ABD MOCK C

What is the most common symptom of renal cel carcinoma? A. HTN B. Proteinuria C. Hematuria D. Increased AFP

C. Hematuria

Fluid dilation of the renal pelvis and calyces is called: A. Pyonephrosis B. Hydronephritis C. Hydronephrosis D. Pyelonephritis

C. Hydronephrosis

Which of the following describes the proper technique for the evaluation of a pediatric hip for suspected transient arthritis? A. Comparison views of the unaffected hip should always be obtained. B. The curved array is used for the best evaluation of the curved structures in the bones hip. C. Transient arthritis requires an immediate arthrocentesis for fluid evaluation. D. The normal hip capsule thickness less than 1 cm.

A. Comparison views of the unaffected hip should always be obtained.

___ resolution is defined as the ability of an ultrasound system to differentiate structures on an image based on variations in the brightness of the echo/pixel. A. Contrast B. Axial C. Lateral D. Elevational

A. Contrast

Which of the following statements correctly describes imaging of the dome of the liver? A. Deep inspiration is required to evaluate this portion of the liver. B. The portal confluence should be used to locate the dome of the liver. C. Because the dome is bordered superiorly by the diaphragm, love artifact commonly inhibits complete evaluation of this portion of the liver. D. Intercostal scanning is the preferred scanning approach to evaluate the dome of the liver.

A. Deep inspiration is required to evaluate this portion of the liver.

Which of the following is not a required part of an ultrasound evaluation for a suspected AAA? A. Evaluate flow in both internal iliac arteries. B. Assess location in relationship to the renal arteries. C. Evaluate the length of the affected segment. D. Evaluate the AP and width measurements of the true and false lumen if thrombus is present.

A. Evaluate flow in both internal iliac arteries.

Renal cell carcinoma is also called: A. Hypernephroma B. Nephroblastoma C. Transitional Cell Carcinoma D. Wilm's Tumor

A. Hypernephroma

A 50yr old female presents with nausea, vomiting and increased vomiting and increased levels of AFP in lab testing. Which of the following pathologies is demonstrated on the image displayed? A. Klatskin tumor B. Hepatoblastoma C. Krukenberg tumor D. Choledochal cysts

A. Klatskin tumor

Which of the following causes of diffuse dilatation of the intrahepatic biliary tree, without dilatation of the extrahepatic biliary tree? A. Klatskin tumor B. mass at the Ampulla of Vater C. Mass at the valves of Heister D. Brenner Tumor

A. Klatskin tumor

A mass that demonstrates propagation speed artifact may lead to a positive diagnosis of: A. Lipoma B. Staghorn calculus C. Renall cyst D. Renal cell carcinoma

A. Lipoma

Which of the following Doppler finding is most consistent with uncomplicated epididymo-orchitis? A. Low resistance flow, resistive index 0.4 B. High resistance flow, resistive index 0.2 C. High resistance flow, resistive index 1.2 D. Low resistance flow, resistive index 0.8

A. Low resistance flow, resistive index 0.4

Which of the following is part of the renal parenchyma? A. Pyramids B. Major calyces C. Minor Calyces D. Segmental arteries

A. Pyramids

A retrorenal spleen is an important consideration when planning: A. a left renal biopsy B. treatment for portal HTN C. AAA repair D. the point of entry for a paracentesis

A. a left renal biopsy

A patient presents for an abdominal ultrasound due to new onset of hematuria, proteniuria and increased serum BUN and creatinine. He complains of recent fever, sore throat, joint pain, and peripheral edema. These clinical findings are most suggestive of? A. acute glomerulonephritis B. Tuberous sclerosis C. transitional cell carcinoma D. renal cell carcinoma

A. acute glomerulonephritis

Decreased serum albumin levels are associated with the development of ___. A. ascites B. kidney stones C. thyroid adenomas D. epididymitis

A. ascites

Which of the following would be an unexpected finding in a patient that has a vasectomy 4 years ago? A. atrophied epididymis B. dilated vas deferens C. spermatoceles D. tubular ectasia of the epididymis

A. atrophied epididymis

An infant is referee's for an abdominal sonogram due to prolonged jaundice after birth. A small triangular echogenic area is identified at the portal vein bifurcation, but no definite extrahepatic duct is noted. The gallbladder is very small and abnormally shaped. These findings are most suggestive of: A. biliary atresia B. biliary ascariasis C. choledochal cyst D. Caroli disease

A. biliary atresia

If the common hepatic duct obstructed, how will this affect the other biliary structures? A. contracted GB and dilated intrahepatic ducts B. contracted GB and dilated extrahepatic and intrahepatic ducts C. dilated extrahepatic ducts D. dilated GB and dilated intrahepatic ducts

A. contracted GB and dilated intrahepatic ducts

Mirizzi syndrome is caused by obstructions of the ___, while Courvoisier gallbladder is related to obstruction of ___. A. cystic duct, distal CBD B. distal CBD, cystic duct C. intrahepatic CBD, extrahepatic CBD D. proximal CBD, distal CBD

A. cystic duct, distal CBD

Which of the following is associated with hyperglycemia? A. diabetes mellitus B. islet cell tumor C. hyperinsulinism D. adenoma

A. diabetes mellitus

The image demonstrates ___, which is commonly associated with ___. A. duplicated collecting system, ureterocele B. staghorn calculus, hydronephrosis C. ureteropelvci obstruction, staghorn calculus D. parapelvic cyst, bladder diverticulum

A. duplicated collecting system, ureterocele

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

A. incisional hernia

Which of the following will increase the amount of color displayed in the abdominal aorta? A. increase frame rate B. increase wall filter C. decrease color threshold D. decrease color gain

A. increase frame rate

A liver mass with a hypoechoic rim should create a strong suspicion of: A. malignancy B. a liver adenoma C. a hepatic lipoma D. portal hypertension

A. malignancy

A patient presents for an abdominal US exam with a history of a recent single episode of significant indigestion. The lab results demonstrate increased levels of AST and normal levels of ALT, alkaline phosphatase and bilirubin. These clinical findings are most consistent with: A. myocardial infarction B. biliary stars with a partial ductal obstruction due to Klaskin tumor C. chronic hepatitis C D. Schistosomiasis

A. myocardial infarction

Which of the following statements is true regarding the form of polycystic kidney disease demonstrated on the image displayed from a 32yr old male patient? A. one parent has the disorder and it spans generations B. The most commonly associated organ with additional cyst formation is the spleen C. The form of PCKD is usually fatal early in life. D. It requires two defective genes in a pair to cause this type of PKCD.

A. one parent has the disorder and it spans generations

A hypoechoic thyroid mass with micro calcifications, hypervascularity and no halo sign most consistent with: A. papillary carcinoma B. goiter C. neuroma D. hyperfunctioning adenoma

A. papillary carcinoma

A solid nodule in the left lobe of the thyroid that measures 2cm AP and 1 cm width is mast suggestive of: A. papillary carcinoma B. adenoma C. anaplastic carcinoma D. colloid cyst

A. papillary carcinoma

Which acoustic artifact will commonly be identified with hydrocele formation? A. posterior enhancement B. comet tail artifact C. edge shadowing D. posterior shadowing

A. posterior enhancement

The psoas muscle is ___ to the kidney. A. posteromedial B. anterolateral C. posterolateral D. anteromedial

A. posteromedial

What structure prevents free fluid in Morison pouch from moving into the subphrenic space? A. right coronary ligament B. falciform ligament C. right hepatoduodenal ligament D. ligamentum teres

A. right coronary ligament

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

A. schistosomiasis

The image demonstrates a coronal vie of the left upper quadrant. Where is free fluid documented on the image? A. subphrenic space and pleural space B. subphrenic space and splenorenal C. subhepatic space and pleural space D. subphrenic space and parabolic gutter

A. subphrenic space and pleural space

Prehn sign is used to differentiate what two abnormalities? A. testicular torsion and epididymo-orchitis B. seminoma and yolk sac tumor C. renal cell carcinoma and oncocytoma D. fungal liver abscess and amoebic liver abscess

A. testicular torsion and epididymo-orchitis

A patient presents with a palpable round lump on the midline anterior neck about 2cm below the jaw. The structure appears anechoic with thin, smooth walls on ultrasound. Which of the following is the most likely explanation for the findings? A. thyroglossal duct cyst B. pharyngeal pouch cyst C. nasopharyngeal duct cyst D. ectopic thyroid cyst

A. thyroglossal duct cyst

Which of the numbered vessels is a part of the portal system? A. 1 B. 2 C. 3 D. 1 and 3

B. 2

In a normal adult patient, the common hepatic duct lumen measure less than or equal to ___. A. 6mm B. 4mm C. 2mm D. 2cm

B. 4mm

A 55yr old female presents with a fever, leukocytosis and LLQ pain. She stated she suffers from Crohn disease. The exam demonstrates a 2.7 cm ill-defined hypoechoic mass in the LLQ that is surrounded by a small amount of ascites. There is no flow within the mass and no movement with peristalsis. These findings are most suggestive of: A. Retroperitoneal lymphadenopathy B. Abscess C. Appendicitis D. Intussusception

B. Abscess

The halo sign is a sonographic characteristic of what thyroid abnormality? A. Germ Cell tumor B. Adenoma C. Complex cyst D. Papillary carcinoma

B. Adenoma

The most common benign, solid lesion of the thyroid is ___. A. Hematoma B. Adenoma C. Gioter D. Cyst

B. Adenoma

Which of the following will help differentiate hepatocellular carcinoma invasion of the portal vein from portal thrombosis on ultrasound examination? A. Measure the portal vein on inspiration and expiration B. Apply Power Doppler to the portal vein C. Measure the portal vein diameter before and after a fatty meal D. Cannot differentiate thrombus from tumor in the portal vein by ultrasound requires CT exam

B. Apply Power Doppler to the portal vein

Which of the following is a common finding in hepatitis, cirrhosis and hepatic abscess formation? A. Hepatoma B. Ascites C. Portal HTN D. Hydatid cyst

B. Ascites

A patient with a history of choledocholithiasis. How will you asses the common bile duct for the presence of a stone? A. Demonstrate a transverse view of the pancreatic had and look for the CBD entering the anterior aspect. B. Demonstrate a longitudinal view of the main portal vein and look for the CBD anterior to it. C. Demonstrate a long axis gallbladder image and look for the CBD superior to it. D. Locate the main portal vein and look doe the CBD posterior to it.

B. Demonstrate a longitudinal view of the main portal vein and look for the CBD anterior to it.

Medullary carcinoma of the thyroid is a common occurrence with: A. Zollinger-Ellison B. MEN Syndrome C. Margan syndrome D. Von Hippel Lindau syndrome

B. MEN Syndrome

What is the most accurate Sonographic predictor or pyloric stenosis? A. Channel length B. Muscle wall thickness C. Gastric volume D. Cross-sectional diameter

B. Muscle wall thickness

A patient presents with LUQ pain, loss of appetite, and elevated levels of lactate dehydrogenase. The findings on the image are most suggestive of: A. mononucleosis B. Non-Hodgkin Lymphoma C. granulomas D. hamartomas

B. Non-Hodgkin Lymphoma

The splenic artery courses across the ___ surface of the pancreas. A. Anterior inferior B. Posterior superior C. Posterior inferior D. None of the above

B. Posterior superior

What structure is indicated by the red arrow? A. CBD B. Proper hepatic artery C. Main portal vein D. common hepatic artery

B. Proper hepatic artery

While performing an ultrasound of the abdominal aorta, the mid and distal portions of the vessel are partially obscured by bowel gas. Which of the following techniques can be used to improve your visualization of the aorta? A. Scan the patient in the semi-erect position. B. Roll the patient into an oblique or decubitus position and rescan the aorta. C. Have the patient drink water and rescan the aorta. D. Give the patient a laxative and rescan after 60 minutes.

B. Roll the patient into an oblique or decubitus position and rescan the aorta.

Which of the following statements is true regarding the image displayed? A. The gallbladder has a normal variant called a phrygian near the neck. B. The gallbladder has a normal variant called a phrygian cap near the fundal area. C. The gallbladder has a normal variant called a Hartmann pouch near the fundal area. The gallbladder has a separation within the fundus.

B. The gallbladder has a normal variant called a phrygian cap near the fundal area.

Which of the following statements correctly describes the findings on the image? A. The calipers are improperly places inside the vessel walls and should be repositioned to measure the distance from outer wall to outer wall for an accurate measurement. B. The portal vein is measured correctly and demonstrates possible portal hypertension. C. The portal vein is measured at the incorrect location along the course of the vessel which cause the false appearance of enlargement. D. The portal is measured correctly and demonstrates normal portal venous anatomy.

B. The portal vein is measured correctly and demonstrates possible portal hypertension.

Which of the following describes splenomegaly? A. The spleen extends to a position immediately adjacent to the pancreatic tail B. The spleen extends below the lower pole of the left kidney C. The spleen extends below the upper pole of the left kidney D. The spleen extends below the mid pole of the left kidney

B. The spleen extends below the lower pole of the left kidney

Which of the following statements best describes the findings on the the image? A. There are several colloid cysts present within the thyroid and some demonstrate the propagation speed artifact. B. There are several colloid cysts present within the thyroid and some demonstrate the comet tail artifact. C. The findings should raise significant suspicion for thyroid malignancy. D. There are several milk of calcium cysts within the thyroid.

B. There are several colloid cysts present within the thyroid and some demonstrate the comet tail artifact.

What is the name of the T4 hormone? A. Thyroid stimulating hormone B. Thyroxine C. Triiodthyronine D. Trypsin

B. Thyroxine

Which of the following pancreatic abnormalities are associated with an increase in amylase and lipase levels in the blood? A. pseudocyst, acute pancreatitis and chronic pancreatitis B. acute pancreatitis and pseudocyst C. chronic pancreatitis and pseudocyst D. pseudocyst and adenoma

B. acute pancreatitis and pseudocyst

Harmonic imaging will: A. reduce the appearance of micro bubble contrast on a contrast echo B. allow for deeper penetration with improved spatial resolution C. degrade lateral resolution and improve axial resolution D. improve temporal resolution

B. allow for deeper penetration with improved spatial resolution

An incidentaloma is: A. an aggressive adrenal carcinoma B. an unexpected mass on an imaging exam C. always a critical finding D. an aggressive splenic carcinoma

B. an unexpected mass on an imaging exam

The fibromuscular stroma of the prostate is called the ___ zone. A. peripheral B. anterior C. transitional D. central

B. anterior

Which of the following statements is correct regarding testicular seminoma? A. unresponsive to radiation and chemotherapy B. associated with cryptorchidism, trisomy 21, Klinefelter syndrome, and smoking C. spreads to liver first with metastasis D. most common in African American males

B. associated with cryptorchidism, trisomy 21, Klinfelter syndrome, and smoking

When performing contrast enhanced ultrasound evaluation of the liver, when are the images obtained? A. at the start of the contrast injection, record an image the area of interest every 30 seconds. B. at the start of the saline flush, record the area of interest for 1 minute and an image every 30-60 seconds until the 6 minute mark C. when the contrast is first visualized in the areas of interest and again when it dissipates completely. D. after the saline flush record an image the area of interest every 60 seconds

B. at the start of the saline flush, record the area of interest for 1 minute and an image every 30-60 seconds until the 6 minute mark

Which of the following correctly describes the sonographic appearance of renal lymphoma? A. unilateral renal atrophy B. bilateral renal enlargement C. unilateral renal enlargement D. bilateral renal atrophy with renal failure

B. bilateral renal enlargement

The liver is divided in the transverse plane by the: A. branching of the hepatic veins B. branching of the portal veins C. course of the biliary vessels through the tissue D. course of the fissures through the tissue

B. branching of the portal veins

Which scrotal arteries penetrate the testicular parenchyma to supply oxygenated blood? A. capsular B. centripetal C. cremasteric D. deferential

B. centripetal

Hypersplenism and anemia are common findings in cases of: A. asplenia B. cirrhosis C. celiac disease D. sickle cell disease

B. cirrhosis

What changes occur on the US image when scanning breast tissue affected by acute mastitis? A. improved visualization of the ductal system due to tissue edema B. decreased penetration due to tissue edema C. posterior enhancement due to tissue edema D. dilated. ductal system within normal breast tissue

B. decreased penetration due to tissue edema

What lab test is used to evaluate the endocrine function of a pancreas transplant? A. anodal trypsinogen levels B. glucose levels C. amylase levels D. hematocrit levels

B. glucose levels

What therapeutic device is implanted inside the distal IVC? A. pacemaker B. greenfield filter C. stent D. catheter

B. greenfield filter

Adrenal gland hemorrhage: A. is most commonly seen in patient over 70yr old B. in adults usually related to trauma or hematologic disorders, such as thrombocytopenia C. is very rare because the adrenal glands are hypovascular fatty organs D. is associated with very high hematocrit levels

B. in adults usually related to trauma or hematologic disorders, such as thrombocytopenia

Where is the Dartos muscle and fascia? A. in the cystic duct B. in the scrotal sac C. in the abdominal wall D. in the urinary bladder

B. in the scrotal sac

A normal portal vein will: A. increase in diameter by placing patient in the upright position B. increase in diameter by more than 20% with deep inspiration C. increase in diameter after exercise D. decrease in diameter after eating

B. increase in diameter by more than 20% with deep inspiration

Which of the following would be associated with the findings on the image? A. decreased serum creatinine B. increased serum creatinine C. increased serum alpha phosphatase D. increased serum alpha fetoprotein

B. increased serum creatinine

Which of the following best describes the normal Doppler tracing from the renal arteries? A. low resistance waveform with increased diastolic flow reversal B. low resistance waveform with increased diastolic flow C. triphasic waveform with increased diastolic flow reversal D. high resistance flow with increased diastolic flow reversal

B. low resistance waveform with increased diastolic flow

A 55yr old female patient presents for an abdominal sonogram due to a history of weight loss and recurrent pain just after eating. What structure(s) should be closely evaluated? A. pylorus B. mesenteric arteries and celiac axis C. portal system D. splenic artery

B. mesenteric arteries and celiac axis

A patient presents with a recent history of a histoplasmosis infection. The referring doctor would like to evaluate the abdomen for residual effects from the infection. Which sonographic finding in the abdomen would be consistent with this type of infection? A. mid to moderate ascites and splenomegaly B. multiple echogenic foci in the liver and/or spleen parenchyma C. dilated ductal system of the liver with inflammation (cholangitis) D. significant amount of lobulate ascites in the bilateral parabolic gutters

B. multiple echogenic foci in the liver and/or spleen parenchyma

While scanning the thyroid, you identify a 0.6cm ovoid structure outside they thyroid, lateral to the left carotid artery. The structure has a thin hypoechoic rim surrounding center. These findings are most suggestive of: A. parathyroid carcinoma B. normal lymph node C. normal espohagus D. thyroglossal duct cyst

B. normal lymph node

What congenital anomaly of the pancreas results in two separate ductal systems that drain the pancreas? A. annular pancreas B. pancreas divisum C. aberrant pancreatic tissue D. pancreatic sequestration

B. pancreas divisum

What ultrasound guided procedure is performed using the area lateral to the rectus abdomens muscle in the left lower abdomen as the most common puncture site? A. ethanol ablation B. paracentesis C. Thoracentesis D. Lovenox injection

B. paracentesis

When inflammation from pancreatitis extends into the tissues surrounding the pancreas, this is called: A. cystadenoma B. phlegmon C. biloma D. psuedocyst

B. phlegmon

The appendix is normally identified: A. anterior to the terminal ileum and lateral to the iliac vessel B. posterior to the terminal ileum and anterior to the iliac vessel C. only in patients less then 150lbs D. originating from the sigmoid colon at the level of the inguinal ligament

B. posterior to the terminal ileum and anterior to the iliac vessel

A porcelain GB causes an increase in the patient's risk for ___. A. adenomyomatosis B. primary carcinoma C. sclerosing cholangitis D. choledocholithiasis

B. primary carcinoma

Harmonic imaging leads to: A. improved axial but degraded lateral resolution B. reduced appearance of lobe artifact C. increase image noise D. reduced signal to nose ratio

B. reduced appearance of lobe artifact

Which of the following would be considered a critical finding on a Point of Care Ultrasound exam? A. 4cm abdominal aortic aneurysm B. severe pericardial effusion C. pneumothorax D. non-obstructive renal calculi

B. severe pericardial effusion

What vessel can be used to differentiate the left renal vein and splenic vein on the ultrasound exam? A. superior mesenteric vein B. superior mesenteric artery C. right renal artery D. left renal artery

B. superior mesenteric artery

The normal gallbladder is usually less than ___ in transverse diameter. A. 3cm B. 3mm C. 5cm D. 8cm

C. 5cm

While scanning the liver in a patient with chronic cirrhosis, you notice a tubular vessel connecting to the left portal vein and exiting the liver coursing inferiorly. Flow within the vesel is very low velocity, continuous and moving in a caudal direction. Which of the following explains the ultrasound finding? A. The ductus venosus is dilated with antegrade flow which is a common complication of cirrhosis. B. A dilated SMV is present with flow reversal which is a common complication of cirrhosis. C. A dilated umbilical vein is present which is a common complication of cirrhosis. D. A dilated coronary vein is present which is a common complication of cirrhosis.

C. A dilated umbilical vein is present which is a common complication of cirrhosis.

Fulminant hepatitis is most commonly caused by: A. Viral infection B. Fungal infection C. Acetaminophen abuse D. Alcohol abuse

C. Acetaminophen abuse

A patient presents for his annual renal scan due to a long history of dialysis treatment. He does not currently have any related complaints. what are the expected findings on the exam? A. Bilaterally enlarged kidneys due to compensatory hypertrophy. B. Bilaterally atrophied kidneys with thickened, echogenic parenchyma and multiple calculi formation. C. Bilateral atrophied kidneys with little to no visible parenchyma and multiple cyst formation. D. Bilaterally hypertrophied kidneys with little to no visible parenchyma and multiple cyst formation.

C. Bilateral atrophied kidneys with little to no visible parenchyma and multiple cyst formation.

A vascular condition of the liver seen in women who take oral contraceptive is: A. Hereditary telangiectasia B. Portal aneurysm C. Budd Chiari Syndrome D. Liver adenoma

C. Budd Chiari Syndrome

The diameter of the normal abdominal aorta is greater at the level of the: A. Renal arteries B. Superior mesenteric artery C. Celiac D. Iliac bifurcation

C. Celiac

Which of the following describes carpal tunnel syndrome? A. Damage to the cartilage between the carpal bones of the wrist causing swelling and pain with motion. B. Damage to the median nerve by chronic compression between the metacarpal bones of the palm. C. Compression of the median nerve by the carpal sheath causing numbness, weakness and pain. D. Compression of the blood vessels as they enter/exit thrombus formation and emboli

C. Compression of the median nerve by the carpal sheath causing numbness, weakness and pain.

A 3yr old presents for a renal scan, complaining of left sided pain. No renal abnormality was identified on the exam but a common anatomical variant was identified. What is the term for a single cortical bulge off of the lateral of the left kidney? A. Fetal lobulation B. Column of Bertin C. Dromedary hump D. Cortical hyperplasia

C. Dromedary hump

The development of scar tissue and fibrous plaque formation involving the tunica albuginea of the penis describes: A. Squamous cell carcinoma of the penis B. Priapism C. Peyronie disease D. Penile fracture

C. Peyronie disease

Which of the following Doppler parameters is most commonly used when evaluating the common hepatic artery in patient with a liver transplant? A. Pulsatility index B. Peak systolic velocity C. Resistive index D. S/D ratio

C. Resistive index

Which of the following statements is true regarding the image displayed? A. The liver is demonstrated in the transverse plane at the level of the caudate lobe and has a normal echotexture. There is an enlarged lymph node seen anterior to the aorta and adjacent to the IVC. B. There is a mass identified in the lateral left lobe of the liver adjacent to the IVC C. There is a mass identified in the medial left lobe of the liver adjacent to the IVC D. The liver is demonstrated in the transverse plan at the level of the caudate and has a normal echotexture.

C. There is a mass identified in the medial left lobe of the liver adjacent to the IVC

A patient presents for an abdominal ultrasound due tools of appetite, weight loss and epigastric pain. A hypoechoic mass is identified in the anterior aspect of the head of the pancreas. Which of the following best describes the next step in evaluating had patient? A. Apply color Doppler to the area to determine if the hypoechoic area is a possible portal thrombosis B. Review the patient chart to view the pancreatic enzyme levels related to acute pancreatitis. C. Transient arthritis requires an immediate arthrocentesis for fluid evaluation. D. The normal hip capsule thickness is less than 1 cm.

C. Transient arthritis requires an immediate arthrocentesis for fluid evaluation.

The Achilles' tendon most commonly ruptures: A. mid-tendon B. at the distal insertion point C. about 4 cm from the distal insertion point D. at the proximal insertion point

C. about 4 cm from the distal insertion point

Increased resistive index in the renal parenchymal arteries is an expected finding with: A. acute renal artery occlusion and acute renal failure B. renal allografts placed less than 1 week ago C. acute tubular necrosis and renal vein thrombosis D. infrarenal aortic aneurysms

C. acute tubular necrosis and renal vein thrombosis

Which of the following will typically demonstrate normal values on liver function tests? A. fatty liver B. hepatocellular carcoinoma C. adenoma D. hepatoblastoma

C. adenoma

Polarization of the hepatic veins is a common finding in which of the following? A. mild to moderate steatosis B. severe tricuspid valve regurgitation C. advanced cirrhosis D. hemolytic adema

C. advanced cirrhosis

The image demonstrates the most common form of Pancreatic Endocrine Tumor (PEI) of the pancreas. What type of PET is displayed? a. adenoma B. psuedocyst C. fibroma D. insulinoma

D. insulinoma

Which of the following correctly describes why the arcuate arteries are not easily or accurately evaluated by PW Doppler? A. The renal capsule attenuates the Doppler signal so only limited information is reflect4ed to the probe. B. because the blood flows parallel to the Doppler sound beam C. because the blood flows perpendicular to the Doppler sound beam D. because the flow is very low resistance

C. because the blood flows perpendicular to the Doppler sound beam

Elevated GGTP and ALP indicates ___. Elevated GGTP and ALT indicates ___. A. hepatocellular disease, biliary obstruction B. cirrhosis, hepatitis C. biliary obstruction, hepatocelular disease D. hepatic carcinoma, hepatic adenoma

C. biliary obstruction, hepatocelular disease

What two acoustic artifacts are associated with biliary hamartoma formation in the liver? A. enhancement and speed propagation B. reverberation and shadowing C. comet tail and twinkle D. shadowing and speed propagation

C. comet tail and twinkle

What vessels drain the blood from the caudate lobe? A. left portal vein B. coronary vein C. emissary veins D. umbilical vein

C. emissary veins

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 for these findings? A. adenomyomatosis B. cholesterolosis C. gangrenous cholecystitis D. chronic cholecystitis

C. gangrenous cholecystitis

Which of the following will cause a moderate increase in alphafetoprotein values in an adult? A. glycogen storage disease B. adenoma C. hepatocellular carcinoma D. hepatoblastoma

C. hepatocellular carcinoma

The average measurement of the normal spleen is: A. 6-10mm B. 5-8cm C. less than 12cm D. 6-10cm

C. less than 12cm

The purple arrow on the images represents which of the following structures? A. ligamentum teres B. medial left lobe C. ligamentum venosum D. caudate lobe

C. ligamentum venosum

All of the following are contraindications for a renal transplant, except: A. significant cardiac disease B. metastatic C. marked increase in serum creatinine D. untreated kidney disease

C. marked increase in serum creatinine

Which of the following is true regarding a renal oncocytoma? A. usually occur on pediatric patients B. usually malignant and very aggressive C. may have a central scar similar to renal cell carcinoma D. easily differentiate from the renal cell carcinoma by the presence of a central scar within the tumor

C. may have a central scar similar to renal cell carcinoma

What blood vessel separates there right and left lobes of the liver? A. common hepatic artery B. left hepatic vein C. middle hepatic vein D. right portal vein

C. middle hepatic vein

Which liver vessel courses within the main lobar fissure? A. right hepatic vein B. main portal vein C. middle hepatic vein D. common hepatic artery

C. middle hepatic vein

What vessel is indicated by the red arrow? A. left renal artery B. right renal vein C. right renal artery D. left renal vein

C. right renal artery

Which of the following will reduce anisotropy artifact? A. turn off harmonic imaging B. dual screen imaging C. rocking the transducer D. reduce color doppler gain

C. rocking the transducer

Aside form the pancreas, what other organ produces amylase? A. pituitary gland B. liver C. salivary glands D. adrenal glands

C. salivary glands

While imaging the long axis of left renal vein, you identify an anterior, somewhat parallel vessel that demonstrates flow moving the same direction. What vessel is this? A. IVC B. superior mesenteric vein C. splenic vien D. splenic artery

C. splenic vien

Which muscle group is located anterolateral to the lobes of the thyroid gland? A. longus colli muscle B. tracheal muscles C. sternocleidomastoid D. strap muscles

C. sternocleidomastoid

Which of the following biliary conditions is the most common cause of acute cholecystitis? A. mass in the duodenum B. pancreatitis C. stone lodged in the cystic duct D. hepatitis

C. stone lodged in the cystic duct

Anemia is least likely to be related to abnormalities of which of the following organs? A. esophagus B. spleen C. thyroid D. aorta

C. thyroid

Which of the following renal tumors is a hypoechoic mass most commonly found in the renal pelvis? A. adenoma B. renal cell carcinoma C. transitional cell carcinoma D. oncocytoma

C. transitional cell carcinoma

Which of the following techniques will lead to degraded lateral resolution? A. increased probe frequency B. increase in number of focal zones C. trapezoidal field of view on linear array D. none of the above

C. trapezoidal field of view on linear array

When using color Doppler to compare testicular perfusion, you should always: A. document flow during the Valsalva strain B. document flow after the Valsalva release C. use the dual screen function to demonstrate an image of both testicles D. document normal flow in one testicle and then adjust color scale and wall filter settings to demonstrate the same amount of flow in the other testicle

C. use the dual screen function to demonstrate an image of both testicles

Which of the following is true regarding a live hemangioma? A. fluid and debris levels are commonly present in a hemangioma. B. Most hemangiomas demonstrate some level of posterior shadowing. C. Color Doppler is a valuable tool in evaluating this highly vascular mass. D. A hemangioma is composed of an abnormal concentration of vascular tissues within the liver.

D. A hemangioma is composed of an abnormal concentration of vascular tissues within the liver.

A 50yr old male presents with paraumbilical pain and a palpable mass. The findings on the image are most suggestive of: A. A large rectus sheath lipoma B. A large rectus sheath hematoma C. Abdominal wall hernia with no bowel protrusion D. Abdominal wall hernia with bowel protrusion

D. Abdominal wall hernia with bowel protrusion

A pituitary tumor that is causing Cushing syndrome will cause what lab value(s) to be increased? A. Cortisol only B. Aldosterone only C. Adrenocorticotropic hormone only D. Adrenocorticotropic hormone and cortisol

D. Adrenocorticotropic hormone and cortisol

Which of the following correctly describes how to differentiate cholangitis from cholangiocarcinoma? A. Cholangitis is a focal disease process while cholangiocarcinoma causes diffuse formation B. Cholangitis leads to dilated intrahepatic ducts while cholangiocarcinoma leads to dilated intrahepatic ducts D. Cholangitis is a diffuse disease process while cholangiocarcinoma causes focal mass formation

D. Cholangitis is a diffuse disease process while cholangiocarcinoma causes focal mass formation

Which waveform represents a normal portal vein waveform? A. A B. B C. C D. D

D. D

All of the following techniques will aid in the visualization of a small renal calculi with questionable shadowing, except? A. Using multiple scanning planes to evaluate the kidney B. Rescanning the patient in the decubitus position C. Reducing the dynamic range D. Decreasing transducer frequency

D. Decreasing transducer frequency

On a transverse 2D view of the right kidney hilum, a prominent tubular anechoic structure is identified that extends into the kidney. Which of the following would help the most to differentiate the cause of the finding? A. Reached the patient for a follow-up exam in a few weeks to see if the structure changes. B. Reschedule the patient for a follow-up exam in a few days to see if the structure changes. C. Have the patient drink 1-24 oz. of water and rescan in 30 minutes. D. Have the patient empty their bladder and rescan the kidney.

D. Have the patient empty their bladder and rescan the kidney.

Which of the following will cause an increase in values on liver function tests? A. Focal nodular hyperplasia B. Adenoma C. Polycystic liver disease D. Hepatitis

D. Hepatitis

Which of the following blood vessels delivers the majority of oxygenated blood that enters the liver? A. Hepatic veins B. Common hepatic artery C. Proper hepatic artery D. Main portal vein

D. Main portal vein

What congenital defect presents as a blind ended, fluid filled bowel loop connected to a normal peristalsing small bowel loop? A. epiploic appendagitis B. pyloric stenosis C. appendicitis D. Meckel diverticulum

D. Meckel diverticulum

What is a epiploic appendigitis? A. perforated appendix with pericolic fluid B. another term to describe Crohn disease C. a fatal type of diverticulitis D. inflammation of the thick fatty strands that attach to the serial surface of the colon

D. inflammation of the thick fatty strands that attach to the serial surface of the colon

Which of the following statements is true regarding the image displayed? A. The main portal vein is significantly dilated, most likely due to portal HTN B. The gallbladder is normal in appearance but the CBD is significantly dilated. C. the gallbladder contains a stone and the main portal vein is significantly dilated. D. The gallbladder demonstrates a solid mass and the CBD is significantly dilated.

D. The gallbladder demonstrates a solid mass and the CBD is significantly dilated.

Air in the gallbladder wall will be demonstrated as areas of hyperechogenicity with posterior dirty shadowing and ring down artifact on sonography. how is this demonstrated on a CT exam? A. the gallbladder will demonstrate no discernible changes of a CT scan with the presence of air in the wall B. the gallbladder will demonstrate linear spokes of shadowing from the pockets of air in the wall C. The gallbladder will demonstrate bright white areas within the wall where air is present D. The gallbladder will demonstrate black areas within the wall where air is present

D. The gallbladder will demonstrate black areas within the wall where air is present

A 1yr old presents for a testicular sonogram due to a 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. Lymphoma B. Seminoma C. Epidermoid Cyst D. Yolk Sac Tumor

D. Yolk Sac Tumor

A patient presents for a renal ultrasound after and aortic surgery left to sepsis. The findings on the image are most consistent with. A. mycetoma B. papillary necrosis C. emphysematous pyelonephritis D. acute tubular necrosis

D. acute tubular necrosis

What congenital anomaly of the pancreas results in duodenal obstruction? A. pancreatic sequestration B. pancreas divisum C. aberrant pancreatic tissue D. annual pancreas

D. annual pancreas

A urinary tract infection is most commonly caused by ___ and starts in the ___. A. bacteria from the intestinal tract, kidney B. bacteria from the vagina, kidney C. bacteria from the vagina, bladder D. bacteria from the intestinal tract, bladder

D. bacteria from the intestinal tract, bladder

Which of the following correctly describes the ducts of Luschka? A. only visible in obese patients B. associated with porcelain GB and GB carcinoma C. located within the 3rd segment of the duodenum D. bile thickening occurs within them

D. bile thickening occurs within them

What blood vessels are demonstrated on the cross section of the penis? A. dorsal arteries B. urethral arteries C. helicine arteries D. cavernosal arteries

D. cavernosal arteries

Median arcuate ligament syndrome involves compression of which vessel during respiration? A. superior mesenteric artery B. inferior mesenteric artery C. main portal vein D. celiac axis

D. celiac axis

Which system control should be turned off when trying to differentiate a small stone in the gallbladder from a sludge ball? A. time gain compensation B. focal zone C. harmonic imaging D. compound imaging

D. compound imaging

Which of the following items can be used to describe the normal flow in the portal vein? A. biphasic B. pulsatile C. hepatofugal D. continuous

D. continuous

Acute cholecystitis can lead to a prominent ___ and its branches with color Doppler evaluation of the thickened gallbladder wall. A. common hepatic artery B. proper hepatic artery C. left hepatic artery D. cystic artery

D. cystic artery

In order to asses low velocity flow, which of the following operator adjustments should be made? A. decrease wall filter setting and compression B. increase scale setting C. decrease compression D. decrease the rejection and wall filter setting

D. decrease the rejection and wall filter setting

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

D. emphysematous cholecystitis

The structure indicated by the arrow is composed of: A. microvessels carrying venous blood B. loops of spermatic cord C. folds of tunica vaginalis D. folds of tunica albuginea

D. folds of tunica albuginea

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

D. fungal

All of the following are intrasegmental vessels of the liver, except? A. portal veins B. hepatic arteries C. bile ducts D. hepatic veins

D. hepatic veins

Hypophosphatemia is a clinical sign of: A. renal failure B. hyperthyroidism C. internal hemorrhage D. hyperparathyroidism

D. hyperparathyroidism

Distal cholangiocarcinoma is most commonly found ___ and a Klatskin tumor is most commonly found ___. A. near the dome of the liver, in the CBD near the aorta hepatis. B. at the junction of the right and left hepatic ducts, outside the liver in the liver. C. in the left love, in the right lobe D. in the extra hepatic CBD near the aorta hepatic, at he junction of the right and left hepatic ducts

D. in the extra hepatic CBD near the aorta hepatic, at he junction of the right and left hepatic ducts

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

D. mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall

The Eiffel Tower sign on ultrasound refers to: A. lymphadenopathy B. portal HTN C. duplex kidney D. normal prostate

D. normal prostate

Which of the following is not part of the patient preparation for a transrectal prostate biopsy? A. have lab testing for PT/INR levels B. begin taking a several day course of antibiotics C. perform a cleansing enema D. nothing to eat or drink at least 8 hours before the procedure

D. nothing to eat or drink at least 8 hours before the procedure

An increase in which of the following hormones causes increased calcium resorption in the small intestines? A. calcitonin B. T4 C. thyroid stimulating hormone D. parathyroid stimulating hormone

D. parathyroid stimulating hormone

A patient is referred for a RUQ scan due to the possibility of a fungal infection of the liver. The have a 4yr history of treatment for aids. The liver demonstrates diffuse presentation of multiple calcifications of different sizes, with and without shadowing. These findings are most consistent with: A. hydatid sand from echinococcal infection B. liver metastasis C. steatosis D. pneumocystis carinii

D. pneumocystis carini

What lab value increases with gallbladder cancer, cholecystitis or prolonged biliary obstruction? A. CA-125 B. alpha-fetoprotein C. lactic dehydrogenase D. prothrombin time

D. prothrombin time

While discussing the medical history with a patient, he tells you that the doctor recommended that he increase his intake of vitamin K due to some recent abnormal lab results. Which of the following lab values was abnormal? A. Alpha feto-protein B. alkaline phosphatase C. red blood cell count D. prothrombin time

D. prothrombin time

If a patient complains of a recent onset of uncontrollable systemic HTN with average BP readings exceeding 170/90mmHg, what vascular cause should be suspected. A. portal HTN B. hepatic congestion C. subclavian stenosis D. renal artery stenosis

D. renal artery stenosis

Which of the following is related to renal failure and vitamin D deficiency? A. nephrocalcinosis B. pulmonary HTN C. hyperthyroidism D. secondary hyperparathyroidism

D. secondary hyperparathyroidism

A patient presents with a palpable scrotal mass. There is no evidence of fever. AFP levels are normal and bet hCG levels are elevated. These findings are most suggestive of? A. yolk sac tumor B. epidermoid cyst C. embryonal cell tumor D. seminoma

D. seminoma

A 12 yr old male patient presets for a renal ultrasound. Mild to moderate hydronephrosis is noted in the left kidney. The image displayed of the patients left side of the bladder. Which of the following is the most likely diagnosis? A. uerthrocele B. posterior urethral valves C. diverticulum D. ureterocele

D. ureterocele

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

D. wandering spleen