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DSM Abd > ABDOMEN II FINAL REVIEW > Flashcards

ABDOMEN II FINAL REVIEW Flashcards

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1
Q

liver is suspended from diaphragm and anterior wall by what ligament

A

Falciform ligament

pg. 208

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2
Q

fatty infiltration may be observed in all patients ( we pick the one that doesn’t fit )

A 
Obesity
Excessive alcohol intake
Poorly controlled hyperlipidemia (cholesterol)
Diabetes mellitus
Excess corticosteriods
Pregnancy
Total parenteral hyperalimentation (nutrition)
Severe Hepatitis
Glycogen Storage Disease
Cystic Fibrosis
Pharmaceutical
Chronic Illness
pg. 235
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3
Q

What is Budd Chiari Syndrome?

A

Thrombosis of the hepatic veins or IVC

pg. 246

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4
Q

Echinococcal cysts have a higher incidence from where?

A

Sheep-herding areas

pg. 255

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5
Q

What is the most common benign tumor of liver?

A

Cavernous hemangioma

pg. 256

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6
Q

What is the benign liver tumor, can be found in patients with glycogen storage disease?

A

Liver Cell Adenoma

pg. 258

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7
Q

Patients with hepatocellular carcinoma likely to have had ___.

A

Cirrhosis

pg. 259

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8
Q

What is the most common form of neoplastic involvement in liver?

A

Metastatic Disease

pg. 259

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9
Q

RPV and GB found in what fissure?

A

Main Lobar Fissure

pg. 276

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10
Q

In severe hepatocellular destruction, AST and ALT levels are ___.

A

AST: significantly elevated
ALT: moderately elevated
pg. 215

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11
Q

Elevated alk phos is associated with ___.

A

Liver and biliary obstruction

pg. 33

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12
Q

Diminished vascular structures in the liver parenchyma most likely suggests ___.

A

Fatty infiltration

pg. 234

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13
Q

The falciform ligament extends from the umbilicus to the diaphragm. It contains the ___.

A

Ligamentum teres

pg. 208

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14
Q

Elevation of bilirubin leads to ___.

A

Jaundice

pg. 218

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15
Q

Patients with an abscess formation may have ___.

A 
Fever
Tenderness and swelling postop
Chills
Weakness
Normal LFT's
Leukocytosis
Sepsis
pg. 466
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16
Q

What tumor consists of large blood filled spaces?

A

Hemangioma

pg. 256

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17
Q

What cells does hepatocellular disease attack?

A 
Liver cells (Hepatocytes)
pg. 213
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18
Q

Glycogen storage disease type 1 is the most common, it is also known as ___.

A

von Gierke’s disease

pg. 239

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19
Q

What is the benign liver tumor located near the free edge of the liver?

A

Liver cell adenoma

pg. 258

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20
Q

What common malignancies affect the pediatric population?

A 
Neuroblastoma
Nephroblastoma (Wilm's Tumor)
Hepatoblastoma
Hepatocellular Carcinoma
Leukemia
Lymphoma
pg. 697-698
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21
Q

In cases of choledocholithiasis, stones tend to lodge in ___.

A

the Ampulla of Vater
CBD?
pg. 295

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22
Q

The right and left hepatic ducts emerge and unite to form ___.

A

Common hepatic duct

pg. 268

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23
Q

What is the size of the common hepatic duct?

A

4 mm

pg. 268

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24
Q

In a 60 year old adult, how big should the common duct be?

A

6 mm

pg. 268

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25
What is a phyrigian cap of the GB?
Folding of the fundus | pg. 273
26
What is the function of the GB?
Reservoir for bile and concentration of bile | pg. 273
27
What is a fold in the neck of the GB called?
Hartmann's pouch | pg. 273
28
What is a positive Murphy's sign?
Acute RUQ pain when palpating area | pg. 281
29
What are classic symptoms of GB disease?
``` RUQ pain after eating greasy food Nausea/vomiting Pain in right shoulder Jaundice pg. 278-279 ```
30
What is inflammation of the GB?
Cholecystitis | pg. 281
31
What are the small polypoid masses that arise from the GB wall?
Cholesterolosis | pg. 288
32
What is the sonographic criteria for cholelithiasis?
``` Increased size Wall thickness Presence of internal reflections w/in lumen Posterior acoustic shadowing pg. 284 ```
33
What is a porcelain GB?
Calcium incrustation of the gallbladder wall Appears hyperechoic with posterior shadowing pg. 288
34
What is sludge?
Thickened bile Low level internal echoes Nonshadowing pg. 279
35
Where are the valves of Heister located?
In the neck of the GB | pg. 273
36
What are ALL of the effects of a fatty meal?
Causes the GB to contract because it pushes bile into the duodenum pg. 273
37
What cavity does the pancreas lie in?
Retroperitoneal cavity pg. 302 Also note that it is in the epigastrium and a portion lies in the left hypochondrium....behind the lesser sac.
38
What duct is in the pancreatic head?
Duct of Santorini | pg. 308
39
What structure is on the anterolateral border of the pancreatic head?
Gastroduodenal Artery | pg. 309
40
What is the primary pancreatic duct?
Duct of Wirsung | pg. 308
41
What is hemorrhagic pancreatitis?
Acute pancreatitis with rupture of vessels Usually occur in alcoholics Homogenous mass that can be septated and later becomes cystic pg. 323-324
42
What veins course sagittal and posterior to the neck of the pancreas?
Superior Mesenteric Vein Main Portal Vein pg. 309
43
What is adenocarcinoma of the pancreas?
Most common primary neoplasm of pancreas Symptoms: Jaundice, weight loss, nausea, palpable GB Sonographic: Loss of parenchymal pattern, hypoechoic, irregular borders, biliary duct dilation pg. 329-330
44
What is the duct of santorini?
Accessory duct located in the head of the pancreas | pg. 308
45
What is the normal size of the pancreatic duct?
Less than 2 mm | pg. 308
46
When a patient has acute pancreatitis, what lab value will be elevated 2 times the normal limit?
Amylase | pg. 311
47
What are the microscopic cells of the pancreas called?
Acini cells Islets of Langerhans pg. 310
48
The splenic vein courses ___ in reference to the pancreas?
posterior | pg. 309
49
What is the most common cause for acute pancreatitis?
Biliary tract disease | pg. 317
50
What is an annular pancreas?
Rare anomaly in which the head of the pancreas surrounds the second portion of the duodenum pg. 309
51
What is cystic fibrosis?
Heredity disease that causes excessive production of thick mucus by the endocrine glands Pancreas is replaced with fatty tissue and sometimes calcifications pg. 327
52
In cases of acute pancreatitis, what does it look like sonographically?
``` Enlarged Hypoechoic Indistinct, but smooth borders IVC may be compressed Peripancreatic fluid collections pg. 319 ```
53
What is the most common obstructive congenital obstruction in utero and in infants?
UPJ | pg. 713
54
Where are parapelvic cysts located?
Renal sinus or pelvis | pg. 380
55
What is the most common solid renal mass found in childhood?
Nephroblastoma (Wilm's tumor) | pg. 387
56
What is fusion of the lower poles of the kidneys?
Horseshoe kidney | pg. 371
57
What is the most echogenic portion of the kidney?
Renal sinus | pg. 359
58
What is a cystlike enlargement of the lower end of the ureter?
Ureterocele | pg. 373
59
What is a cortical bulge at the lateral border of the kidney?
Dromedary hump | pg. 366
60
What is a dilated renal pelvis without ureteral involvement?
Ureteropelvic Junction Obstruction | pg. 713
61
What is the most likely reason for a renal artery duplex?
Hypertension
62
What could a perinephric fluid collection post transplant be?
Acute rejection pg. 407 Wasn't hematuria and hematoma an option...?
63
The baseline ultrasound after a transplant should be done within ___.
48-72 hours | pg. 407
64
What is a common finding in people over 50?
Simple Renal Cyst | pg. 379
65
What is dilatation of the renal pelvis without thinning of the renal cortex?
Hydronephrosis?? | pg. 397-398
66
When will ureteral jets not be visualized?
Ureteral Obstruction | pg. 713
67
What is the process of disposing metabolic waste?
Excretion | pg. 358
68
When a patient has extensive damage to a kidney, what might be found in the urine?
Hemoglobin | pg. 359
69
What cavity are kidneys located in?
Retroperitoneum | pg. 355
70
What 'stuff' is outside the renal capsule?
Perinephric fat | pg. 356
71
What vessel is seen in a sagittal IVC scan that is posterior to it in a transverse plane?
Right renal artery | pg. 363
72
Renal sonography is not helpful in evaluating ___.
Function
73
What is the space between the liver edge and the right kidney?
Morison's pouch | pg. 356
74
Renal cell carcinoma commonly invades the IVC via the ___.
Renal vein | pg. 385
75
What is pyonephrosis referred to as?
Pus found in the collecting renal system Emergent procedure needed Sonographic: low-level echoes, anechoic dilated system pg. 401
76
What are 3 different reasons why there might be dilatation of the renal pelvis?
Hydronephrosis | pg. 397
77
What is a benign vascular fatty tumor of the kidney?
Renal Angiomyolipoma | pg. 388
78
What cavity does the spleen lie in?
Intraperitoneal cavity pg. 422 Note that it is in the left hypochondrium as well as being in the reticuloendothelial system.
79
What is the size of the spleen?
8-13 cm x 7 cm x 3-4 cm | pg. 424
80
Reasons why one might develop splenomegaly?
Mild to moderate: Infection, portal hypertension and AIDS Moderate: Leukemia, lymphoma, infectious mononucleosis Massive: Myelofibrosis Focal Lesions: Lymphomatous involvement, metastatic disorder, hematomas p. 431
81
What are the functions of the spleen?
Production of lymphocytes and plasma cells Production of antibodies Storage of iron Storage of other metabolites Maturation of the surface of erythrocytes Reservoir Culling Pitting function Disposal of senescent or abnormal erythrocytes Functions related to platelet and leukocyte life span p.427
82
Where would an accessory spleen be located?
Near hilum or inferior border | pg. 425
83
The splenic vein courses ___ along the pancreas.
Posteromedially | pg. 424
84
What is the best position to evaluate the spleen on ultrasound?
Steep right decubitus | pg. 428
85
What is a spleen that has migrated from its normal location?
Wandering spleen | pg. 425
86
What is the major function of the spleen?
To filter the peripheral blood and is active in the body's defense against disease pg. 426
87
What is a measurement of the spleen considered splenomegaly?
Greater than or equal to 13 cm | pg.430
88
Why might someone have atrophy of the spleen?
Sickle cell anemia patients | Pg 429
89
What are the hormones of the thyroid?
T3 and T4 and Calcitonin | pg. 590
90
What is the size of the thyroid?
40-60mm (length) x 20-30mm (AP) x 13-18mm (width) | pg. 589
91
What are the neighboring structures around thyroid? (muscles)
Anterior: Sternothyroid Omohyoid, Sternohyoid (Appear thin, hypoechoic) Sternocleidomastoid (Large, Oval, located anterior and lateral) Posterior: Longus colli (Hypoechoic, Triangular, located posterior and lateral) pg. 589
92
What is a pyramidal lobe of the thyroid?
The pyramidal lobe arises from the isthmus and tapers superiorly just anterior to the thyroid cartilage. It may be seen in the pediatric population but usually atrophies in the adults. It is found in 15-30% of patients. Pg. 589
93
What is the most common cause for thyroid disorders worldwide?
Iodine deficiency | pg. 593
94
What are the common disorders associated with hyperthyroidism?
``` Common: Diffuse Toxic Hyperplasia (Grave's disease) Toxic multi nodular goiter Toxic adenoma. Uncommon: Acute or subacute thyroiditis Hyperfunctioning thyroid cancer Choriocarcinoma or hydatidiform mole TSH-secreting pituitary adenoma Neonatal thyrotoxicosis associated with maternal Graves disease pg. 590 ```
95
What is the sonographic criteria for a thyroid adenoma?
Solid mass Peripheral halo Cystic degeneration pg. 596
96
How many parathyroid glands are there?
4 | pg. 600
97
What is the position of parathyroid glands?
2 lie posterior to the superior pole of thyroid 2 lie posterior to the inferior pole of thyroid pg. 600
98
If you see a thyroid nodule with a lymphadenopathy of the same side, what is it suspicious for?
Malignancy | pg. 596
99
What is the common cause for primary hyperparathyroidism?
Adenoma | pg. 601
100
Thyroglossal duct cysts are found ___.
Anteriorly to the trachea | pg. 602
101
What disease process is thyroid inferno?
Hyperthyroidism | pg. 599
102
What is the most common thyroid malignancy?
Papillary Carcinoma | pg. 596
103
What is the shape of an abnormal lymph node?
Round | pg. 603
104
What is a cystic formation lateral to the thyroid gland?
Branchial cleft cysts | pg. 602
105
What is the fibrous capsule the covers the teste?
Tunica Albuginea | pg. 606
106
What is the normal measurement of the testicles?
``` L= 3-5 cm W= 2-4 cm H= 3 cm ``` pg. 604
107
What is the sonographic criteria of the tecticles?
Smooth Medium gray Fine echo textures pg. 604
108
What is mediastinum testes?
Vertical septum formed from the posterior aspect of tuica albuginea that reflects into the testis pg. 606
109
What is the location of the epididymis?
Begins superior and then courses posteriolateral to the testis pg. 604
110
What is the most common cause of acute scrotal pain in an adolescent?
Torsion | pg. 616
111
What are varicoceles?
Abnormal dilation of veins of pampiniform plexus, usually caused by incompetent venous valves within the spermatic vein. More common on the left side, and will measure more than 2 mm in diameter. Color Doppler will be very lite up pg. 618
112
What are spermatoceles?
- Cystic dilations of efferent ductules of the epididymis - Always located in the epididymal head - More often seen following vasectomy pg. 618
113
What is the most common cause of acute scrotal pain on adults?
Epididymo-orchitis | pg. 615
114
What almost always transpires secondary to epididymitis?
Orchitis, infection of testis | pg. 615
115
What is the appearance of a seminoma?
Homogeneous or hypoechoic lesion with smooth, well-defined borders pg. 626
116
Epididymorchitis most commonly results from ___.
Spread of a lower urinary tract infection via the spermatic cord pg. 615
117
What is the primary source of blood flow to the testicles?
Right and left testicular arteries | pg. 608
118
Microlithiasis of the teste is associated with ___.
Testicular malignancy, cryptorchidism, Klinefelter's syndrome, infertility, varicoceles, testicular atrophy and male pseudohermaphroditism pg. 625
119
What is the appendix teste?
Small protuberance from the head of the epididymis, upper pole of the testis between the testis and the epididymis pg. 605
120
What layers does a hydrocele form in?
Between the visceral and parietal layers of the tunica vaginalis pg. 620
121
Where is a rete teste located?
At the hilum of the testis where the mediastinum resides | pg. 623
122
What are the important lab values for accessing renal function?
BUN Creatinine pg. 359
123
AAA's are present when the diameter exceeds ___.
3cm | pg. 173
124
What is the most common AAA type?
Fusiform | pg. 173
125
What is the innermost layer of the aorta?
Tunica intima | pg. 165
126
What are the clinical symptoms of acute appendicitis?
Pain rebound tenderness over McBurney's point, diarrhea, fever, nausea/vomiting pg. 348
127
What would a collection of air or gas in the pleural cavity be?
Pneumothorax
128
What vessels form the portal confluence?
Splenic vein and SMV | pg. 302
129
What is the most dependent area in the flanks of the abdomen and pelvis?
Gutters | pg. 462
130
What are the typical symptoms with an abscess formation?
``` Fever Tenderness and swelling from postop procedure Chills Weakness Malaise Pain Increased WBC's Sepsis pg. 466 ```
131
What is the most common cause for renal failure?
Diabetes Per handout ATN Per Beth
132
What is an area in an organ that has become necrotic due to lack of oxygen called?
Infarct?
133
What are the potential signs for rejection?
Renal: enlargement, decreased echogenicity, loss of cortical medullary boundary, increased RI (greater than 0.8 = dysfunction) Per handout
134
What is ATN?
Acute tubular necrosis | pg. 412
135
What is a thoracentesis?
Drainage of fluid in the chest The patient sits on the side of the bed, leaning on a bedside table with a pillow for comfort. This opens up space between the ribs to be able to get needle in to drain the fluid pg. 523
136
Why is a time out performed?
Patient recites their name Patient's ID and MRN is confirmed Type and location of procedure is said
137
What is a lack of normal fixation to the testes called?
bell clapper??
138
What technique is used to find evidence of a varicocele?
Valsalva maneuver | pg. 620
139
What are the layers of the teste?
Parietal- outer layer Visceral- inner layer Which form to create the tunica vaginalis
140
Skin dimpling may be caused by ___.
Breast cancer | pg. 571
141
What is a fibroadenoma?
Most common benign breast tumor which occurs primarily in young women and is stimulated by estrogen pg. 575
142
What is the best needle gage for a thyroid FNA?
25 gauge | pg. 498
143
What is the primary advantage of ultrasound guidance?
To have continuous real-time visualization of the biopsy needle, allowing for adjustment of the needle as needed pg. 495
144
What is the functional portion of the breast called?
Mammary (glandular) layer | pg. 550
145
What is the sonographic appearance of Cooper's ligaments?
- Echogenic and are dispersed in a linear pattern - Best identified when the beam strikes the ligaments at a perpendicular angle pg. 552
146
What is a specific complication of a kidney biopsy?
Perinephric hematoma and Hematuria | pg. 519

DSM Abd (9 decks)

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