ABD 2 Final Prep Flashcards by Sonography ♡

A patient fell down a flight of stairs. They are complaining of LUQ pain. They stated that they came down hard onto the edge of the stairs. You should tailor your exam to look for…

Fluid in the peritoneal cavity
Sonolucent mass in the left upper quadrant
An anechoic collection between the capsule and splenic parenchyma

(Note: you would NOT expect to see an echogenic, shadowing focal splenic mass.)

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What would most likely appear on a longitudinal scan as a circular structure coursing posterior to the inferior vena cava?

Right renal artery

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What lab test is associated with atherosclerosis?

Elevated serum cholesterol (ESC)

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What is the BEST way to demonstrate an aortic dissection with sonography?

Show an intimal flap that vibrates with the flow of blood

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What is described as a weakening of the arterial wall resulting in a circumferential dilation of the vessel?

Fusiform aneurysm

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What arterial branch(es) is/are most likely to be involved with abdominal aortic aneurysms?

Common iliac arteries

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What is the biggest risk factor for rupture of an abdominal aortic aneurysm?

Aneurysm size

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What is the most likely result of enlargement of the pancreatic head?

Biliary obstruction

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What are three characteristics that describe a simple liver cyst?

Anterior acoustic enhancement
Sonolucent
Round or oval in shape

(Note: does NOT have thin walls with potential edge shadowing)

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What can be described as an outpouching of the walls of a structure?

Diverticulum

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If a tumor arises in the CBD at the ampulla of Vater:

The gallbladder will be hydropic &
the CHD and intrahepatic ducts will be dilated.

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What are three structures that are in contact with the spleen?

Left hemidiaphragm
Stomach
Pancreas

(Note: NOT hepatic flexure of the colon)

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Elevation of serum bilirubin results in:

Jaundice

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(Pic) Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and elevated white blood cell count. He states that 3 months ago he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram.
What is your differential diagnosis?

Echinococcal cyst

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

Adenoma

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What is the most common cause of dilated biliary ducts?

Obstruction

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What is the most important factor associated with cholelithiasis?

Abnormal bile composition

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What are three tumors which arise in the kidneys?

Mesoblastic nephroma
Angiomyolipoma
Wilms tumor

(Note: Neuroblastoma does NOT arise in the kidneys)

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What is the expected sonographic appearance of a patient who has a Cholangiocarcinoma at the level of the common hepatic duct?

Dilated intrahepatic bile ducts

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What are three common findings with appendicitis?

Diameter measures greater than 7mm
Patient presents with leukocytosis
Wall thickness is greater than 3mm

(Note: appendix will NOT be compressible with appendicitis)

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What is associated with Rokinansky-Aschoff sinuses?

Adenomyomatosis

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You detect the presence of free fluid in the space between the liver and the right kidney. What is the name for this anatomic location ?

Morrisons pouch

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Congenital ectasia of the intrahepatic biliary ducts predisposing to biliary stone disease and cholangitis describes:

Caroli’s disease

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What are three risk factors for the development of pancreatic cancer?

Smoking
Chronic pancreatitis
Diabetes

(Note: NOT hypertension)

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What is the most frequent benign tumor of the pancreas?

Islet cell tumor

What is the usual cause of acute tubular necrosis?

Lack of blood supply to the kidney (renal ischemia)

A 3 year old boy presents with hematuria and a palpable left flank mass. Sonography depicts a solid renal mass. What is the most likely cause of these findings?

Wilm’s tumor

Your first patient of the day were jaundiced, had worsening abdomen pain, and nausea/vomiting. While scanning you noticed a fistula between the gallbladder and the duodenum. What does this patient most likely have?

Mirizzi syndrome

The most common cause of chronic renal failure is:

Diabetes mellitus

?? What is another name for a hepatocellular carcinoma mass?

Hepatoma

Which lab test is the most specific for hepatocellular disease?

ALT

T/F Lipase, Trypsin, and amylase are endocrine secretions of the pancreas that aid in digestion.

False Those are exocrine secretions. Endocrine secretions include insulin and glucagon.

What developmental anomaly is the most common renal cystic disease in infants?

MDKD

What is the most common GI location to find a Leiomyoma?

Stomach

What pathology is indistinguishable from renal cell carcinoma sonographically ?

Renal adenoma

T/F A well distended bladder bladder can have a wall measurement above 3 mm in patients that are over the age of 65.

False

What is described as a disruption of all layers of the arterial wall resulting in an adjacent communicating pocket?

Pseudoaneurysm

What is the most likely cause of caudate lobe enlargement?

Cirrhosis

What are three common sonographic findings with acute hepatitis ?

1.Normal liver parenchymal echogenicity 2. Periportal cuffing 3. Decreased liver parenchymal echogenicity (Note: NOT decreased echogenicity of portal vein walls; it is actually increased)

What is associated with the use of oral contraceptives?

Adenoma of the liver

T/F A patient that is experiencing postoperative paralytic ileum will have a peristaltic bowel.

True

?? What are four common causes of a small or nonvisualized gallbladder?

1. Biliary atresia 2. Recent fatty meal 3. Obstruction of the common hepatic duct 4. Chronic cholecystitis (Note: NOT obstruction of the common bile duct)

T/F When evaluating for hypertrophic pyloric stenosis, you tale an image of the “cervix sign”. If this canal is over 12 mm, it is considered elongated.

False

What is the most likely diagnosis for a 5 week old male infant with projectile vomiting and a palpable epigastric mass?

Hypertrophic pyloric stenosis

What are four characteristics of renal parapelvic cysts?

1. There are no significant associated lab findings 2. They lie in the area of the renal hilum 3. They may be lymphatic in origin 4. They are usually discovered incidentally (Note: they are NOT true renal cysts.)

Bilateral infantile polycystic kidney disease is…

Incompatible with life

What renal mass is more echogenic than the renal sinus?

Angiomyolipoma

What are three typical sonographic findings in acute pancreatitis?

1. Hypoechoic pancreas 2. Subsequent pseudocyst formation 3. Uniform generalized enlargement of the pancreas (Note: NOT small echogenic pancreas w irregular contour and calcifications)

What is a primary malignancy of the urinary tract lining?

Transitional cell carcinoma (TCC)

What is the most consistent finding with dilated calyces with low-level debris?

Pyonephrosis

What is the best method to differentiate an abscess from a hematoma?

CT (computed tomography)

Which organ(s) is/are most likely to be associated with congenital renal anomalies?

Reproductive organs

What is the most likely diagnosis for a patient with easy bruising, pallor, fatigue, recurrent infections, non-healing of minor wounds, and the only remarkable sonographic finding is splenomegaly?

Leukemia

How would you best distinguish a thrombus in the IVC from a tumor?

Color Doppler

What can be described as torsion of a segment of bowel?

Volvulus

What sonographic finding(s) is/are expected from a 35 year old man with poor renal function, bilaterally enlarged kidneys, and whose father died of renal failure at the age of 43?

Numerous bilateral renal cysts

McBurney’s point is best described as a point between what two structures?

Umbilicus and right iliac crest

What is associated with small bowel obstruction?

Dilation of bowel loops proximal to the site of obstruction.

What is the most common sonographic sign of gastrointestinal pathology?

Wall thickening

Where are the Valves of Heister located?

Cystic duct

What is a normal linear echogenic structure that can be seen just anterior to the caudate lobe in transverse scans of the liver?

Ligamentum venosum

A 2 year old girl with cystic fibrosis is seen with abdominal pain, vomiting, and lethargy. A sausage-shaped mass is palpated in the RUQ. What is the most likely diagnosis?

Intussusception

What is the most common form of neoplasticism involvement of the liver?

Metastases

The normal gut signature:

Consists of up to 5 layers. With layers 1, 3, & 5 echogenic and layers 2 & 4 hypoechoic.

Crohn’s disease:

Typical onset is 15-30 years of age

****WRITTEN You've scanned the bladder for 45 minutes and only been able to demonstrate a right sided ureteral jet. Give me two different reasons that this could happen. Your reasons need to be completely different from one another. The same problem in two different locations is does not constitute separate answers.

1. The patient does not have a left kidney 2. The patients left ureter is being blocked by a stone

***WRITTEN Name a renal pathology that give the pyramids an echogenic appearance.

Medullary Sponge Kidney

(Pic) What is it called when the liver and gallbladder have a similar appearance?

Hepatization

***WRITTEN List 6 retroperitoneal structures

1. Aorta 2. IVC 3. Kidneys 4. Ureters 5. Duodenum 6. Pancreas

Hepatocellular disease:

Affects the hepatocytes and interferes with liver function

What enzyme elevates late but persists longer with pancreas damage?

Lipase

What is the most likely cause of mid to low-level echoes in the gallbladder that layer out, do not shadow, exhibit through transmission, and move sluggishly when the patient changes position?

Sludge

What is the usual sonographic appearance of chronic glomerulonephritis?

Bilateral, shrunken, echogenic kidneys

Cavernous hemangioma:

The most common benign liver tumor.

Hemangioendothelioma:

The most common soft tissue vascular tumor in infants.

Pancreatic adenocarcinoma

The 4th leading cause of cancer-related death in the United States.

Reidel’s lobe:

A tongue-like projection of the right lobe of the liver.

Pancreatic divisum

The most common congenital variant of pancreatic duct anatomy.

Staghorn calculus:

A large stone with branching extensions that fill the renal pelvis and calyces.

ABD 2 Final Prep Flashcards

(79 cards)