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ARDMS ABD REVIEW > Retroperitoneum > Flashcards

Retroperitoneum Flashcards

1
Q

Which of the following muscles would be situated closest to the spine?

rectus abdominis
psoas muscle
quadratus lumborum
iliacus

A

psoas muscle

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2
Q

Which of the following is included in the clinical findings of retroperitoneal fibrosis?

hematuria
migraine medication use
diabetes mellitus
diarrhea

A

migraine medication use

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3
Q

A 45 year old patient presents to the sonography department with chest pain and shortness of breath. During the sonographic examination of the abdomen, an anechoic fluid collection is noted superior to the diaphragm. This most likely represents:

congential cystic adenomatoid malformation of the lung
pulmonary sequestration
pleural effusion
cystic adenomatoid malformation

A

pleural effusion

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4
Q

The “sandwich” sign denotes:

pyloric stenosis
intussusception
retroperitoneal fibrosis
abdominal lymphadenopathy

A

abdominal lymphadenopathy

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5
Q

Abnormal lymph nodes typically measure more than:

10 mm
7 mm
8 mm
1 mm

A

10 mm

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6
Q

Where is the thymus located?

within the neck
within the mediastinum
superior to the rectum
anterior to the abdominal AO

A

within the mediastinum

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7
Q

Fluid located around the lungs is termed:

ascites
pleural effusion
lung consolidation
pericardial effusion

A

pleural effusion

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8
Q

What is the most common location of a retroperitoneal hematoma in a hemophiliac patient?

rectum
anterior abdominal wall
psoas muscle
rectus abdominis muscle

A

psoas muscle

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9
Q

Which of the following is NOT located within the mediastinum?

heart
thymus
esophagus
lungs

A

lungs

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10
Q

The replacement of normal air-filled alveoli with fluid, inflammation, blood, or neoplastic cells is referred to as:

pneumothorax
congenital cystic adenomatoid malformation
pulmonary sequestration
lung consolidation

A

lung consolidation

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11
Q

Free air within the chest outside the lungs is referred to as:

pneumothorax
congenital cystic adenomatoid malformation
pulmonary sequestration
lung consolidation

A

pneumothorax

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12
Q

A separate mass of nonfunctioning lung tissue with its own blood supply describes:

pneumothorax
congenital cystic adenomatoid malformation
pulmonary sequestration
lung consolidation

A

pulmonary sequestration

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13
Q

A mass consisting of abnormal bronchial and lung tissue that develops within the fetal chest best describes:

pneumothorax
congenital cystic adenomatoid malformation
pulmonary sequestration
lung consolidation

A

congenital cystic adenomatoid malformation

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14
Q

The diagnostic or therapeutic procedure where fluid is removed from the pleural space is referred to as:

thoracentesis
pneumothorax
paracentesis
pericardial centesis

A

thoracentesis

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15
Q

Which of the following could result from undergoing a thoracentesis?

DVT
penumothorax
pericardial effusion
ascites

A

pneumothorax

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16
Q

Typically, a hematoma appears:

hyperechoic
hypoechoic
complex
all of the above

A

all of the above

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17
Q

The diagnosis of a pneumothorax is typically via a(n):

upright position
thoracentesis
chest radiograph
nuclear medicine chest perfusion study

A

chest radiograph

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18
Q

Fluid located around the heart is termed:

ascites
pleural effusion
lung consolidation
pericardial effusion

A

pericardial effusion

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19
Q

Which of the following is the most likely sonographic appearance of the thymus?

echogenic mass that contains linear and punctuate echogenicities

anechoic structure anterior to the sternum

complex mass anterior to the iliac crest

homogenous mass with posterior shadowing containing anechoic cystic structures

A

echogenic mass that contains linear and punctuate echogenicities

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20
Q

Which of the following is the most common sonographic appearance of retroperitoneal fibrosis?

hypoechoic mass surrounding the AO
multiple small lymph nodes anterior to the AO
anechoic mass in the lower abdomen
echogenic mass posterior to the kidneys

A

hypoechoic mass surrounding the AO

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21
Q

Which of the following can be seen posterior and lateral to the kidney?

rectus abdominis
psoas muscle
quadratus lumborum
iliacus

A

quadratus lumborum

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22
Q

Which of the following would NOT be a typical clinical finding of a patient with retroperitoneal hematoma?

low hematocrit
trauma
weight loss
hemophilia

A

weight loss

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23
Q

Enlargement of the abdominal lymph nodes is referred to as:

retroperitoneal fibrosis
retroperitoneal lymphadenopathy
abdominal consolidation
retroperitoneal sequestration

A

retroperitoneal lymphadenopathy

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24
Q

Which of the following is a linear muscular section of the diaphragm that attaches to the anterolateral surfaces of the upper lumbar vertebrae?

crus of the diaphragm
psoas muscle
iliacus
quadratus lumborum

A

crus of the diaphragm

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25
Q

All of the following are potential causes of lung consolidation EXCEPT:

pneumonia
hemorrhage
carcinoma
pulmonary sequestration

A

pulmonary sequestration

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26
Q

One complication of a thoracentesis that may require a chest radiograph for diagnosis is the development of a:

pneumothorax
sequestration
cystic adenomatoid malformation
rib fracture

A

pneumothorax

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27
Q

Common locations for abdominal lymph nodes include all of the following EXCEPT:

mesentery
renal hilum
along the length of the abdominal AO
within the subhepatic space

A

within the subhepatic space

28
Q

Lung consolidation typically appears sonographically as:

several internal echoes that radiate in a linear pattern because of air within the bronchi

an anechoic mass with posterior enhancement

an echogenic mass with posterior shadowing

a large, hypoechoic mass surrounding the pericardial space

A

several internal echoes that radiate in a linear pattern because of air within the bronchi

29
Q

A 65 year old patient presents to the sonography department with a history of abdominal pain and weight loss. Sonographically, you visualize multiple hypoechoic masses that extend along the anterior border of the abdominal AO. Which of the following would be most likely?

pulmonary sequestration
retroperitoneal hematoma
retroperitoneal lymphadenopathy
encapsulated ascites

A

retroperitoneal lymphadenopathy

30
Q

What patient position is typically required for a thoracentesis?

upright
prone
supine
trendelenburg

A

upright

31
Q

A 35 year old female patient presents to the sonography department with a history of migraine headache medication use, weight loss, nausea, and malaise. Sonographically, you visualize a 15 cm hypoechoic mass within the abdomen. Which of the following would be most likely?

volvulus
retroperitoneal fibrosis
intussusception
retroperitoneal lymphadenopathy

A

retroperitoneal fibrosis

32
Q

All of the following are true of abnormal lymph nodes EXCEPT:

they tend to lose their echogenic hilum

enlargement may be associated with infection or malignancy

they tend to measure less than 1 cm

the “sandwich” sign denotes abdominal nodes surrounding and compressing the AO and IVC

A

they tend to measure MORE than 1 cm

33
Q

Which of the following most often accompanies lung consolidation?

ascites
retroperitoneal fibrosis
retroperitoneal hematoma
pleural effusion

A

pleural effusion

34
Q

A 63 year old male patient presents to the sonography department for an examination of the abdomen. He has a history of lung cancer and is suffering from SOB. Sonographically, the liver and GB appear normal. However, you visualize a heterogenous fluid collection superior to the right hemidiaphragm. What is the most likely diagnosis?

pulmonary sequestration
complex pleural effusion
pneumothorax
cystic adenomatoid malformation

A

complex pleural effusion

35
Q

A 38 year old female patient presents to the sonography department with a history of femoral artery puncture and back pain. What lab value would be helpful to assess the patient for active bleeding?

hematocrit
blood urea nitrogen
alkaline phosphatase
creatinine

A

hematocrit

36
Q

A pleural effusion that is associated with infection will sonographically appear:

complex
anechoic
septated
varying sonographic appearances have been noted

A

varying sonographic appearances have been noted

37
Q

Which of the following best describes a hemophiliac?

a person who lacks hemoglobin and hematocrit clotting factors

a person who has an inherited bleeding disorder that inhibits the control of blood clotting

a person who has an inherited breathing disorder that causes the development of pulmonary sequestration

a person who has abnormally shaped RBCs

A

a person who has an inherited bleeding disorder that inhibits the control blood clotting

38
Q

The tissue comprising a lung consolidation can appear sonographically isoechoic to:

the liver
the IVC
the AO
the rectus abdominis

A

the liver

39
Q

Enlarged, abnormal lymph nodes tend to deviate from their normal sonographic appearance and become more:

isoechoic
anechoic
hypoechoic
anechoic or hypoechoic

A

anechoic or hypoechoic

40
Q

All of the following may be discovered sonographically within the chest EXCEPT:

bronchial infections
pleural effusion
lymphomas
thymomas

A

bronchial infections

41
Q

Which of the following structures is NOT retroperitoneal in location?

spleen
kidneys
pancreas
AO
psoas muscles

A

spleen

42
Q

You are performing an abdominal sonogram and detect a striated, hypoechoic structure immediately posterior to the right kidney. A similar structure is seen posterior to the left kidney. What are you imaging?

psoas muscle
quadratus lumborum muscle
adrenal gland
diaphragmatic crura
gerota’s fascia

A

quadratus lumborum muscle

43
Q

The kidneys lie in what retroperitoneal space?

posterior pararenal space
perirenal space
retrofascial space
anterior pararenal space
the kidneys are not retroperitoneal in location

A

perirenal space

44
Q

During sonographic evaluation of the periaortic area, you detect several hypoechoic structures, each measuring slightly greater than 2.0 cm, adjacent to the celiac trunk and SMA. What is the most likely etiology of theses structures?

diaphragmatic crus
retroperitoneal fibrosis
para-aortic lymph nodes
mesenteric aneurysms
lymphoceles

A

para-aortic lymph nodes

45
Q

A patient has been referred for abdominal sonography with abdominal pain and increased serum amylase. You detect a fluid pocket in the left pararenal space. Given these ultrasound findings and patient history, what is the most likely etiology of the mass?

exophytic renal cyst
pancreatic pseudocyst
retroperitoneal hemorrhage
lymphocele
urinoma

A

pancreatic pseudocyst

46
Q

A patient has been referred for ultrasound evaluation with suspicious of retroperitoneal fibrosis. What structure will you image to identify this abnormality?

pancreas
kidneys
adrenal glands
abdominal AO
psoas muscle

A

abdominal AO

47
Q

During a routine abdominal sonogram, you detect several small lymph nodes adjacent to the abdominal AO. Your exam should include which of the following?

spectral Doppler analysis of each lymph node
diameter measurements of each lymph node
graded compression of each lymph node
evaluation of the pelvis
examination with patient in a prone position

A

diameter measurements of each lymph node

48
Q

You are performing an abdominal ultrasound on a patient with a history of pheochromocytoma. Sonographic evaluation of what structure will be most beneficial in identification of this abnormality?

pancreas
kidneys
psoas muscle
abdominal AO
adrenal glands

A

adrenal glands

49
Q

You are performing an abdominal ultrasound on a patient with a history of lung cancer. What retroperitoneal structure is a common site for metastasis from the lung?

pancreas
kidneys
psoas muscle
duodenum
adrenal glands

A

adrenal glands

50
Q

You have been asked to identify the right adrenal gland. Which of the following correctly describes its location?

medial to the IVC
superolateral to the upper pole of the right kidney
between the IVC and abdominal AO
posterior to the IVC
medial to the crus of the diaphragm

A

posterior to the IVC

51
Q

You are performing an abdominal ultrasound to search for lymphadenopathy. Where should you look?

splenic hilum
porta hepatis
renal hilum
para-aortic area
all of the above

A

all of the above

52
Q

During ultrasound evaluation of the kidney, you detect a striated structure located posteromedial in relation to the kidney. What muscle are you imaging?

quadatrus lumborum
rectus sheath
psoas
iliacus
piriformis

A

psoas

53
Q

Abdominal sonography of a 42 year old male reveals a solid mass located at the upper pole of the kidney. Which of the following would be the most helpful in differentiation between a renal and adrenal mass?

scan the patient in both deep inspiration and expiration
evaluate the mass with color Doppler
have the patient drink 32oz of water and rescan
give the patient a fatty meal and rescan in 20 min
perform spectral Doppler resistive indices from vessels within the mass

A

scan the patient in both deep inspiration and expiration

54
Q

You are performing an abdominal ultrasound and suspect a left adrenal mass. Which of the following may stimulate an adrenal mass?

thickened diaphragmatic crus
accessory spleen
gastric diverticulum
retroperitoneal lymphadenopathy
all of the above

A

all of the above

55
Q

You have been asked to identify the left adrenal gland. Which describes the correct anatomic relationship of this gland?

superolateral to the left kidney
anterior to the pancreatic tail
lateral to the abdominal AO and diaphragmatic crus
inferior to the quadratus lumborum muscle
inferior and lateral to the splenic hilum

A

lateral to the abdominal AO and diaphragmatic crus

56
Q

Which of the following describes the anatomic location of the right diaphragmatic crus?

anterior to the IVC and superior to the RRA

posterior to the IVC and RRA

medial to the right kidney and posterior to the abdominal AO

anterior to the abdominal AO and inferior to the pancreas

lateral to the pancreatic head and anterior to the IVC

A

posterior to the IVC and RRA

57
Q

What is the most useful criteria or assessment of nodal disease?

since ultrasound cannot detect normal abdominal lymph nodes, whenever they are visualized it means they are abnormal

only lymph nodes measuring greater than 1.0 cm are considered to be abnormal

whenever the hilum of the lymph node is echogenic, it is considered to be abnormal

only abdominal lymph nodes that have an oval shape are considered to be abnormal

only abdominal lymph nodes that show increased vascularity by color Doppler are considered to be abnormal

A

only lymph nodes measuring greater than 1.0 cm are considered to be abnormal

58
Q

You are performing an abdominal ultrasound on a patient with a palpable mass following kidney transplantation. Your imaging reveals an anechoic mass with multiple septations located lateral to the midline and 2 cm below the abdominal wall. Which of the following is most likely?

lymphocele
varices
pancreatic pseudocyst
hematoma
exophytic renal cyst

A

lymphocele

59
Q

Which retroperitoneal compartment contains no solid organs?

anterior pararenal space
perirenal space
posterior pararenal space
retrofascial space
C and D

A

C and D

60
Q

Which retroperitoneal compartment contains the psoas and quadratus lumborum muscles?

anterior pararenal space
periprenal space
posterior pararenal space
retrofascial space
none of the above

A

retrofascial space

61
Q

You are performing an ultrasound on a patient with acute pancreatitis to rule out the presence of a pseudocyst. Which retroperitoneal compartment is most frequently involved with pseudocyst?

anterior pararenal space
perirenal space
posterior pararenal space
retrofascial space
B and C

A

anterior pararenal space

62
Q

You have been asked to perform an ultrasound on a patient to rule out a leaking abdominal aortic aneurysm. Which retroperitoneal compartment contains the aorta?

anterior pararenal space
perirenal space
posterior pararenal space
retrofascial space
the AO is not retroperitoneal in location

A

anterior pararenal space

63
Q

You have been requested to perform an abdominal ultrasound on a patient with abnormal BUN levels. All other lab work is normal. Considering this history, what is the study area of interest?

pancreas
liver
adrenal gland
kidney
AO

A

kidney

64
Q

You have been requested to perform an abdominal ultrasound on a patient with abnormal lipase levels. All other lab work is normal. Considering this history, what is the specific area of interest?

pancreas
liver
adrenal gland
kidney
AO

A

pancreas

65
Q

While performing an abdominal ultrasound, you detect multiple hypoechoic nodules surrounding the abdominal AO and separating the mesenteric vessels. You are most likely imaging:

pancreatic pseudocysts
retroperitoneal fibrosis
lymphadenopathy
urinomas
lymphoceles

A

lymphadenopathy

ARDMS ABD REVIEW (27 decks)

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