ABDOMEN FINAL REVIEW

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B.

A non-encapsulated collection of necrotic and edematous peripancreatic tissue is termed: A. cystadenoma B. pseudocyst C. phlegmon D. hematoma

B.

A non-encapsulated collection of necrotic and edematous peripancreatic tissue is termed: A. hematoma B. pseudocyst C. cystadenoma D. phlegmon

D.

A normal variant of the thyroid gland is the _______ lobe. A. Thymal B. Isthmus C. Semilunar D. Pyramidal

D.

Highly elevated PSA levels are found in a patient with? A. epididymitis B. orchitis C. BPH D. prostate carcinoma

D.

Main renal vein thrombosis is most likely to be visualized in which of the following patients? A. renal calculi B. angiomyolipoma C. pyelonephritis D. renal cell carcinoma

C.

The most common renal cancer in adults is: A. nephroblastoma B. lymphoma C. hypernephroma D. transitional cell carcinoma

C.

The most common site for the echinococcal virus to grow is the _____________. A. lungs B. bone C. liver D. brain

B.

The most common solid echogenic tumor in children who present with a palpable flank mass, hematuria, hypertension and fever is: A. hypernephroma B. Wilm's tumor C. angiomyolipoma D. oncocytoma

B.

The most common testicular germ cell tumor is A. teratoma B. seminoma C. yolk sac tumor D. choriocarcinoma

D.

The most common testicular neoplasm which may be associated with undescended testes: A. papillary carcinoma B. lymphoma C. adenocarcinoma D. seminoma

C.

The most common type of scrotal hernia: A. incarcerated B. abdominal C. external D. ventral

A.

The liver is anatomically divided into how many lobes? A. 3 B. 8 C. 2 D. 4

B.

The portal vein delivers approximately what percentage of blood to the liver? A. 20% B. 80% C. 10% D. 90%

C.

The most common mixed cell tumor of the scrotum: A. leydig B. sertoli C. teratocarcinoma D. choriocarcinoma

C.

What benign liver tumor has been found in association with patients suffering from Type I glycogen storage disease? A. hamartoma B. lipoma C. liver cell adenoma D. hepatocellular carcinoma

C.

What bright linear echogenic focus separate the right and left lobes of the liver? A. right portal vein B. ligamentum venosum C. main lobar fissure D. left portal vein

D.

What bright linear echogenic focus separates the right and left lobes? A. left portal vein B. right portal vein C. ligamentum venosum D. main lobar fissure

D.

What can be excluded when the patient presents with a normal thyroid-stimulating hormone (TSH) level? A. acute thyroiditis B. parathyroid adenoma C. thyroid cyst D. hypothyroidism

C.

What condition is associated with urinary stasis? A. duplication anomaly B. glomerulonephritis C. nephrolithiasis D. angiomyolipoma

B.

Which of the following is not a type of Islet Cell tumor? A. non-functioning B. pepticoma C. functioning D. insulinoma

B.

A longstanding cystic duct obstruction gives rise to: A. a gallbladder kink B. a hydropic gallbladder C. adenomyomatosis D. a septated gallbladder

B.

A male with a history of alcoholism is diagnosed with chronic pancreatitis. The appearance of the patient's pancreas would likely be: A. hypoechoic B. echogenic C. swollen D. all of the above

D.

A mass in the head of the pancreas which compresses the common bile duct producing an enlarged gallbladder is known as: A. Grey turner's sign B. Homan's sign C. Murphy's sign D. Courvoisier's sign

D.

A relatively common malignant tumor involving the kidney in children is: A. hypernephroma B. transitional cell carcinoma C. neuroblastoma D. nephroblastoma

B.

A renal mass that has continuously increased vascular flow is characteristic of: A. hematoma B. hypernephroma C. angiomyolipoma D. adenoma

D.

A renal sonogram demonstrates bilaterally enlarged and echogenic kidneys. What is the probable diagnosis? A. MDKD B. APKD C. Medullary Cystic Disease D. IPKD

B.

A renal sonogram of a diabetic patient who presents with uremia shows small kidneys with echogenic pyramids. What is the most probable diagnosis? A. APKD B. Medullary Cystic Disease C. IPKD D. MDKD

D.

A renal sonogram shows a normal right kidney and a left kidney that has been replaced with multiple, large and discrete cysts. What is the probable diagnosis? A. Medullary Cystic Disease B. IPKD C. APKD D. MDKD

C.

A small, echogenic nodular liver best describes which of the following? A. viral hepatitis B. a normal pediatric liver C. cirrhosis D. ascites

C.

A sonogram of the GB is performed; diffuse wall thickening with comet-tail artifacts is visualized. This is most characteristic of: A. chronic cholecystitis B. hydrops of the GB C. adenomyomatosis D. cholesterolosis

C.

A spermatocele lies: A. in the body of the epididymis, lateral to the testis B. in the body of the epididymis, posterior to the testis C. in the head of the epididymis, superior to the testis D. in the tail of the epididymis, inferior to the testis

A.

A staghorn calculus refers to a large stone within the: A. renal pelvis B. gallbladder C. urinary bladder D. common bile duct

A.

A tuberculosis infection in the adrenal gland can cause: A. Addison's Disease B. Conn's Disease C. Cushing's Disease D. Moon Face

B.

A tumor at the union of the right and left hepatic ducts is known as: A. Caroli tumor B. Klatskin tumor C. Murphy tumor D. Courvoisier tumor

B.

A urinary tract congenital anomaly specific to males would be: A. diverticula B. posterior urethral valves C. urachal cysts D. ureterocele

C.

A varicocele is an A. abnormal dilatation of the draining veins of the scrotum often seen in association with epididymitis B. abnormal dilatation of the draining veins of the scrotum seen only with a malignant condition C. abnormal dilatation of the draining veins of the scrotum seen in infertile and subfertile men D. abnormal dilatation of the draining veins of the scrotum that cannot be sonographically differentiated from spermatoceles and epididymal cysts

A.

A vascular tumor composed of blood vessel cells: A. hemangioma B. cavernous lymphangioma C. adenoma D. hamartoma

C.

A wedge-shaped lesion due to arterial occlusion of the kidney would most likely represent a(n): A. abscess B. renal tumor C. infarct D. junctional parenchymal defect

A.

Approximately what percentage of the liver's blood is supplied by the hepatic artery? A. 25% B. 60% C. 75% D. 50%

C.

As portal venous flow to the liver decreases, hepatic arterial flow: A. Stabilizes B. Decreases C. Increases D. Remains the same

A.

Asplenia is associated with: A. bilateral right sidedness B. bilateral left sidedness

C.

Based on the Pancreatic Pathology power point, what is being measured in the image below? A. choledochal cyst B. fibroadenoma C. adenocarcimoa D. cholangiocarcinoma

D.

Below is an ultrasound image of a 32 y/o male patient who presented with a painless, palpable scrotal mass. Which of the following choices would be the most likely diagnosis? A. abscess B. hematoma C. complex spermatocele D. testicular malignancy

B.

Budd Chiari is defined as ___________. A. occlusion of the hepatic artery B. occlusion of the hepatic veins C. occlusion of the portal veins D. occlusion of the common bile duct

A.

Budd Chiari is: A. thrombosis or occlusion of the hepatic veins & IVC B. thrombosis or occlusion of the hepatic artery & veins C. thrombosis or occlusion of the portal veins & IVC D. thrombosis or occlusion of the hepatic artery & IVC

D.

Common clinical indications for liver ultrasound include: A. Abnomal LFT's B. Hepatomegaly on physical exam C. Jaundice D. All of the above

D.

Compared to the normal testicular parenchyma, what is the predominant sonographic appearance of malignant testicular tumors? A. Anechoic B. Isogenic C. Hyperechoic D. Hypoechoic

B.

Congenital variants of the spleen include all of the following except: A. wandering spleen B. splenomegaly C. accessory spleen D. asplenia

D.

Differentiation of a varicocele can be enhanced by: A. color-flow Doppler B. upright scanning C. valsalva maneuver D. all of the above

B.

Diffuse uniform thyroid enlargement not resulting from inflammation, hyperthyroidism or malignancy is known as: A. hyperthyroidism B. simple goiter C. toxic goiter D. thyroiditis

B.

Dilation of the renal pelvis with thinning of the renal cortex is characteristic of: A. column of Bertin B. hydronephrosis C. extrarenal pelvis D. duplex collecting system

C.

Enlargement of the pancreatic head will most likely lead to which of the following? A. cystic fibrosis B. hypertension C. biliary obstruction D. ascites

D.

Extension of renal cell carcinoma into the IVC occurs through the: A. portal vein B. lymph nodes C. renal artery D. renal vein

C.

Fatty infiltration is often patchy or focal. A less affected region of the liver is called: A. revascularized B. infiltrated C. spared D. hyperfused

B.

Fatty infiltration may be seen in which of the following patients? A. chronic pancreatitis B. hepatitis C. acute pancreatitis D. hepatoportal fistula

C.

Flash artifact is associated with: A. Wraparound B. Diaphragm interface C. Color related to tissue motion D. Decreased respiration

C.

Hepatoma is also called: A. hemagioendothelioma B. hemangiosarcoma C. hepatocellular carcinoma D. hepatocellular disease

A.

If a 53-year-old woman presents with the most common solid thyroid mass sonographically identified as well circumscribed, an oval contour, and a halo effect, what is the most likely diagnosis? A. adenoma B. goiter C. carcinoma D. hemorrhage

C.

If a mass is found in the head of the pancreas, what other areas should be imaged? A. duct of Santorini B. spleen C. intrehepatic and extrehepatic biliary ducts D. duodenum

A.

If a pelvic kidney is suspected, the sonographer should first: A. look in the renal fossae for presence of kidneys B. refer the patient for a nuclear scan to determine renal function C. perform a spectral analysis D. find the physician

A.

If an enlarged prostate is found, the sonographer should also scan the __________. A. kidneys for hydronephrosis B. spleen for enlargement C. liver for metastasis D. scrotum for hydroceles

B.

In chronic viral hepatitis, hepatomegaly and inhomogenous, patchy or diffuse increases in echogenicity are common and related to the: A. Amount of vascular compression B. Amount of fatty infiltration and fibrosis present C. Amount of fibrosis present D. Amount of portal hypertension

C.

In patients with uncomplicated acute epididymitis A. a loculated fluid collection often containing low level echoes which appears cephalad to the testis B. there is enlargement of the testis with focal or generalized thickening of the epididymis C. the epididymis is uniformly enlarged and more hypoechoic than usual

D.

In some patients with fatty infiltrative or cirrhotic disease, the _________ lobe of the liver is often a site for focal fatty sparing. A. right B. falciform C. Reidel's D. medial segment of the left

A.

In some patients with fatty infiltrative or cirrhotic disease, the _________ lobe of the liver is often a site for focal fatty sparing. A. medial segment of the left B. falciform C. Reidel's D. right

D.

In the acute phase of testicular torsion, the testicles appear: A. small and echogenic B. normal size with large epididymis C. hypoechoic with increased blood flow D. enlarged with decreased echogenicity

D.

In the adult, splenomegaly is diagnosed when the length of the spleen exceeds: A. 11 cm B. 14 cm C. 12 cm D. 13 cm

A.

In the image below, what is the most likely diagnosis? A. echinococcal cyst B. ascariasis C. candidiasis D. schistosomiasis

D.

In the normal adult, whose age is less than 60 and whose gall bladder is in place, the intraluminal diameter of the common hepatic duct should not exceed the measurement of: A. 2 mm B. 8 mm C. 4 mm D. 6 mm

A.

In the normal adult, whose age is less than 60 and whose gallbladder is in place, the intraluminal diameter of the common hepatic duct should not exceed the measurement of: A. 6 mm B. 2 mm C. 4 mm D. 8 mm

B.

In the presence of a horseshoe kidney, what anomaly may be simulated? A. duplicated central renal sinus B. lymphadenopathy C. enlargement of the sinus area D. hydronephrosis

C.

In this young male patient with a history of sepsis, which of the following is an accurate diagnosis based on the image below? A. Budd Chiari B. portal vein thrombosis C. cavernous transformation of the portal vein D. esophageal varices

B.

In what part of the pancreas do most pancreatic carcinomas occur? A. tail B. head C. body D. neck

A.

In which vessels does the right branch bifurcate into an anterior branch and a posterior branch? A. Portal vein B. Aorta C. Inferior vena cava D. Hepatic vein

A.

Increased vascularity w/color Doppler termed "thyroid inferno" is often seen with A. Graves' disease B. Hashimoto's disease C. papillary carcinoma D. de Quervain's thyroiditis

A.

Inflammation of the gallbladder is known as: A. cholecystitis B. cholesterosis C. choledocholithiasis D. adenomyomatosis

D.

Inflammation of the prostate is called: A. BPH B. Carcinoma C. Orchitis D. Prostatitis

C.

Insulinomas of the pancreas are most likely to be located A. in the head, never in the body and tail B. frequently in the head, rarely in the body and tail C. frequently in the tail and body

D.

Intrahepatic ductal dilatation with normal extrahepatic ducts is characteristic of which of the following? A. Caroli's disease B. cholangitis C. cholangiocarcinoma D. Klatskin's tumor

D.

Liver enzymes detected during liver function tests would include all of the following, except: A. ALT B. alk phos C. AST D. amylase

C.

Liver mets often presents as: A. singular solid lesions B. singular cystic lesions C. multiple solid lesions D. multiple cystic lesions

C.

Multinodular goiter is best described below as A. mild enlargement with fever and pain B. chronic inflammatory process C. very highly vascular with thyroid inferno D. uniform homogeneous enlargement of the thyroid gland

A.

This image is a coronal scan through the patient's right flank. Of the two longitudinal vessels seen on this image, name the vessel shown closest to the transducer? A. IVC B. Aorta C. Renal Arteries D. Renal Veins

D.

Portal hypertension is often accompanied by all of the following except: A. splenomegaly B. esophageal varices C. recanalization of the ligamentum teres D. recanalization of the ligamentum arteriosum

B.

Portal hypertension is suggested when the main portal vein measures greater than A. 13 cm B. 13 mm C. 10 cm D. 10 mm

D.

Splenic rupture is most likely to be seen in patients with: A. lymphoma B. metastases C. storage diseases D. large hemangioma

A.

Splenomegaly is diagnosed when the spleen measures greater than: A. 13 cm B. 13 mm C. 10 cm D. 10 mm

C.

Swelling and tenderness of the thyroid gland is indicative of: A. multinodular goiter B. thyroid carcinoma C. de Quervian's thyroiditis D. follicular adenoma

B.

The "target" or "bulls-eye" lesion is most characteristic of which of the following? A. abscess B. metastasis C. hemangioma D. adenoma

D.

The LHV (left hepatic vein) is located within which fissure? A. right intersegmental fissure B. main lobar fissure C. left intrasegmental fissure D. left intersegmental fissure

B.

The WES triad relates to examination with chronic contracted or nonvisualized gallbladders. The acronym WES stands for: A. "wide-echo-stone" B. "wall-echo-shadow" C. "wall-echo-sludge" D. "wall-echo-stone"

B.

The ____________ layer is a constant anatomic feature of the GI tract and serves as a useful landmark to identify a loop of bowel. A. muscularis propria B. submucosal layer C. muscularis mucosa D. adventitial surface

C.

The _______________ is considered incomplete and runs from the right portal vein to the GB fossa. A. left intersegmental fissure B. right intersegmental fissure C. main lobar fissure D. fissure of ligamentum teres

B.

The accumulation of serous fluid within the peritoneal cavity in known as: A. pleural effusion B. ascites C. rectus sheath hematoma D. urachal cyst

A.

The appearance of a hemangioma on sonography would most likely be: Selected Answer: A. hyperechoic B. hypoechoic C. anechoic D. isoechoic

D.

The appearance of gallbladder carcinoma includes A. stones may be present B. focal or diffuse gallbladder wall thickening C. irregular echogenic mass within the gallbladder D. all of the above

C.

The appearance of protruding, staring eyes with decreased movement is known as A. hyperthalmos B. amaurosis fugax C. exophthalmos D. cutaneous manifestation

A.

The approximate length of the normal liver is: A. 15.5 cm B. 19.0 cm C. 17.5 cm D. 13.5 cm

C.

The area anterior to the right kidney and posterior to the right lobe of the liver is called: A. pouch of Douglas B. lesser sac C. Morrison's pouch D. Hartman's pouch

A.

The arrow in the picture below in pointing to what echogenic linear structure? A. ligamentum venosum B. main lobar fissure C. ligamentum teres D. falciform ligament

D.

The arrows in the image below are pointing to a specific type of artifact seen in which of the following gallbladder conditions? A. posterior enhancement associated with polyps B. through transmission associated with edema C. comet-tail artifact associated with cholesterolosis D. comet-tail artifact associated with adenomyomatosis

C.

The bare area of the spleen is located ________________. A. posterosuperior B. against the diaphragm C. at the hilum

B.

The best acoustic window for the right hemidiaphragm is the ___________. A. right kidney B. liver C. right lung D. spleen

D.

The best approach(es) to scanning the spleen is _________________. A. intercostal B. subcostal C. RLD D. All of the above

B.

The best sonographic characteristic for a thyroid CA is: A. hypovascularity B. solid, complex mass with heterogeneous echo pattern and irregular margins C. more hyperechoic than normal thyroid tissue D. normal size lymph nodes

D.

The best sonographic window to image the left hemidiaphragm is the: A. stomach B. kidney C. liver D. spleen

C.

The caudate lobe occupies the _____________________ surface of the liver. A. anterior-inferior B. anterior-superior C. posterior-superior D. posterior-inferior

B.

The common hepatic artery arises from the celiac trunk and further branches into the proper hepatic artery and which vessel? A. right gastric a. B. gastroduodenal a. C. left gastric a. D. right hepatic a

B.

The embryologic remnant of the obliterated umbilical vein is _____________. A. falciform ligament B. ligamentum teres C. ductus venosus D. main lobar fissue

A.

The enzyme that is the most sensitive over time in laboratory tests for the diagnosis of acute pancreatitis is: A. lipase B. amylase C. alkaline phosphatase D. aspartate amniotransferase (AST)

C.

The falciform ligament contains the _________________. Selected Answer: A. ligamentum venosum B. ligamentum falciformis C. ligamentum teres D. coronary ligament

A.

The fissure of the ligamentum venosum divides the liver into: A. left lobe and caudate lobe B. right anterior and posterior segments C. right and left lobes D. left medial and lateral segments

C.

The following image most likely demonstrates: A. HCC B. Hepatoblastoma C. Lipoma D. Metastatic lesion

A.

The following image shows the liver of a patient with primary GI cancer. What is the most likely diagnosis? A. metastatic lesions B. lipomas C. hepatoblastoma D. HCC

B.

The following is an image of the spleen. What abnormality is the arrow pointing towards? A. sickle cell B. infarct C. hematoma D. lymphoma

D.

The halo sign as it pertains to thyroid masses is defined as a rim of sonolucency surrounding an intrathyroidal mass. It is most commonly encountered in a(n): A. case of Grave's disease B. cyst C. case of thyroiditis D. adenoma

C.

The image below shows an ultrasound of the left kidney of a 62-year-old male with hx of diabetes who presented with pain, FUO, and hematuria. The right kidney appears normal. What is the probable diagnosis? A. Wilm's Tumor B. hematoma C. RCC D. mylolipoma

C.

The inferior vena cava may be compressed and displaced posteriorly by: A. right renal vein thrombosis B. a mass in the lower pole of the right kidney C. a mass in the caudate lobe of the liver D. right renal artery aneurysm

D.

This image is a coronal scan through the patient's right flank. What is the name of the vessel that is seen running longitudinal and deep on this image? A. Renal Veins B. Renal Arteries C. IVC D. Aorta

A.

This image is a coronal scan through the patient's right flank. What vessels are extending from both sides of the deep longitudinal vessel in this picture? A. Renal Arteries B. Aorta C. Renal Veins D. IVC

A.

The laboratory findings of renal failure include: A. increased creatinine and blood urea nitrogen B. increased serum amylase and creatinine C. increased serum amylase and lipase D. increased creatinine and alkaline phosphatase

B.

The landmarks the sonographer should use to image the appendix include all of the following except: A. Right colon B. Left colon C. Cecum D. Psoas muscle

D.

The left lobe is divided into medial and lateral segments by the ___________. A. left portal vein B. main lobar fissure C. ligamentum venosum D. left hepatic vein E. middle hepatic vein

B.

The liver is considered _______________. A. retroperitoneal B. intraperitoneal

A.

The liver is covered by a connective tissue layer called ________________. A. Glisson's capsule B. Gerota's fascia C. Douglas fascia D. Murphy's capsule

D.

The liver receives blood via which of the following vessels? A. portal veins B. hepatic arteries C. hepatic veins D. A and B

B.

The lobes of the liver are clearly defined by segmental anatomy which is differentiated by the portal and hepatic veins. The portal veins are ______. A. intersegmental B. intrasegmental C. interportal D. intraportal

D.

The long axis measurement of the spleen on an average sized adult should not measure more than ______. A. 15 cm B. 20 cm C. 9 cm D. 13 cm

A.

The main portal vein bifurcates at the porta hepatis into A. right and left portal veins B. anterior and posterior portal veins C. hepatic veins D. medial and lateral portal veins

B.

The major function of the spleen is: A. hematopoiesis B. to filter the peripheral blood C. to manufacture leukocytes D. to fight infection

D.

The majority of primary retroperitoneal tumors (which are not associated with an organ) are malignant. Which is an example of a retroperitoneal tumor? A. hepatoma B. hematoma C. adenocarcinoma D. leiomyosarcoma

D.

The most common benign tumor of the liver is: A. adenoma B. mesenchymal hamartoma C. infantile hemangioendothelioma D. cavernous hemangioma

C.

The most common benign tumor of the spleen is: A. fibroma B. chondroma C. cavernous hemangioma D. lymphoma

D.

The most common cause for abdominal aortic aneurysm is: A. Atheroma B. Cystic medical necrosis C. Syphilis D. Arteriosclerosis

B.

The most common cause of acute pancreatitis in young children is: A. drinking B. trauma C. surgery D. calcifications

D.

The most common cause of obstructive jaundice is: A. cholecystitis B. occlusion of the IVC C. acalculous cholecystitis D. choledocholithiaisis

B.

The most common cause of thyroid disorders worldwide is: A. hyperthyroidism B. iodine deficiency C. Goiter D. calcium deficiency

C.

What developmental cyst occurs because of a congenital modification in the cervical lymphatic system? A. branchial cleft cyst B. cleft fistula C. cystic hygroma D. thyroglossal duct cysts

C.

What do the thyroid gland hormones regulate? A. regulates insulin production B. serve as beta and calcium channel blockers C. metabolism and growth D. synthesize and develop protein

C.

The most common collaterals in portal hypertension are: A. splenorenal and omental veins B. splenoperitoneal and retroperitoneal veins C. left gastric and paraumbilical (umbilical) veins D. retroperitoneal and short gastric veins

B.

The most common feature of a thyroid adenoma is: A. hemorrhage B. peripheral halo C. inhomogeneity D. diffuse echogenicity

D.

The most common focal neoplasm found in the spleen is a: A. hemangiosarcoma B. hamartoma C. cavernous lymphangioma D. cavernous hemangioma

D.

The most common intrascrotal inflammation is: A. spermatocele B. orchitis C. varicocele D. epididymitis

A.

The most common islet cell tumor is: A. insulinoma B. adenocarcinoma C. gastrinoma D. pseudocyst

A.

The most common malignant tumor of the thyroid is A. papillary carcinoma B. follicular carcinoma C. lymphoma D. medullary carcinoma

B.

The most common pancreatic malignancy is: A. insulinoma B. adenocarcinoma C. adenoma D. melanoma

C.

The normal average measurement of the portal vein is approximately: A. 1.7 cm B. 2.2 cm C. 1.2 cm D. 0.1 cm

C.

The normal gallbladder wall should measure no more than: A. 4 mm B. 3 cm C. 3 mm D. 2 cm

B.

The porta hepatis (portal triad) contains the portal vein, hepatic artery, and what other structure? A. Gastrohepatic ligament B. Common hepatic duct C. Liver lobule D. Hepatic vein

A.

The portal veins are: A. intrasegmental B. intersegmental C. interportal D. intraportal

D.

The primary hormones produced in the pancreas are: A. collagen and fibrin B. pancreatin and secretin C. lipase and cholase D. glucagon and insulin

B.

The primary neoplasm which most frequently metastasizes to the spleen is: A. gallbladder CA B. melanoma C. pancreatic CA D. breast CA

B.

The right lobe of the liver is divided into _______________________. A. medial and lateral segments B. anterior and posterior segments C. caudate and quadrate lobes D. a and b

B.

The right lobe of the liver is divided into: A. medial and lateral segments B. anterior and posterior segments C. caudate and quadrate lobes D. a and b

A.

The seminal vesicles are: A. superior to prostate B. superior to bladder C. superior to vas deferens

E.

The shape of the spleen is _________________. A. concave superior B. convex superior C. concave inferior D. convex inferior E. b and c F. a and d

D.

The sonographic appearance of a normal spleen in relationship to the liver is: A. hyperechoic and homogeneous B. hypoechoic and heterogeneous C. anechoic D. isoechoic and homogeneous

C.

The sonographic appearance of chronic pyelonephritis is: A. echogenic foci in the medullary regions B. decreased echogenicity and medullary thinning C. areas of cortical thinning and increased echogenicity D. hypoechoic enlarged kidney

B.

The sonographic findings that are associated with varicoceles include: A. a solid mass outside of the testes B. dilated veins caused by obstruction of the venous return C. a cyst along the course of the vas deference D. blood filled sac that surrounds the testicle, secondary to trauma or surgery

D.

What echogenic intraluminal projection does not change location with a change in the patient's position and does not cast an acoustic shadow? A. Diverticulitis B. Gallbladder calculi C. Fundal folding D. Polyp

A.

What entity is associated with sinus lipomatosis? A. enlargement of the sinus area B. duplicated central renal sinus C. hydronephrosis D. lymphadenopathy

B.

What is a diagnostic explanation for a 40-year-old woman with right upper quadrant pain, mild jaundice, and elevated alkaline phosphatase? A. sludge B. cholelithiasis C. polyps D. phrygian cap

A.

What is a wandering spleen at an increased risk for? A. torsion and infarction B. splenomegaly C. splenic rupture D. leukemia and lymphoma

C.

What is associated with portal hypertension? A. decreased echogenicity of portal vein walls B. blood clots in portal vein C. splenomegaly D. blood clots in hepatic vein

C.

What is being measured in the image? A. cholangiocarcinoma B. fibroadenoma C. adenocarcinoma D. choledochal cyst

B.

What is demonstrated by the arrows in this image? A. gallbladder carcinoma B. pericholecystic fluid C. WES sign D. gallstones

A.

What is demonstrated in this image? A. WES sign B. Porcelain gallbladder C. gallbladder carcinoma D. gallbladder sludge

A.

What is failure of the testes to descend called? A. cryptorchidism B. orchiopexy C. agenesis D. Klinfelter's syndrome

B.

What is leukocytosis typically the response to? A. lupus B. bacterial infection C. hemorrhage D. chemotherapy

B.

What is leukopenia? A. increased WBC B. frequently the side effect of chemotherapy C. the result of severe inflammation D. a normal finding

A.

What is ruled out when the sonographer demonstrates the spleen? A. Asplenia B. Neoplasm C. Accessory spleen D. Splenomegaly

D.

Which of the following increases a patient's risk of developing gallbladder malignancy? A. gallstones B. chronic cholecystitis C. porcelain gallbladder D. all of these

A.

Which of the following is a benign lesion of the thyroid? A. adenoma B. papilloma C. medulloma D. adenocarcinoma

D.

Which of the following is a congenital anomaly affecting the pancreas? A. adenocarcinoma B. insulinoma C. pseudocyst D. cystic fibrosis

A.

Which of the following is a hyper-functioning adrenal syndrome? A. Cushing's Syndrome B. Addison's Syndrome C. Grave's Syndrome D. Down's Syndrome

B.

Which of the following is a malignant neoplasm of the liver due to carcinogen exposure A. hepatoma B. hemangiosarcoma C. hemangioendothelioma D. hepatoblastoma

C.

Which of the following is a perinephric fluid collection? A. hemangioma B. ureterocele C. urinoma

C.

Which of the following is a peritoneal structure? A. Kidney B. Aorta C. Liver D. Uterus

B.

Which of the following is a sonographic pattern of testicular neoplasms? A. hypoechoic area of decreased or no vascularity B. diffuse and ill-defined region of decreased echogenicity C. anechoic lesion with increased through transmission

D.

Which of the following is an autosomal dominant disease is characterized by the presence of multiple small cysts in the kidney, liver, and pancreas? A. cystic fibrosis B. type II diabetes C. Von Hippel-Lindau D. polycystic disease

B.

Which of the following is an example of hepatocellular disease? A. hepatomegaly B. hepatitis C. portal hypertension D. splenomegaly

C.

Which of the following is an intrinsic cause of unilateral hydronephrosis? A. neurogenic bladder B. pelvic mass C. ureter calculi D. enlarged prostate

D.

Which of the following is characteristic of an extrahepatic mass? A. anterior displacement of right kidney B. external bulging of liver capsule C. displacement of hepatic radicles D. anteromedial displacement of IVC

B.

Which of the following is considered a functional liver cell? A. phagocyte B. hepatocyte C. kupffer cell D. sinusoid

A.

Which of the following is not a classic characteristic of a simple cyst: A. posterior shadowing B. thin walls with posterior acoustic enhancement C. round or oval D. hypoechoic

D.

Which of the following is not a symptom of gallbladder disease? A. nausea and vomitng B. epigastric or RUQ pain C. pain that radiates to the right shoulder D. hematuria

A.

Which of the following is not part of the hepatic portal venous system? A. superior mesenteric artery B. splenic vein C. superior mesenteric vein D. right portal vein

B.

Which of the following is the best indicating marker for diagnosing prostate cancer? A. digital rectal examination B. prostate-specific antigen C. endorectal sonography D. frequent urination

A.

Which of the following is the most common cause of orchitis? A. chlamydia B. gonorrhea C. syphilis D. UTI

A.

Which of the following is the most common site for a pancreatic pseudocyst to occur? A. lesser sac B. head of pancreas C. posterior to pancreas D. tail of pancreas

D.

Which of the following is the most common site for a pancreatic pseudocyst to occur? A. tail of pancreas B. posterior to pancreas C. head of pancreas D. lesser sac

D.

Which of the following is the most probable diagnosis of the image below in a patient who presented with postprandial nausea, shoulder and chest pain? A. gangrenous GB B. excessive bowel gas C. porcelain GB D. WES

B.

Which of the following is the remnant of the ductus venosus? A. ligamentum teres B. ligamentum venosum C. falciform ligament D. none of these

B.

Which of the following is the routine way to image the thyroid gland? A. coronal scan with the patient in the decubitus position B. hyperextend the patient's neck C. observation of the esophagus and swallowing D. all of the above

A.

Which of the following is true if a patient has acute pancreatitis? A. amylase and lipase both rise, but lipase stays elevated for a longer period of time B. amylase and BUN will both rise, but amylase remains higher for a longer period of time C. amylase and alkaline phosphatase will both rise, but amylase remains higher for a longer period of time D. amylase and lipase both rise, but amylase stays elevated for a longer period of time

A.

Serous fluid is: A. anechoic B. inhomogenous C. complex D. echogenic

C.

Signs of renal disease may include: A. Murphy's sign B. McBurney sign C. oliguria or polyuria

D.

Sonographic finding that may accompany a hematocele: A. a condition in which the testicle have not descended B. dilated veins caused by obstruction of the venous return C. a cyst along the course of the vas deferens D. blood filling the sac that surrounds the testicle, secondary to trauma or surgery

D.

Sonographically, one may recognize fatty infiltrates of the liver by: A. uniform echogenicity and attenuation B. increased visualization of vascular structures C. hepatomegaly D. diffuse increase in liver parenchymal echoes

B.

*IMAGE REQUIRED Which of the following terms describes the type of blood flow in the Doppler image below? A. venous blood flow B. low resistance blood flow C. high resistance blood flow

D.

What vessels course along the base of the pyramids? A. Interlobar B. Main Renal C. Segmental D. Arcuate

D.

A 14-year-old male patient presents with sudden onset of left-sided scrotal pain, nausea and vomiting. Which of the following would be the most likely diagnosis following the ultrasound exam image below: A. orchitis B. inguinal hernia C. testicular cancer D. testicular torsion

A.

A 2 month old infant presents with persistent jaundice and a palpable RUQ mass. The sonogram demonstrates a normal gallbladder and a cystic mass in the porta hepatis that appears to be separate from the gallbladder. The CBD appears to be entering the cystic mass. What is the most likely diagnosis? A. choledochal cyst B. biliary atresia C. multiseptate gallbladder D. interposition of the gallbladder

D.

A 2-week-old infant presents with a sudden onset of jaundice. The sonogram demonstrates intrahepatic ductal dilatation but does not demonstrate a gallbladder or CBD. Which congenital biliary anomaly is the most likely cause? A. interposition of the gallbladder B. choledochal cyst C. multiseptated gallbladder D. biliary atresia

C.

What kidney pole is affected by this finding? A. upper pole B. mid pole C. lower pole

A.

A 33-year-old male presents with decreased hematocrit, right sided pain and hypotension. What is the most likely cause? A. hematoma B. hemangioma C. hepatoma D. hepatocellular carcinoma

B.

A 30 year old patient presents with abdominal pain and abnormal LFTs. The abdominal US reveals a dilated portal and superior mesenteric vein with hepatofugal blood flow. This is most characteristic of _____________. A. portal fistula B. portal hypertension C. portal aneurysm D. portal atresia

A.

A 78-year-old male was brought to the hospital with end stage renal failure. His BUN & creatinine were abnormal. The sonographer would most likely expect to find: A. small echogenic kidneys B. normal kidneys C. hydronephrotic kidney D. enlarged hypoechoic kidneys

A.

A 30-year-old male presents with unilateral, painless, testicular enlargement. This is most characteristic of which of the following? A. hydrocele B. torsion C. testicular cancer D. abscess

C.

A 31 y/o female presents to the ED with flank pain secondary to kidney stones. While scanning the patient's RUQ, the sonographer noted the below finding. What is the most likely diagnosis? A. hematoma B. solitary metastatic lesion C. hemangioma D. hamartoma

A.

A 31 year old male patient presents with pain, fever, dysuria and a history of UTI. What is the most likely diagnosis based on the following image? A. epididymitis B. varicocele C. orchitis D. spermatocele

D.

A 38-year-old man with a history of diabetes and obesity presents for an abdominal sonogram due to elevated LFT's. While performing the exam, you are having difficulty penetrating through the liver. What is the most likely diagnosis based on the history and image below? A. cirrhosis B. hepatoma C. hemangioma D. fatty liver infiltration

A.

A 40-year-old female with known tuberous sclerosis presents to the ER with hematuria. An Ultrasound is ordered. It shows a highly echogenic, sound attenuating mass on the right kidney. This is most suggestive of: A. angiomyolipoma B. pheochromocytoma C. renal metastasis D. hypernephroma

A.

A 42-year-old white female presented with complaints of nausea, increasing abdominal pain, and dark urine. She has a history of infiltrating ductal adenocarcinoma of the left breast and metastatic deposits in the brain, lung and bone. Her liver functions tests are elevated. The liver ultrasound shows a 19 cm. liver which is consistent with _____________. In addition, multiple small echogenic lesions were seen within the liver. These findings are highly suspicious of ___________________________________. A. hepatomegaly, hepatic metastatic disease B. hepatomegaly, hemangiomas C. hepaoma, fatty liver disease D. hepatic atrophy, hepatic metastatic disease

B.

A 42-year-old woman presents for an abdominal sonogram with a history of gallbladder disease. While evaluating the right lobe of the liver, you locate the finding seen in this image. What is the most likely diagnosis? A. cirrhosis B. hemangioma C. hepatoma D. fatty liver infiltration

D.

A 45-year-old man with a history of acute hepatitis, jaundice, and right upper quadrant pain. An examination of the upper abdomen is ordered to evaluate the liver and biliary system. This image was taken of the RUQ. No gallstones were seen. What is the most likely diagnosis? A. gallbladder carcinoma B. choledochal cyst C. calculus cholecystitis D. acalculus cholecystitis

D.

A 50-year-old diabetic patient presents with abdominal pain and slightly elevated LFTs. The liver measures 18.5 cm. with diffuse increase in the liver parencymal echogenicity. This is characteristic of: A. hepatocellular CA B. cirrhosis C. normal findings for the age of this patient D. fatty infiltration

C.

A 50-year-old man has a long history of alcoholism presents with increased abdominal girth. An ultrasound exam is performed; the most probable finding is: A. hepatoma B. liver metastasis C. massive ascites and cirrhosis D. hemangioma

A.

A 50-year-old man with a history of ETOH abuse presents with increased abdominal girth and abnormal LFTs. An ultrasound exam is ordered; the most probable finding is _________________. A. ascites and cirrhosis B. hepatoma C. liver metastasis D. hemangioma

D.

A 52-year-old patient presents with hydronephrosis and asymmetric prostate enlargement. What is the most likely sonographic finding? A. orchitis B. BPH C. prostatitis D. prostate carcinoma

C.

A 56-year-old woman's clinical signs include chills, fever, back pain, malaise, dysuria, and frequent, urgent urination. Her laboratory values include leukocytosis, hematuria, pyuria, and bacteriuria. Sonographically, a small kidney is seen with parenchymal loss and multifocal echoes in the cortical and medullary regions probably from focal fibrosis. Which of the following is the most likely diagnosis? A. acute diffuse bacterial nephritis B. acute bacterial nephritis C. chronic atrophic pyelonephritis D. pyonephrosis

A.

Clinical findings of acute scrotal pain, nausea and vomiting are suggestive of A. torsion B. a neoplasm C. orchitis D. epididymitis

D.

A 60 yr. old patient presents with loss of appetite and intolerance to fatty foods. The sonographic findings include a heterogeneous liver, gallstones with a mass protruding into the lumen of the gallbladder. This is most characteristic of: A. chronic cholecystitis B. porcelain gallbladder C. cholesterolosis D. GB carcinoma

D.

A 60-year-old female presents with hepatomegaly, abdominal pain, weight loss and abnormal LFTs. On ultrasound the portal vein is thrombosed, there is ascites and several masses with hypoechoic halos around them. Your diagnosis for this patient is ________. A. cirrhosis B. hemangioma C. focal nodular hyperplasia D. hepatocellular carcinoma

D.

A 60-year-old female presents with hepatomegaly, abdominal pain, weight loss and abnormal LFTs. On ultrasound the portal vein is thrombosed. There is ascites and several masses with hypoechoic halos around them. Your diagnosis for this patient is: A. hemangioma B. cirrhosis C. fatty infiltration D. hepatoma

A.

A 60-year-old patient presents with painless jaundice and weight loss. The pancreatic head measures 4.0 cm with an enlarged pancreatic duct. This is most likely A. adenocarcinoma B. insulinoma C. Courvoisier's sign D. pancreatitis

D.

A 76-year-old patient presents for an abdominal sonogram with chronic abdominal pain. An irregular mass is seen projecting into the gallbladder lumen. Color Doppler detects flow within the mass. Gallstones are also seen. What is the most likely diagnosis? A. adenomyomatosis B. Courvoisier gallbladder C. gallbladder sludge and stones D. gallbladder carcinoma

A.

A benign fatty tumor of the kidney is: A. angiomyolipoma B. hypernephroma C. lymphoma D. neuroblastoma

B.

A cause of non-obstructive hydronephrosis is: A. calculi B. overhydration C. neoplasm D. ureteropelvic stricture

D.

A comet tail reverberation artifact is seen originating from the anterior gallbladder wall. What gallbladder pathology is most likely causing this artifact? A. sludge B. gallstone C. gallbladder carcinoma D. adenomyomatosis

C.

A common echogenic benign solid mass of the kidney is: A. hemangioma B. neuroblastoma C. angiomyolipoma D. lymphoma

B.

A complete abdominal sonogram shows multiple cysts in both kidneys as well as the liver and spleen. What is the most probable diagnosis? A. MDKD B. APKD C. Medullary Cystic Disease D. IPKD

D.

A complex adrenal mass is identified in a neonate who experienced trauma at birth. This most likely represents: A. adrenal cyst B. neuroblastoma C. Cushing's disease D. adrenal hemorrhage

D.

A condition that causes increased secretion of abnormal mucus by the exocrine glands is: A. cystic mucosal disease B. lipimucosa C. diabetes D. cystic fibrosis

D.

A cyst within a cyst (daughter cyst) is a classic example of which of the following liver masses? A. polycystic liver disease B. hemangioma C. hepatoma D. echinococcal (hydatid) cyst

B.

A finding of elevated alpha fetoprotein in a non-gravid patient may be indicative of: A. normal finding in an adult B. hepatoma C. biliary obstruction D. normal pregnancy

D.

A fluid collection that tends to occur 2 to 6 weeks post-transplantation and is associated with a decrease in renal function rather than an acute decrease in urine output: A. seroma B. abscess C. urinoma D. lymphocele

A.

A fluid filled mass anterior to the pancreas may be all of the following except: A. aortic aneurysm B. stomach C. loculated cyst D. pseudocyst

D.

A four year old patient presents with weight loss, hepatomegaly and increased AFP. What is the most likely diagnosis? A. HCC B. lipoma C. metastatic lesion D. hepatoblastoma

A.

A frequent cause of acute scrotal pain in adult males would be A. epididymitis B. teratoma C. testicular ischemia D. testicular CA

E.

A hepatoma may be associated with _______. A. end-stage cirrhosis B. hepatitis B C. metabolic disorders D. invasion of the portal venous system E. all of the above

B.

A hernia in the scrotum that does not show peristalsis or blood flow: A. external B. incarcerated C. internal D. ventral

A.

A highly malignant adrenal gland mass found in children is: A. neuroblastoma B. adenoma C. nephroblastoma D. pheochromocytoma

A.

A hydrocele develops between: A. the parietal and visceral layers of the tunica vaginalis B. the tunica albuginea and the tunica vaginalis C. the scrotum and tunica albuginea D. the visceral and pariental layers of the tunica albuginea

D.

A hyperechoic focal lesion is seen in the spleen along the border. It is wedge shaped. It is most likely a/an _____________. A. hematoma B. hamartoma C. hemangioma D. infarct

B.

A large stone in the center of the renal pelvis is known as: A. bullhorn calculi B. staghorn calculi C. llama calculi D. buckshot calculi

D.

A patent umbilical vein would be seen within the _______________ on ultrasound. This is a sonographic sign of PHTN. A. falciform ligament B. intersegmental ligament C. main lobar fissure D. ligamentum venosum

D.

A patient has a history of chronic alcohol abuse and liver cirrhosis. The ultrasound exam reveals a heterogeneous pancreas. There are calcifications present within the pancreas. The pancreatic duct is dilated. What condition is most likely given this history and ultrasound findings? A. adenocarcinoma of the pancreas B. islet cell tumor of the pancreas C. acute pancreatitits D. chronic pancreatitits

A.

A patient in late stages of sickle cell anemia will have a spleen that is: A. small and echogenic B. small and hypoechoic C. enlarged and echogenic D. enlarged and lobulated

D.

A patient is suspected to have a porcelain gallbladder if: A. GB appears as WES B. necrosis is present C. there is an decreased risk for GB carcinoma D. GB wall appears as an echogenic arc with dense shadowing

D.

A patient presents to the ER the morning after a night of binge drinking. An ultrasound is ordered. The patient appears to be in shock and there is a slight discoloration of the patient's flank areas. The most likely finding you would expect to see is: A. acute pancreatitis B. normal abdominal sonogram C. phlegmonous pancreatitis D. hemorrhagic pancreatitis

C.

A patient presents to the ER with scrotal pain, palpable mass and leukocytosis. An ultrasound exam was performed (below). Based on these findings, the most likely diagnosis would be which of the follow: A. seminoma B. inquinal hernia within the scrotum C. orchitis with abscess formation D. epididymitis

C.

A patient presents with LUQ pain. An abdominal US reveals a complex mass in an enlarged spleen with free fluid in the abdominal/pelvic cavity. This most likely represents: A. lymphangioma B. asplenia C. hematoma D. hamartoma

C.

A patient presents with a dilated gall bladder and a dilated common bile duct. The level of the obstruction should be at the: A. common hepatic duct B. cystic duct C. distal common bile duct D. right or left hepatic duct

A.

A patient presents with ampulla of Vater obstruction, distension of the GB, and painless jaundice. This is associated with: A. Courvoisier's sign B. Hartmann's pouch C. hydrops of the gall bladder D. choledochal cyst

B.

A patient presents with an elevated insulin level and clinical signs of hypoglycemia. This is most characteristic of: A. adenocarcinoma B. insulinoma C. adenoma D. gastroma

A.

A patient was involved in an auto accident and c/o of tenderness in the LUQ, what would the most likely diagnosis? A. splenic hematoma B. splenic infarct C. histoplasmosis D. normal spleen

D.

A patient who presents with jaundice, weight loss, and a palpable RUQ mass should be evaluated for: A. cholecystitis B. pancreatitis C. pancreatic pseudocyst D. adenocarcinoma of the pancreas

B.

A patient with leukemia will most likely have a spleen that's which of the following? A. normal B. enlarged C. atrophied D. micro-nodular

B.

A patient with sudden onset of LUQ pain and a wedge shaped region seen in the periphery of the spleen would present with this likely diagnosis: A. lymphoma B. infarct C. rupture D. focal abscess

D.

A pediatric patient presents with a palpable mass, intermittent jaundice & pain. Ultrasound shows a large cystic mass in the portal hepatic region with dilatation of the CHD & CBD. This a characteristic of which of the following? A. Caroli's disease B. biliary atresia C. Klatskin tumor D. choledochal cyst

A.

A pheochromocytoma is a rare encapsulated, highly vascular solid mass of the: A. adrenal gland B. bladder C. lymph nodes D. kidney

D.

A pheochromocytoma is a usually benign, hypertensive causing mass found in the retroperitoneal cavity of adults. Which of the following is it a mass of? A. pancreas B. testicle C. thyroid gland D. adrenal gland

B.

A post-surgical patient presents with abdominal tenderness and elevated WBC. An ultrasound is performed and an ill-defined, complex mass is identified. This most likely represents a(n): A. hematoma B. abscess C. urinoma D. lipoma

D.

A problem that is bacterial or viral in origin that affects some adolescent and middle age men is A. an epididymal cyst B. a spermatocele C. testiculitis D. epididymo-orchitis

A.

A rare hepatic malignant tumor seen in infancy and childhood is: A. hepatoblastoma B. adenoma C. adenolipoma D. Wilm's tumor

A.

A. hydronephrosis B. multicystic kidney C. nephrocalciniosis D. sponge kidney

A.

A. nephrolithiasis B. nephrocalcinosis C. medullary sponge kidney D. polycystic kidney

B.

A. polycystic kidney B. medullary sponge kidney C. nephrocalcinosis D. renal sinus lipomatosis

B.

A. sponge kidney B. hydronephrosis C. multicystic kidney D. nephrocalciniosis

C.

Clinical symptoms associated with inflammatory renal masses include A. epigastic pain B. hypoglycemia C. fever D. referred shoulder pain

C.

AAA (abdominal aortic aneurysm) is diagnosed when the intra-luminal diameter measures greater than : A. 7 cm B. 10 cm C. 3 cm D. 5 cm

A.

Abdominal sonography is ordered on a 23-year-old male with a history of exposure to hepatitis but without history of ETOH or IVDA. Blood studies were positive for Hepatitis B, ALT, AST, alk phos, and bilirubin. Sonography revealed irregular areas of increased echogenicity throughout the left lobe and a large focal density located within the hyperechoic right lobe. The most likely pathology in this patient is ________. A. hepatocellular carcinoma B. hemangioendothelioma C. hemangioma D. hepatic angiosarcoma

A.

Accessory spleens are most often located in the: A. hilum of the spleen B. lesser sac C. anterior to the spleen D. posterior to the spleen

B.

Acute cholecystitis is most likely to occur secondary to which entity? A. acute hepatitis with jaundice B. calculi impaction in the cystic duct C. cholangitis D. trauma to the RUQ

A.

Acute pancreatitis may be caused by: A. alcohol abuse B. insulinoma C. renal reflux D. adenocarcinoma

C.

Acute testicular torsion is demonstrated sonographically by what crucial finding(s) A. enlarged, echogenic testicle with hypervascular color flow B. small, echogenic testicle with absent color flow C. enlarged, hypoechoic testicle with absent color flow D. small hypoechoic testicle with hypervascular color flow

A.

Addison's syndrome is a disease that results from: A. adrenal hypofunction B. adrenal hyperfunction C. thyroid hypoactivity D. excessive production of cortisol

B.

Addison's syndrome is a disease that results from: A. chronic adrenal hyperfunction B. chronic adrenal hypofunction C. thyroid hypofunction D. thyroiditis

C.

Adenomyomatosis of the gall bladder: A. is a malignant proliferation of the gallbladder characterized by a hypoechoic halo B. is a malignant proliferation of the gallbladder wall C. is a benign proliferation of the gallbladder wall associated with comet tail artifact D. is a benign proliferation of the gallbladder wall also known as strawberry gallbladder

B.

Adjacent lymph node enlargement may be seen in association with all of the following except: A. thyroiditis B. toxic multinodular goiter C. thyroid carcinoma

B.

Adult polycystic kidney disease may be characterized by A. an autosomal recessive disease B. macro renal parenchymal cysts C. a latent disease until the seventh to eighth decade D. cysts in the ovary

B.

Adult polycystic kidney disease may be characterized by A. it is an autosomal-recessive disease B. it is a progressive disease that may led to renal failure C. it is a latent disease occurring in the 3rd or 4th decade of life

D.

Alkaline Phosphatase is markedly increased in patients with: A. hepatocellular disease B. polycystic disease C. hydatid disease D. early obstruction

C.

All of the following are tests used to evaluate the liver except: A. prothombin time B. SGOT C. amylase D. bilirubin

D.

All of the following congenital renal anomalies may produce a "mass-like" effect on sonogram except: A. duplex collecting system B. column of Bertin C. dromedary hump D. multicystic dyplastic kidney

B.

All of the following lesions are benign except: A. hamartoma B. hepatoma C. hemangioma D. hepatic adenoma

C.

All of the following produce diffuse enlargement of the thyroid except: A. Grave's disease B. Hashimoto's disease C. adenoma D. multinodular goiter

A.

Although in most cases the sonographic appearance of the testes remains unchanged after vasectomy, what changes can occur in approximately 40% of post vasectomy patients? A. enlargement of the epididymis B. infarction of one or both testis C. hyperemia to one or both testis D. atrophy of the scrotal sac

A.

An abdominal sonogram demonstrates a large hypoechoic mass in the head of the pancreas. The gallbladder is enlarged with a thin wall. Murphy's sign is negative. No gallstones are seen and the bile ducts are normal in caliber. What is the most likely diagnosis? A. Courvoirsier's gallbladder B. cholelithiasis C. choledocholithiasis D. cholecystitis

D.

An abscess found below the diaphragm may be called: A. pleural B. intrahepatic C. subhepatic D. subphrenic

A.

An abscess usually appears sonographically as: A. a variable echotexture with irregular borders and varied through transmission B. solid with smooth borders and no through transmission C. a "bull's eye" target lesion D. echo-free, round, with smooth borders and good through transmission

C.

An adult kidney which measures less than _______ is indicative of renal failure. A. 9 cm B. 7 cm C. 8 cm D. 6 cm

A.

An amebic abscess may reach the liver through the: A. portal vein B. hepatic veins C. gastroduodenal artery (GDA) D. hepatic arteries

C.

An aneurysm that is connected to the vascular lumen by a neck that varies in size is: A. berry B. fusiform C. saccular D. cylindroid

C.

An echogenic mass consistent with hemangioma is seen just anterior to the middle hepatic vein. In which liver segment is the mass located? A. Posterior right lobe B. Anterior right lobe C. Medial left lobe D. Lateral left lobe

A.

An elderly man presents with a history of weight loss, jaundice, abdominal pain and anorexia. Which of the following would you expect to see on ultrasound? A. pancreatic adenocarcinoma B. acute pancreatitis C. chronic pancreatitis D. pancreatic pseudocyst

A.

An elderly man with a history of alcoholism recently was diagnosed with acute pancreatitis. He now presents with decreased hematocrit and hypotension. Your differential includes: A. pancreatic hemorrhage B. cholecystitis C. pseudocyst D. chronic pancreatitis

D.

An enlarged RT adrenal gland may result in which of the following? A. posterior displacement of AO B. anterior displacement of RRA C. anterior displacement of IVC D. medial displacement of IVC

D.

An enlarged kidney with decreased echogenicity of the parenchymal tissue on US is characteristic of? A. chronic pyelonephritis B. renal abscess C. hydronephrosis D. acute pyelonephritis

C.

An enlarged spleen may be caused by: A. late stage sickle cell anemia B. splenic rupture C. portal hypertension D. asplenia

C.

An in-utero scan demonstrates bilateral enlarged echogenic kidneys. The most probable diagnosis is: A. multi-cystic dysplastic kidneys B. chronic renal failure C. autosomal recessive cystic kidney disease D. acquired cystic disease

B.

An infection that has spread to the testicle is: A. hydrocele B. orchitis C. epididymitis D. spermatocele

D.

An inferior tongue-like projection of the right lobe of the liver, which is a normal variant: A. Glisson's lobe B. quadrate lobe C. caudate lobe D. Reidel's lobe

B.

An ureterocele is a congenital abnormality seen where? A. UPJ B. UVJ C. Adrenal D. Renal

C.

Caroli's disease may include all of the following except: A. intermittent jaundice B. saccular dilatation of intrahepatic ducts C. polypoid mass D. cystic structures within liver

C.

Caudate to right lobe ratio technique may be helpful when diagnosing: A. hepatitis B. old age C. cirrhosis D. fatty infiltrations

B.

Cholangitis includes which of the following: A. thin bile duct wall B. stricture C. beading of intrahepatic ducts D. cholecystitis

B.

Cholangitis refers to inflammation of the: A. bladder B. bile duct C. choledochal cyst D. gallbladder

C.

Classic signs & symptoms of cholelithiasis include all of the following except: A. right upper quadrant pain B. nausea and vomiting C. abdominal distension D. radiating shoulder pain

B.

Cholesterolosis is also known as: A. porcelain gallbladder B. strawberry gallbladder C. WES

C.

Cryptorchidism is the medical term describing A. congenital agenesis of the testis B. testicles that do not produce the hormones that produce masculine features C. testicles that have not descended and lie either in the abdomen or in the groin D. a benign enlargement of the testis

A.

Cystic dilation of the CBD which is usually present in the 1st year of life is known as: A. choledochal cyst B. adenomyomatosis C. biliary atresia D. Courvoisier cyst

B.

Discrete, high-level, comma-like, specular echoes arching over the tops of the pyramids described the normal sonographic appearance for what renal structure? A. renal parenchyma B. arcuate vessels C. renal cortex D. corticomedullary junction

C.

Echinococcal cysts have the highest incidence in countries where: A. poultry is abundant B. fishing is common C. sheep grazing is common D. rock climbing is prevalent

C.

Elevation of serum bilirubin results in: A. hepatocellular disease B. hemolysis C. jaundice D. ascites

A.

Empyema of the gallbladder refers to: A. pus-filled gallbladder B. gas in the gallbladder C. calcified gallbladder D. distention of the gallbladder

A.

Focal nodular hyperplasia has which characteristic(s): A. solitary mass with a central scar B. poor blood supply C. predominant in men D. all of the above

B.

Following testicular torsion, the testicle will appear sonographically A. the same as a normal testicle B. in the acute stage, enlarged and hypoechoic; in its chronic stage, small and echogenic C. in the acute stage, small and echogenic; in its chronic stage, enlarged and hypoechoic

A.

Functions of the liver include all, except ________________. A. hemolysis B. bile production C. storage D. detoxification

C.

Functions of the spleen include all except ____________________. A. blood reservoir B. production of plasma cells C. production of enzymes D. destruction of RBCs

D.

Fungal infections in the liver are characterized by A. snail fever B. hemangioma C. daughter cysts D. wheel within a wheel

A.

Fungal infections in the spleen are characterized by: A. wheel within a wheel B. snail fever C. daughter cysts D. hemangioma

A.

Gallbladder carcinoma is associated with: A. polypoid mass B. Klatskin's tumor C. acute cholecystitis D. medullary nephrocalcinosis

A.

Gallbladder sludge is composed of all the following except: A. uric acid B. thick bile C. calcium bilirubinate granules D. cholesterol crystals

A.

Gallstones may form due to: A. biliary stasis B. normal bile composition C. low saline level of patient D. pancreatic duct enlargment

D.

Given the clinical findings of a fever, RUQ pain, and leukocytosis, what would one expect to find in the patient's liver? A. metastasis B. hemangioma C. hepatoma D. abscess

A.

Grave's disease is a combination of A. hyperthyroidism plus diffuse goiter B. mild enlargement plus fever C. hypothyroidism plus diffuse goiter

C.

Hashimoto's disease is a type of chronic A. orchitis B. hepatitis C. thyroiditis D. pancreatitis

D.

Hepatomegaly is diagnosed when the liver length measures greater than: A. 15 cm B. 17 mm C. 13 cm D. 17 cm

D.

Hydronephrosis may be caused by all of the following except: A. prostatic hypertrophy B. lymphadenopathy C. urethral strictures D. medullary sponge kidney

B.

Hyperthyroidism associated with diffuse goiter is associated with A. Hashimoto's thyroiditis B. Grave's disease C. adenoma D. papillary carcinoma

B.

Metastases to the spleen A. are common B. appear when the primary lesion has disseminated widely C. are not known to occur D. are usually the first sign of carcinoma

C.

Microlithiasis of the testes may be associated with: A. hematocele B. hydrocele C. malignancy D. hernia

A.

Mirizzi syndrome is characterized by a(n) A. stone(s) impacted in the gallbladder neck B. stones in the distal portion of the CBD C. contracted gallbladder D. enlarged gallbladder

B.

Most undescended testis occurs in which region? A. lymphatics B. inguinal canal C. retroperitoneum D. retrovesicular pouch

C.

Non-shadowing, low-mid amplitude layering echoes found in the dependent portion of the gallbladder best describes: A. polypoid mass B. gallstones C. sludge D. adenomyomatosis

B.

Normal portal venous blood flow is ________________. A. hepatofugal B. hepatopetal

D.

Obstruction of the CBD by a mass in the head of the pancreas will lead to: A. contracted GB with dilated biliary radicles B. portal hypertension C. cirrhosis D. dilated GB with dilated biliary radicles

A.

Of the solid renal masses listed, the most common solid renal mass encountered in neonates is: A. mesoblastic nephroma B. Wilm's tumor C. neuroblastoma D. hypernephroma

C.

Of the solid renal masses listed, the most common solid renal mass encountered in neonates is: A. Wilm's tumor B. IPKD C. mesoblastic nephroma D. hypernephroma

D.

On a longitudinal image, which of the following major vessels is located to the right of midline with the cephalic portion curving ventrally? A. Hepatic vein B. Portal vein C. Hepatic artery D. Inferior vena cava

D.

On sonographic examination, a seminoma of the testicle tends to appear as A. cannot be detected sonographically B. a large, multilocular cystic mass C. a small, simple cyst D. a solid, homogeneous mass

D.

Parathyroid adenomas would most likely be associated with: A. lymphadenopathy B. headaches C. cysts D. hypercalcemia

B.

Serous fluid accumulated in the scrotum: A. pyocele B. hydrocele C. tumor D. hematocele

C.

Parathyroid adenomas may be associated with A. lymphadenopathy B. headaches C. hypercalcemia D. cysts

D.

Patients with portal hypertension may have which of the following: A. dilated hepatic veins B. atrophied spleen C. decreased echogenicity of the portal vein radicles D. collaterals formed between the portal and systemic circulation

D.

Persistent fever, swelling, and tenderness are most indicative of: A. hydronephrosis B. malignancy C. angiomyloma D. infection

C.

Polycystic kidney disease is transmitted as either autosomal dominant or autosomal recessive. The dominant form is also known as ______, while the recessive form is also known as ________. A. MCDK; IPKD B. APKD; MCDK C. APKD; IPKD D. IPKD; APKD

A.

Polycythemia Vera is characterized by: A. increased blood viscosity B. increased perfusion C. decreased blood viscosity D. decreased RBC's

A.

Polysplenia is associated with A. bilateral left sidedness B. bilateral right sidedness

D.

Pyonephrosis refers to the: A. presence of a perinephric abscess B. presence of blood in the collecting system C. presence of urine in a dilated collected system D. presence of pus in a dilated collecting system

A.

The sonographic findings that are associated with varicoceles include: A. dilated veins caused by obstruction of the venous return B. a solid mass outside of the testes C. blood filled sac that surrounds the testicle, secondary to trauma or surgery D. a cyst along the course of the vas deference

D.

The sonographic landmarks for the caudate lobe include _______________. A. middle and left hepatic veins B. aorta and left portal vein C. confluence of splenic vein and portal vein D. ligamentum venosum and inferior vena cava

B.

The sonographic landmarks for the caudate lobe include: A. middle and left hepatic veins B. ligamentum venosum and IVC C. aorta and left portal vein D. confluence of splenic vein and portal vein

B.

The spleen in a patient with leukemia will most likely be: A. micro-nodular B. enlarged C. atrophied D. normal

A.

The spleen is _________________. A. intraperitoneal B. retroperitoneal

C.

The spleen is an essential organ in young children because of ________. A. phagocytosis B. storage of blood CorrectC. production of antibodies D. hematopoiesis

A.

The spleen is considered enlarged when its length is greater than: A. 13 cm B. 15 cm C. 9 cm D. 11 cm

B.

The spleen is located: A. inferior and lateral to the right kidney B. posterior and lateral to fundus of stomach C. superior to the diaphragm D. anterior and medial to the tail of pancreas

D.

The splenic artery is ________________. Selected Answer: CorrectD. a and b Answers: A. the left branch of the celiac trunk B. found superior to the pancreas C. found posterior to the pancreas D. a and b

C.

The spreading process of diffuse inflammatory edema of soft tissues that may proceed to necrosis is: A. pseudocyst B. hemorrhagic pancreatitis C. phlegmon D. chronic pancreatitis

C.

The superior vena cava is formed by the junction of the: A. internal jugular veins B. external jugular veins C. brachiocephalic veins D. subclavian veins

B.

The triangular echogenic focus with posterior shadowing in the image below represents: A. calcification in the liver B. falciform ligament C. ligamentum venosum D. main lobar fissure

C.

The type of neoplasm that arises from the bile ducts to account for 10% of all primary liver cancers is: A. cholangiolipoma B. cholangioma C. cholangiocarcinoma D. cholangiosarcoma

C.

The type of neoplasm that arises from the bile ducts to account for 10% of all primary liver cancers is: A. cholangiolipoma B. cholangioma C. cholangiocarcinoma D. cholangiosarcoma

A.

The typical characteristics of cholelithiasis on ultrasound are: A. gravity dependent, mobile, echogenic B. gravity independent, mobile, hypoechoic C. gravity dependent, immobile, echogenic D. gravity dependent, immobile, hypoechoic

C.

The ultrasound appearance of gangrenous cholecystitis includes: A. enlarged GB B. wall thinning C. irregular fundal contour D. comet-tail artifact

A.

The vascular supply to the liver, spleen and stomach is via the: A. celiac trunk B. portal vein C. superior mesenteric vein D. gastroduodenal artery

E.

Thickening of the gallbladder wall may be caused by: A. hepatitis B. ascites C. adenomyomatosis D. hypoproteinenemia E. all of the above

C.

What is the term that describes embryonic production of blood cells? A. Hemolysis B. Hemostatic C. Hemopoiesis D. Hemoptysis

A.

This portion of the liver is not covered by the peritoneum and rests directly against the diaphragm. A. bare area B. quadrate lobe C. left lobe D. caudate lobe

C.

This round structure located posterior to the spleen in the picture below most likely represents: A. Lymph node B. Left kidney C. Supernumerary spleen D. Wandering spleen

B.

Two non-biliary reasons for diffuse GB wall thickening are: A. pancreatitis & renal failure B. ascites & acute hepatitis C. congestive heart failure & porcelain GB D. cholesterol polyps & adenomyomatosis

A.

Typical symptoms of a patient with an abscess include: A. fever and leukocytosis B. leukopenia and hypothermia C. nausea and vomiting D. pain and diarrhea

B.

Undescended testicles: A. Originate in the scrotum B. Have an increased incidence of infertility C. Are always found in the inguinal canal D. Are never ectopic

C.

Uremia may be present in a patient with which of the following? A. renal cyst B. angiomyolipoma C. renal insufficiency

D.

Ureteral jets are not visualized in patients with ___________________. A. duplex collecting system B. acute nephritis C. malignant tumors D. obstruction

C.

Ureteral jets are: A. a pathologic condition B. caused by reflux of urine C. the result of urine being sprayed into the static urine of the bladder from the ureters D. a rare occurrence

C.

Varicoceles are: A. arteries measuring less than 2 mm B. arteries measuring more than 2 mm C. dilated veins measuring more than 2 mm D. dilated veins measuring less than 2 mm

A.

What adrenal tumor is occasionally found in adult patients with uncontrolled hypertension? A. pheochromocytoma B. adrenal hemorrhage C. nephroblastoma D. myelolipoma

A.

What adrenal tumor is occasionally found in adult patients with uncontrolled hypertension? A. pheochromocytoma B. myelolipoma C. nephroblastoma D. adrenal hemorrhage

C.

What anatomy is located on the anterior border of the spleen? A. Splenic cords B. Left kidney C. Stomach D. Splenorenal ligament

B.

What anomalous condition occurs if the allantoic canal remains open and results in a communication channel between the bladder and the umbilicus? A. distal ureteral obstruction B. patent or persistent urachus C. posterior urethral valves D. exstrophy

D.

What anomaly refers to renal fusion that usually occurs at the lower pole level? A. hypoplasia B. duplication C. pelvic ectopic D. horseshoe kidney

A.

What artifact is the arrow pointing to in this image? A. comet tail B. shadowing C. refraction D. enchancement

B.

What cystic liver disease is inherited and associated with other organs? A. echinococcal cysts B. polycystic disease C. simple cysts D. hydatid cysts

D.

What cystic renal structures are the arrows pointing to in the image below? A. columns B. hydronephrosis C. parapelvic cysts D. pyramids

D.

What definition describes a posterior urethral valve? A. eversion through anterior abdominal wall B. thin-walled fluid-filled masses, outward projections C. cyst-like, thin-walled masses, inward projections D. dilated and elongated prostatic urethra

A.

What is the best diagnosis if the sonographic features include an irregular, solid, uneven, neovascular, hypoechoic mass with internal echoes within the walls of a normal-sized thyroid gland? A. thyroid carcinoma B. multinodular activity C. goiter D. thyroid adenoma

C.

What is the best explanation if the sonogram reveals a focal area of high echogenicity with acoustic attenuation (shadowing)? A. cholecystitis B. thickened wall C. cholelithiasis D. sludge

D.

What is the dilatation seen in the scrotal image? A. varicocele B. spermatocele C. mediastinum teste D. ectasia of rete testes

B.

What is the likely cause for echoes originating from within the gallbladder with acoustic shadows? A. Cholecystitis B. Cholelithiasis C. Bile D. Perforated gallbladder

A.

What is the likely explanation for a septated cystic mass in the head of the pancreas in a 43-year-old, chronic alcoholic who presents with a normal serum lipase, elevated serum amylase, and an enlarging mass in the epigastrium? A. pancreatic pseudocyst B. acute pancreatitis C. necrosis D. hepatoma

C.

What is the location of a mass detected anterior and to the left of the ligamentum venosum? A. Caudate lobe B. Right anterior superior segment C. Left lobe D. Right anterior inferior segment

B.

What is the most common cause of a pancreatic pseudocyst in an adult patient? A. drug related B. acute pancreatitis C. peptic ulcer disease D. none of the above

C.

What is the most common composition of renal calculi? A. uric acid B. magnesium phosphate C. calcium oxalate D. staghorn formation

B.

What is the most common etiology of Graves disease? A. diffuse hyperthyroidism B. autoimmune disorder C. vitamin K deficiency D. multiple cysts

D.

What is the most common malignancy to metastasize to the gallbladder? A. colon B. breast C. lung D. melanoma

C.

What is the most common primary tumor to metastasize to the testis? A. Lung B. Kidney C. Prostate D. Colon

C.

What is the most common scrotal fluid collection? A. Varicocele B. Spermatocele C. Hydrocele D. Pyocele

C.

What is the most common sonographically visualized abnormality of the spleen? A. splenic rupture B. lymphoma C. splenomegaly D. splenic abscess

D.

What is the most common type of benign vascular mass in infants? A. hemangiosarcoma B. hepatoma C. hepatoblastoma D. hemangioendothelioma

A.

What is the most difficult portion of the biliary system in which to diagnose stones? A. cystic duct B. body of GB C. neck of GB D. fundus of GB

C.

What is the most important factor associated with gallstone formation? A. diffuse liver disease B. high fat, low protein diet C. abnormal bile composition D. pregnancy

D.

What is the most likely diagnosis if a patient presents with a cold thyroid nodule on a technetium-99m (Tc-99m) radioiodine scintigraphy examination and the sonography examination demonstrates an anechoic circular area with smooth sharp borders and good through transmission? A. thyroid adenoma B. calcified thyroid adenoma C. goiter D. thyroid cyst

C.

What is the most likely diagnosis? A. nephrolithiasis B. renal cell lipomatosis C. angiomyolipoma D. nephrocalcinosis

D.

What is the most likely pathology seen in this image? A. hepatization B. gallstones C. pericholecystic fluid D. sludge

A.

What is the normal liver length along the midclavicular region? A. 15 to 17 cm B. 10 to 12 cm C. 19 to 22 cm D. 11 to 14 cm

D.

What is the pathology seen in this image? A. adenomyomatosis B. gallbladder polyp C. cholesterolosis D. gallstone

A.

What is the pre-existing condition that occurs in patients with hepatomas? A. cirrhosis B. abscesses C. gallstones D. hematomas

D.

What is the primary adult malignant tumor of the liver? A. Hemangioma B. Adenoma C. Hepatoblastoma D. Hepatoma

A.

What is the primary adult malignant tumor of the liver? A. Hepatoma B. Hemangioma C. Adenoma D. Hepatoblastoma

C.

What is the reticuloendothelial function of the liver? Selected Answer: CorrectC. phagocytosis by Kupffer cells Answers: A. formation of bile B. blood reservoir CorrectC. phagocytosis by Kupffer cells D. converts proteins to carbohydrates

D.

What is the sonographic appearance of bladder diverticula? A. urine-filled inpouchings B. homogeneous inpouchings C. hyperechoic inpouchings D. urine-filled outpouchings

C.

What is the sonographic appearance of the image below? A. Bunny tail B. Mickey mouse C. Honeycomb D. Snowball

A.

What is the sonographic appearance of the kidneys in a patient who is in end-stage renal disease? A. small and echogenic B. small and hypoechoic C. large and echogenic D. large and hypoechoic

D.

What is the spleen's function in the embryological stage of development? A. Storage reservoir for iron B. Platelet destruction C. Lymphocyte destruction D. Hematopoiesis

B.

What organ should be thoroughly examined if the diagnosis of transitional cell carcinoma is made? A. Gallbladder B. Bladder C. Liver D. Adrenal

A.

What pathology is best demonstrated by use of Doppler for evaluating ureteral jets? A. ureteral obstruction with unilateral calculi B. forward flow with bladder diverticulum C. reflux D. urinary tract infection

A.

What pathology is demonstrated in this image? A. Adenomyomatosis B. Gallstones C. Polyp D. Cholesterolosis

C.

What pathology is most likely demonstrated on a patient with a painfully swollen prostate gland, an elevated prostate-specific antigen level, and the endorectal sonogram documenting several irregular, hypoechoic areas in the periurethral area? A. benign prostatic hypertrophy B. retention cysts C. prostatitis D. carcinoma

C.

What separates the intrahepatic right lobe from the left lobe? A. Left hepatic vein B. Caudate lobe C. Main lobar fissure D. Ligamentum teres

C.

What separates the left lobe from the caudate lobe? A. Falciform Ligament B. Coronary Ligament C. Ligamentum Venosum D. Ligamentum Teres

B.

What sonographic appearance describes how to identify hydronephrosis? A. multiple cystic masses throughout the renal parenchyma B. fluid-filled pelvocaliceal collecting system C. hyperechoic pelvocaliceal collecting system D. distorted renal outline

A.

What straddles the midline, is superior to the head of the pancreas, and is anterior to the inferior vena cava? A. Caudate lobe B. Right anterior segment C. Reidel's lobe D. Left lateral segment

C.

What structure along with the left hepatic vein separates the left hepatic lobe from the caudate lobe? A. Left coronary and suspensory ligaments B. Intersegmental fissure C. Ligamentum venosum fissure D. Triangular ligament

A.

What structure are the arrows pointing to in the image below? A. common hepatic artery B. celiac axis C. CBD D. portal vein

C.

What structure can present as a thick lucent band sometimes identified anterior to the spine, inferior vena cava, or aorta? A. Left renal vein B. Esophogastric junction C. Crus of the diaphragm D. Right portal vein

C.

What structure is represented by the two arrows in the image below of a patient with an obstructing stone (echogenic foci marked by calipers)? A. fallopian tube B. vagina C. distal ureter D. proximal ureter

D.

What structure is seen in the image below while assessing a 54-year-old male patient with a history of cirrhosis and portal hypertension? A. IVC B. aorta C. portal vein D. TIPS

D.

What structure is the straight arrow pointing to in the image below of a 45 yr old male patient with a history of alcohol abuse and persistent epigastric and back pain? A. a prominent and tortuous splenic artery B. varicies from portal hypertension C. a dilated common duct D. a dilated duct of Wirsung

C.

What structure lies posterior to the CHD (common hepatic duct) and anterior to the IVC? A. common bile duct B. hepatic artery C. portal vein D. hepatic vein

D.

What symptom describes tenderness over the gallbladder with probe pressure? A. Morrison's pouch B. Courvoisier's gallbladder C. Douglas's sign D. Murphy's sign

A.

What term describes the echogenicity of the normal splenic parenchyma when compared to the liver? A. Isoechoic B. Hyperechoic C. Heterogeneous D. Hypoechoic

B.

What thin, tendinous structure connects the two rectus abdominis muscles at the midline? A. tranversus abdominis B. linea alba C. ligamentum teres D. internal oblique

D.

What tumor accounts for approximately 80% to 90% of all renal malignancies in adults? A. transitional cell carcinoma B. lymphomas C. urothelial tumors D. renal cell carcinoma

B.

What vascular landmark separates the liver into right and left lobes? A. right portal vein B. middle hepatic vein C. main portal vein D. left hepatic vein

D.

What would one not expect to see with later stage cirrhosis? A. difficulty visualizing vessels B. decreased liver size C. increased echogenicity D. enlarged liver

D.

When compared to a normal liver, the echogenicity of the pancreas in a 60-year-old patient is: A. heterogeneous B. isoechoic C. hypoechoic D. echogenic

A.

When gallstones are identified on ultrasound, the sonographer should pay close attention to the: A. pancreas B. kidney C. stomach D. spleen

A.

When is the spleen considered to be enlarged? A. The length exceeds 13 cm. B. It appears ventral to the left kidney. C. There is left upper quadrant pain. D. A right sided bulging diaphragm is demonstrated.

C.

When performing an US of the pancreas, which identifying vessel is commonly seen posteriorly & presents in long axis while scanning in transverse on the body? A. SMV B. SMA C. splenic vein D. splenic artery

C.

When performing color Doppler imaging of the liver: A. portal venous flow will always be displayed in blue and hepatic veins in red B. portal venous flow will always be displayed in red and hepatic veins in blue C. portal and hepatic veins may be either red or blue because color assignment depends on flow direction in relation to the transducer

C.

When using Couinaud's anatomy to divide the liver, the liver is divided into how many segments? A. 2 B. 6 C. 8 D. 4

A.

When would the sonographer NOT be able to image a thickened gallbladder wall? A. postcholecystectomy B. in the presence of ascites C. after prolonged fasting D. with cholecystitis

A.

Which area is primarily affected as benign prostatic hypertrophy progresses? A. central zone B. transitional zone C. fibromuscular stroma D. peripheral zone

D.

Which benign liver tumor is well-circumscribed, multinodular, and non-encapsulated with a stellate scar? A. liver cell adenoma B. lipoma C. cavernous hemangioma D. focal nodular hyperplasia

B.

Which blood test is a good marker for hepatoblastoma? A. bilirubin B. alpha fetoprotein C. alk phos D. albumin

D.

Which condition is suggestive of parathyroid pathology? A. decreased T3 B. increased T4 C. hyperglycemia D. hypercalcemia

B.

Which criteria accurately differentiate portal veins from hepatic veins? A. increase in caliber near the IVC B. walls are more echogenic C. interhepatic D. intersegmental

C.

Which is a predisposing factor of hepatoma? A. cavernous hemangioma B. echincoccal cyst C. cirrhosis D. biliary disease

E.

Which is an indication for a scrotal ultrasound? A. detection of testicular torsion B. evaluation of an enlarged and/or painful scrotum C. distinction between epididymitis and a tumor involving the testicle D. a primary method for diagnosing a testicular tumor E. all of the above are good indications for a scrotal ultrasound

A.

Which is the most relevant factor associated with formation of GB calculi? A. abnormal bile composition B. diffuse liver disease C. GB malignancy D. low protein, high fat diet

A.

Which lab value is most specific for liver function? A. ALT B. bililrubin C. AST D. Alk Phos

B.

Which lab value would you expect to be normal in a patient who suffers solely of renal failure? A. blood urea nitrogen (BUN) B. serum bilirubin C. serum calcium D. proteinuria

D.

Which ligament attaches the spleen to the greater curvature of the stomach? A. Phrenicocolic B. Lienorenal C. Left triangular D. Gastrosplenic

B.

Which ligament extends from the umbilicus to the diaphragm and connects the liver to the anterior abdominal wall? A. ligamentum teres B. falciform ligament C. coronary ligament D. ligamentum venosum

B.

Which method of measuring the liver is the most accurate while performing an ultrasound exam? A. vertical measurement B. mid-clavicular measurement C. subjective assessment, measurement not necessary D. AP measurement

C.

Which of the follow functions does the liver NOT perfrom? A. Storage of vitamins B. Production of clotting factors C. Production of digestive enzymes D. Formation of bile

A.

Which of the follow laboratory values CANNOT evaluate liver function? A. BUN B. ALT C. AST D. ALP

C.

Which of the following abnormalities would be seen laterally to the neck near the carotid arteries? A. esophagus B. thyroglossal duct cyst C. branchial cleft cyst D. cystic hygroma

D.

Which of the following abnormalities would you most likely find on the ultrasound exam of the patient in the image below? A. goiter B. thyroglossal duct cyst C. carotid artery aneurysm D. branchial cleft cyst

A.

Which of the following are both interlobar and intersegmental? A. Hepatic veins B. Hepatic arteries C. Portal veins D. Bile ducts

B.

Which of the following can re-canalize with portal hypertension? A. umbilical artery B. ligamentum venosum C. ligamentum arteriosum D. ligamentum broadum

C.

Which of the following can recanalized with portal hypertension? (Best answer from the choices below) A. umbilical artery B. ligamentum arteriosum C. ligamentum venosum D. ligamentum broadum

A.

Which of the following cannot be visualized on a normal liver ultrasound? A. all can be visualized on the normal liver ultrasound B. main lobar fissure C. ligamentum venosum D. falciform ligament

A.

Which of the following describes Mirizzi syndrome? A. stone impacted in the GB neck causing CHD dilatation B. stone in distal portion of CHD causing CBD dilatation C. absence of GB D. contracted GB

C.

Which of the following does not make up the portal triad? A. bile duct B. hepatic artery C. hepatic vein D. portal vein

D.

Which of the following drain the liver of deoxygenated blood? A. hepatic arteries B. portal veins C. umbilical veins D. hepatic veins

C.

Which of the following drain the liver of deoxygenated blood? A. portal veins B. hepatic arteries C. hepatic veins D. umbilical veins

B.

Which of the following is true regarding echinococcus granulosis: A. it's highest incidence is in countries where the parasite is unknown B. it is the most common cause of hydatid disease in humans C. it is also known as snail fever D. it is a genus of plant

A.

Which of the following lab values is most specific for HCC of the liver? A. alpha-fetoprotein B. alkaline phosphatase C. bilirubin D. blood urea nitrogen

D.

Which of the following lies within the main lobar fissure? A. Right Hepatic Vein B. Left Hepatic Vein C. Main Portal Vein D. Middle Hepatic Vein

C.

Which of the following ligaments do not help to stabilize the spleen? A. gastrosplenic B. lienorenal C. falciform D. phrenicocolic

D.

Which of the following may be a sonographic appearance of acute hepatitis? A. decreased visualization of portal vein walls B. increased gallbladder size C. increased echogenicity of the liver parenchyma D. decreased echogenicity of the liver parenchyma

D.

Which of the following may cause the spleen to enlarge? A. sickle cell anemia B. infarcts C. hepatopedal blood flow D. portal hypertension

A.

Which of the following muscles can be seen posterior to the thyroid during a thyroid ultrasound? A. longus colli B. strap muscles C. sternocleidomastoid D. all of the above

B.

Which of the following renal cystic diseases is often unilateral? A. adult polycystic kidney disease B. multicystic dysplastic kidney disease C. medullary cystic disease

B.

Which of the following renal masses is the most acoustically reflective hyperechoic lesion that is denser than renal parenchyma? A. fibroma B. angiomyolipoma C. oncocytoma D. hemangioma

B.

Which of the following should be done to better image the near field of the liver? A. change from a linear to a sector transducer B. change from a sector to a curved array transducer C. change the transducer from 5.0 to 3.5 MHz. D. roll the patient on their side

C.

Which of the following statements about the spleen is false? A. the normal-sized spleen should not extend past the mid-portion of the left kidney B. a prominent bulge along the medial surface of the spleen can be seen in normal patients C. the spleen is retroperitoneal organ D. the sonographic texture of the normal spleen is homogeneous

C.

Which of the following statements is FALSE regarding the spleen? A. the spleen is surrounded by a fibrous capsule B. the spleen is located in the left hypochondrium C. the spleen is retroperitoneal D. the spleen lies posterior to the stomach

D.

Which of the following statements regarding gallstones is false? A. the prevalence of gallstones is higher in females than males B. the majority of stones in the US are made up of cholesterol C. abnormal gallbladder emptying and altered absorption are precursors to stone formation D. the majority of gallstones cause symptoms

B.

Which of the following statements regarding polyps is false? A. polyps are attached to the gallbladder wall by a stalk B. polyps will move to the dependent portion of the gallbladder C. polyps typically do not shadow D. polyps are typically adenomatious or made of cholesterol

D.

Which of the following statements regarding the differences between hepatic and portal veins is FALSE? A. Portal veins decrease in caliber as they course away from the porta hepatis B. Hepatic veins are intersegmental while portal veins are intrasegmental C. The portal veins have highly echogenic walls D. Hepatic veins decrease in caliber as they course towards the diaphragm

B.

Which of the following supplies oxygenated blood to the liver? A. Hepatoduodenal artery B. Hepatic artery C. Hepatic veins D. Portal vein

F.

Which of the following vessels form the confluence of the main portal vein? Selected Answer: A. splenic vein B. superior mesenteric artery C. superior mesenteric vein D. inferior mesenteric vein E. a, b and c F. a, c and d G. all of the above

A.

Which of the following will cause a thick walled gallbladder? A. hydrops B. acute cholecystitis C. a fatty meal D. chronic cholecystitis

A.

Which of the following would a sonographer most likely see a "halo" around? A. follicular adenoma B. papillary carcinoma C. thyroid tissue in a post radiation patient D. multinodular goiter

B.

Which of the following would most likely cause anterior displacement of the superior mesenteric artery and vein? A. small-bowel obstruction B. para-aortic lymphadenopathy C. pancreatic neoplasm D. cholelithiasis

B.

Which of the following would sonographically appear as cystic fluid surrounding the testicle? A. tumor B. hydrocele C. orchitis D. epididymis

B.

Which pathology is responsible for the majority of primary hyperparathyroid cases? A. Papillary carcinoma B. Parathyroid adenoma C. Hyperplasia D. Parathyroid cysts

B.

Which pathology is responsible for the majority of primary hyperparathyroid cases? A. hyperplasia B. parathyroid adenoma C. papillary carcinoma D. parathyroid cysts

A.

Which patient position is best for scanning the normal adult spleen? A. Right lateral decubitus B. Prone C. Erect D. Supine

C.

Which sonographic technique is used to document a varicocele? A. Quiet respiration B. Expiration C. Valsalva maneuver D. Inspiration

D.

Which statement describes the correct anatomic location of structures adjacent to the spleen? A. The fundus of the stomach and lesser sac are medial and posterior to the splenic hilum. B. The right adrenal and kidney lie superior to the spleen C. The diaphragm is anterior, lateral and inferior to the spleen D. The left kidney lies inferior and medial to the spleen

A.

Which statement is false about adrenal adenocarcinoma? A. These tumors are associated with Addison's syndrome. B. They are aka adrenocortical carcinoma. C. There is a tendency for invasion into the adrenal vein and inferior vena cava. D. Metastases to nodes are common.

B.

Which statement is false regarding Wilm's tumor? A. patient may present with HTN and anemia in advanced stages B. peak incidence is 10 years of age C. generally appears homogeneous and echogenic D. may invade the IVC or renal vein

A.

Which statement is the best description of the sonographic appearance of a bladder tumor? A. Echogenic structures protruding into anechoic bladder lumen B. Thickened bladder mucosa with hypoechoic or cystic structures along the wall C. Mega-ureter, upper urinary tract dilatation, ureterocele D. High-intensity echoes within the bladder

A.

Which structure is retroperitoneal? A. Pancreas B. Gallbladder C. Stomach D. Spleen

C.

Which testicular carcinoma is the most aggressive and presents as a focal or diffuse hypoechoic mass with distinct or indistinct boundaries? A. seminoma B. teratocarcinoma C. embryonal cell D. choriocarcinoma

A.

Which urinary bladder anomaly is sometimes described as a cyst within a cyst? A. ureterocele B. bladder exstrophy C. bladder diverticula D. ectopic ureter

D.

Which vascular structure divides the right lobe into anterior and posterior A. left hepatic vein B. right portal vein C. middle hepatic vein D. right hepatic vein

A.

Which vessels are used to delineate the right and left lobes; the right posterior and right anterior segments; and the left medial and left lateral segments? A. Hepatic veins B. Hepatic ducts C. Hepatic arteries D. Portal vein

D.

Which vessels increase in size as they course superiorly toward the diaphragm? A. patent umbilical veins B. hepatic arteries C. portal veins D. hepatic veins

D.

While performing an ultrasound exam, the sonographer finds that both kidneys measure 5 cm in length. They are very echogenic. One should consider the possibility of: A. renal artery aneurysm B. chronic pancreatitis C. chronic cholecystitis D. renal vein thrombosis

D.

With advanced chronologic age, the pancreas: A. becomes less echogenic and grossly enlarged B. increases in size and increases in echogenicity C. increases in size and increases in echogenicity D. decreases in size and increases in echogenicity

B.

With epididymitis, the epididymis should demonstrate A. decreased color flow B. increased color flow C. no flow D. reversed color flow

D.

With epididymitis, the epididymis should demonstrate A. decreased color flow B. no flow C. reversed color flow D. increased color flow

A.

With polycystic liver disease, what other organs could also have multiple cysts? A. Kidneys B. Adrenals C. Testicles D. Ovaries

C.

Within which portion of the biliary tract is the small stone in the image below (represented by the arrow) located? A. CHD B. GB neck C. cystic duct D. Hartman's pouch

C.

You are asked to locate a mass found within the right posterior segment. Which vessel separates the right anterior segment of the liver from the right posterior segment? A. Middle hepatic vein B. Left hepatic vein C. Right hepatic vein D. Main portal vein


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