Final Exam Prep 2

Spleen is the __ most common site of metastases.

10th

Which one of the following syndromes demonstrates a decrease in adrenal function? 1) Adrenogenital 2) Addison 3) Conn 4) Cushing

2) Addison

Which one of the following is the most common cause of primary adrenal tumors? 1) Cyst 2) Adenoma 3) Carcinoma 4) Pheochromocytoma

2) Adenoma

Metastases to the adrenal gland are most commonly caused by primary carcinoma of the __________, __________, and __________. 1) Breast; liver; kidney 2) Lung; breast; stomach 3) Lung; breast; liver 4) Kidney; colon; liver

2) Lung; breast; stomach

Which one of the following statements describes adrenal cysts? 1) Male patients are affected more than female patients. 2) Patients are typically asymptomatic. 3) Adrenal cysts are a common finding. 4) Adrenal cysts are usually bilateral.

2) Patients are typically asymptomatic.

Spleen contains about __ to __ml of erythrocytes

20-30

Which one of the following demonstrates an excessive secretion of epinephrine? 1) Adrenal cyst 2) Adrenal adenoma 3) Medulla tumor 4) Neuroblastoma Medulla tumor

3) Medulla tumor

The most common adrenal tumor in infancy is the: 1) Adenoma 2) Pheochromocytoma 3) Neuroblastoma 4) Liposarcoma

3) Neuroblastoma

Which one of the following statements about the adrenal medulla is true? 1) The medulla is the outer portion of the adrenal gland. 2) The medulla secretes a large range of steroids. 3) The medulla is not essential to life. 4) The medulla secretes estrogen.

3) The medulla is not essential to life.

The diameter of the common hepatic duct is approximately __ mm.

4

Adrenal insufficiency is typically caused by: 1) Adrenal adenoma 2) Adrenal cyst 3) Lymphadenopathy 4) Metastatic lesions

4) Metastatic lesions

What adrenal tumor demonstrates intermittent hypertension and severe headaches? 1) Neuroblastoma 2) Adenoma 3) Myolipoma 4) Pheochromocytoma

4) Pheochromocytoma

Epstein-Barr infection is best described as:

A herpes vrius that can lead to infectious mononucleosis in children

The left adrenal glands lie lateral to the: A) crus of the diaphragm B) tail of the pancreas C) stomach D) IVC

A) crus of the diaphragm

Thalassemia:

Abnormally shaped RBCs destroyed in great numbers. Splenomegaly is present.

Sonographic findings of acute hepatitis include

Accentuated brightness, more extensive demonstration of portal vein radicals, and an overall decrease echogenicity of the liver

What benign liver tumor has been found in patients with type 1 glycogen storage disease?

Adenomas,focal nodular hyperplasia and hepatomegaly

A condition causing RUQ pain in which small polypoid masses arise from the gallbladder wall is

Adenomyomatosis

Small polypoid projections from the gallbladder wall

Adenomyomatosis

In cases of choledocholithiasis, stones tend to lodge in the:

Ampulla of vater

All of the following statements are true about the features most often observed in an intrahepatic mass except

Anterior displacement of the right kidney

Gaucher's Disease:

Appears as splenomegaly, presents with bone pain and change in skin pigmentation. Affects 50% of patients younger than 8 years.

The right adrenal gland lies posterior to the: A) crus of the diaphragm B) IVC C) right kidney D) liver

B) IVC

Hyperechoic mass with an echogenic central core (abscesses metastases)

Bulls eye target lesion

Which one of the following is present in urine whenever extensive damage of destruction of the functioning erythrocytes occurs? A) protein B) creatinine C) hemoglobin D) albumin

C) hemoglobin

Patients positive for AIDS are at the risk for developing:

Cholangitis

Cystic growth on the common duct that may cause obstruction

Choledocal cyst

Variant of adenomyomatosis; cholesterol polyps

Cholesterolosis

Diminished vascular structures within the liver parenchyma most likely

Cirrhosis

The most common form of neoplastic involvement of the liver is?

Colon, breast and lung

Collection in the right posterior subphrenic space cannot extend between the bare area of the liver and the ________.

Coronary ligament

The valves of Heister are tiny valves found with the:

Cystic duct

The hepatic duct is joined by the ___________ to form the ___________ .

Cystic duct; Common Bile Duct

Atrophy of the spleen may be found in all of the following except: A) normal individuals B) wasting diseases C) sickle cell anemia D) cirrhosis

D) cirrhosis

Affects hepatocytes and interferes with liver function

Diffuse hepatocellular disease

Through the process of______ the liver expels these waste products from the body via its excratory product, bile, which also plays an important role in fat absorption

Digestion

_____________ the only parasite to form splenic cysts.

Echinococcus

What commonly causes occlusion of the splenic artery or its branches?

Emboli from the heart, produced from mural thrombi or vegetation of left heart valves.

Polycythemia Vera:

Excess RBCs. Symptoms of weakness, fatigue, vertgo, flushing or redness of skin, blue-black spots. Presence of splenomegaly.

Spleen's main function:

Filter peripheral blood, defense against disease

In the focal spring, the most common affected areas are interior to the___ or the portal vein and the posterior portion of the __ of the liver

Gallbladder, left lobe

Another name for splenoma is:

Hamartoma

Asymptomatic rare benign tumor. Sonographically appears as hyperechoic with cystic and solid components, well-defined but not encapsulated.

Hamartoma

Small parts of the gallbladder that lies near the cystic duct where stones may collect

Hartmann's pouch

An evaluation of the spleen reveals a 1-cm, rounded echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis?

Hemangioma

Classic symptoms of gallbladder disease include all of the following EXCEPT:

Hematuria

Diffuse enzymatic destruction of the pancreatic substance is _________.

Hemorrhagic Pancreatitis

Reed-Sternberg cells indicate:

Hodgkin lymphoma

_______________ may appear as a hypoechoic mass or with necrosis, a cystic mass in the pancreas.

Intraabdominal lymphoma

small septum within the gallbladder, usually arising from the posterior wall

Junctional fold

The most common tumor sites that can spread carcinoma to the biliary tree include all of the following EXCEPT the:

Kidney

Cancer at the bifurcation of the hepatic ducts; may cause asymmetrical obstruction of the biliary tree

Klatskin's tumor

Most common location for a pseuodocyst is in the ________.

Lesser Sac

Phrenococolic ligament:

Ligament in contact with posterior peritoneal wall.

The most common site for ecchinococcal virus growth is in the

Liver

A patient presents with left upper quadrant pain. An abdominal sonogram reveals a complex mass in the spleen with free fluid in the abdominal/pelvic cavity. This most likely represents:

Lymphoma

Atrophy of spleen:

May be found in normal individuals. May also occur in wasting diseases. Chronic hemolytic anemias (sickle cell anemia).

The liver is a major center of_____ which may be defined as the physical and chemical process whereby foodstuffs are synthesized into complex element

Metabolism

Small echogenic foci scattered throughout the spleen most likely represents?

Multiple benign granulomas

A 35-year-old male patient presents to the ultrasound department for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen?

Multiple granulomas

___________ presentation tends to be large tumors in the head of the pancreas with a high incidence of malignancy.

Non-functioning Islet-Cell Tumors

Classification of liver disease where the main problem is blocked bile excretion within the liver or biliary system

Obstructive disease

__________ has a high mortality rate if left untreated.

Pancreatic Abscess

The distal duct lies __with the anterior wall of the inferior Vena cava

Parallel

Splenorenal ligament:

Peritoneal ligament attaching spleen to stomach and kidney.

Are primary or secondary diseases more common in the spleen?

Secondary sources, the spleen is rarely the site of primary diseases.

Sickle Cell Anemia:

Seen in infants and children as enlarged spleen. Degenerates with age until it becomes a small fibrous mass in adults.

Normal arrangement of assymetricbody parts is called:

Situs solitus

All of the following sonographic appearances are found in cases of gallbladder carcinoma EXCEPT:

Sludge

Sickle cell disease will often lead to:

Splenomegaly

The most common cause of biliary ductal obstruction is in the presence of a ductal:

Tumor

Which one of the following actions should be done to image the near field of the liver

Use a curved array transducer

In glycogen storage disease type 1 is the most common and is also known as _____ disease

Von Gierke

Metastatic tumors appear as:

Well-defined lesions that range from hypoechoic, iso-echoic, hyperechoic. Can appear as target or halo lesions. Larger lesions are more complex.

A congenital absence of the spleen can indicate other problems such as: a) Cardiac malformations b) Duplicated urinary collecting system c) Uterine anomalies d) Pancreatic agenesis

a) Cardiac malformations

All of the following sonographic appearances are found in cases of gallbladder carcinoma except: a. Sludge b. Wall thickening c. Cholelithiasis d. Intraluminal wall mass

a. Sludge

Common malignancies affecting the pediatric population include all of the following except: a. Neuroblastoma b. Wilms tumor c. Leukemia d. Hepatoblastoma

d. Hepatoblastoma

The stomach is _____ and _____ to the splenic hilum.

anterior and medial

All of the following actions can be attempted to improve an image of the near field of the liver to see borders EXCEPT: a. Increase transducer frequency. b. Change to a linear transducer. c. Use a curved array transducer. d. Adjust focal zones to near field

b. Change to a linear transducer.

Which one of the following is noted in type I glycogen storage disease? a. Small liver and hypoechoic parenchyma b. Hyperechoic liver and hepatomegaly c. Normal texture and hepatomegaly d. Normal texture and prominent intrahepatic biliary ducts

b. Hyperechoic liver and hepatomegaly

An abnormal decrease in platelets may be the result of a(n): a) Infection b) Bone marrow disorder c) Internal hemorrhage d) Allergic reaction

c) Internal hemorrhage

The splenorenal ligament: a) is a double fold of peritoneum. b) both a and b are correct. c) holds the spleen rigidly fixed to the stomach and kidney. d) contains blood vessels and nerves.

c) holds the spleen rigidly fixed to the stomach and kidney.

The most common primary retroperitoneal tumor is: 1) Lymphoma 2) Fibrosarcoma 3) Germ cell tumor 4) Leiomyosarcoma

1) Lymphoma

True cysts may be _________or __________.

congential , aquired

______ arises as a cystic neoplasm from the ducts.

cystadenocarcinoma

___________ is a rare, benign disease with female predominance.

cystadenoma

Extends from the umbilicus to the diaphragm in sagittal plane and contains the ligamentum teres

falciform ligament

the liver is suspended fro the diaphragm and anterior abdominal wall by the

falciform ligament

fatty infiltration may be observed in all patients EXCEPT those with? a. Diabetes mellitus b. Chronic alcoholism c. Hepatoportal fistula d. Hepatitis

hepatoportal fistula

The spleen may grow to enormous size with extension into the ______ ______.

iliac fossa

LUQ mass will displace spleen...

inferiorly

________ are the most common islet cell tumors. _______ are the second most common.

insulinoma, gastrinoma

Which congenital splenic disorder is associated with visceral heterotaxy of bilateral left-sideness?

polysplenia syndrome

Spleen is part of the ___________ system.

reticuloendothelial

What systemic disease results in the development of granulomatosis?

sarcoidosis

In adults with a history of sickle cell anemia, the spleen is typically:

small

A 14-year-old male patient presents to the US department after falling from his bicycle. An abdominal sonogram reveals a complex-appearing mass within the spleen. This most likely represents a:

splenic hematoma

Inferiomedial surface comes in contact with... (4)

stomach, left kidney, pancreas, and splenic flexure of colon

The splenic artery enters the spleen at the splenic hilum _____ and _____ to the splenic vein.

superior, anterior

Pancreatic cysts may be________ or ________.

unilocular, multilocular