Miscellaneous

Question 0

What is the most reliable finding in patients with abscesses?

Answer 0

Presence of fever

Increased WBC count

Question 1

How does an abscess appear on ultrasound?

Answer 1

Complex mass

Debris, septations and gas can be seen within

Question 2

In the absence of gas within a collection, how is an abscess differentiated from a hematoma?

Answer 2

Percutaneous aspiration

Question 3

What is a biloma?

Answer 3

Extrahepatic collections of extravasated bile

Question 4

How do bilomas appear on ultrasound?

Answer 4

Cystic masses located in the RUQ

Question 5

What surgeries result in the complication of a lymphocele?

Answer 5

Renal transplantation
Gynecological surgery
Vascular surgery
Urological surgery

Question 6

What is a lymphocele?

Answer 6

Leakage of lymph from a renal allograft, or by a surgical disruption of the lymphatic channels

Question 7

What is a urinoma?

Answer 7

Collection of urine which is located outside of the kidney or bladder

Question 8

What are urinomas most commonly associated with?

Answer 8

Renal transplantation

Posterior urethral valve obstruction

Question 9

How does a urinoma appear on ultrasound?

Answer 9

Loculated fluid collection

Question 10

What is developmental dysplasia of the hip?

Answer 10

Spectrum of disorders affecting the proximal femur and acetabulum that leads to hip subluxation and dislocation

Question 11

What are risk factors for hip dysplasia?

Answer 11

Female
Firstborn
Frank breech presentation
Family history
Oligohydramnios

Question 12

Which hip is DDH three times more common?

Answer 12

Left hip

Question 13

What are the two stress maneuvers of the hip?

Answer 13

Barlow – dislocation of the hip by adducting and pushing the legs posteriorly
Ortolani – relocation of the dislocated hip by abducting the leg

Question 14

What are the two groups of neoplasms in lymphoma?

Answer 14

Non-Hodgkin’s lymphoma

Hodgkin’s disease

Question 15

How do lymph nodes appear sonographically?

Answer 15

Anechoic/hypoechoic mass containing a central echogenic foci

Question 16

What is the “sandwich” or “mantle” sign?

Answer 16

Presence of perivessel lymphoma

Question 17

Where do lymphomatous nodules typically cluster?

Answer 17

Anterior and posterior to linear structures such as the aorta, IVC and SMA

Question 18

What are associated findings with non-Hodgkin lymphoma?

Answer 18

Nodal masses
Fever
Night sweats
Weight loss
Splenomegaly 
Hepatomegaly
Cytopenia
Abdominal mass causing bowel obstruction
Hydronephrosis due to retroperitoneal nodes

Question 19

What are two mechanisms that produce ascites?

Answer 19

Low serum osmotic pressure – protein loss

High portal venous pressure

Question 20

What are causes of ascites?

Answer 20

Cirrhosis
Renal failure
Congestive heart failure
Cancer

Question 21

What is pseudomyxoma peritonei?

Answer 21

Malignancy characterized by the progressive accumulation of mucus secreting tumor cells within the peritoneum

Question 22

How does pseudomyxoma peritonei appear on ultrasound?

Answer 22

Bowel loops are seen matted to the posterior abdominal wall

Question 23

What is most commonly associated with cancer of the appendix?

Answer 23

Pseudomyxoma peritonei

Question 24

How is an adominal paracentesis performed with ultrasound?

Answer 24

Area of abdominal fluid (midline or lateral) is localized avoiding the epigastric vessels bilateral on the mammary line

Question 25

What is a pleural effusion?

Answer 25

Accumulation of fluid within the plural space

Question 26

What causes transudative effusions?

Answer 26

Increased hydrostatic pressure and decreased plasma oncotic pressure Heart failure – Most common cause Liver failure – Cirrhosis Renal failure – Nephrotic syndrome

Question 27

What causes exudative effusions?

Answer 27

Increased capillary permeability Pneumonia Cancer PE

Question 28

What is the laboratory analysis of pleural effusions?

Answer 28

``` Total protein LDH Cell count and differential Gram stain Aerobic and anaerobic bacterial cultures Cytology ```

Question 29

How is pneumothorax identified on ultrasound?

Answer 29

Absence of gliding of the parietal and visceral pleura and presence of a comet tail artifact

Question 30

How is thoracentesis performed with ultrasound?

Answer 30

Dorsal intercostal space is selected superior to the visualized diaphragm Needle insertion is on the superior aspect of the rib Pleural fluid is aspirated slowly as not to exceed 1.5 L per day

Question 31

What is a Baker's cyst?

Answer 31

Collection of synovial fluid in the popliteal fossa

Question 32

What are causes of a Baker's cyst?

Answer 32

Rheumatoid arthritis Osteoarthritis Overuse of the knees

Question 33

What is a giant cell tumor of the tendon sheath?

Answer 33

Second most common tumor of the hand and wrist

Question 34

How does a giant cell tumor appear on ultrasound?

Answer 34

Solid masses that may have varying appearances | Beware of cystic appearing masses that do not have sound enhancement

Question 35

What forms the linea alba?

Answer 35

The rectus sheath encasing the rectus abdominis muscles

Question 36

Where is the arcuate line?

Answer 36

Midway between the umbilicus and the symphysis pubis where the posterior wall of the sheath ends

Question 37

What causes a rectal sheath hematoma?

Answer 37

Bleeding from the superior or inferior epigastric vessels or from a tear of the rectus muscle

Question 38

What determines the location of a rectal sheath hematoma?

Answer 38

The linea alba and the arcuate line

Question 39

What space will a rectus muscle hematoma extend into if it is inferior to the arcuate line?

Answer 39

Space of Retzius | Causes external compression and irritation of the urinary bladder

Question 40

What causes rectal sheath hematomas?

Answer 40

``` External trauma Trauma from surgery Vigorous muscle contraction Valsalva with severe coughing/vomiting Pregnancy Anticoagulation therapy ```