ch 4 Bile Ducts ART
39. For pts older than age 60, or those who have had a Cholecystectomy, a maximum diameter of ___ may be considered normal. a. 1 cm b. 12 mm c. 14mm d. 15cm
a. 1 cm
32. The Biliary Duct wall should NEVER measure more than: a. 2mm b. 9mm c. 4mm d. 5mm
a. 2mm
10. The Klatskin Tumor is located: a. At the junction of the right & left hepatic ducts b. At the junction of the cystic & CBD c. At the junction of the CBD & CHD d. Between the pancreatic head & duodenum
a. At the junction of the right & left hepatic ducts
20. Which of the following would be the most distal portion of the Biliary Tree? a. CBD b. CHD c. GB d. Intrahepatic radicles
a. CBD
14. The presence of an echogenic dot in the nondependent part of a dilated duct representing small fibrovascular bundles is seen with: a. Caroli Disease b. Choledochal Cysts c. Biliary Atresia d. Mirizzi Syndrome
a. Caroli Disease (Caroli Disease: a congenital disorder characterized by segmental dilatation of the intrahepatic ducts)
30. Which of the following is not associated w/the development of Pneumobilia? a. Cholangiopenumonia b. Gastric Surgery c. Acute Cholecystitis d. Fistula Formation
a. Cholangiopenumonia
4. Which of the following is associated w/ Charcot Triad? a. Cholangitis b. Cholesterolosis c. Klatskin Tumor d. Choledochal Cyst
a. Cholangitis
18. Which of the following is considered the most proximal portion of the Biliary Tree? a. Intrahepatic radicles b. Cystic duct c. CHD d. CBD
a. Intrahepatic radicles
13. Air within the biliary tree is referred to as: a. Pneumobilia b. Choledocholithiasis c. Choledocholithiasis d. Cholesterolosis
a. Pneumobilia
26. Sonographically, you visualize scattered echogenic linear structures within the liver parenchyma that produce ring-down artifact. What is the most likely diagnosis? a.Pneumobilia b.Choledocholithiasis c.Sludge balls d.Cholesterolosis
a. Pneumobilia
5. The merging point of the Pancreatic Duct & Common Bile Duct @ the level of Duodenum is referred to as the: a. Sphincter of Oddi b. Ampulla of Vater c. CBD d. Cystic Duct
b. Ampulla of Vater
37. The yellowish pigment found in Bile that's produced by the breakdown of old RBCs by the Liver is: a. Biliverdin b. Bilirubin c. Cholesterol d. Chyme
b. Bilirubin
31. A Klatskin Tumor is a form of: a. Lymphocytic Carcinoma b. Cholangiocarcinoma c. Pancreatic Carcinoma d. GB Carcinoma
b. Cholangiocarcinoma
25. A 32- y/o female pt presents to the sono department w/ a history of Fever, Leukocytosis, RUQ pain. Sono., you see dilated Bile Ducts that have thickened walls & contain Sludge. What's the most likely diagnosis? a. Choledocholithiasis b. Cholangitis c. Mirizzi Syndrome d. Biliary Atresia
b. Cholangitis
7. A gallstone located w/in the Biliary Tree is referred to as: a. Cholecystitis b. Choledocholithiasis c. Cholangitis d. Cholangiocarcinoma
b. Choledocholithiasis
21. Which of the following could accidentally introduce bacteria into the biliary tree & thus cause Cholangitis? a. Computed tomography b. Endoscopic retrograde cholangiopancreatography c. Magnetic resonance imaging d. Radiography
b. Endoscopic retrograde cholangiopancreatography
34. Which segment of the biliary tree tends to dilate first with obstruction: a. Intrahepatic b. Extrahepatic
b. Extrahepatic
12. A patient presents w/ Jaundice, Pain, Fever secondary to an impacted stone in the cystic duct. This is referred to as: a. Caroli Syndrome b. Mirizzi Syndrome c. Choledochal cysts d. Biliary Atresia
b. Mirizzi Syndrome
19. Pneumobilia will produce: a. Through transmission b. Ring-down artifact c. Acoustic shadowing d. Edge artifact
b. Ring-down artifact
8. Which of the following disorders is associated w/ the sonographic Triangular Cord Sign? a. Cholangitis b. Choledocholithiasis c. Biliary Atresia d. Ascariasis
c. Biliary Atresia
3. Primary biliary tree cancer is referred to as: a. GB Carcinoma b. Biloma c. Cholangiocarcinoma d. Lymphangioma
c. Cholangiocarcinoma
28. An ABD sono is ordered for an infant in the intensive care unit who is suffering from Jaundice & Fever. Sono., you see a cystic mass w/in the CBD that's causing a focal enlargement. This is most suggestive of: a. Cholangiocarcinoma b. Mirizzi Syndrome c. Choledochal Cyst d. Biliary Atresia
c. Choledochal Cyst
35. Which of the following is not a plausible cause of CBD obstruction in adults? a. Choledocholithiasis b. Chronic Pancreatitis c. Choledochal Cyst d. Pancreatic Carcinoma
c. Choledochal Cyst
24. The most common level for Biliary obstruction to occur is the: a. Junction of the right & left hepatic ducts b. Proximal CHD c. Distal CBD d. Cystic Duct
c. Distal CBD
33. Clinical findings of Choledocholithiasis include all of the following except: a. Jaundice b. Elevated Bilirubin c. Elevated blood urea nitrogen d. Elevated ALP
c. Elevated blood urea nitrogen
17. If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated? a. Main Pancreatic Duct b. GB only c. Intrahepatic Ducts d. Distal CBD
c. Intrahepatic Ducts
9. The yellowish staining of the whites of the eyes & the skin secondary to a liver disorder or Biliary obstruction is referred to as: a. AIDS cholangitis b. Pruritus c. Jaundice d. Bilirubinemia
c. Jaundice
16. Which of the following is characterized by fibrotic thickening of the Bile Ducts, found most often in young males, & is associated w/ inflammatory bowel disease or ulcerative colitis? a. Ulcerative biliary atresia b. Oriental cholangitis c. Sclerosing cholangitis d. AIDS biliary atresia
c. Sclerosing cholangitis
23. The muscles that controls the emptying of Bile & Pancreatic juices into the Duodenum is the: a. Cystic Duct b. Ampulla of Vater c. Sphincter of Oddi d. CBD
c. Sphincter of Oddi
2. Ascariasis is: a.) a form of biliary tree carcinoma b.) a congenital disorder characterized by segmental dilatation of the intrahepatic ducts c.) caused by a parasitic roundworm d.) a type of ringworm that invades the liver
c.) caused by a parasitic roundworm
22. If an obstructive biliary calculus is located w/in the distal common duct, which of the following could ultimately dilate? a. CBD b. GB c. CHD d. All above
d. All above
1. A congenital disease in which there is narrowing or obliteration of the Bile Ducts is referred to as: a. Caroli Disease b. Mirizzi Disease c. Choledochal Cysts d. Biliary Atresia
d. Biliary Atresia
27. A 64-y/o man presents to the sono department of a RUQ sono. He's complaining of ABD pain, weight loss, & Pruritus. Sono., you see an area of dilated ducts that abruptly end. What's the most likely diagnosis? a. Biliary Atresia b. Choledocholithiasis c. Caroli Syndrome d. Cholangiocarcinoma
d. Cholangiocarcinoma
11. Inflammation of the bile ducts is referred to as: a. Pneumobilia b. Choledocholithiasis c. Cholelithiasis d. Cholangitis
d. Cholangitis
38. Which of the following is typically found in pediatric pts & is described as the Cystic Dilation of CBD? a. Biliary Atresia b. Mirizzi Syndrome c. Caroli Disease d. Choledochal Cyst
d. Choledochal Cyst
40. Which of the following would be the most common cause of obstructive Jaundice? a. Klastin Tumor b. Cholangiocarcinoma c. Biliary Atresia d. Choledocholithiasis
d. Choledocholithiasis
6. Which of the following would be the least helpful laboratory value to analyze in pts w/ suspected Biliary Tract Disease? a. ALT b. ALP c. GGT d. Creatinine
d. Creatinine
15. The Spiral Valves of Heister are located w/in the: a. CBD b. Pancreatic Duct c. CHD d. Cystic Duct
d. Cystic Duct
29. All of the following are clinical findings consistent w/ Cholangiocarcinoma except: a. Pruritus b. Weight Loss c. Elevated Bilirubin d. Dilation of the Intrahepatic Ducts
d. Dilation of the Intrahepatic Ducts
36. All of the following are forms of Cholangitis except: a. Acute bacterial b. AIDS c. Oriental d. Parabolic
d. Parabolic