Pathology Questions CH. 1-17

indirect signs of pancreatic adenocarcinoma

Courvoisier's gallbladder, pancreatic duct dilation, liver metastasis, and a dilated biliary tract all are considered?

neuroblastoma

a 1 month old infant presents with a palpable abdominal mass and no other symptoms. lab results reveal elevated catecholamine levels. the sonogram reveals a 5 cm homogeneous left suprarenal mass; calcifications within the mass are noted. Doppler reveals moderate blood flow within the mass. what does this mass likely represent?

hepatoblastoma

a 1 year old boy with history of premature delivery. he presented with hepatomegaly and elevated alpha fetoprotein levels. a 9 cm hepatic mass with calcification is noted. the mass appears to have invaded the adjacent portal vein. what do the clinical history and features of this mass suggest?

MCDK

a 1 year old girl presents with a palpable mass on the right side and no other symptoms. the sonogram reveals multiple, noncommunicating cysts in the right renal bed. what is the most likely cause for this sonographic appearance?

tuberous sclerosis

a 12 year old developmentally delayed boy with multiple small facial bumps; US shows multiple cysts in addition to small echogenic masses in both kidneys. this is consistent with?

lymphoma

a 19 year old woman presents with enlarged cervical lymph nodes, fatigue, and leukopenia. before her scheduled bone marrow biopsy, an abdominal sonogram revealed diffuse, hypoechoic lesions within the spleen. this describes?

hemangioendothelioma

a 2 day old infant is referred for an abdominal sonogram because of an echogenic liver nodule seen on the prenatal obstetric sonogram. additionally, the infant has a strawberry-colored mass on the right side of her neck. the sonogram is most likely to reveal which type of liver mass?

focal nodular hyperplasia

a 22 year old woman experiencing RUQ pain presents to ED. a 3cm mass at the periphery of the right lobe of the liver is incidentally noted. the mass appears solid, homogeneous, and nearly isoechoic to the liver parenchyma. with color Doppler, the mass exhibits central blood flow in a stellate configuration. what is the most likely diagnosis?

calcium stone

a 23 year old man present to the ED complaining of severe sharp pain in the left side and back and nauseated. the pain was of sudden onset. urine is positive for blood. there is an echogenic shadowing focus in the lower pole of the left kidney. these findings are most suggestive of which of the folowing?

Mirena

a 23 year old woman undergoes a pelvic sonogram for missing IUD strings. her last menstrual period was 6 months prior, and a recent pregnancy test was negative. an IUD with a hypoechoic stem and hyperechoic arms is identified in the endometrial cavity. what type of IUD is imaged?

acute glomerulonephritis

a 24 year old female opera singer presents with pharyngitis and decreased volume and frequency of urination and hematuria. kidneys are enlarged with increased echogenicity of the parenchymal cortex. which of the following diagnoses may result from these limited findings?

endometrial ablation

a 25 year old woman with menorrhagia; pelvic US demonstrates multiple intramural and subserosal fibroids, with the largest measuring 8 cm. the physician presents several treatment options but the patient wants to maintain fertility. which of he following is not a treatment option likely to be offered? myomectomy endometrial ablation uterine artery ablation progestin-releasing IUD

myometrial penetration

a 27 year old woman complaining of severe pelvic pain undergoes a pelvic sonogram. the patient has a history of IUD insertion after her most recent pregnancy. the IUD is eccentrically located with the right T arm extending lateral to the endometrium. what is the most likely diagnosis?

perforation of IUD into the peritoneal cavity

a 27 year old woman with a history of IUD insertion 6 months prior is seen now because the IUD strings are missing. her last menstrual period was 3 weeks ago. the pelvic sonogram reveals normal appearing uterus without evidence of an IUD. a radiograph demonstrates an IUD within the pelvis. what is the most likely explanation regarding the IUD?

renal abscess

a 29 year old woman with prior US 1 week ago in ED, but left AMA and presents with worsening symptoms. prior US revealed an enlarged right kidney with decreased cortical echogenicity that was diagnosed as pyelonephritis. todays US reveals an ill-defined anechoic mass with internal echoes and faint dirt shadowing. these findings are most suggestive of which of the following?

biliary atresia

a 3 week old infant presents with persistent jaundice, dark urine, and enlarged girth. an enlarged liver with an echogenic area superior to the portal vein bifurcation is demonstrated in the RUQ. no gallbladder is identified in the fasting infant. what is the likely diagnosis for this patinet?

Wilms' tumor

a 3 year old boy with abdominal pain is seen with a large, firm, palpable mass in the LUQ. he is referred for abdominal US which reveals a large spherical, heterogenous LUQ mass which is identified as the kidney. evaluation of the IVC and left renal vein reveals the presence of tumor thrombus. based on the clinical presentation and findings, what does this mass most likely represent?

UVJ obstruction

a 3 year old girl is referred for renal sonography following a 6 month history of recurrent UTIs. the sonogram reveals a duplicated collecting system on the right kidney. mild to moderate hydronephrosis is evident. a mildly dilated right ureter can be followed to its insertion into the bladder where a ureterocele is noted. what condition does this describe?

Retained products of conception (RPOC)

a 30 year old woman 2 months postpartum with AUB undergoes transvaginal sonography. the exam reveals a normal size uterus, a 12 cm thick endometrium, and an echogenic mass within the uterine cavity. hCG testing is negative. what is the most likely cause of AUB

follow-up sonogram

a 30 year old woman is referred for a renal sonogram for back pain. the sole finding is a 3cm right renal cyst that is categorized a bosniak type 1. the most appropriate follow-up to this finding is?

submucosal fibroid

a 30 year old woman with menorrhagia. sonogram reveals a hypoechoic mass distorting the endometrium. this mass attenuates the sound beam, it has a broad base, and the endometrium courses over it. what is the most likely diagnosis?

acute renal failure

a 33 year old man with a history of tobacco use and history of urinary tract obstruction now has reduced urine output and hematuria. lab results show increased creatinine levels, increased BUN and a decrease in GFR. the kidneys are enlarged and show increased echogenicity compared with the liver. what might be the cause of these findings?

lipoma

a 33 year old man with tuberous sclerosis; sonographically multiple renal angiomyolipoma's are noted in addition to a 2.4 cm hyperechoic mass in the dome of the liver. deep to this mass, the diaphragm appears to be displaced. what is the most likely diagnosis?

Adenomyomatosis

a 34 year old woman with intermittent pain in the RUQ undergoes an abdominal sonogram. the sonogram reveals a gallbladder with multiple, small polypoid lesions projecting from the gallbladder wall. the lumen of the gallbladder is anechoic, and the remainder of the examination is unremarkable. these findings most likely represent which of the following?

cholangitis

a 35 year old man with AIDS undergoes a sonogram for abdominal pain, fever, and jaundice. sonographic findings reveal dilation of the bile ducts and thickening of the bile duct wall. based on the patient history, what is the most likely diagnosis?

splenosis

a 35 year old man with a history of HIV presents with severe LUQ pain, decreased hematocrit, and hypotension. clinical assessment and CT imaging confirmed rupture of the spleen. a consequence of splenic rupture is?

IUD migration

a 35 year old woman with pelvic pain has had an IUD for the pas 3 years without complication. the sonogram reveals a normal-appearing uterus with an IUD located in the LUS. this is consistent with which of the following?

ADPKD

a 38 year old woman with family history of "kidney problems". the kidneys appear enlarged with five cysts on the right kidney and four on the left kidney. each cyst measures 2 to 3 cm in diameter. these findings are consistent with?

hemangioma

a 38 year old woman with mildly elevated LFT's; in the right lobe of the liver, three small echogenic masses are notes, which are well circumscribed and display no flow with color Doppler. what is the most likely diagnosis?

fundal infection

a 39 year old woman has a history of long term antibiotic use for chronic renal infections. the right kidney is normal, whereas the left kidney shows a hypoechoic, dilated renal pelvis with medium echo density and round, mobile, nonshadowing soft tissue masses throughout the collecting system. these findings are most suggestive of which of the following?

hemorrhagic adenoma

a 39 year old woman presents to the ED with severe RUQ pain. sonography shows that the gallbladder is normal, but a 3.8cm heterogeneous mass is noted in the anterior segment of the right lobe of the liver. the patient has been on OCPs since 22 years old. what is the most likely diagnosis?

pyloric stenosis

a 4 week old girl with projectile vomiting for 2 days is seen. she is jaundiced, and the physician is able to palpate an olive-shaped mass in the RUQ on physical examination. what is the most likely diagnosis?

adenoma

a 40 year old woman is having microscopic hematuria; sonogram is unremarkable except for a 3cm, well defined mass with a central scar in the left kidney. despite the fact that all solid renal masses must be considered suspicious for RCC, what mass is suggested by the presence of the central scar?

IUD removal because copper IUDs lose effectiveness after 10 years

a 40 year old woman presents for a pelvic sonogram because of abdominal menses. the sonogram reveals a Copper 7 IUD, which has been in place for 12 years. what is the most likely course of treatment for this patient?

amebic abscess

a 42 year old man with significant RUQ pain, diarrhea, and fever. lab results pending. the patient reports that he spent 1 month in africa last year participating in a medical mission trip. the sonogram reveals a hypoechoic lesion measuring 4.8 cm in the right lobe of the liver with acoustic enhancement. which of the following diagnosis is most likely?

cholelithiasis

a 42 year old woman who is morbidly obese undergoes a sonographic evaluation of the RUQ. the patient complains of having RUQ pain after a lunch of pepperoni pizza. sonographic investigation reveals multiple small echogenic foci within the gallbladder and are gravity-dependent. what is is the most likely diagnosis

tamoxifen changes

a 42 year old woman with a history of breast cancer. sonogram demonstrates cystic changes within the endometrium. what is the cause of the endometrial appearance?

wandering spleen

a 43 year old woman presented with abdominopelvic pain. imaging of the abdomen revealed normal liver and kidneys. the spleen was absent in the LUQ. sonographic images of the abdomen and pelvis revealed a homogeneous, medium gray, mass like lesion in the superior left adnexa. this finding is consistent with?

metastasis

a 45 year old man with a history of colon cancer has increasing abdominal pain, elevated LFTs and weight loss. the liver has several masses within the right lobe. the masses appear echogenic with a hypoechoic halo. given the patient's history and the appearance of the hepatic masses, what is the most likely diagnosis?

endometrial polyp

a 45 year year old woman with intermenstrual spotting undergoes transvaginal sonography. endometrial thickness is 20 mm, and saline introduced during hysterosonography outlines a focal mass isoechoic to the endometrium. what is the most likely diagnosis?

pyloric stenosis

a 46 year old man presents with a history of stomach ulcers, electrolyte imbalance, and persistent vomiting. what is the most likely diagnosis?

simple cyst

a 47 year old woman with a history of renal cancer and elevated LFTs; the liver appears normal except for a 2cm anechoic mass in the posterior segment of the right lobe. this mass displays sharp wall, posterior enhancement, and no flow on Color Doppler. what is the most likely diagnosis?

hydronephrosis

a 48 year old woman presents with right flank pain. the left kidney is normal. a sagittal view of the right kidney shows multiple centrally located cystic regions. a coronal view of the kidney demonstrates connection between the cysts. this is most consistent with?

Endometrial hyperplasia

a 48 year old woman undergoes a pelvic sonogram because of AUB. the uterus has a homogeneous echo texture, and the endometrial thickness is 1.7cm. sonohysterography reveals diffuse endometrial thickening with no intraluminal masses. what is the most likely diagnosis?

2

a 49 year old asymptomatic man sent for US demonstrates a solitary 2.5cm right renal cyst with thin septations. this is most consistent with what Bosniak category?

adenomyosis

a 50 year old woman experiencing AUB undergoes pelvic sonography. the uterine body is globular and slightly heterogeneous in appearance, several myometrial cysts are identified, and the endometrial myometrial junction is not clearly delineated. what is the most likely diagnosis?

acute tubular necrosis

a 50 year old woman who was involved in a MVA and is in the ICU. she was in the OR 2 days prior and had 3 units of blood transfused and was found to have transfusion reaction. urine output is steadily declining. sonogram shows an increase in cortical echo density with a normal appearing medulla. what is the most likely diagnosis?

endometrial polyp

a 50 year old woman with AUB undergoes a pelvic sonogram. transvaginal sonography reveals a thickened endometrium with a single vascular feeding vessel apparent on color Doppler imaging. what is the most likely diagnosis?

ureteral stone

a 51 year old man presents with severe left flank pain and hematuria and is referred for an abdominal sonogram; a dilated left renal collecting system and proximally dilated ureter are identified. the right kidney appears normal. the bladder is also scanned, and no ureteral jet can be identified on the left. these findings are most consistent with?

Hepatocellular carcinoma

a 54 year old morbidly obese man with markedly elevated LFTs; the patient has a coarsened, highly echogenic liver suggestive of steatohepatitis. there is a single hypoechoic lesion measuring 5 cm in the medial segment of the left lobe. what is the most likely diagnosis for this mass?

renal cell carcinoma

a 55 year old man is mildly obese and has been a smoker for more than 20 years. he reports some shortness of breath and a new symptom of intermittent, gross hematuria. a solid, hypoechoic mass is identified in the renal cortex of the right kidney. what is the most likely diagnosis?

chronic kidney disease

a 55 year old man with fatigue, pruritus, and nausea undergoes a renal sonogram. he ahs a history of diabetes and lab results reveal decrease in GFR, increased BUN, elevated creatinine of 5.1 and anemia. the kidneys are echogenic and decreased in size bilaterally compared with previous sonograms, and the renal parenchyma appears thin. these findings are most consistent with which of the following?

infected cyst

a 55 year old woman with a history of UTIs, and elevated whit blood cell count, and right flank pain; two simple renal cysts are seen on the right kidney. in addition there is a third cyst that is slightly echogenic. this is consistent with?

bilateral, well-defined, small echogenic renal cortex masses

a 55 year old woman with a history of tuberous sclerosis, recent onset of hematuria, and pain is referred for renal sonography. the sonographer is asked to evaluate for the presence of angiomyolipoma. given the patient history, what is the most likely appearance if a mass is discovered?

emphysematous cholecystitis

a 57 year old man with long-standing diabetes presents to the ED with signs and symptoms of severe, acute cholecystitis. the sonographic findings include gallbladder wall thickening and multiple comet-tail artifacts emanating from the wall. the gallbladder lumen contains low-level echoes from which comet-tail artifacts are also seen; however, there is no evidence of cholelithiasis. what is the most likely diagnosis?

metastasis

a 59 year old woman with a past history of breast cancer and recent unintentional weight loss; sonogram reveals ascites and multiple, hypoechoic lesions in the right and left lobes of the liver. what is the most likely diagnosis?

pyogenic abscess

a 60 year old woman presents with severe RUQ pain, fever, and a history of a recent surgery for cholelithiasis. lab values reveal elevated LFT's and leukocytosis. an RUQ ultrasound exam reveals a solitary hypoechoic lesion in the right lobe of the liver that measures 3.7 cm at its largest diameter. the walls of the lesion appear thickened, and acoustic enhancement is identified posterior to the lesion. these findings are most consistent with which of the following?

liver cyst

a 62 year old man undergoes an RUQ sonogram because of mild epigastric pain after ingestion of spicy foods. a solitary, anechoic lesion is identified in the right lobe measuring 1.5cm with smooth walls and acoustic enhancement. this lesion most likely represents which of the following?

hepatocellular carcinoma

a 62 year old man who recently moved to the US from southeast Asia with a chief complain of abdominal discomfort and a low-grade fever has suspicious hepatomegaly. lab results show elevated alpha fetoprotein. ultrasound shows a 6 cm heterogeneous mass occupying the left lobe of the liver. what is the most likely diagnosis for this mass?

multiple simple cysts

a 62 year old woman presents with abdominal pain. US shows normal renal size bilaterally with three cortical cysts on the right kidney and two on the left kidney. this is most likely?

stage 1

a 65 year old man with known RCC is referred to evaluate the extent of a tumor. the mass is found to be 4cm and confined to the kidney. what stage is this tumor?

parapelvic cysts right kidney

a 65 year old woman has an incidental finding of three irregular shaped, noncommunicating cystic regions within the right renal sinus that is seen in both longitudinal and transverse scan planes. which of the following describes the most likely condition seen in the patient?

hydronephrosis caused by the enlarged prostate obstructing flow

a 69 year old man with a history of an enlarged prostate presents with left flank pain, painful urination and microscopic hematuria. he claims to drink large amounts of milk every day. abdominal sonogram reveal normal anatomy except for the left kidney. it displays a hypoechoic, dilated renal collecting system to include the ureter with no echogenic foci. this finding is most consistent with which of the following?

hepatocellular carcinoma

a 72 year old man with a history of alcohol abuse is seen for monitoring of cirrhosis. in addition to elevated LFT's, his clinician notes elevated serum alpha fetoprotein. on sonogram, the liver appears lobulated and coarsened, and a moderate amount of ascites is noted. a 2.5cm hypoechoic solid mass is seen in the medial segment of the left lobe. What is the most likely diagnosis?

renal cell carcinoma with renal vein invasion

a 75 year old man presents with no pain and microscopic hematuria. the sonogram reveals a small solid left renal mass and echogenic material in the left renal vein. this is most suggestive of?

endometrial carcinoma

a 75 year old woman with postmenopausal bleeding undergoes pelvic sonography, which reveals a 1.5cm endometrium. what is the most likely diagnosis?

focal fat sparing

a RUQ sonogram has been ordered to rule out gallbladder disease in an obese 47 year old woman. the RUQ organs appear mostly normal; however the liver is hyperechoic, with a 5.4cm x 3.5cm x 3cm, poorly defined, hypoechoic area in the right lobe, anterior to the gallbladder. all lab results are within normal ranges. which of the following diagnoses is most likely?

TIPS stenosis

a TIPS evaluation with pulsed-wave Doppler demonstrates a peak systolic velocity in the shunt of 216 cm/s. this finding suggests?

normal

a __________ appendix must be identified to rule out appendicitis completely.

pseudocyst

a history of previous biliary surgery, intermittent epigastric pain, and occasional fever and the sonographic finding of a fluid collection anterior to the tail of the pancreas support which of the following entities?

7 to 12

a linear transducer with a range of __ to __ MHz is used during sonographic evaluation of the appendix.

perinephric hematoma

a middle aged woman who has recently undergone a kidney biopsy for renal disease developed microscopic hematuria and a decreasing hematocrit level. the left kidney is normal. the right kidney appears normal with the suggestion of a sonolucent crescent at the kidney's edge. this is most consistent with?

angiomyolipoma

a middle-aged woman with microscopic hematuria has no significant symptoms or laboratory findings. the abdominal sonogram reveals an intensely echogenic mass in the cortex of the left kidney. the echogenicity of the mass is equal to that of the renal sinus fat. what is this mass most likely to represent?

acute hepatitis

a moderately obese patient with slightly elevated ALT. the patient has a history of drug abuse and needle sharing. a liver sonogram reveals an overall hypoechoic appearance . the smaller portal veins appear more echogenic than normal. the liver is enlarged, measuring 19cm from superior to inferior border. what is the most likely explanation for these findings?

fatty liver disease

a moderately obese patient with slightly elevated ASR, ALT and direct bilirubin is referred for liver sonography. the patient has no previous significant medical history. the liver sonogram demonstrates an overall hyperechoic appearance. the hepatic vasculature was difficult to visualize. what is the most likely explanation for these findings?

absence of splenic tissue

a neonate's echocardiogram revealed both atria to have features of the right atrium. the abdominal sonogram revealed a partial situs inversus of the abdominal organs. what would the expectation be for the spleen?

unilateral adrenal hemorrhage

a newborn boy after a prolonged labor and breech delivery presents with a questionable RUQ mass. a swollen and bluish discolored scrotum is noted. lab results reveal anemia. the abdominal US reveals a crescent shaped, slightly hyperechoic right suprarenal mass. what is the most likely cause for this finding?

posterior urethral valves

a newborn boy is seen as follow up of an OB sonogram that showed markedly distended bladder, hydronephrosis, dilated and tortuous ureters, and keyhole appearance of the proximal urethra. these findings are most consistent with which of the following congenital obstructive disorders?

sludge

a patient in the ICU because of a spinal cord injury with a long hospitalization complains of intermittent RUQ pain and sonographically reveals a gallbladder containing low-level echoes that layer and are gravity dependent. this finding is most consistent with which of the following?

portal hypertension

a patient presents with a history of alcohol abuse and ascites. images of the spleen reveal enlargement with dilation of the vessels at the hilum. this is most likely consistent with which of the following?

Tuboovarian abscess (TOA)

a patient presents with a history of severe pelvic pain, fever, and purulent discharge. a pelvic sonogram demonstrates a properly placed IUD and a complex adnexal mass. the ovary cannot be identified within or adjacent to the adnexal mass. what is the most likely diagnosis?

metastatic bone disease

a patient presents with elevated AST and ALT. she has a history of colon carcinoma. the liver sonogram demonstrates a liver of normal size and echogenicity. no liver masses are notes. what is the most likely explanation for the elevated enzymes?

T

a patient who is scheduled for a pelvic sonogram states that she currently has a Mirena IUD in place. what is the shape of this IUD?

decreased or normal size

a patient with a history of celiac disease and a compromised immune system. the clinical concern is hyposplenism. what sonographic findings might be expected?

hepatocellular carcinoma

a patient with a history of chronic hepatitis C presents with two hypoechoic liver masses, one in the left lobe and one in the right lobe. the masses display halos. a likely conclusion is the presence of?

transitional cell carcinoma

a patient with a history of smoking presents with painful frequent urination and gross hematuria. sonogram of the urinary tract demonstrates mild hydronephrosis and an irregular echogenic mass in the bladder. this is most consistent with?

ectopic pregnancy

a patient with a positive pregnancy test and an IUD in place; the sonogram reveals an IUD within the uterine cavity with no evidence of an intrauterine gestation. a complex adnexal mass separate from the ovary is identified, and a moderate amount of hypoechoic fluid is noted in the cul-de-sac and RUQ. the patient's last menstrual period was 7 weeks prior. what is the most likely diganosis?

preterm labor

a patient with an IUD in place ahs a positive pregnancy test. a sonogram reveals a 7 week, viable gestation within the uterus. the IUD is identified in the lower uterine segment.; however, the strings are not visible to the obstetrician. leaving the IUD in situ during the pregnancy increases the risk for which on of the following complications?

caudate

a patient with biopsy-proven cirrhosis is referred for sonographic evaluation of the liver. which lobe of the liver should the sonographer expect to demonstrate hypertrophy?

recanalization of the umbilical vein

a patient with cirrhosis and portal hypertension is referred for sonographic evaluation. a hypoechoic, tubular structure in the region of the ligament of teres is noted. within this structure, pulsed-wave and color Doppler demonstrate blood flow exiting the liver. this finding most likely represents?

ARPKD

a prenatal sonogram reveals the presence of bilateral enlarged kidneys with a loss of corticomedullary differentiation. hepatomegaly, mildly increased hepatic echogenicity, dilated intrahepatic biliary ducts, and poorly visualized peripheral portal veins are also noted. after delivery, the infant is referred for renal sonography, which displays the same characteristic large echogenic kidneys with poor corticomedullary differentiation; macrocysts are not present. the liver abnormalities noted on prenatal sonogram are no longer evident. what is the most likely cause for these findings?

contrast-enhanced ultrasound

a technique that uses microbubbles of gas to enhance the echogenicity of blood flow and improve the assessment of vascularity of lesions is known as?

calculi with partial ureteral obstruction

a young patient with right flank pain, hematuria, and nausea and vomiting undergoes a renal sonogram. the left kidney appears mildly hydronephrotic. small echogenic foci with posterior acoustic shadowing are seen at the base of the bladder at the insertion site of the ureter; color Doppler reveals a "twinkle sign". what is the most likely diagnosis?

sudden, severe onset of epigastric pain

acute pancreatitis often manifests with which of the following clinical signs or symptoms?

men older than age 60

adenocarcinoma of the pancreas has a high mortality rate and occurs most often in?

weight gain

all but which of the following might occur with IHPS? dehydration metabolic alkalosis projectile vomiting weight gain

duodenum

all but which of the following must be evaluated when using ultrasonography to image the pylorus? channel length muscle thickness gastric peristalsis duodenum

intussusception

an 8 month old boy with a history of new-onset irritability presents with lethargy, abdominal distention, and fever. a moderate amount of blood is found to be present in the infant's stool. what is the most likely diagnosis?

acute glomerulonephritis

an 8 year old boy presents with recent fever, sore throat, foggy appearance to urine, joint pains, and costovertebral tenderness. lab results show increased BUN and creatinine levels, hematuria and proteinuria. the kidneys appear enlarged bilaterally. the left kidney shows irregular cortical echotexture. these findings are most consistent with which of the following?

intussusception

an 8 year old girl with a history of cystic fibrosis is seen with nonspecific abdominal pain and diarrhea. sonographic mass in the RUQ similar in appearance to a kidney. what is the most likely diagnosis?

gallbladder carcinoma

an 82 year old woman presents with RUQ pain, jaundice, nausea, and vomiting. she also reports unexplained weight loss. ultrasound of the gallbladder reveals cholelithiasis. in addition, an irregular focal thickening of the gallbladder wall is seen in the fundus. these findings are most suggestive of which of the following?

gallbladder carcinoma

an 82 year old woman presents with RUQ pain, jaundice, nausea, and vomiting. the physician orders a sonogram of the gallbladder to rule out which of the following?

ADPKD

an 88 year old man is a poor historian with limited information on requisition, but points to a raised area on his right arm that displays a palpable thrill from a hemodialysis access graft (treatment for renal failure). sonogram reveals gallstones and bilaterally small kidneys with multiple small cysts. this is consistent with?

pedunculated fibroid

an adnexal mass is palpated in a 34 year old woman with pelvic pressure. pelvic US reveals a 4 cm solid adnexal mass with a normal appearing ovary adjacent to the mass. what is the most likely diagnosis?

slightly increased

an adult patient presents with mild left sided pain. the spleen appeared to be of normal echogenicity. in a normal patient, what is the expected echogenicity of the spleen compared with the liver?

mild of calcium cyst

an asymptomatic patient has a small cyst within the upper pole of the right kidney demonstrating an internal echogenic layer that layers posteriorly. this finding is consistent with?

hemangioma

an asymptomatic patient undergoes sonography for possible enlargement of the spleen on physical exam. the sonogram reveals a splenic length of 11.6 and a 1.5cm round hyperechoic nodule in the superior aspect. these findings are most likely consistent with which of the following?

Tuberculosis

an elderly patient who is a poor historian presents for an abdominal sonogram. splenic images reveal multiple diffuse, small, echogenic foci without posterior shadowing. which of the following illnesses may the patient have had in the past?

WBC count

an elevated _____ ________ can be an indicator for appendicitis; however, the accuracy of this test alone is limited.

type 3

an endoleak occurs when blood is allowed to flow into the aneurysm sac after endograft placement. based on the endoleak classification, flow into the aneurysm owing to an inadequate seal between components of the device or a tear in the fabric of the graft would be given which of the following designation?

tail of the pancreas

an oral contrast agent is used during pancreatic sonography to improve visualization of which of the following structures?

chronic pancreatitis

atrophy, fibrosis, scarring, and calcification of the pancreas are consistent with which of the following pancreatic pathologies?

RLQ

classic symptoms of appendicitis include periumbilical pain, followed by nausea, ______ pain, and subsequent vomiting with fever.

men 65 to 75 years old who have ever smoked

guidelines recommend a one-time screening with sonography for AAA in

6 cm in diameter

high blood pressure and current smoking increase the growth rate of aneurysms, and the resultant risk of rupture sharply increases with aneurysms of more than?

intrasplenic arteries do not anastomose or communicate

in what way does the vascular system of the spleen differ from other organ circulation?

renal artery stenosis

morbidly obese 51 year old man with history of hypertension, difficulty breathing, and lower back pain. lab results show a decrease in GFR. the kidneys have a normal sonographic appearance and measure WNL bilaterally. Doppler analysis shows a lengthened systolic rise time, slow systolic acceleration, and rounding of the systolic peak on Doppler analysis. what is a possible diagnosis from these sonographic findings?

functioning islet cell tumors

pancreatic tumors that have the potential to secrete hormones are known as?

von Hippel-Lindau disease

pseudocyst formation in the pancreas is associated with all of the following except? acute pancreatitis chronic pancreatitis con Hippel-Lindau disease trauma

peritoneal irritation

rebound tenderness in the RLQ found in patients with appendicitis is associated with _____________ _____________

McBurney's Sign

rebound tenderness in the RLQ is called _________________ ________

5.5cm; 0.6 to 0.8 cm

repair of an AAA is indicated when the aneurysm becomes greater than _______ cm in diameter or grows more than _______ cm per year.

dissection

rupture of the intima of the aorta, which then separates from the media with a column of blood between the two layers, is the definition of _____________

graded compression

sonographic imaging of the appendix includes using a technique called __________ ______________.

cecum

the appendix arises form the inferior tip of the __________, located near the junction of the terminal ileum of the small intestine, and the proximal ascending colon.

30

the appendix can be "hidden" from the anterior peritoneum ___% of the time

hypotension, abdominal or back pain, and pulsatile abdominal mass

the classic presentation of a ruptured AAA includes the triad of

cervix

the classic sonographic appearance of intussusception includes all but which of the following? cervix doughnut pseudokidney sandwich

> 3mm muscle wall, > 17 mm channel length

the diagnosis of IHPS can be determined with confidence via sonography when which of the following diagnostic criteria are demonstrated?

cirrhosis

the liver is evaluated with a high-frequency transducer. ascites and significant scalloping of the surface of the liver are noted. these findings most likely represent?

Hepatofugal flow

the liver is evaluated with color Doppler through the right intercostal spaces. the color Doppler images show flow in the main portal vein to be "away from" the transducer. this finding indicates?

dehydration

the most common clinical symptoms demonstrated in patients with intussusception include all but which of the following? abdominal pain bloody stool dehydration vomiting

sonography

the preferred method of evaluation and screening for AAA is _________________

36

the risk of rupture increases significantly when appendicitis is not treated within ____ hours of the onset of symptoms.

highly echogenic stem with intense posterior shadowing

the sonographic appearance of a copper wire IUD includes which of the following?

descending aorta

the sonographic technique used in the diagnosis of dissection varies depending on the location of the dissection. which section of the aorta may benefit from transabdominal sonography?

sonography

what is the imaging method of choice for diagnosing IHPS?

AP in the longitudinal plane

when performing a scan to rule out AAA, the abdominal aorta should be measure ______________________

focal dilation 1.5 times its normal diameter; an infrarenal diameter of 3cm or larger

which of the following best describes the conventionally accepted definition of AAA?

macrocystic cystadenoma

which of the following pancreatic neoplasms occurs more frequently in the body and tail and is associated with a suspicion for malignant conversion?