ARRT ABD Review - Penny Ch 1-14
What systemic disease results in the development of granulomas within the spleen and throughout the body?
Sarcoidosis. Histoplasmosis and tuberculosis can also result in granulomas in the spleen
Which pancreatic enzyme neutralizes stomach acid?
Sodium bicarbonate
The splenic hamartoma may be discovered more often in individuals with a history of:
Tuberous sclerosis
What is a substance produced by a cancerous tumor or organ or structure in response to cancer?
Tumor marker
What are the clinical findings of HCC?
Unexplained weight loss Fever Cirrhosis Elevated AFP Possible abnormal liver function tests Chronic hepatitis Hepatomegaly Ascites Palpable mass
Which of the following is considered to be a malignant testicular neoplasm? a. neuroblastoma b. Hepatoma c. Yolk sac tumor d. hamartoma
c. yolk sac tumor
Which if the following would be the least helpful laboratory value to analyze in patients with suspected biliary tract disease? a. ALT b. ALP c. GGT d. Creatinine
d. Creatinine
What is a hepatoma?
A MALIGNANT tumor of the liver
Epstein-Barr infection is best described as:
A herpes virus that can lead to infectious mononucleosis
Which cells perform the exocrine function of the pancreas?
Acinar cells
What is the most common cause of ARF?
Acute tubular necrosis
What are the causes of ARF?
Acute tubular necrosis Renal artery stenosis Renal infection UTI Polycystic kidney disease Amyloidosis Henoch-Schonlein purpura
What is the most common cause of cirrhosis?
Alcoholism
Which cells perform the endocrine function of the pancreas?
Alpha, beta, and delta cells of the islets of Lagerhans
What do the acinar cells of the pancreas produce?
Amylase, lipase, sodium bicarbonate, and tripsin, chymotrypsin, & carboxypolypeptidase
What is Henoch-Schonlein purpura?
An autoimmune disorder and form of vasculitis associated with purple spots on the skin, gastrointestinal complications, joint pain, and possibly renal failure - mostly occurs in childhood
What is the triangular cord sign?
An avascular, echogenic, triangular or tubular structure anterior to the portal vein represents replacement of the extrahepatic duct with fibrous tissue in the portahepatis
What is a courvoisier gallbladder?
An enlarged, palpable gallbladder caused by a pancreatic head mass
What is Zollinger-Ellison syndrome?
An excessive secretion of stomach acid caused by the presence of a functional gastroma within the pancreas
What is ascariasis?
An infection of the small intestine that is caused by a parasitic roundworm
What is a gastrinoma of the pancreas?
An islet cell tumor of the pancreas
The right portal vein divides into:
Anterior and posterior branches
What are the clinical findings for chronic pancreatitis?
Asymptomatic; persistent epigastric pain; jaundice; back pain; possible elevation in amylase, lipase, or ALP; Anorexia, vomiting, weight lose, constipation
What are the functions of the spleen?
Blood reservoir Stores iron Defense against disease Hematopoiesis Destruction of flawed RBCs
A 32-year old female patient presents to the sonography department with a hx of fever, leukocytosis, and RUQ pain. Sonographically, you visualize dilated bile ducts that have thickened walls and contain sludge. What is the most likely diagnosis?
Cholangitis
What is biliary atresia?
Congenital narrowing or obliteration of all or a portion of the biliary tree (associated with triangular cord sign)
What is the most common cause of CRF?
Diabetes mellitus
What are the sonographic features of chronic pancreatitis?
Dilated pancreatic duct with possible stones within, calcifications within the pancreas, pancreatic pseudocyst, heterogeneous, hyperechoic, possible portosplenic vein thrombosis
What type of fluid within the abdomen is associated with cancer?
EXUDATE ascites
What are the clinical findings or ARF?
Elevated BUN and creatinine Oliguria Hypertension Leukocytosis Hematuria Edema Hypovolemia
What are the clinical findings of pancreatic adenocarcinoma?
Elevated amylase and lipase, loss of appetite, weight loss, jaundice, courvoisier gallbladder, epigastric pain, elevated ALP
What are the specific lab markers for acute pancreatitis?
Elevated amylase within 24 hours, elevated lipase within 72 hours
What are the clinical finding of acute pancreatitis
Elevated amylase, lipase, or ALT; leukocytosis; abdominal pain especially in supine position; back pain; fever; nausea and vomiting
What is the protective layer surrounding the kidneys called?
Gerota fascia or renal capsule
What do alpha cells secrete? What does it do?
Glucagon - raises blood glucose level by promoting the release of glucose from the liver
What is considered the most common benign childhood hepatic mass?
Hemangioendothelioma
What is associated with splenomegaly?
Hemolytic abnormalities (sickle cell) Trauma Infection Cirrhosis Leukemia or Lymphoma Elevated WBC count
Which hepatic mass is associated with E. granulosus?
Hydatid liver cyst aka echinococcal cyst
What is the most common echogenicity of an acutely inflamed pancreas?
Hypoechoic
What is the characteristic clinical finding of an insulinoma?
Hypoglycemia
What do beta cells secrete? What does it do?
Insulin - stimulates the body's use of glucagon
What is the most common islet tumor?
Insulinoma
The aorta originates at the:
Left ventricle
What is Mirizzi syndrome?
Lodged stone in the cystic duct causing compression of the common duct Pt presents with jaundice, pain, and fever
What is sodium bicarbonate responsible for in the digestive system?
Neutralizes stomach acid
What is tuberous sclerosis?
Noncancerous growths (benign tumors), in parts of the body, most commonly in the brain, eyes, kidneys, heart, lungs and skin, although any part of the body can be affected.
The Whipple procedure is performed on patients who have:
Pancreatic carcinoma
Which part of the pancreas is located right lateral to the SMV, anterior to the IVC, and inferior to the portal vein?
Pancreatic neck
The presence of purulent material within the renal collecting system is termed:
Pyonephrosis
What is the charcot triad? What is it associated with?
RUQ pain, jaundice and fever; associated with cholangitis
What are the clinical findings of glomerulonephritis?
Recent throat infection Smoky urine Hematuria Proteinuria Fever Hypertension Azotemia - excess urea in the bloodstream
What type of tissue is responsible for phagocytic functions in the spleen?
Red pulp
What do delta cells secrete? What does it do?
Restrains insulin and glucose level
What are the sonographic features of acute pancreatitis?
(May appear normal) Diffusely enlarged, hypoechoic pancreas, focal hypoechoic area; unencapsulated free fluid, pseudocyst, abscess, biliary obstruction
A renal scar most likely appears as:
A echogenic area that extends from the renal sinus through the renal parenchyma
What is Beckwith-Wiedemann syndrome?
A growth disorder synonymous with enlargement of several organs including the skull, tongue, and liver
What is von Hippel-Lindau disease?
A hereditary disease that involves the development of cysts within the pancreas and kidneys and tumors in the CNS, orbits, and adrenal glands
What is amyloidosis?
Accumulation of proteins in the form of abnormal, insoluble fibers, known as amyloid fibrils in the kidneys and other organs that can lead to renal failure
What are the extrinsic causes of hydronephrosis?
Benign prostatic hypertrophy Neurogenic bladder Pelvic masses (uterine leiomyoma, ovarian masses, tubo-ovarian abscess, and bowel masses) Pregnancy Retroperitoneal fibrosis Surgery Trauma Urethritis - inflammation of urethra
What is the typical appearance of kidneys affected by ARPKD?
Bilateral enlarged echogenic kidneys Loss of corticomedullary differentiation
What disorder is associated with the triangular cord sign?
Biliary atresia
A 64-year old male patient presents to the sonography department. He complains of abdominal pain, weight loss, and pruritus. You visualize an area of dilated ducts that abruptly end. What is the most likely diagnosis?
Cholangiocarcinoma
What malignant testicular tumor consists of trophoblastic cells?
Choriocarcinoma
What are the clinical findings of CRF?
Diabetes mellitus Malaise Elevated BUN and creatinine Fatigue Hypertension Hyperkalemia
What does amylase do?
Digests carbohydrates
What are the layers of the gallbladder wall?
From inner to outer: mucosal, fibromuscular, serosal
Which hepatic mass is closely associated with oral contraceptive use?
Hepatic adenoma
What is the most common reason for a liver transplant?
Hepatitis C
What does lipase do?
It breaks down fats into fatty acids and glycerol
What is the white pulp of the spleen responsible for?
Lymphatic function - produces lymphocytes to aid the immune system
The left portal vein divides into:
Medial and lateral branches
Sonographic findings of ARF:
Normal appearance Echogenic kidneys Hydronephrosis
What kind of artifact will pneumobilia cause?
Ring-down
Sonographic findings of CRF:
Small, echogenic kidneys Cortical thinning Loss of corticomedullary differentiation Renal cysts (possible)
A 15-year-old male patient presents to the sonography department with a history of left sided trauma 5 years earlier. He currently has no LUQ discomfort. The sonographic findings of the spleen include a mass that contains calcification producing posterior shadowing. What is the most likely diagnosis?
Splenic hematoma
What is the implantation of ectopic splenic tissue secondary to splenic rupture termed?
Splenosis
Where is the benign pheochromocytoma commonly located?
The adrenal gland
Where is a neuroblastoma most commonly found?
The pediatric adrenal gland
Where would an angiosarcoma most commonly be found?
The spleen
What is pitting?
The splenic process of cleaning RBCs of unwanted material
What is culling?
The splenic process of removing irregular RBCs from the bloodstream
What are the intrinsic causes of hydronephrosis?
Urolithiasis Congenital abnormality (vesicourethral reflux, posterior urethral valves, and ureterovesicular junction obstruction) Hematoma (blood clot) Neoplasm Ureteropelvic junction obstruction or ureteral stricture Ureterocele
Which vessel would be shortest in length? a. Right renal vein b. Right renal artery c. Left renal vein d. Left renal artery
a. Right renal vein
Which of the following would have a pulsatile triphasic blood flow pattern? a. Renal veins b. Hepatic veins c. Gonadal veins d. Common iliac veins
b. Hepatic veins (due to proximity to the heart)
Which of the following is a tumor marker that may be used in cases of suspected testicular malignancy? a. BUN b. Creatinine c. Human gonadotropin (beta-hCG) d. Calcitonin
c. beta-hCG
All are associated with Conn syndrome except: a. adrenal adenoma b. hypertension c. excessive thirst d. thinning arms & legs
d. thinning arms & legs
The arterial blood supply to the head of the pancreas is via the:
gastroduodenal artery
What is Zollinger-Ellison syndrome?
rare condition characterized by gastrin-producing tumors (gastroma) in the duodenum and/or pancreas that lead to oversecretion of gastrin, which lead to gastric and duodenal ulcers
The inherited disorder associated with the development of tumors in the central nervous system, orbits, renal cysts, and adrenal tumors is:
von Hippel-Lindau syndrome
