Test 1
Air within the biliary tree is referred to as: a. Pneumobilia b. Cholangitis c. Choledocholithiasis d. Cholesterolosis
a.
All of the following are clinical findings of HCC except: a. Reduction in AFP b. Unexplained weight loss c. Fever d. Cirrhosis
a.
At which level of the gallbladder is the junctional fold found? a. Neck b. Fundus c. Body d. Phrygian cap
a.
Clinical findings of fatty infiltration of the liver include: a. Elevated liver function tests b. Fever c. Fatigue d. Weight loss
a.
Diabetic patients suffering from acute cholecystitis have an increased risk for developing: a. Emphysematous cholecystitis b. Gangrenous cholecystitis c. Chronic cholecystitis d. Gallbladder torsion
a.
Focal tenderness over the gallbladder with probe pressure describes: a. Murphy sign b. Strawberry sign c. Courvoisier sign d. Hydrops sign
a.
Normal flow toward the liver in the portal veins is termed: a. Hepatopetal b. Hepatofugal
a.
The Klatskin tumor is located: a. At the junction of the right and left hepatic ducts b. At the junction of the cystic and common bile duct c. At the junction of the common bile duct and common hepatic duct d. Between the pancreatic head and the duodenum
a.
The childhood syndrome Beckwith-Weidemann is associated with an increased risk for developing: a. Hepatoblastoma b. Cirrhosis c. Portal hypertension d. Hepatitis
a.
The covering of the liver is referred to as: a. Glisson capsule b. Gerota fascia c. Morison pouch d. Hepatic fascia
a.
The diffuse polypoid appearance of the gallbladder referred to as strawberry gallbladder is seen with: a. Cholesterolosis b. Adenomyomatosis c. Cholangitis d. Kawasaki disease
a.
The inferior extension of the caudate lobe is referred to as: a. Papillary process b. Focal hepatomegaly c. Riedel process d. Morison lobe
a.
The left lobe of the liver can be divided into: a. Medial and lateral segments b. Medial and posterior segments c. Anterior and medial segments d. Anterior and posterior segments
a.
The ligamentum teres can be used to separate the: a. Medial and lateral segments of the left lobe b. Medial and posterior segments of the right lobe c. Anterior and medial segments of the left lobe d. Anterior and posterior segments of the right lobe
a.
The middle layer of the gallbladder wall is the: a. Fibromuscular layer b. Mucosal layer c. Serosal layer d. Muscularis layer
a.
The most common variant of gallbladder shape is the: a. Phrygian cap b. Hartmann pouch c. Septated gallbladder d. Junctional fold
a.
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.
The right intersegmental fissure contains the: a. Right hepatic vein b. Middle hepatic vein c. Left portal vein d. Right portal vein
a.
The sequela of acute cholecystitis that is complicated by gas within the gallbladder wall is: a. Emphysematous cholecystitis b. Membranous cholecystitis c. Chronic cholecystitis d. Gallbladder perforation
a.
Which hepatic mass is closely associated with oral contraceptive use? a. Hepatic adenoma b. Hepatic hypernephroma c. Hepatic hamartoma d. Hepatic hemangioma
a.
Which of the following is associated with Charcot triad? a. Cholangitis b. Cholesterolosis c. Klatskin tumor d. Choledochal cyst
a.
Which of the following is associated with cholelithiasis and is characteristically found in Africans or people of African descent? a. Sickle cell disease b. Gallbladder torsion c. Cholesterolosis d. Arland-Berlin syndrome
a.
Which of the following is considered the most proximal portion of the biliary tree? a. Intrahepatic radicles b. Cystic duct c. Common hepatic duct d. Common bile duct
a.
Which of the following is not a risk factor for the development of gallstones? a. Phrygian cap b. Pregnancy c. Total parenteral nutrition d. Oral contraceptive use
a.
Which of the following is typically transmitted through contaminated water found in places such as Mexico, Central America, South America, Asia, India, and Africa? a. Amebic liver abscess b. Hydatid liver cyst c. Candidiasis d. Hepatoma
a.
Which of the following would be the most distal portion of the biliary tree? a. Common bile duct b. Common hepatic duct c. Gallbladder d. Intrahepatic radicles
a.
Which part of the gallbladder is involved in Hartmann pouch? a. Neck b. Fundus c. Body d. Phrygian cap
a.
Which statement is not true of cholelithiasis? a. Men have an increased likelihood of developing cholelithiasis. b. Patients who have been or are pregnant have an increased occurrence of cholelithiasis. c. A rapid weight loss may increase the likelihood of developing cholelithiasis. d. Patients who have hemolytic disorders have an increased occurrence of cholelithiasis.
a.
Which structure is a useful landmark for identifying the gallbladder? a. Main lobar fissure b. Hepatoduodenal ligament c. Falciform ligament d. Ligamentum venosum
a.
With which of the following is Courvoisier gallbladder associated? a. A pancreatic head mass b. A stone in the cystic duct c. Cholecystitis d. Chronic diverticulitis
a.
A gallstone located within the biliary tree is referred to as: a. Cholecystitis b. Choledocholithiasis c. Cholangitis d. Cholangiocarcinoma
b.
A patient presents with jaundice, pain, and 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.
Acute cholecystitis that leads to necrosis and abscess development within the gallbladder wall describes: a. Emphysematous cholecystitis b. Gangrenous cholecystitis c. Chronic cholecystitis d. Gallbladder perforation
b.
All of the following are sequela of cirrhosis except: a. Portal vein thrombosis b. Hepatic artery contraction c. Portal hypertension d. Splenomegaly
b.
Empyema of the gallbladder denotes: a. Gallbladder hydrops b. Gallbladder filled with pus c. Gallbladder completely filled with air d. Gallbladder completely filled with polyps
b.
Normal flow within the hepatic artery should demonstrate a: a. High-resistance waveform pattern, with a slow upstroke, and gradual deceleration with diastole b. Low-resistance waveform pattern, with a quick upstroke, and gradual deceleration with diastole c. Low-resistance waveform pattern, with a slow upstroke, and gradual acceleration with diastole d. High-resistance waveform pattern, with a quick upstroke, and gradual deceleration with diastole
b.
Pneumobilia will produce: a. Through transmission b. Ring-down artifact c. Acoustic shadowing d. Edge artifact
b.
Right-sided heart failure often leads to enlargement of the: a. Abdominal aorta b. IVC and hepatic veins c. IVC and portal veins d. Portal veins and spleen
b.
The TIPS shunt is placed: a. Between the main hepatic artery and main portal vein b. Between a portal vein and hepatic vein c. Between the common hepatic duct and common bile duct d. Between a portal vein and hepatic artery
b.
The diameter of the gallbladder should not exceed: a. 8 cm b. 5 cm c. 7 mm d. 3 cm
b.
The innermost layer of the gallbladder wall is the: a. Fibromuscular layer b. Mucosal layer c. Serosal layer d. Muscularis layer
b.
The left lobe of the liver can be separated from the right lobe by the: a. Right hepatic vein b. Middle hepatic vein c. Left hepatic vein d. Falciform ligament
b.
The main lobar fissure contains the: a. Right hepatic vein b. Middle hepatic vein c. Main portal vein d. Right portal vein
b.
The main portal vein divides into: a. Middle, left, and right branches b. Left and right branches c. Anterior and posterior branches d. Medial and lateral branches
b.
The merging point of the pancreatic duct and common bile duct at the level of duodenum is referred to as the: a. Sphincter of Oddi b. Ampulla of Vater c. Common bile duct d. Cystic duct
b.
The spiral valves of Heister are found within the: a. Gallbladder neck b. Cystic duct c. Gallbladder fundus d. Gallbladder wall
b.
Tumefactive sludge can resemble the sonographic appearance of: a. Cholelithiasis b. Gallbladder carcinoma c. Cholecystitis d. Adenomyomatosis
b.
What hormone causes the gallbladder to contract? a. Estrogen b. Cholecystokinin c. Bilirubin d. Biliverdin
b.
What is/are cholelithiasis? a. Inflammation of the gallbladder b. Gallstones c. Hyperplasia of the gallbladder wall d. Polyps within the biliary tree
b.
Which of the following is the most common reason for a liver transplant? a. Hepatocellular carcinoma b. Hepatitis C c. Hepatitis B d. Hepatic metastasis
b.
Which of the following is true about the portal veins? a. Portal veins carry deoxygenated blood away from the liver. b. Portal veins have brighter walls than the hepatic veins. c. Portal veins should demonstrate hepatofugal flow. d. Portal veins increase in diameter as they approach the diaphragm.
b.
A 71-year-old patient presents to the emergency department with painless jaundice and an enlarged, palpable gallbladder. These findings are highly suspicious for: a. Acute cholecystitis b. Chronic cholecystitis c. Courvoisier gallbladder d. Porcelain gallbladder
c.
A nonmobile, nonshadowing focus is seen within the gallbladder lumen. This most likely represents: a. Gallstone b. Gallbladder carcinoma c. Gallbladder polyp d. Sludge ball
c.
A tonguelike extension of the right lobe of the liver is termed: a. Papillary lobe b. Focal hepatomegaly c. Riedel lobe d. Morison lobe
c.
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.
Budd-Chiari syndrome leads to a reduction in the size of the: a. Hepatic arteries b. Portal veins c. Hepatic veins d. Common bile duct
c.
Calcification of the gallbladder wall is termed: a. Concrete gallbladder b. Heister syndrome c. Porcelain gallbladder d. Hyperplastic cholecystosis
c.
Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with: a. Acute cholecystitis b. Acalculous cholecystitis c. Adenomyomatosis d. Gallbladder perforation
c.
Hepatization of the gallbladder occurs when the gallbladder: a. Perforates b. Becomes hydropic c. Fills with sludge d. Undergoes torsion
c.
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. Gallbladder only c. Intrahepatic ducts d. Distal common bile duct
c.
Intermittent obstruction of the cystic duct by a gallstone results in: a. Emphysematous cholecystitis b. Gangrenous cholecystitis c. Chronic cholecystitis d. Acute cholecystitis
c.
Primary biliary tree cancer is referred to as: a. Gallbladder carcinoma b. Biloma c. Cholangiocarcinoma d. Lymphangioma
c.
The champagne sign is associated with: a. Adenomyomatosis b. Cholangiocarcinoma c. Emphysematous cholecystitis d. Acalculous cholecystitis
c.
The cystic artery is most often a direct branch of the: a. Main pancreatic artery b. Celiac artery c. Right hepatic artery d. Left hepatic artery
c.
The gallbladder is connected to the biliary tree by the: a. Common hepatic duct b. Common bile duct c. Cystic duct d. Right hepatic duct
c.
The left umbilical vein after birth becomes the: a. Falciform ligament b. Main lobar fissure c. Ligamentum teres d. Ligamentum venosum
c.
The most common cause of cirrhosis is: a. Portal hypertension b. Hepatitis c. Alcoholism d. Cholangitis
c.
The outermost layer of the gallbladder wall is the: a. Fibromuscular layer b. Mucosal layer c. Serosal layer d. Muscularis layer
c.
The right lobe of the liver is divided into segments by the: a. Middle lobar fissure b. Middle hepatic vein c. Right hepatic vein d. Left hepatic vein
c.
The right portal vein divides into: a. Middle, left, and right branches b. Left and right branches c. Anterior and posterior branches d. Medial and lateral branches
c.
The yellowish staining of the whites of the eyes and the skin secondary to a liver disorder or biliary obstruction is referred to as: a. AIDS cholangitis b. Pruritus c. Jaundice d. Bilirubinemia
c.
WES sign denotes: a. The presence of a gallstone lodged in the cystic duct b. Multiple biliary stones and biliary dilatation c. A gallbladder filled with cholelithiasis d. The sonographic sign of a porcelain gallbladder
c.
Which of the following disorders is associated with the sonographic triangular cord sign? a. Cholangitis b. Choledocholithiasis c. Biliary atresia d. Ascariasis
c.
Which of the following is associated with E. granulosus? a. Candidiasis b. Amebic liver abscess c. Hydatid liver cyst d. Hepatocellular carcinoma
c.
Which of the following is characterized by fibrotic thickening of the bile ducts, found most often in young males, and is associated with inflammatory bowel disease or ulcerative colitis? a. Ulcerative biliary atresia b. Oriental cholangitis c. Sclerosing cholangitis d. AIDS biliary atresia
c.
Which of the following is the most common form of liver cancer? a. Hepatocellular carcinoma b. Adenocarcinoma c. Metastatic liver disease d. Hepatoblastoma
c.
Which of the following would be least likely to cause focal gallbladder wall thickening? a. Gallbladder polyp b. Adenomyomatosis c. Ascites d. Adhered gallstone
c.
Which of the following would not be the least likely finding of acalculous cholecystitis? a. Gallbladder wall thickening b. Pericholecystitic fluid c. Cholelithiasis d. Positive Murphy sign
c.
A 32-year-old female patient presents to the sonography department with vague abdominal pain. The sonographic investigation of the gallbladder reveals a focal area of gallbladder wall thickening that produces comet tail artifact. These findings are consistent with: a. Gangrenous cholecystitis b. Gallbladder perforation c. Acalculous cholecystitis d. Adenomyomatosis
d.
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.
All of the following are located within the porta hepatis except: a. Main portal vein b. Common bile duct c. Hepatic artery d. Middle hepatic vein
d.
All of the following are sources of diffuse gallbladder wall thickening except: a. Acute cholecystitis b. AIDS c. Hepatitis d. Gallbladder polyp
d.
Clinical findings of hepatitis include all of the following except: a. Jaundice b. Fever c. Chills d. Pericholecystic fluid
d.
Inflammation of the bile ducts is referred to as: a. Pneumobilia b. Choledocholithiasis c. Cholelithiasis d. Cholangitis
d.
Normal flow within the hepatic veins is said to be: a. Biphasic b. Irregular c. High resistant d. Triphasic
d.
Shortly after birth, the ductus venosus collapses and becomes the: a. Falciform ligament b. Main lobar fissure c. Ligamentum teres d. Ligamentum venosum
d.
Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of: a. Portal vein thrombosis b. Metastatic liver disease c. Primary liver carcinoma d. Fatty liver disease
d.
The diameter of the portal vein should not exceed: a. 4 mm b. 8 mm c. 10 mm d. 13 mm
d.
The direct blood supply to the gallbladder is the: a. Cholecystic artery b. Common hepatic artery c. Main portal vein d. Cystic artery
d.
The gallbladder wall should measure not more than: a. 5 mm b. 6 mm c. 4 mm d. 3 mm
d.
The left portal vein divides into: a. Middle, left, and right branches b. Left and right branches c. Anterior and posterior branches d. Medial and lateral branches
d.
The right lobe of the liver can be divided into: a. Medial and lateral segments b. Medial and posterior segments c. Anterior and medial segments d. Anterior and posterior segments
d.
The spiral valves of Heister are located within the: a. Common bile duct b. Pancreatic duct c. Common hepatic duct d. Cystic duct
d.
What form of hepatic abnormality are immunocompromised patients more prone to develop? a. Hepatic adenoma b. Amebic abscess c. Hydatid liver abscess d. Candidiasis
d.
Which of the following benign liver masses is typically isoechoic and contains a central scar? a. Hepatoblastoma b. Cavernous hemangioma c. Hamartoma d. Focal nodular hyperplasia
d.
Which of the following is considered the most common benign childhood hepatic mass? a. Hepatoblastoma b. Hepatoma c. Hematoma d. Hemangioendothelioma
d.
Which of the following is the most likely clinical finding of adenomyomatosis? a. Murphy sign b. Hepatitis c. Congestive heart failure d. Asymptomatic
d.
Which of the following masses would be most worrisome for malignancy? a. Echogenic mass b. Cystic mass with posterior enhancement c. Isoechoic mass with a central scar d. Hyperechoic mass with a hypoechoic halo
d.
Which of 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.
Which of the following would not be a laboratory finding typically analyzed with suspected gallbladder disease? a. ALP b. ALT c. Bilirubin d. Alpha-Fetoprotein
d.