the area of the adrenal gland d. acute drop in hematocrit

d. acute drop in hematocrit

All of the following are clinical findings of ARF except: a. hematuria b. hypertension c. oliguria d. decreased BUN and creatinine

d. decreased BUN and creatinine

Clinical findings of an AAA include all of the following except: a. lower extremity pain b. back pain c. abdominal bruit d. elevated hematocrit

d. elevated hematocrit

All of the following are common clinical findings in infants who present with pyloric stenosis except: a. weight loss b. dehydration c. Olive sign d. first-born female

d. first-born female

Other abnormalities that can present much like pyloric stenosis include all of the following except: a. midgut malrotation b. pylorospasm c. gastroesophageal reflux disease d. intussusception

d. intussusception

The adrenal glands receive a portion of their blood supply from all of the following except the: a. suprarenal branches of the inferior phrenic arteries b. suprarenal branches of the aorta c. suprarenal branches of the renal arteries d. suprarenal branches of the celiac trunk

d. suprarenal branches of the celiac trunk

All of the following are associated with Con syndrome except: a. adrenal adenoma b. hypertension c. excessive thirst d. thinning arms and legs

d. thinning arms and legs

Which of the following would be useful to employ during a sonographic evaluation of a suspected abdominal wall hernia? a. upright positioning b. prone positioning c. graded compression d. valsalva

d. valsalva

The most common congenital anomaly of the urinary tract is:

duplicated collecting system

What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely result in?

endoleak

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

exophytic

The most common shape of an AAA is:

fusiform

What anatomic structure may be noted as a bulls-eye structure anterior to the abdominal aorta and posterior to the left lobe of the liver in the sagittal scan plane?

gastroesophageal junction

When internal bleeding is suspected, what laboratory value is useful for a sonographer to evaluate?

hematocrit

A localized collection of blood describes a:

hematoma

The veins seen attaching to the IVC just below the diaphragm are the:

hepatice veins

What flow pattern would the postprandial SMA yield in small bowel ischemia?

high resistance

Which of the following would result in buffalo hump and moon-shaped face clinical findings?

hypercortisolism

The most common sonographic appearance of a pheochromocytoma is a(n):

hyperechoic mass

What is the term for low levels of sodium in the blood?

hyponatremia

What vessel may attach to the splenic vein before reaching the portal confluence?

inferior mesenteric vein

The situation when bowel protrudes into the groin is referred to as a(n):

inguinal hernia

The sonographic finding of fluid-filled, distended loops of bowel is consistent with:

intestional obstruction

A patient presents to the sonography department with a history of Marfan syndrome. The sonographic evaluation reveals a linear echo within the aortic lumen that extends from the celiac axis to the iliac arteries. Color Doppler reveals flow throughout the aorta on both sides of the linear echo. The patient has had no surgeries, and there is no AAA. What does the linear echo most likely represent?

intimal flap

The most common cause of intestional obstruction in children less than 2 years of age is:

intussusception

The telescoping of one segment of bowel into another is referred to as:

intussusception

What abnormality associated red currant jelly stools?

intussusception

The left gonadal vein drains directly into the:

left renal vein

The left suprarenal vein drains directly into the:

left renal vein

What vessel travels directly anterior to the left renal artery?

left renal vein

The aorta originates at the:

left ventricle

Suspicion of cortical thinning should occur when the renal cortex measures:

less than 1cm

What should the postprandial flow pattern be within the SMA?

low resistance

A patient presents to the sonography department with bilious vomiting. While investigating the pediatric patient for pyloric stenosis, you note that while the pyloric sphincter appears normal, the SMA is abnormally located to the right of the SMV. What is the most likely diagnosis?

midgut malrotation

An aneurysm associated with infection is termed:

mycotic

The most common, extracranial, malignant mass in children is the:

neuroblastoma

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

pyonephrosis

The protective capsule of the kidney is referred to as:

renal capsule

What is the most likely location of TCC in the kidney?

renal pelvis

The kidneys are:

retroperitoneal organs

The IVC terminates at the:

right atrium

In what position is the infant placed for better sonographic visualization of the pyloric sphincter?

right lateral decubitus

Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen in cases of:

right-sided heart failure

A patient presents with unexplained abdominal pain for a vascular assessment of the SMA. Sonographically, you note that the patient's SMA yields a persistent high-resistive flow pattern. This is indicative of:

small bowel ischemia

The main portal vein is created by the union of the:

splenic vein and superior mesenteric vein

Traditionally, treatment for intussusception is by means of:

therapeutic enema

Pediatric patients could suffer from bowel obstructions that are caused by a buildup of ingested hair. The mass associated with this type of obstruction is termed a:

trichobezoar

The outer wall layer of a vessel is the:

tunica adventitia

The inner wall layer of a vessel, closest to the passing blood, is the:

tunica intima

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

von Hippel-Lindau syndrome