ultrasound registry test pathology pt1

Chronic moderate congestive heart failure cause this tributary of the IVC to be visualized sonographically due to the formation of collateral pathway a). azygous vein B coronary vein portal vein D umbilical vein

Significant chronic Dilatn of the IVC can lead to dilated azygous and hemiazygos veins. These veins connect upper abdominal IVC to the SVC in the chest so that the blood can reach the right atrium. azygos vein a)

Note the Enlarged nodes sorrounding the portal vein on the image The IVC is the anaechoic structure posterior to the portal vein as it enters the liver.

enlarged ln

Note the rings of alternating hyperechoic and hypoechoic tissue giving the mass an "onion appearance. Also note that the mass is avascular. The normal lab values confirm diagnosis an epidermoid cyst.

epidermoid cyst.

dash is the most common malignant neoplasm found in the prostate. Adenocarcinoma B Transitional zone sarcoma C Metastasis D Central zone sarcoma A Adenocarcinoma

A Adenocarcinoma

Most patients with adrenal cortical cancer have associated: A Cushing Syndrome B Addison Disease C Budd Chiari Syndrome D Conn Disease

A Cushing Syndrome

Which of the following is commonly associated with contaminated water and causes debris/occlusion within intrahepatic portal venous system? A pyogenic abscess B candidiasis C schistosomiasis d) amebic abscess

Candidiasis is commonly seen in immunocompromised patients, such as those with HIVAIDS, cancer, or a recent transplant. Amebic abscesses are associated with protozoan parasites found in contaminated water and typically reside the liver tissue near the dome. Schistosomiasis is associated with contaminated water that contains fluke parasites and they obstruct portal circulation. c) schistosomiasis

Lung, breast and renal cell cancers are the most common primary carcinomas to metastasize to the thyroid

thyroid mets

The dash zone the prostate zone most commonly affected by BPH transitional B peripheral C central d)paraprostatic

transitional

Which of the following is true regarding a transjugular intrahepatic shunt? A Air is retained within the shunt after placement which limits the US evaluation for the first 3-5 days B A harvested branch of the hepatic vein normally used as the shunt c)The shunt is advanced into the liver through puncture of the groin and is common iliac vein d)The shunt connects the diated umbilical vein to the IVC

A Air is retained within the shunt after placement which limits the US evaluation for the first 3-5 days

halo sign is sonographic characteristic what thyroid abnormality? A Adenoma B Complex cyst C Papillary carcinoma D Germ Ceil tumor

60% of thyroid adenomas demonstrate thin, Echolucent rim known the halo sign. Adenoma a)

28yr old presents for a testicular sonogram due to paipable lump. The lab work in the chart indicates high levels of alpha fetoprotein and b-hCG. A mostly solid intratesticular mass is identified in the right testicle that disrupts the smooth contour of the teste. There is a small cystic area centrally. These findings are most suggestive of: A Embryonal Cell Carcinoma b) Seminoma C Lymphoma d) Yolk Sac Tumor

A Embryonal Cell Carcinoma Embryonal Cell Carcinoma is most common in men age 25-36yrs, it is the most aggresaive testicular malignancy with invasion of tunica albuginea in most patients. Alpha fetoprotein and beta hcg are elevated most cases These tumors are more heterogeneous than seminoma and can have solid and cystic portions, along with coarse calcifications. Distortion of the organ contour will be seen with fumor invasion

Steatosis refers to: A Fatty liver disease B Pneumocystis carinii c)Glycogen storage disease of the liver d)Chronic hepatitis infection

A Fatty liver disease

Which of the following lab values is usually unaffected by an isolated biliary duct obstruction? A Aspartate Aminotransferase B Gamma glutamyl transpeptidase C Total bilirubin D Alkaline phosphatase

ALP. GGTP, and bilirubin levels will increase with ductal obstructions. Total bilirubin refers to the amount of conjugated bilirubin plus the amount unconjugated bilirubin in the błood. Serum levels of conjugated Bilirubin will increase with ductal obstruction, therefore the total bilirubin levels will increase also. AST levels are not affected by a ductal obstruction. A Aspartate Aminotransferase

Che most common cause acute scrotał pain in postpubertal men is: a)Torsion B Orchitis c) Hydrocele d) Acute epididymitis

Acute epididymitis

Which liver disorder leads to the sonographic appearance of hepatomegaly with decreased echogenicity and scattered bright portal reflections within the parenchyma? a) acute hepatitis B chronic hepatitis C cirrhosis D hydatid disease

Acute hepatitis demonstrates the sonographic appearance of hepatomegaly with decreased echogenicity and scattered bright portal reflections within the parenchyma (starry night). a) acute hepatitis

What do pancreatic adenocarcinoma and focal pancreatitis have in common? A They both are usually treated using the Whipple procedure B They both most commonly occur in the pancreatic tail c)They both most commonly occur in the pancreatic head d)They both cause a significant increase in alpha-fetoprotein levels

Adenocarcinoma and focal pancreatitis most commonly affect the pancreatic head. The Whipple procedure surgical resection Performed for pancreatic cancer. AFP levels increase certain types cancer but would not demonstrate any change with pancreatitis c)They both most commonly occur in the Pancreatic head

Adrenal hemorrhage most commonly seen in dash A juvenile patients with chromosomal defects B newborns C adults over 70yrs d) adults over 50yrs

Adrenal Hemorrhage usually presents as jaundice and anemia. most commonly occurs newborns and caused by birthing process. In adults is related to trauma hematologic disorders such thrombocytopenia. Adrenal glands are highly vascular organs and hemorrhage results decreased hematocrit indicates Internal bleeding). Sonographic Appearance: Mass with varied echogenicity with age thrombUs B newborns

Alcohol abuse is the most common cause for: renal failure B chronic pancreatitis C acute pancreatitis D cholecystitis

Alcohol consumption is the most common cause for micronodular cirrhosis and chronic pancreatitis. Biliary tract disease the common cause of acute pancreatitis, alcohol abuse is #2. b) chronic pancreatitis

A hematoma of the rectus abdominis muscle that occurs below the arcuate line can extend int to A pouch of Douglas b)Morrison pouch C space of Retzius d) the Umbilicus

An acute hematoma will be anechoic or mildly hypoechoic surrounding tissues. The linea alba stops the blood hom crossing midline, above the level ot the arcuate line. Błood not confined within sheath below the arcuate line which allows the blood to extend into the pelvis (space of Retzius) C space of Retzius

The term used to describe the involution of the small bowel upon itself is: a)irritable bowel syndrome b) Crohn's syndrome C colitis d) intussusception

An intussusception refers to a segment bowel that involutes Into itself. You will see focal area of concentric rings of bowel that do not peristalsis or change shape. d) intussusception

Which of the following describes a non-infectious cause for hepatitis? A Bacteria Anabolic steroids C Fungus D Virus

Anabolic steroids

Which type of thyroid cancer is most lethal? A follicular b)medullary c) papillary D anaplastic

Anaplastic CA make up about 10% Thyroid malignancies. it is very aggressive and the most lethal type of thyroid malignancy. it most commonly presents as a hard fixed mas with rapid growth and usually invades surrounding neck structures

Which of the following is not characteristic of an abnormal lymph node? A decreased visibility of the central hilum b) round shape C hypoechoic with an echogenic central hilum D posterior enhancement

As lymph nodes enlarge with fluid accumulation, they appear more rounded and hypoechoic/anechoic. The "plump" cortex causes decreased visualization of the central hilum. Color Doppler can be used to locate the hilum and main vascular supply. C hypoechoic with an echogenic central hilum

large calculus located in the renal pelvis area is called: A Parapelvic stone B Staghorn calculi C Gerota calculi D Parapelvic stone or staghorn calculus

B Staghorn calculi, seen with Xanthogranulomatous pyelonephritis

Which testicular tumor is composed of bone, cartilage and smooth muscle fibers? A Yolk Sac Tumor B Teratoma C Choriocarcinoma D Seminoma

B Teratoma

Which of the following common associated findings with horseshoe kidneys? A bilateral renal atrophy and echogenic cortex B calculi and hydronephrosis C emphysematous pyelonephritis and ureterocele D renal cell carcinoma and oncocytoma

B calculi and hydronephrosis Horseshoe kidneys refer to the attachment of the kidneys across the midline of the body, usually the lower poles hydronephrosis is common due Abnormal structure of collecting system aid course and location of ureter. Calculi and pyelocaliectasis is common finding b) calculi and hydronephrosis

The hormone changes with pregnancy have been associated with the enlargement of what type of liver mass? A hepatoma B hemangioma granuloma D. schistosomiasis

B hemangioma Estrogen replacement therapy and pregnancy can cause a hemangioma to increase in size.

A right renal mass will displace the IVC: A superiorly B medially C laterally D inferiorly

B medially

Which sone of prostate has ihe highest tisk for carcinoma development? a)stromal Bperipheral c)central D transitional

B peripheral Prostate Cancer Location: 70% peripherai zone, 20% transitional zone, 10% central zone

What is caput medusa? A failure of TIPS shunt B tortuous vessels around the umbilicus caused by portal HTN C formation of splenorenal varices D formation of gastroesophageal varices

B tortuous vessels around the umbilicus caused by portal HTN

Which of the following is a cause of parasitic cholangitis? A gram negative bacteria B biliary ascariasis C HIV infection d)ulcerative colitis

Bacterial cholangitis nearly always associated with do of ascariasis. May see worms within the inflamed ducts obstruction (stone or tumor). Bile is infected by gram negative bacteria. Parasitic cholangitis involves liver echogenic tortuous strands in the lumen. HIV cholangitis occurs in patients with advanced HIV infection. Most patients with pr of the biliary ducts. aclerosing cholangitis have inflammatory bowel disease or ulcerative colitis. It causes chronic inflammation and fibrosis of the biliary ducts B biliary ascariasis

If a liver transplant patient has an interposition anastomosis, how does this affect your evaluation? A there will be two anastomosis sites in The main portal vein that must be evaluated B there will be two anastomosis sites in the iVC that must be evaluated c) the hepatic artery anastomosis wil not be able to be visualized because it is located deep within the Tissue D each hepatic vein is Connected to the natlve ivC separatety there will be three anastomosis sites in the ivC that must be evaluated

Before beginning the exam, the surgical notes should be reviewed to determine if the patient has a full or partial transplant, a piggyback or interposition anastomosis and note the anastomosis sites for all vasculature. Piggyback hepatic confluence Transplant liver attached to native IVC; single anastomosis site interposition- donor IVC segment replaces a segment of the native iVC, two anastomosis sites B there will be two anastomosis sites in the iVC that must be evaluated

Which of the following statements is true regarding retroperitoneal lymph nodes? A Both normal and abnormal lymph nodes exhibit mild posterior shadowing. b)Normal Ilymph nodes exhibit posterior enhancement. C Abnormal lymph nodes exhibit posterior enhancement , D lymph node is considered abnormally enlarged once it reaches a maximum dimension 3cm.

C Abnormal lymph nodes exhibit posterior enhancement Normal lymph nodes do not exhibit posterior enhancement, They are composed mainly laity tissue and lymphatic tissue which absorb and scatter sound. Abnormal Ilymph nodes do exhibit posterior enhancement due to the increased fiuid within the inflamed tissues. The increased tuid within ithe tissues allows mcre sound be transmitted through the node instead of refiected by tve tissues. This leaas te the enhancement of the reflection from the lissues posterlor to the enlarged node

Which of the following is the most common cancer of the Gl tract? A Kaposi sarcoma B Krukenberg tumor C Adenocarcinoma D Gastric sarcoma

C Adenocarcinoma

What fetal syndrome is associated with hepatoblastoma? A Trisomy B Budd Chiari Syndrome C Beckwith-Wiedemann Syndrome d) Down Syndrome

C Beckwith-Wiedemann Syndrome

Which of the following describes how to differentiate adenomyomatosis of the GB from cholesterolosis of the GB? A Adenomyomatosis is usually diffuse process and cholesterolosis is a focal process. b)Adenomyomatosis is usually focal process and Cholesterolosis is diffuse process. c) The polyps in Cholesterolosis do not exhibit the comet tail artifact but polyps with adenomyomatosis do demonstrate the artifact d) The polyp in adenomyomatosis do not exhibit the comet tail artifact but połyps with cholesteroiosis demonstrate the artifact.

C The polyps cholesterosis do not exhibit the comet tail artifact but polyps with adenomyomatosis do demonstrate artifact

Which type of liver abscess is caused by a parasite? A fungal pyogenic C amebic d)viral

C amebic

Which type of gallbladder disease is more common males and diabetic patients? A chronic cholecystitis B GB perforation C emphysematous cholecystitis D cholangitis

C emphysematous cholecystitis

Which following not usually treated surgical intervention A pyloric stenosis b) spigelian hernia C intussusception d)appendicitis

C intussusception intussusception treated by nonsurgical reduction. Air or contrast is administered through the rectum (enema) to push the involuted bowel back out of the colon. The other choices al require surgical treatment

A patient presents with a small, palpable extratesticular mass on the left side. The US exam demonstrates a mobile, hyperechoic mass with posterior shadowing. Which of the following best describes the findings? A adenomatoid tumor b) abscess C scrotal pearl d)microlithiasis

C scrotal pearl, extra testicular calcification

Primary testicular carcinoma is usually usually dash A Heterogeneous, isoechoic B B hypoechoic. isoechoic C unilateral, bilateral d)hypervascular, hypovascular

C unilateral, bilateral

An 85yr old patient presents with a history of epigastric pain. Lab values are normal. The exam demonstrates normal intrahepatic ducts and a 10mm CBD that appears patent. The pancreas appears normal. What is the most likely reason for the 10mm CBD? A The obstruction in the CBD must be due to biliary stricture which is hard to visualize Sonographically b). The CBD normally dilates with age C Cholangitis usually only affects the CBd and can lead to a focal extrahepatic dilatn . D The Patient most ikely has portal HTN which can cause ductal ditatation

CBD diameter increases with patient age. Approximately 1mm diameter = 10yrs age b). The CBD normally dilates with age

What is a potentially life threatening complication of portal HTN? A ruptured gastroesophageal varices B. portal embolism C ascites formation d)pulmonary embolism

Cavernous transformation causes the formation of varices that can rupture and cause significant hemorrhage. A ruptured gastroesophageal varices

Adrenal Cortical Cancer causes neoplasm formation due to abnormal proiferation of cortical cells. The mass can get pretty large in size >6cm. it leads elevated androgen levels and is associated with hirsutism due to excessive androgen production. Most patients also have Cushing syndrome, NO contrast washout CT exam, contrast stays within mass though out artertalvenous phaseB, most benlgn adenomas will demonstrate washout in venous phase. Sonographic Appearance: Demonstrates complex appearance with hypoechoic solid components and cystic changes, Very aggressive, metastasis common, Can invade renal vein and iVC

Che ck

Non-Seminomatous tumors usually contain cystic areas and calcifications that assist differentiating them from seminomatous tumors. These tumors are more aggressive than a seminoma tumor. They are the second most common primary malignancy of the testicles.

Che ck

The patient symptoms are related to an infectionn, most likely the RLQ area of pain. Colitis will cause the thickening the bowel wall seen on the image. The haustra are visible which indicates colon segment and not the appendix. irritable bowel syn(IBS) is diffuse functional disorder of the colon that would not cause a fever or enlarged nodes.

Che ck

Pyloric stenosis is diagnosed when the muscle wall thickness exceeds: A 6mm 8mm 2mm D 4mm

D 4mm

The most common extra-testicular neoplasm is: A Hamartoma AV malformation Lipoma D Adenomatoid tumor

D Adenomatoid tumor

The most common secondary malignancy of the testicles A Myeloma B Leukemia C Hypernephroma D Lymphoma

D Lymphoma

Which of the following prostate abnormalities most significantly elevates the amount of serum prostate specific antigen in lab testing? A prostatitis B abscess C benign prostatic hypertrophy D carcinoma

D carcinoma>10 mg/ ml, significant than bph

Which type of liver abscess presents as a mass with internal septations similar to the spokes of a wheel? A pyogenic B amebic c) viral D fungal

D fungal

right sided pheochromocytoma will displace the ipsilateral kidney A superiorlyb anteriorly C medially D inferiorly

D inferiorly

The diaphragm sign, displaced crus sign, and bare area sign are indicative of what abnormality? A pneumonia b)pleural effusion c) ascites d)diaphragmatic Hernia

Diaphragm Sign when using an abdominal approach to view the fluid, fluid below the diaphragm and more centrally located = ascites, fluid above the diaphragrn and more peripherally located pleural effusion. Displaced Crus Sign If the fluid is displacing the crus away from the spine, It is located in the chest cavity Area Sign pleural fluid will extend behind the liver at the level of bare area, ascites cannot reach this area b)pleural effusion

What is the most common congenital anomaly the urinary system? A dromedary hump pancake kidney duplicated collecting system D ectopic kidney

Duplicated collecting system is the most common congenital anomaly of the urinary system. c duplicated collecting system

Splenic torsion is most commonly associated with: A ectopic spleen b)asplenia C accessory spleen d)Gaucher disease

Ectopic Spleen AKA wandering spleen refers to the spleen moving to a different position the abdomen. Weak Splenic ligaments lead to the organ migrating to Unusual locations, it can be mistaken tor mass. Due to the abnormal location has an increased risk of torsion resulting in significant pain. A ectopic spleen

Liver elastography is used for: A staging of steatosis staging of primary malignancy C staging of secondary malignancy D staging of fibrosis

Elastography can be used to stage the degree of liver fibrosis present. Place the region of interest (ROI) box over an optimized image of the liver tissue. The box must be at least 2cm from the skin surface and 2cm from Glisson capsule Patient should perform neutral breath hold for a few seconds. DO NOT ask the patient to take a deep breath and hold or perform the Valsalva maneuver during Evaluation or results can be skewed. Record 10 measurements from the same ROI. Increased elastography values indicate more severe fibrosis, D staging of fibrosis

Embryonal Cell Carcinoma usually affects men age 25-35 yrs. It is the most aggressive testicular cancer. Alpha fetoprotein and beta hCG elevated in most cases. Sonographic Appearance: More heterogeneous than Seminoma, Can have solid and cystic portions along with coarse calcifications: Distortion of the organ contour with tumor invasion

Embryonal Cell Carcinoma

nich testicular tumor will cause b-hCG levels to rise but AFP levels will be normal? A Embryonal Cell Carcinoma B Choriocarcinoma C Epidermoid Cyst D Yolk Sac Tumor

Embryonal cell carcinoma usually leads to increased levels of b-hCG and AFP. Yolk sac tumors usually cause an increase in AFP. Choriocarcinoma usually leads to an increase in b-hCG. B Choriocarcinoma

mass is identified in the left testicle, It is rounded with well-defined borders. There are internal rings hyperechoic and hypoechoic tissues giving the appearance of onion. No color flow is demonstrated within the mass. These findings are most consistent with: A Sperm granuloma B Epidermoid cyst C Testicular infarct d) Dilated rete testes

Epidermoid cysts have fibrous walls that may calcify. They are described having an onion-like appearance due to alternating rings of hyperechoic and hypoechoic tissues. These cysts contain thick keratin and are avascular. B Epidermoid cyst

A 10 yr old presents for arn abdominal ultrasound with palpable RUQ mass. He has no history of liver disease and alpha-fetoprotein levels are normal. You identify 9cm mass in the right lobe that demonstrates punctate calcifications and central scar. These findings are most suggestive of? A Fibrolamellar Carcinoma b Hepatoma C Metastasis D Hepatoblastoma

Fibrolamellar Carcinoma is a subtype of HCC found in adolescents and young adults with no coexisting liver disease. Alpha-fetoprotein(AFP) levels are normal. Punctate calcifications and central echogenic scar help to differentiate from hepatoma. All the other choices would have elevated AFP in most cases. A Fibrolamellar Carcinoma

Which liver function level is the most sensitive indicator for alcoholism? A AFP B GGTP C ALT d)AST

GGTP Gamma-glutamyl transpeptidase normally found in liver cells and Biliary epithelium. Evaluation of this liver enzyme the most sensitive indicator for alcoholism. moderate increase is seen with liver damage due to alcohol, drugs, and chemotherapy. A marked increase is seen with liver disease and post Hepatic Biliary obstruction. Increased GGTP + ALP = Bilary obstruction Increased GGTP ALT = Hepatocellular disease B GGTP

Seminoma tumors do not normally exhibit cystic degeneration and areas of internal necrosis. Germ cell tumors commonly demonstrate those characteristics.

Germ cell tumors

A patient presents for a thyroid US due increased T3 and T4 levels the blood. Additional symptoms include weight loss, sweats and exophthalmos. The thyroid demonstrates an increase size and diffuse decrease echogenicity with coarse, heterogeneous texture. Whic of the following best findings? A Hashimoto disease b/)Graves' disease C Goiter D Hurthle Cell cancer

Graves' disease is most common cause of hyperthyroidism. Symptoms include increased T3 and T4 levels in the blood, weight loss, nite sweats and Exophthalmos. Sonographically, the gland will enlarge with a heterogeneous echotexture and increased vascularity B Graves' disease

Graves' disease refers to type of: Carcinoma B Hypothyroidism C Hyperthyroidism DI Multinodular Goiter

Graves' disease is the most common cause of hyperthyroidism. Sonographically, the gland will enlarge with a heterogeneous echotexture and increased vascularity. hyperthyroidism.c)

All of the following are commonly associated with ascites, except? A Cirrhosis B Oncocytoma c)Hepatic abscess d) Hepatitis

Hepatitis and abscess formation are related to infectionn in the abdomen. Fluid accumulation is common inflammatory response. Cirrhosis causes decreased liver function and filtration of the Gi tract blood. The excess fluids and waste tom the portal system may accumulate within the peritoneal cavity in the form of ascites. B Oncocytoma

Which of the following would cause an increase in serum AST levels with normal serum ALT levels? A cirrhosis B metastasis C hepatitis D CHF

If AST is elevated with normal ALT, the cause is non-hepatic. These non-hepatic causes include myocardial Infarction, heart failure, muscle injury, and CNS disease. D CHF

A patient presents with right groin pain. You identify hernia sac medial to the common femoral vein. What type of hernia is present? A umbilical b) direct inguinal! C spigelian d)femoral

In a femoral hernia, the hernia sac usually lies medial to common femoral vein. (below the inguinal ligament) Umbilical and spigelian hernias abdominal hernia. and inferior and medial the inferior epigastric artery origin direct inguinal hernia occurs superior to the inguinal ligament d)femoral

Which of the following Doppler findings is most consistent with uncomplicated epididymo-orchitis? A Low resistance flow; resistive index 0.4 b)High resistance flow; resistive index 1.2 c)High resistance flow; resistive index 0.2 d)Low resistance flow; resistive index 08

In cases of acute epididym0-orchitis, hypervascularity will be identified in the area infection. The affected side will show decreased vascular resistance hypervascularity) compared unaffected side. The Resistive index (RI) a value between 0 and 1. Acute infection is associated with Ri values <o.5 affected testes. Diastolic Bow reversal in cases epididymo orchitis can indicate the presence of a complication, venous infarction. A Low resistance flow; resistive index o.4

dash lobe of the liver does not normally atrophy with chronic Budd Chiari Syndrome. A caudate B left medial right anterior D right posterior

In the later stages of Budd Chiari disease the right and left lobes will atrophy but the caudate lobe does not reduce in size because the emissary veins drain the blood from this lobe, not the hepatic veins. A caudate

What type of hernia is a delayed complication of upper abdominal surgery? A amyand Hernia B inDirect inguinal hermia C incisional hernia D direct inguinal hermia

Incisional Hernia is delayed complication of abdominal surgery. It usually occurs in few months after surgery and more common with vertical incisions than with transverse incisions. Elderly, obese and malnourished patients have increased risk of an incisional hernia. C incisional hernia

A 6 month old female is referred for an abdominal ultrasound due suspected Kasabach-Merritt syndrome. What are you looking for on the exam? A ascites, pleural effusion and abscess formation in the abdominal wall b)absence of the biliary tree C liver or spleen hemangioma formation D pancreatic divisum

Kasabach-Merritt syndrome is also called hemangioma thrombocytopenia syndrome. it is also seen in infants with large hemangiomas. Sequestration and destruction of platelets within the large Cavernos hemangioma causes significant thrombocytopenia visible cutaneous blue reddish-brown lesions are usually present on the extremities. Hepatomegaly or jaundice can also be identified . if the skin lesions are present with significant thrombocytopenia, the liver and spleen shouid be evaluated for retated hemangioma formation. penia (reduced platelet count). visible cutaneous blue reddish-brown lesions are usually present on the extremityy C liver or spleen hemangioma formation

patient presents with a history of a 5mm Leydig Cell turnor identified on an exam months ago. What is a common complication this type neoplasm? A gynecomastia b) metastasis C varicocele d)Ceilulitis

Leydig cell tumors can caUse an endocrine Imbalance which an lead to the Development of gynecomastia. Any testicular tumor that is associated with elevated beta hCG can lead to gynecomastia A gynecomastia

Which of the following is false regarding differences between autosomal dominant polycystic kidney disease and multicystic dysplastic kidney disease? a)ADPKD affects both kidneys and MCKD usually affects only one Kidneys. B B MCKD in fatal early in life bilateral. ADPKD is usually not fatal early in life but can reduce renal function c). MCKD can caused by an insult occurring in utero, between weeks 14 and 18 of fetal development ADPKD is an inherited genetic disorder. d)The liver, pancreas and spleen can also demonstrate cystic changes wwith MCKD.

MCKD is usually unilateral and if t is bilateral will be fatal. Adult PCKD is always bilateral and can result reduced renal function later in life. Both disorders are congenital abnormalities. ADPKD is an inherited genetic disorder and MCKD caused by an insult during the weeks 14-18 in fetal development. d)The liver, pancreas and spleen can also demonstrate cystic changes wwith mckd

A patient presents 2cm palpable reddened lump on the bottom of her foot. The patient states she accidentally stepped on a piece of broken glass. The doctor suspects there may be some glass remaining in her foot. Which of the following statements is true regarding the evaluation of a this patient's foot? A The radiologist should be consulted because MRI is preferred over Sonography for foreign body detection b)Most foreign bodies are echogenic with significant posterior enhancement. c) Inflammation usually leads to a hypoechoic ring surrounding the foreign body d)Improved visualization of the foreign body occurs as US beam becomes more parallel to the structure

MRI is contraindicated for some types of foreign bodies (metallic). Most foreign bodies present as an echogenic structure with some degree of posterior shadowing. Inflammation usually leads to a hypoechoic ring surounding the foreign body. Improved visualization of the foreign body occurs as the US beam becomes more perpendicular to the structure. C Inflammation usually leads to a hypoechoic ring surrounding the foreign body

The gallbladder wall is asymmetrically thickened with hypervascularity and perfusion defects noted on color Doppler evaluation. Intraluminal membranes and sludge are also present. What is the most likely cause these findings? A gangrenous cholecystitis B chronic cholecystitis C Cholesterolosis D adenomyomatosis

Membranous gangrenous cholecystitis a potential complication of untreated choiecystitis, would present as diffusely thickened GB wal with hypervascularity and intraluminal membranes. There will be areas where perfusion defects are detected the Thickened wail by Doppler, which indicate areas of necrosis (gangrene). Abscess formation may also be demonstrated, A gangrenous cholecystitis

Which of the following abnormalities associated with the production of milk of calcium bile? acute cholecystitis B chronic cholecystitis C hepatoma D cirrhosis

Milk of Calcium Bile (AKA limey bile) refers to sludge-like material with a high concentration of calcium. b) chronic cholecystitis

The most common location for an aortic aneurysm is: A juxtarenal B suprarenal C aortic arch d)infrarenal

Most aortic aneurysms lie below the level of the renal artery origins (Infrarenal). an aneurysm at or above the level the renal Arteries, the positive complications are much greater and treatment more Difficult. d)infrarenal

All of the following are associated with increased risk of thyroid malignancy, except A psammoma bodies b) wider than tall mass orientation c)absence of the halo sign d)intranodular flow patterns

Most malignancies invade the thyroid across tissue planes from posterior to anterior. These produces taller than wide mass. A benign thyroid mass displaces normal tissues and is usually wider than tall. Absent halo sign, microcalcifications and intranodular flow patterns offer very strong indication thyroid malignancy. Microcaicifications also referred to as psammoma bodies (small round calcifications) b) wider than tall mass orientation

A 65yr old male patient presents with bilateral scrotal swelling and mild pain. The US exam demonstrates bilateral hypoechoic, solid masses within the testicular parenchyma. Which of the following is the most likely diagnosis for the findings? A lymphoma choriocarcinoma C bilateral seminoma D bilateral orchitis

Most primary testicular cancers are unilateral in formation. Testicular lymphoma, leukemia and metastasis usually oCcur bilaterally. A lymphoma

All of the following would associated with an adrenal mass, except: A Pheochromocytoma Conn disease C Nephroblastoma d)Cushing syndrome

Nephroblastoma is primary malignancy of the kidney. Adrenal tumors are commonly seen with Cushing syndrome and Conn disease. A pheochromocytoma primarily presents as a benign tumor of the adrenal gland that causes symptoms similar to anxiety C Nephroblastoma.

Nephrocalcinosis is the formation of multiple calcifications/stones within the pyramids of a medullary sponge kidney. The reduced function of the medullary sponge kidney is thought to be the cause of the formation of the stones.

Nephrocalcinosis

Which of the following describes the Doppler appearance of liver transplant rejection? a)Nodular formations within the liver parenchyma B High 1esistance flow in the hepatic artery C Mottled appearance of the liver parenchyma with ascites D Low resistance flow in the portal vein

Normal flow in the hepatic artery is low resistance with forward flow in diastole. Transplant rejection will case increases resistance in the liver tissues which causes increased resistance in the hepatic artery waveform. Flow in the portal vein should be low resistance. b)High resistance flow in the hepatic artery

Which of the following is true regarding a renal oncocytoma? A easily differentiated from renal cell carcinoma by the presence of a central scar within the tumor b) usually occur in pediatric patients c) may have a central scar similar to renal cell carcinoma d)usually malignant and very aggressive

Oncocytoma S are most commonly benign tumors that occur later in life. They cannot be distinguished from renal cel carcinoma without a biopsy. Both RCC and oncocytoma s can demonstrate central scar. C may have a central scar similar to renal cell carcinoma

Which of the following foreign body types is better visualized on sonography than with radiography? A rose thorn glass C broken needle D gravel

Organic foreign bodies are not well seen on radiography, but easily detected on sonography. Metal and inorganic foreign bodies, such as gravel or glass, are radiopaque on an x-ray, more easily identified a) rose thorn

Which of the following is a potential collateral pathway formed in patients with cirrhosis? A blood moves from the splenic vein into the coronary vein B blood moves from the coronary and short gastric veins into the esophageal veins C blood moves from the emissary veins into the umbilical vein D blood moves from the gastric vein into the splenic vein

Pathways carry portal system blood directly into the systemic veins, bypassing liver Gastroesophageal varices form between the coronary and short gastric veins and the systemic esophageal veins Umbilical umbilical vein lies in the falciform ligament and connects the left portal vein to systemic epigastric veins near the umbilicus Splenorenal/Gastrorenal - varices form between the splenic, coronary, and short gastric veins and the left adrenal or renal veins Intestinal varices form between veins of the ascending and descending colon, duodenum, pancreas, and iver and the renal, phrenic, and lumbar veins Hemorrhoidal- blood from the IMV empties into the superior rectal veins which anastomose with the systemic middle and inferior rectal veins B blood moves from the coronary and short gastric veins into the esophageal veins

Peyronie Disease causes the development of scar tissue and fibrous plaque formation that usually involves the tunica albuginea, causes restriction and curvature of the affected side of the penis during erection and can be very painful 2D imaging demonstrates hyperechoic areas along the outer margins of the corpus cavernosa.

Peyronie Disease

What the sonographic appearance of pseudomyxoma peritonei? A multiple echogenic foci throughout the abdominal wall B mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall C mucinous secretions and tumor formation within abdomen that cause the liver to be pushed inferiorly against the diaphragm D multiple echogenic foci throughout the psoas muscle

Pseudomyxoma Peritonei refers to Intraperitoneal accumulation of a gelatinous ascites secondary to rupture of a mucinous tumor. The most common cause is ruptured mucinous tumor of the appendix B mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall

A patient presents for renal ultrasound due to a recent diagnosis of staphylococcus aureus infection, right flank pain and microscopic hematuria. The chart states the referring physician suspects a renal carbuncle has formed. How will this abnormality be identified Sonographically? A 1.5cm complex mass with ring down and dirty shadowing located within the renal parenchyma b)A hyperechoic mass of fibrous tissue replaces the tissues of the renal sinus causing significant outflow obstruction c)1.5cm complex mass located within the renal pelvis that iS causing renal vein thrombosis D A single large calculus obstructing the renal pelvis with severe hydronephrosis

Renal Carbuncle refers to renal abscess that forms in the parenchyma and is caused by hematogenous spread of Staphylococcus aureus. A corticomedullary renal abscess is caused by ascending bacteria in the urinary tract. Dirly shadowing and ring down artifact can be seen i gas is produced by bacteria in the abscess. A 1.5cm complex mass with ring down and dirty shadowing located within the renal parenchyma

Where is the most common location for the occurrence of retroperitoneal fibrosis? A at the level of the renal arteries B at the level of the aortic bifurcation C at the lateral borders of the kidneys D adjacent to the diaphragm surrounding aorta

Retroperitoneal Fibrosis (Ormond disease) Usually occurs at The level of the aortic bifurcation. It refers to idiopathic(usually) overgrowth fibrous tissue. can be related to drugs, infection, malignancy or cancer therapy. The overgrowth of tissue may lead to ureteral obstruction causing hydronephrosis. B. B at the level of the aortic bifurcation

Bilateral ureteral obstruction can be caused by? A retroperitoneal fibrosis B renal cell carcinoma of the left kidney c)splenic varices D liver mass in the posterior right lobe

Retroperitoneal fibrosis typically occurs at the level of the aortic bifurcation in the pelvis area. The ureters pass through this space to reach the bladder. If both ureters impinged, bilateral hydronephrosis wil occur, The other choices listed would only cause unilateral hydronephrosis. A retroperitoneal fibrosis

The most common parasitic infection in humans is: A pneumocystis carini B schistosomiasis c) hepatitis D hydatid disease

Schistosomiasis is caused by a fluke parasite found in polluted waters and infested shell fish/snails. The portal vein carries the worm to liver. The infection causes narrowing occlusion of smaller portal vessels causing portal hypertension. it is the most common parasitic infection in humans. B schistosomiasis

Seminoma the most common primary malignancy of the testicle Mixed germ cell is the second most common primary malignancy younger men age 20-30yrs

Seminoma

a patient presents with an enlarged left scrotum and palpable mass. The US demonstrates an intratesticular mass is also an irregular central cystic area. These findings are most suggestive of at is hypoechoic and heterogeneous with multiple coarse calcifications. There is also an irregular central cystic area. these findings are most suggestive of A teratoma only b)seminoma only C embryonal cell tumor teratoma D seminoma, embryonal cell tumor or teratoma

Seminomas normally present as hypoechoic, heterogeneous solid tumors. Cystic areas and coarse calcifications are common in embryonal cell tumors and testicular teratomas. C embryonal cell tumor teratoma

Why does the spleen have an increased risk of infarction compared to the other abdominal organs? a) because of the small size the Splenic vein and increased risk of stasis thrombosis B because is non-encapsulated c)because there is only one intrasplenic artery d) because the intrasplenic arteries do not have communicating branches

Splenic artery branches into superior and inferior splenic Arteries. The superior and Inferior Splenic Arteries give rise to several Segmental Arteries. The intrasplenic arterial Branches do not connect to communicate with each other. This is a characteristic that is unique to the intrasplenic arteries, Other organs and extremities have smaller connections between the different arteries supplying the part and this allows for collateral circulation when needed. The lack of anastomosis in The intrasplenic arterial circulation eliminates the possibilty of collateral formation when infarction Occurs. The spleen carries greater risk of infarction occurs. the spleen carries greater risk of infarction Occurs. the spleen carries a greater risk of infarction than other organs/ extremities d) because the intrasplenic arteries do not have communicating branches

Spontaneous splenic rupture is associated with all of the following, except: A splenosis B. trauma c)HIV D mononucleosis

Splenic rupture occurs due to trauma or it can occur spontaneously. Spontaneous rupture seen in patients with hepatitis A, malaria, cytomegalovirus, mononucleosis, and HIV. Splenosis refers to the autotransplantation of Splenic tissue in the peritoneal cavity when the spleen ruptures. Traumatic and spontaneous splenic rupture associated with Splenosis. B. trauma

A referring doctor requests a scrotal US rule out orchitis. Which of the following is an expected sonographic finding for this abnormality? a) multiple small cysts within the testicle B hematocele C hyperechoic testicle D increased intratesticular vascularity

Testicular infection can lead to increased blood flow to the testicle which causes hypervascularity identified on color Doppler. D increased intratesticular vascularity

A 16yr old male presents with acute onset of significant left scrotal pain. The exam reveals a hypoechoic, heterogeneous mass located Between the head of the epididymis and the testicle mass demonstrates no vascularity with epididymis and testicle. Which of the following could describe the findings? The Doppler evaluation. Normal flow demonstrated in the A adenomatoid tumor B seminoma C torsion of the appendix testis D Sarcoidosis

The acute onset of pain indicates potential torsion. The other choices list tumors that grow over which would not an acute onset of pain. Seminoma and sarcoidosis are intratesticular intra-epididymal tumors C torsion of the appendix testis

A patient presents with an acute onset of left scrotal pain this morning. The US exam demonstrates small hydrocele and an enlarged body and tail of the epididymis. There is very minimal flow demonstrated in the body the head appears normal. These findings are most suggestive of: a)Torsion of the epididymal body b) Sperm granuloma C Focal epididymitis of the head D Focal epididymitis of the body and tail

The blood flow in the epididymis should be consistent throughout the gland. A difference flow between two segments can indicate partial or complete torsion in the Segment with little to no flow. a)Torsion of the epididymal body

Which of the following statements best describes the appearance color Doppler evaluation of testicular abscess? A There will be no color flow demonstrated centrally with increased color flow displayed around the periphery the abscess. B B There will be a significant increase in vascularity within the abscess due to inflammation. There will be focal areas of increased vascularity in the central abscess and limited color flow dermonstratod at the periphery of he abscess. Due to fluid accumulation with inflanmation, color Doppler does not usualy demonstrate flow around or within an abscess

The central portion of the abscess is fluid and debris with no vascularity. The surrounding tissues are inflamed which leads increased flow and an increase in the color flow displayed. A There will be no color flow demonstrated centrally with increased color flow displayed around the periphery of the abscess.

What biliary anomaly is suspected if jaundice persists more than 14 days after birth? A ectopic GB B. agenesis of the GB c)biliary atresia d)choledochal cyst

The lack of opening in the biliary tree will cause the persistence of jaundice after birth. c) biliary atresia

Which of the following is least likely to cause anterior displacement of the aorta? a)retroperitoneal fibrosis B lymphadenopathy C mass in the left diaphragm crura d) spinal mass

The left and right crura cross just anterior the aorta and extend to the spine on both sides of the aorta. A mass in this structure would displace the aorta posteriorly. The IVC is anterior to the right crura. C mass in the left diaphragm crura

vein in the pampiniform plexus is considered abnormally dilated when the diameter exceeds: A 2mm b) 4mm c)8 mm d)6 mm

The pampiniform plexus refers to the venous drainage system of the testicle and scrotum. Normally they are arm in diameter. varicocele is diagnosed when the veins Dilate >2mm. a) 2 mm

A patient presents with history of fever and vomiting with increased serum levels of amylase and lipase. While scanning abdomen complicated cyst in the anterior pararenal space on the left side. These findings are most consistent with: A Gi tract mass B Pancreatic pseudocyst C Splenic aneurysm D splenic varices

The patient suffers from pancreatitis. The lab results indicate pancreatitis. Pseudocyst formation in the left pararenal space is common complication

Which of the following most likely to demonstrate a simple cyst with gravity dependent debris in the right lobe the liver? A early schistosomiasis infection B chronic focal nodular hyperplasia C chronic hydatid infectionn D early Echinococcalinfection

The presentation of Echinococcal infectionn varies with the length of time untreated. Early appearance simple cyst debris that was producef with development hydatid sand) Later, larger cysts with "daughter cysts" within them will form. honeycomb appearance, Water lily Sign) Walls may be thick or calcified in cases of chronic infection, Chronic infestation can resultt n a calcified mass. Echinococcal infection most commonly affects the right lobe D early Echinococcalinfection

A right adrenal mass will displace the IVC: A inferiorly B posteriorly C superiorly d) anteriorly

The right adrenal gland is posterior to the IVC. Tumor formation can displace the ivc more anteriorly. d) antly

When pancreas transplant has enteric drainage: A the allograft will be located in the chest b)bowel should be evaluated for obstruction c) the urinary bladder should be evaluated for abnormalities d) it is common for the stomach to be dilated with pancreatic juices

The two most common drainage routes for the pancreatic juices in a transplant are into the bowel (enteric) and into the urinary bladder, Images of bowel to took for obstruction with enteric exocrine drainage. Images of the urinary bladder should be obtained with bladder drainage b)bowel should be evaluated for obstruction

Which of the following is a common cause of transudate pleural effusion? pneumonia B malignancy C congestive heart failure d)tuberculosis

Transudate fluid has low protein and lactate dehydrogenase concentrations, Free fluid is pushed outside the capillary bed due to high pressure in the capillary beds. It is usually related CHF, Iiver and kidney disease. Exudate fluid has high protein and lactate dehydrogenase concentration. It is usually related to malignancy, lupus, pneumonia and tuberculosis. Free fluld leak outside the capillary cells due inflammation. c) chf

A patient presents with mild testicular pain that has increased over the last few months. The US exam demonstrates a normal right testicle. The left testicle demonstrates many tiny cysts clustered centrally along the mediastinum. No color flow is identified within the cystic structures. Which of the following best describes the findings A spermatocele B tubular ectasia C cystadenoma D varicocele

Tubular ectasia of rete testis refers to dilated testicular mediastinal tubules. This is benign condition thought to result from partial or complete obliteration of the efferent ducts. B B tubular ectasia

When diaphragmatic paralysis is suspected, a)the diaphragmatic thickness should be measured during inspiration and expiration B the patient should be evaluated for free air in the chest C the patient should be evaluated for free air in the abdomen d) thick linear calcifications form in the affected side

When diaphragmatic paralysis suspected, the diaphragmatic thickness should be measured the zone of apposition during inspiration and expiration. Thickening should occur during inspiration. Minimal or absent thickening indicates paralysis, M-mode can be used document abnormal of absent motion and thickening. a)the diaphragmatic thickness should be measured during inspiration and expiration

thrombosis of the splenic vein or pseudoaneuryam of the spienic artery

Which of the following are vascular complications seen with pancreatitis? A cholecystitis and phiegmon formation progression Budd Chiari syndrome and the development of congestive heart failure C portal hypertension and Biliary strictures thrombosis of the splenic vein or pseudoaneurysm of the spleic artery

increased serum copper level, increased alt,ast

Wilson Disease: Autosomal recessive inherited disease Disorder of copper metabolism that characterized by excessive deposition of copper in liver, brain, and tissues liver, brain, and othe tissues Causes hepatic dysfunction, hepatilis, cirrhosis and/or tiver failure Symploms include jaundice, hematemesis, portal HTN, ascites Rusty brown-colored ring around the iris of eye (Kayser-Fieischer rings) tncreased AST and ALT, bilirubin, PT Decreased albumin Elevated serum and urne copper levels Liver biopsy performed to contirm Sonographic Appearance: Ecthogenic fatty twer Fitrotic periportas thickening PNodular cirhlic changes

1yr old presents testicular sonogram due to palpable lump. The lab work in the chart indicates high levels of alpha fetoprotein. A mostly solid intratesticular mass is identified in the right testicle. There is a small area of possible necrosis centrally. These findings are most consistent with: a)Seminoma b) Epidermoid Cyst C Lymphoma c) Yoik Sac Tumor

Yoik Sac Tumor the most common testicular tumor in patients <2 yrs of age. They produce alpha fetoprotein (AFP). Sonographically they usually have areas of hemorrhage and necrosis in the mass causing complex appearance. c) Yoik Sac Tumor

most common benign, solid lesion of the thyroid is dash A Cyst B Hematoma C Goiter D Adenoma

a cyst and a hematoma are not considered solid masses. A goiter is a diffuse condition. The adenoma is the most common solid, benign thyroid mass. D Adenoma

Distal cholangiocarcinoma is most commonly found dash commonly found and Klatskin tumor most commonly found dash a) in the extrahepatic CBD near the porta hepatis, at the junction of the right and left hepatic duct B near the dome of the liver, in the CBD near the porta hepatis c) at the junction of the right and left hepatic ducts, outside the liver in the CBD d) in the left lobe, in the right lobe

a) in the extrahepatic CBD near the the porta hepatis, at the junction of the right and left Hepatic ducts

Schistosomiasis and chronic cystitis are commonly associated with what Sonographic findings in the urinary bladder? a) Diffuse bladder wall calcification B The bladder lumen is filed with numerous non-shadowing stones c)Bladder wall atrophy due to reduced arterial supply d) Ureteroceles formation

a)Diffuse bladder wall calcification Diffuse bladder wall calcification commonly associated with schistosomiasis and chronic cystitis.

Which of the following statements describes the appearance of testicular prosthetic on the US image? a)Round structure with reflective borders and an anechoic lumen. B Homogenous, hypoechoic structure with Sound attenuation posteriorly causing decreased visibility of the posterior borders the prosthesis C Solid, oblong structure with homogenous, hypoechoic texture compared to the native testes . D Solid, round structure with homogenous, hypoechoic texture compared to the native testes.

a)Round structure with reflective borders and anechoic lumen. Testicular prosthetics are most commonly silicone or gel filed which provides no reflection of the sound beam (anechoic)

Which of the following would result in 7em right kidney and a 9.8cm left kidney in an average sized patient? a)right renal artery stenosis B renal lymphoma C acute thrombosis of the right renal vein d) Autosomal dominant polycystic kidney disesse

a)right renal artery stenosis Average adult renal length 9-12 cm, widths 4-6 cm and AP 3-4 cm. The length measurements of the adult kidneys should be within 2cm of each other, In this case the right kidney is small and the left kidney normal in size. Stenosis of the right renal artery can cause renal ischemia and atrophy. The other choices would result unilateral or bilateral renal enlargement.

A significant increase in blood supply/drainage thyroid will seen with thyroiditis. This can be demonstrated with dash Doppler and is called the dash sign. A PW,color flash b) Color, inferno C Color, string of pearls sign D Color, flame

b) Color, inferno

Which of the following is the most commonly occurring germ cell tumor of the testicle? a)choriocarcinoma b) seminoma c) teratoma d)embryonal cell tumor

b) seminoma about 40 to 50 percent of germ cell tumors

A lab report demonstrates that a testicular tumor contains choriocarcinoma cells and embryonal cell carcinoma, Which of the following best describes the tumor? A Metastatic tumor b) Mature teratoma c)Mixed germ cell tumor D Seminomatous tumor

c)Mixed germ cell tumor contain components of 2 or more types of germ cell growth

What is one of the most common findings on a transrectal ultrasound in prostatitis? A heterogeneous gland with hypovascularity B multiple macrocalcifications c)hypoechoic halo at the periurethral area D homogeneous gland with Hypovascularity

c)hypoechoic halo at the periurethral area. Prostatitis demonstrates a heterogeneous peripheral gland with hypoechoic halo at the periurethral area. Abscess formation can occur later, There marked hypervascularity in tissues affected.

Adenomyomatosis causes diffuse or segmental thickening of gallbladder wal with the formation of diverticula within wall. The Gallbladder has an irregular lumen contour and comet tall artifacts occur from cholesterol deposits in Rokitansky-Aschoff sinuses.

check

Chronic infection, radiation therapy, CHF and liver Failure can all be associated with scrotal wal thickening. Normal scrotal wall thickness is <8mm.

check

Wilm's tumor AKA nephroblastoma the most common renal tumor children. They grow quite large and are usual palpable at the time of dlagnosis. The mass formation can lead to blood from the kidney entering the urine as it is formed. A pheochromocytoma is adrenal tumor not commonly found in children.

check

bhCG can elevated. Most seminomatous tumors over 1.6om demonstrate hypervascularity embryonal cell carcinoma usually associated with increased levels of b-hCG and AFP.a yolk sac tumor is usually associated with increased levels of AFP Associated Note the lab results and the internal vascularity of the mass. AFP levels are always normal in cases of Seminoma but levels of AFP An epidermoid cyst would not demonstrate internal vascularity

check

A fecalith is a hard stony mass of feces in the intestinal traci. fecalith can obstruct the appendix, leading to appendicitis. Fecalith can also obstruct Diverticuli. Also known as coprolith and stercolith.

cheech

Note the enlarged nodes surrounding the portal vein on the image. When multiple Ilymph nodes are surrounding vessel, it is called the sandwich sign. The vessel is sandwiched between the lymph nodes

cheech

Note the membranous structure covering the ureteral opening into the bladder, obstructs normal outflow of the urine to the bladder causing the hydronephrosis Posterior urethral valves would cause significant urination issues and an over distended bladder with Bilateral hydronephrosis A Diverticulum is structures bladder abnormality that presents an in out-pouching the bladder wall.

cheech

The bladder demonstrates thickened, irregular inferior wall with floating debris. This represents a urinary tract infection manifested as cystitis.

cheech

The parathyroid produces parathyroid hormones that affect calcitonin production by the thyroid. Calcitonin affects the body's ability metabolize the calcium our food a form that is excreted by our intestines and kidneys. The higher the PTH levels, the lower the calcitonin levels. the calcitonin levels are low, the calcium levels remain very high in the blood. The constant fitration of excess calcium the kidneys can lead formation.

cheech

The most common location of ectopic thyroid tissue formation outside the neck is in thedash A base of skull B shoulder C chest D groin

chest c The thyroid forms within the pharyngeal pouches in the neck and migrates Inferiorly to its position at the hase of the neck. When ectopic tissue present, most commonty migrates beyond the base of the neck and located mote inferiorly in the mediastinum area.

choledochocele is: A a cyst of the intraduodenal portion of the duct Ba type of cyst that forms at the terminal ducts in the biliary tree C a collection of bile that forms around a perforated gallbladder d) an intrahepatic collection of bile that forms around major branch of the biliary tree

choledochocele is cyst the intraduodenal portion of the duct. Peribiliary fluid is a collection of bile that form around perforated gb. A a cyst of the intraduodenal portion of duct

What is the most common cause of cholangitis? choledocholithiasis B adenomyomatosis C Klatskin tumor D AIDS

choledocholithiasis

Contrast enhanced ultrasound is used determine the outcome of tumor ablation in the liver. If the procedure was a success, what are the expected findings on the image? A Contrast uptake occurs during the venous phase B Contrast uptake occurs during the arterial phase C Consistent contrast uptake occurs during the arterial and venous phase d)No contrast enters the lesion during the cardiac cycle

d)No contrast enters the lesion during the cardiac cycle Ablation procedures are used to eliminate vascular supply to a tumor. the procedure is a success, no contrast will enter the tumor during the exam.

Ascites may appear complex and contain debris/septations if there is associated dash A internal bleeding B bacterial infection C viral infection d)all of the above

d)all of the above Ascites may appear complex and contain debris/Septations there is associated bacterial infection, Internal bleeding, and viral infection.

What changes occur on the US image when scanning breast tissue affected by acute mastitis? A posterior enhancement due to Tissue edema dilated ductal system within normal breast tissues C improved visualization of the ductal system due t tissue edema d)decreased penetration due to tissue edsma

d)decreased penetration due to tissue edema

A patient presents for liver ultrasound due to a history advanced cirrhosis. What is the expected Doppler tracing from the hepatic veins in this patient? a)triphasic with exaggerated respiratory phasicity b)triphasic with exaggerated cardiac pulsatility c) very minimal to absent flow d)monophasic with minimal respiratory phasicity

d)monophasic with minimal respiratory phasicity Cirrhosis causes compression of the hepatic veins due to liver tissue fibrosis. The normal triphasic pattern becomes monophasic with minimal respiratory phasicity

d)monophasic with minimal respiratory phasicity Cinhosis causes compression of the hepatic veins due to liver tissue fibrosis. The normal triphasic pattern becc monophasic with minimal respiratory phasicity

d)monophasic with with minimal respiratory phasicity cirrhosis leads to

Which of the following is least likely to cause pancreatic pseudocyst formation? A abdominal trauma b) pancreatitis C pancreatic carcinoma. d)portal HTN

d)portal HTN Because the pancreas not encapsulated, any damage to the tissue can lead to leakage of the pancreatic juices into the retroperitoneal spaces. Portal HTN does not normally cause pseudocyst formation.

If pneumobilia is suspected, visualization of what acoustic artifact would support that diagnosis A range resolution B slice thickness posterior enhancement D ring down

d)ring down An air tissue interface will cause reverberation or ring down artifact. Pneumobilia indicates air in the biliary tree. Ring down and dirty shadowing wi seen posteroir to the echogenic ducts.

Weakened gastrosplenic and splenorenal ligaments can lead to: situs inversus B asplenia C polysplenia D wandering spleen

d)wandering spleen caused weakened splenic ligaments. The ectopic spleen is an abnormal position in the abdomen. If spleen absent from the LUQ, scan the rest of the abdomen for a mass of tissue that has expected size and echotexture as the spleen, This condition increases the risk for splenic torsion. D wandering spleen

There is mass infiltration into the wall of the urinary bladder. Note the infiltration and loss of definition of the affected wall as compared to the unaffected segments. thickening of the bladder wall. Thrombus accumulation would be limited to the internal lumen of the bladder. Cystitis most commonty displays as

diffuse thickening of the bladder wall

There are enlarged Ilymph nodes present on either side of the aorta. The vessel is sandwiched between the nodes Sandwich

enlarged Ilymph nodes

The symptoms and urinalysis are related to an infection the urinary system. The image demonstrates focal mass of renal cortex vwith mild heterogeneity. Focal pyelonephritis is identified at mid pole of the right kidney. Note loss of definition of corticomedullary boundary

focal pyelonephritis

Which of the following is NOT medication that can be used treat patients hypothyroidism? A Levothyroxine B lodine supplements c)Coumadin D Iron supplements

for treatment is the use of lodine supplements, iodine deficiency can sometimes Iead to decreased thyroid function. in be helpful. In some cases, iron deficiency can cause hypothyroidism. in these Synthroid or Levothyroxine the most commonly used medication used for treatment of hypothyroidism. Another option these cases, iodine supplements cases, iron supplements may be helpful c) coumadin

Systemic causes GB wall thickening include CHF, renal failure and cirrhosis. The edematous wall demonstrates tissue stratification with edema and NO hypervascularity. These two characteristics help to differentiate it from an inflammatory cause, such as cholecystitis or hepatitis.

gb wall thickening

The image demonstrates an opening the peritoneum and muscular fascia of the abdominal wall with "mushroom cloud" of intestine extending anteriorly through the herniation. The Valsalva maneuver is helpful evaluating the presence absence of bowel protruding through herniation the abdominal wal. The Increase in intra-abdominal pressure should force the bowel through the opening and peristalsis should occur upon release,

hernia

Note the dilated całyces with thickened walls and debris, consistent with an infection. Fever and increased WBC count will occur with most infections.

infections

The image demonstrates large hematoma within the abdominal wall. Note the heterogeneous blood has replaced the normal striated muscle appearance. Trauma is common cause for this finding. Malignancy invades tissues form solid mass.

large hematoma

Which of the following would not be associated with jaundice? A mucocele of the GB B hepatitis C sphincter of Oddi dysfunction d) a stone at the Ampulla of Vater

mucocele of the GB is caused by a song standing obstruction of the cystic duct. The remainder of the Bilary system is normal and jaundice would occur, A mucocele of the GB

While scanning the thyroid, you note a 1.5cm hypoechoic, mildly heterogeneous nodule that appears be posterior to the lower pole of right lobe the thyroid. There is distinct fascial plane thyroid and the nodule. There are no other nodules identified on the exam. Which of the between following most likely descritbes the findings? a)goiter b) normal esophagus C c)parathyroid adenoma d)branchial cleft cyst

parathyroid adenoma usually results in a solid hypoechoic nodule posterior and inferior to the thyroid gland. The esophagus located on the let side of the neck and would not appear as hypoechoic nodule. A goiter refers to an Enlarged thyroid gland usually with multiple solid nodules. A branchial cleft cyst would appear anechoic and would be located more cephalic in the neck. c)parathyroid adenoma

There is hypoechoic ovoid mass posterior to the Thyroid. The esophagus is noted medial to the mass and the carotid artery is lateral the mass. The homogeneous hypoechoic appearance is common in parathyroid adenomas.

parathyroid adenomas.

A patient presents with history of hepatitis C and you identify solid liver mass with hypoechoic halo, This finding is most consistent with: a)hepatic metastasis B hepatic adenoma C hepatocellular carcinoma d)focal nodular hyperplasia

patient history of a primary cancer the body + liver mass with halo = usually liver metastasis patient history of chronic liver disease + liver mass with halo usually hepatocellular carcinoma hepatocellular carcinoma c)

The dash zone is the prostate zone most commonly affected by malignancy A peripheral B paraprostatic C transitional D central

peripheral zone

A varicocele Would located laterally adjacent to the edge of the scrotal sac. Note the lack of an Anterior wal of the loculated fluid. The testicular capsule can be seen compressed beneath the fluid which also indicates the formation extra-testicular. The testicle would present as enlarged with heterogeneous appearance and no evidence of internal blood flow, if torsion of the cord had occurred. the fluid surrounding the testicle complicated with debris and Septations consistent wlth pyocele formation due to intoction. Note the thickened sertoli wall anteriorly which would help differentiate the mass from a hematoma.

pyocele

image demonstrates pyocele Formation due chronic infectionn. Note the septations and debris within the fluid surrounding the testicle. Pain, Fever, increased WBC, and Swellng are al symptoms of infection.

pyocele

There a small amount ascites in Morrison pouch and right pleural effusion. The renal echotexture is normal compared to the liver and the renal parenchyma is of normal thickness so renal failure is not demonstrated sonographically.

renal

The patent symptoms should lead to a diagnosis related to infection related the recent biopsy. The complex cystic mass demonstrates debris Levels and the adjacent tissues are hypoechoic with a loss if definition of the medial aspect of the lower pole.

renał abcess

Tuberculosis and dash demonstrate similar ultrasound findings in the spleen. A infarction b) hamartoma C hemangioma d)sarcoidosis

sarcoidosis Sarcoidosis and TB will demonstrate multiples hypoechoic nodules the spleen with active disease. After the nodules heal, they become echogenic that can demonstrate posterior shadowing.

Which of the following is not a sonographic characteristic of prostatitis? A increased vascularity seen with color Doppler b) solid hypoechoic mass C increased gland size d) heterogeneous gland

solid hypoechoic mass, prostatitis is usually a diffuse prices that affects the entire gland

sperm granuloma Is a common complication of a vasectomy.

sperm granuloma

Which the following are vascular complications seen with pancreatitis? A cholecystitis and phiegmon formation B progression Budd Chiari syndrome and the development of congestive heart failure c) portal hypertension and Biliary strictures D thrombosis of the splenic vein or pseudoaneurysm of the splenic artery

thrombosis of the splenic vein or pseudoaneurysm of the splenic artery is the most important vascular complications seen with pancreatitis these issues are related to the pancreatic enzymes causing vascular erosion of the vessels near the pancreas

Which of the following is an expected Sonographic finding with complete duplication of the collecting system of the kidney? A circumferential cortex at the lower pole b) circumferential cortex at the upper, mid and lower poles C circumferential cortex at the mid pole d) circumferential Cortex at the upper pole

transverse view ttc norma! kidney desmonstrates cortical tissue surrounding the upper and lower poles, while the mid pole demonstrates the renal pelvis with lack cortical tissue in the area the renal pelvis. When documenting a duplicate d collecting system with usg, obtain transverse images Demonstrating the upper pole with a hilum, the mid pole witt circumferential cortex so hilum), and the lower pole with hilum. Color Doppler can assist in demonstrating vessels entering the upper and lower pole hilar areas, but not the expected mid pole area. C circumferential cortex at the mid pole

The renal pelvis and Calyces are dilated, but the ureter normal, This indicates an obstruction at the ureteropelvic junction. parapelvic cyst would not normally cause the calyces to dilate. A UVJ obstruction and a ureterocele would cause the ureter to dilate with the renal pelvis and całyces, Increased levels of creatinine would indicate renal disease.

upj obstruction

The ureter is noted entering the bladder posteriorly. There is an echogenic foci w/ sight shadowing noted near the junction with the bladder.

ureter

varicocele is demonstrated on the image. The Valsalva maneuver will increase the size of the veins and can cause flow reversal to occur. The abnormality has been linked in infertility in some cases. It is more commonly seen on the left side due to relationship the gonadal vascular anatomy to surrounding structures. The left renal vein courses between the SMA and aorta which Increases risk of extrinsic compression causing decreased drainage of the left gonad. (nutcracker syndrome)

varicocele

Thrombosis of the splenic vein or pseudoaneurysm of the splenic artery are the most important vascular complications seen with pancreatitis. These issues are pancreas. related to the pancreatic enzymes causing vascular erosion of the vessels near

vascular erosions of vessel near the pancreas