Abdominal final

Question 1

Abdominal sonography of a 42 yr old male reveals a solid mass located at the upper poleof the kidney. which would be most helpful in differentiation between a renal and adrenal mass?

Answer 1

Scan the patient in both deep inspiration & expiration

Question 2

A 45 yr old obese woman with thin arms and legs, hypertension & severe fatigue presents to the ultrasound department for an abdominal sonogram. You should evaluate the adrenal glands closely for sings of

Answer 2

both Adrenal adenoma & primary adrenal carcinoma

Question 3

which of the folloeing hormones are responsible for the “flight or flight” response?

Answer 3

Epinephrine & norepinephrine

Question 4

The most common sonographic appearance of a pheochromocytoma is a/an

Answer 4

Hyperechoic mass

Question 5

The adrenal mass often associated with uncontrollable hypertension, tachycardia & tremors is the

Answer 5

Pheochromocytoma

Question 6

A 32 yr old woman with intermittent pain in the RUQ is seen for an abdominal ultrasound. The exam reveals a gallbladder w multiple comet-tail artifacts emanating from the gallbladder wall. The lumen of the gallbladder is unremarkable. The most likely represents which

Answer 6

Adenomyotosis

Question 7

Intermittent obstrustion of the cystic duct by a gallstone results in

Answer 7

Chronic cholecystitis

Question 8

Acute cholecystisis that leads to necrosis & abscess development with in the gallbladder wall describes

Answer 8

gangrenous cholecystitis

Question 9

An 85yr old female w jaundice, weight loss & palpable RUQ mass, what is the best diagnosis

Answer 9

Adenocarcinoma of the gallbladder

Question 10

Tumefactive sludge can resemble the sonographic appearance of

Answer 10

gallbladder carcinoma

Question 11

Which of the following is not a plausible cause of common bile duct obstruction in adults

Answer 11

Choledochal cyst

Question 12

Air within in biliary tree is referred to as

Answer 12

Pneumobilia

Question 13

You have been asked to perform an ultrasound to evaluate for biliary obstruction in a patient with a history of weight loss and midepigastric pain. you find both tintrahepatic & extrahepatic biliary dilation. The gallbladder is hydropic. Which condition causing ductal dilation should you look for

Answer 13

Choledochlithiasis

Pancreatic carcinoma

and

Chronic pancreatitis

Question 14

The yellowish staining of the whites of the eyes & the skin secondary to a liver disorder or biliary obstruction if referred to as

Answer 14

Jaundice

Question 15

Focal tenderness over the gallbladder with probe pressure describes

Answer 15

Murphy sign

Question 16

Courvoisier’s gallbladder is associated with which of the following

Answer 16

A pancreatic head mass

Question 17

The best way to identify the intrahepatic biliary system is to image which structures

Answer 17

intrahepatic portal veins

Question 18

The normal measurment for the biliary duct should be

Answer 18

<6mm

Question 19

The telescoping of one segment of bowel into another is referred to as

Answer 19

Intussusception

Question 20

All of the following are sonographic findings of acute appendicitis except

Answer 20

Compressible, blind-ended tube

Question 21

A 6 month old female presents to your department with vomiting ABD pain and blood in her stool. Give the BEST diagnosis

Answer 21

Intussusception

Question 22

Clinical findings of fatty infiltrate of the liver include

Answer 22

Elevated liver function tests

Question 23

NOrmal flow toward the liver in the portal vein is termed

Answer 23

Hepatopedal (toward)

Question 24

A 51 yr old man undergoes an ultrasound of the RUQ. Pertinant history includes multiple previous ultrasound ecaminations that document a small liver that is difficult to penetrate. Liver enzymes levels are elevated. The patient is very thin, with a slightly protruding abdomen. The liver remains small and difficult to penetrate, with poorly documented hepatic vasculature. No specific masses are noted. Free fluid is noted within Morrison’s pouch and the right subphrenic space. The anterior border of the liver is noted to have scalloped appearance. Which of the following is the most likely diagnosis

Answer 24

Cirrhosis

Question 25

A 70 yr old woman is seen for malaise & wasting. The clinician orders an abdominal ultrasound because of the patient's history of colon cancer & elevated liver function tests. The sonographer notes multiple hyperechoic lesions within the liver & hepatomegaly. This is suggestive of

Answer 25

Metastatic disease

Question 26

Clinical findings for hepatitis include all of the following except

Answer 26

Pericholecystic fluid

Question 27

A solitary, anechoic lesion is identified in the right lobe of a 50 yr old woman. The lesion is 2.5cm with smooth walls and acoustic enhacement. The patient has mild epigastric pain, especially with spicy foods & the remainder of the ultrasoun examination is unremarkable. The anechoic leasion most likely represents which of the following

Answer 27

Liver cyst

Question 28

All of the following are located within the porta hepatis except

Answer 28

Middle hepatic vein

Question 29

The most common cause of cirrhosis is

Answer 29

Alcoholism

Question 30

Joe, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever & elevated white blood cell count. He states the 3 months ago he was kicked in the ribs. An irregular mass with low-level echoes is found on the ultrasound. What is the differential diagnosis

Answer 30

Chinococcal cyst

Question 31

This 56 yr old female presents to the ultrasound department with elevated liver enzymes and a history of lung cancer. How would you best describe the attached image?

Answer 31

Multiple hypechoic masses througout slightly hyperechoic liver

Question 32

Ascited is the accumulation of fluid in which cavity

Answer 32

Peritoneal cavity

Question 33

What is the most common malignancy of the testicles

Answer 33

Seminoma

Question 34

A large complex hydrocele is most commonly associated with which of the following

Answer 34

orchitis

Question 35

A 7 yr old boy presents to the emergency fepartment with acute testicular pain localized to the superior pole of his right testis. What is the most likely diagnosis

Answer 35

Torsion of the testicular appendage

Question 36

Obtained during an ultrasound exam on a 17 yr old male for scrotal pain. What is the BEST diagnosis

Answer 36

Epididymitus

Question 37

You are performing doppler analysis of the spermatic cord. Which of the following arteries or structures is found within the speramatic cord?

Answer 37

Vas deferens Tersicular artery Cremasteric artery and Deferential artery

Question 38

Clinical findings of acute scrotal pain and swelling are suggestive of

Answer 38

Torsion

Question 39

A common cyst most often seen in the head of the epididymis that contains noviable sperm is the

Answer 39

Spermatocele

Question 40

Enlargement of the prostate in older men is most often caused by

Answer 40

Bengin prostatic hypertrohy

Question 41

You have been asked to perform a thyroid ultrasound on a patient with a palpable nodule in the left neck. Which transducers would provide the most optimal scan

Answer 41

MHz linear array

Question 42

The differential diagnosis for thyroiditis includes all of the following except

Answer 42

Hemorrhagic cyst

Question 43

The most common feature of a thyroid adenoma is

Answer 43

Peripheral sonocucent halo

Question 44

A patient with no significant medical history is seen with a palpable nodule in the left lobe of the thyroid. On ultrasound examination, the nodule is found to be mostly cystic but contains no debris. The mass is more likely

Answer 44

Benign thyroid nodule

Question 45

Images obtained during a thyroid ultrasound done due to a palpable neck mass in a 42 yr old. The BEST diagnosis is

Answer 45

Adenoma

Question 46

What is the most common cause of hypothyroidism

Answer 46

Hashimoto thyroiditis

Question 47

Which vascular structure is located closest to the thyroid lobes

Answer 47

Common carotid artery

Question 48

A 35 yr old remale patient presents to the ultrasound department with a history of migraine medicine use, weight loss, nausea & malaise. Sonographically, you visualize a 15cm hypoechoic mass within the abdomen. Which of the following would be most likely

Answer 48

Retroperitoneal fibrosis

Question 49

Fluid located around the lungs is termed

Answer 49

plueral effusion

Question 50

You've been asked to rule out pseudocyst formation in a patient with acute pancreatisis. What is the ultrasound appearance of a pancreatic pseufocyst

Answer 50

Cyst without internal echoes cyst with lo-level echoes cyst with internal septations and well defind wall

Question 51

What is the additional name for the accessory duct of the pancreas

Answer 51

Duct of santorini

Question 52

The most common location of adenocarcinoma of the pancreas is within the

Answer 52

Head

Question 53

The pancreatic tail is outlined posteriorly by what vascular structure

Answer 53

splenic vein

Question 54

Part of your routine protocol for pancreatic imaging is to comment on the chogenicity of the organ. what is the normal echogenicity of the normal pancreas

Answer 54

Either isoechoic or hyperechoic compared to the liver

Question 55

Which of the following is a risk factor for the development of pancreatic cancer

Answer 55

Smoking diabetes and chronic pancreatitis

Question 56

You have a patient who is scheduled for pancreatic surgery following ultrasound and CT evaluation. What is the surgical procedure of choice for pancreatic cancer

Answer 56

Whipple procedure

Question 57

what is the most common cause of acute pancreatitis

Answer 57

obstruction of the pancreatic duct by biliary calculi

Question 58

A thin patient has been referred for ultrasound evaluation of the pancreas. Which of the folloeing transducers would be best for this examination

Answer 58

5 MHz curved linear array

Question 59

a 23 yr old male reports to the ultrasound department for LUQ ultrasound with a history of mononucleosis. What is the best diagnosis

Answer 59

splenomegaly

Question 60

Patient presents with RUQ pain, tender hepatomegaly, fever, nausea, vomiting & weight loss. He recently traveled to a foreign country. He also has a history of abdominal aortic aneurysm. What is the best diagnosis

Answer 60

Abscess

Question 61

The largest tributaries to the IVC are

Answer 61

Hepatic veins

Question 62

A 25 year old female patient presents to the ultrasound department for a complete abdominal ultrasound. She complains of right lower quadrant pain & nausea. The right upper abdomen appears normal. A small mass is noted in the area of the splenic hilum. This mass appears isoechoic to the spleen. What does this most likely represent

Answer 62

Accessory spleen

Question 63

A complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the

Answer 63

Hydatid cyst

Question 64

An area within the spleen that had become necrotic because of a lack of oxygen is referred to as a

Answer 64

Splenic infarct

Question 65

The most common benign neoplasm of the spleen include all of the following except

Answer 65

Infarctions

Question 66

The normal adult spleen measures

Answer 66

8-13cm

Question 67

A rare malignant tumor of the spleen that consists of blood vessels is a/an

Answer 67

Angiosarcoma

Question 68

you are performing an ultrasound study on a patient with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents

Answer 68

Metastasis

Question 69

The major function of the spleen is

Answer 69

To filter the peripheral blood

Question 70

Where is the most common location of an accessory spleen

Answer 70

Splenic hilum

Question 71

Which malignant tumor is most common in chilfren aged 2-5

Answer 71

Wilm's tumor

Question 72

During routine surveillance of the urinary bladder, you detect the presence of periodic ureteral "jets". This is a sign of

Answer 72

Normalcy

Question 73

What is the normal appearance of the central sinus of the kidney

Answer 73

Highly echogenic compared to the renal cortex

Question 74

During performance of a renal sonogram, you identify only one kidney. what should you do

Answer 74

Scan the pelvis area to rule out the presence of a pelcic kidney

Question 75

Which of the following is not consifered an extrinsic cause of hydronephrosis

Answer 75

ureteral stricture

Question 76

What is the indication for a doppler renal study to rule out renal artery stenosis

Answer 76

uncontrolled hypertension

Question 77

The most common congenital anomaly of the urinary tract is

Answer 77

Duplicated collecting system

Question 78

A teenage boy is tackled roughly diring a football game. After the game, he has abdominal pain. the pain becomes intense & the next day he is seen at the emergency department. The lab values are abnormal, the hematocrit is low & microscopic hematuria is found. A renal ultrasound is ordered. The ultrasound of the left kidney is normal. The right kidney appears normal, but a sonolucent ring is seen surrounding the kidney. This is most consistent with

Answer 78

Perinephric hematoma

Question 79

You have detected comensatory hypertrophy of the right kidney in a 35 yr old maale. This finding is associated with which of the following

Answer 79

Nephrectomy renal agenesis and renal hypoplasis

Question 80

All of the following are clinical findings of acute renal failure except

Answer 80

Decreased BUN creatinine

Question 81

A 24 yr old frmale with a 12 yr history of recurring urinary tract infections arrives at the ultrasound department needing a renal sonogram. She has hypertension, a high fever, nausea, vomiting and painful urination. The lab findings include bacteriuria, proteniuria & increased BUN/Creat levels. Sonographically, the right kidney appears normal, but the left renal parenchyma appears narrowed and has focal areas of increased echogenicity. In addition, the left kidney measures abnormally small and appears misshapen and it's borders are difficult to visualize. what might by the cause of these sonographic findings

Answer 81

Chronic pyelonephritis

Question 82

A patient with a history of tuberous sclerosis, recent onset of hematuria and pain is seen for a renal ultrasound. The ulrasound reveals bilateral well-defind echogenic renal cortex masses with increased posterior scoustic enhancement. This finding is most consistend with

Answer 82

AML

Question 83

A 40 yr old female is seen for renal ultrasound. Microscopic hematuria was found during her routine annual physical exam. A solid mass is identified in the renal cortex. The mass is more echogenic than the renal sinus and the collecting system is not dilated. what is the most likely diagnosis

Answer 83

AML

Question 84

You are scanning a 69 yr old male with hematuria. Your ultrasound findings include right-sided hydronephrosis and a mass within the urinary bladder. which tumor most commonly occurs with in the urinary bladder

Answer 84

TCC (transitional cell carcinoma)

Question 85

You are scanning a patient with right flank pain and known polycystic kidney disease. You suspect the presence of hemorrhage within one of the renal cysts. What is the conographic appearance of this

Answer 85

Low-level echoes within the cyst

Question 86

Which of the following describes the normal course of the left renal vein

Answer 86

between the superior mesenteric artery and the aorta

Question 87

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

Answer 87

Morrison's pouch

Question 88

Occulsion of the hepatic veins describes

Answer 88

Budd-Chiari syndrome

Question 89

A 58 yr old female with epigastric pain with eating is seen for an abdominal ultrasound to rule out gallstones. The sonographer identifies normal-appearing gallbladder, liver, pancreas and spleen. The sonographer also documents a dilation of the aorta, which measures 6cm at its largest diameter. This woul dbe consistent with which

Answer 89

Aortic Aneursym

Question 90

The most common tumor to incade the IVC is

Answer 90

Renal cell carcinoma

Question 91

Which of the following is the biggest risk factor for rupture of an AAA

Answer 91

Aneurysm size

Question 92

Which of the following arteries are branches of the celiac trunk

Answer 92

Splenic Left gastric and Common hepatic

Question 93

A 55 yr old man is seen for a routine physical exam. During the exam, the physicians feel a pulsitile mass at the level of the umbilicus. and ultrasound is ordered for which of the following indications

Answer 93

To rule out an abdominal aortic aneurysm

Question 94

You are performing a doppler study of the portal vein and detect that the flow direction in the main portal vein is the same as the hepatic artery, what does this indicate

Answer 94

Normal flow pattern in the portal vein

Question 95

Enlargement of the IVC, with subseequent enlargement of the hepatic veins, is seen in cases of

Answer 95

Right sided heart failure

Question 96

An image was obtained on a patient post operative with a history of DVT's in the lower extremities. What is the most likely diagnosis

Answer 96

Greenfield filter in the IVC

Question 97

What veins join to form the portal splenic confluence

Answer 97

Splenic, SMV, IMV

Question 98

Which viseral artery is most commonlu involved with aneurysmal formation

Answer 98

Splenic artery

Question 99

An outpatient with a history of back pain and hypertension presents to the ultrasound department for an abdominal aortic sonogram. Sonographically, you visualize a 6cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. what is the most likely diagnosis

Answer 99

Aortic dissection

Question 100

The permanent localized dilation of an artery with an increase in diameter of greater than 1.5 times it's normal diameter is termed

Answer 100

an aneurysm

Question 101

A 40 yr old man with a history of Marfan sundrom is seen with intense chest pain in the emergency department. which of the following diagnoses should be the primary consideration

Answer 101

Aortic dissection

Question 102

Obtained during an abdominal ultrasound of a 34 yr old female with a history of oral contraceptive usage. What is the BEST diagnosis

Answer 102

Cavernous hemangioma

Question 103

Obtained during an abdominal ultrasound exam on a 26 yr old female with ledt flank pain for 4 weeks. What is the BEST diagnosis

Answer 103

Renal stones

Question 104

A 65 yr old male presents of the u/s department for a palpable mass in his left flank and hematuria. What is the BEST diagnosis

Answer 104

Renal cell carcinoma

Question 105

An African American male presents to the u/s depatment for a RUQ ultrasound for pain. He has a history of smoking and diabetes. Give the best diagnosis

Answer 105

Adenocarcinoma

Question 106

This patient presented with flank pain. You performed a RUQ ultrasound on the patient. What is the BEST diagnosis

Answer 106

Medullary sponge

Question 107

The first branch of the abdominal aorta is

Answer 107

Celiac axis

Question 108

What body cavity/s are the aorta and IVC in

Answer 108

retroperitoneal

Question 109

Which vessel below provides the greatest amount of oxygenated flow to the liver

Answer 109

portal vein

Question 110

What three stuctures form the portal triad

Answer 110

Portal vein, hepatic artery & common duct

Question 111

What is a difference in non-resistive and resistive blood vessels

Answer 111

Non-resistive vessels provide constant profusion to organs