Clinical #2 Flashcards by lindsay crouse

Which of the following arteries are evaluated during a penile duplex exam for erectile dysfunction?

dorsal
cavernosal
urethral
ventral

cavernosal

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A patient presents for an extremity ultrasound to evaluate the bicep tendon for tendonitis. The following image was obtained on the symptomatic left arm. All of the following would improve the tendon evaluation, EXCEPT:

rock the transducer back and forth to ensure the transducer face is perpendicular to the tendon

the right bicep tendon should be evaluated to provide comparison views

power Doppler should be applied to assess any increased vascularity associated with inflammation

ask the patient to hold a 5lb weight and reassess the thickness of the tendon

ask the patient to hold a 5lb weight and reassess the thickness of the tendon

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A patient presents with a history of Addison disease. Which of the following hormone levels will be increased?

cortisol
aldosterone
ACTH
epinephrine

ACTH

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When removing a protective gown:

untie the strings, pull the gown forward from the shoulders using the neck strings to turn it inside out as it is removed, remove your gloves, wash your hands

remove your glove, untie the strings, pull the gown forward from the center of the front of the gown to remove it with the exposed side out, roll it into a ball, wash your hands

remove your gloves, untie the strings, pull the gown forward from the shoulder using the neck strings, grab the inside shoulder seams to pull it off the arms and turn it inside out as it is removed, wash your hands

untie the strings, roll the gown from the bottom edge to turn it inside out, pull it from the shoulder and off the arms, remove your gloves, wash your hands

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When the prostate is enlarged, what other structures should be evaluated for related findings?

PV for thrombosis
RVs for Nutcracker syndrome
kidneys for hydronephrosis
RAs for thrombosis

kidneys for hydronephrosis

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Chest sonography is a valuable tool that can be used to evaluate all of the following EXCEPT:

pleural effusion
pneumothorax
pulmonary sequestration
the number of lobes in each lung

the number of lobes in each lung

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A patient presents with a history of Conn syndrome. Which of the following hormone levels will be increased?

epinephrine
aldosterone
ACTH
cortisol

aldosterone

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A patient presents for a neck ultrasound due to swelling under the angle of the jaw and anterior to the ear. She also complains of a dry mouth, dry cough, and dry eyes. These clinical findings are most suggestive of:

Hashimoto thyroiditis
Graves’ disease
sjogren syndrome
hemolytic anemia

sjogren syndrome

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A 40 year old male presents for an abdominal ultrasound exam with a history of anxiety, headaches, and excessive sweating. His current BP is 175/90mmHg with a pulse of 102bpm. What is the referring doctor expecting to find?

pheochromocytoma
adenoma
aortic aneurysm
Budd Chiari

pheochromocytoma

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A pituitary tumor that is causing Cushing syndrome will cause what lab value(s) to be increased?

aldosterone only
ACTH only
ACTH and cortisol
cortisol only

ACTH and cortisol

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Which of the following prostate abnormalities most significantly elevates the amount of serum prostate specific antigen in lab testing?

carcinoma
prostatitis
abscess
BPH

carcinoma

causes increased PSA levels usually much more significantly than BPH

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Prostatic Acid Phosphatase (PAP) levels are increased with:

prostate carcinoma
BPH
prostate calcifications
prostatitis

prostate carcinoma

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Which of the following is a symptom of Addison disease?

hypernatremia
weight gain
hyperkalemia
hypertension

hyperkalemia

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The image displayed is an infant hip ultrasound with measurements added. Which letter indicates where the alpha angle is measure?

B
C
D
none of the above

measured between the yellow and red lines
formed by the acetabular roof to the vertical cortex of the iliac bone
normal = greater or equal to 60 degrees
less than 60 degrees = dysplasia, subluxation, dislocation

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A patient presents with a history of Cushing syndrome and an adrenal tumor. What lab results are expected in the clinical findings?

elevated cortisol levels in the urine
elevated epinephrine levels in the urine
elevated serum levels of cortisol and ACTH
elevated serum levels of aldosterone

elevated cortisol levels in the urine

no pituitary gland involvement = normal ACTH

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A positive Tinel sign indicates:

pyloric stenosis
ruptured Achilles’ tendon
carpal tunnel syndrome
patellar tendonosis

carpal tunnel syndrome

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Internal rotation of the arm is preferred for evaluation of the ___ tendon, while external rotation of the arm is preferred for evaluation of ___ tendon.

long bicep, short bicep
flexor, biceps
supraspinatus, subscapularis
subscapularis, supraspinatus

supraspinatus, subscapularis

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Which of the following is not a common indication for a chest ultrasound in adults?

evaluate a superficial mass seen on chest CT
evaluate PICC line placement
suspected mass in the thymus
suspected pneumothorax

suspected mass in the thymus

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All of the following are common symptoms of colitis, EXCEPT:

bloody diarrhea
hemoptysis
watery diarrhea
low grade fever

hemoptysis = coughing up bloody septum from the lungs

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Which of the following structures can be used as an acoustic window when evaluating the pediatric mediastinum?

thymus
lung pleura
thyroid
diaphragm

thymus

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Which of the following chest masses would be most easily be evaluated with ultrasound?

a mass located between the bronchial tubes
a mass located in the posterior lobes
a mass located between the pleura and chest wall
a mass located in the central portion of the lung

a mass located between the pleura and chest wall

no air to obscure the image

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Which of the following describes the proper technique for visualization of the bicep tendon?

oblique probe position with the notch turned 30 degrees medially; placed on the posterior upper arm, just proximal to the elbow joint

scanning with the US beam as perpendicular to the tendon as possible to improve visualization

oblique probe position with the notch turned 60 degrees medially; placed on the anterior upper arm, just proximal to the elbow joint

longitudinal probe position on the posterior upper arm, just proximal to the elbow joint

scanning with the US beam as perpendicular to the tendon as possible to improve visualization

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You are providing instructions for a patient that needs a core needle biopsy. Which of the following medications should be taken as initially prescribed until the day of the procedure?

aspirin
hypertension medication
ibuprofen
lovenox

hypertension medication

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What clinical symptoms are common with adrenal hemorrhage?

nausea and vomiting
jaundice and low hematocrit
hyperkalemia and dysuria
weight loss and edema

jaundice and low hematocrit

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Which of the following are clinical findings related to a pheochromocytoma? hirsutism and bilateral pedal edema palpitations and skin discoloration bradycardia and fatigue increased adrenaline and anxiety

increased adrenaline and anxiety

Excessive androgen production is commonly associated with adrenal hyperplasia, adrenal cortical cancer, and polycystic ovarian disease. How will these increased androgen levels present as a clinical finding? pedal edema hirsutism excessive nausea and vomiting alopecia

hirsutism

A mother presents with her 3 month infant due to excessive vomiting and crying for 3 days. The referring physician suspects a lactobezoar may be the problem. Where will you look for this abnormality? anywhere along the digestive tract appendix gallbladder urinary bladder

anywhere along the digestive tract

Red currant jelly stool is a common clinical finding associated with: appendicitis pyloric stenosis intussusception mesenteric ischemia

intussusception

The Graf classification requires the measurement of ____ to determine the presence of abnormal findings on the ultrasound exam. vessel diameter end diastolic velocity resistive index alpha and beta angles

alpha and beta angles alpha angles < 60 degrees = abnormal alpha angles <43 degrees = dislocation

Which of the following maneuvers is utilized to assist in the diagnosis of the abnormality displayed? Murphy Valsalva Glisson Homan

Valsalva

Which of the following is an important part of a transrectal ultrasound performed prior to brachytherapy? to determine prostate size and volume to locate the main arterial branch that is feeding the carcinoma to obtain a PW Doppler signal from the base and apex of the gland to measure the distance from the prostate to the anterior abdominal wall

to determine the prostate size and volue determines the number of seeds needed and seed distribution

All of the following are clinical signs of congenital hip dysplasia, EXCEPT: palpable clunking sound on physical exam Allis sign asymmetric skin folds of the hip and thigh Barlow sign

Barlow sign - maneuver used to assess the hip during the exam

Hypernatremia and hypokalemia are clinical signs of: Conn syndrome Addison disease adrenal hemorrhage adrenal myelolipoma

Conn syndrome

Hyperpigmentation of the skin that results in brownish discoloration is a clinical sign of: Conn disease adrenal hemorrhage Cushing syndrome Addison disease

Addison disease

What does McBurney point refer to? an ectopic ridge of thyroid tissue in the chest as ectopic mass of endometriosis on the right kidney the most common location of the appendix the point of greatest tenderness in the RUQ in a patient with cholecystitis

the most common location of the appendix

Which of the following describes the placement for the first line for measurement of the alpha angle during an infant hip evaluation? extends from the iliac bone along the labrum extends from the bony edge of the acetabulum to the medial aspect of the femoral head extends from the bony edge of the acetabulum to the lateral aspect of the femoral head aligned with the iliac bone and extends through femoral head

Line 1 = aligned with the iliac bone and extends through the femoral head Line 2 = extends from the iliac bone along the labrum on the MEDIAL aspect of the femoral head Line 3 = extends from the bony edge of the acetabulum to the LATERAL aspect of the femoral head

Which of the following patients would need a guardian to sign an informed consent form for a liver nodule ablation? a patient that does not speak English a patient with Parkinson disease a patient with Alzheimer disease a blind patient

a patient with Alzheimer disease

Which of the following is a contraindication for transrectal ultrasound? Crohn disease significant prostatitis hepatitis lesion of the ileocecal valve

significant prostatitis significant rectal abnormalities that prevent tolerable probe insertion: fissures, neoplasms, hemorrhoids, prostatitis

Sjogren syndrome is an immune system disorder that commonly affects: thyroid adrenal glands bile ducts salivary glands

salivary glands

When evaluating an infant for pyloric stenosis, the infant should be placed in the ___ position for better visualization of the pylorus. semi-erect LLD prone RLD

RLD

Which of the following are common symptoms of Cushing syndrome? hypotension and fever cholecystitis and ascites anorexia and vomiting hyperglycemia and hirsutism

hyperglycemia and hirsutism

A 55 year old male patient presents with a script that states "pelvic ultrasound; post biopsy, Gleason score of 8." What should you expect to find on the exam? inguinal hernia caused by recent bladder wall biopsy lymphadenopathy and metastasis related to prostate cancer lymphadenopthy and metastasis related to bladder TCC bladder puncture caused by recent biopsy of the seminal vesicle

lymphadenopathy and metastasis related to prostate cancer

When evaluating an infant hip, the transducer is placed ___, but for a pediatric hip evaluation the transducer is placed ___. on the lateral hip, on the posterior hip on the anterior hip, on the posterior hip on the lateral hip, on the anterior hip on the anterior hip, on the lateral hip

on the lateral hip, on the anterior hip

Which of the following abnormalities would benefit the most from the administration of a water enema during the ultrasound evaluation? gastric sarcoma distal abdominal AO adenocarcinoma of the descending colon pancreatic adenocarcinoma (head)

adenocarcinoma of the descending colon

Which of the following describes the proper technique for the evaluation of a pediatric hip suspected transient arthritis? comparison views of the unaffected hip should always be obtained the curved array is used for the best evaluation of the curved structures in the boney hip the normal hip capsule thickness is less than 1cm transient arthritis requires an immediate arthrocentesis for fluid evaluation

comparison views of the unaffected hip should always be obtained

What patient age is preferred for performing ultrasound of the infant hips? 4-6 weeks 1-2 weeks >6 months 4-6 months

4-6 weeks

Which of the following is a symptom of Addison disease? hypokalemia hypertension hyponatremia weight gain

hyponatremia

The ___ sign is a clinical finding with pyloric stenosis, while ___ sign is a sonographic sign of pyloric stenosis. bird, snowman pseudokidney, yin yang olive, doughnut murphy, homan's

olive, doughnut

Which of the following should be performed when evaluating a suspected inguinal hernia? use dual screen imaging, with and without valsalva, over the suspected location of the hernia record bowel peristalsis on a cine clip have the patient fill their bladder and evaluate the scrotal sac for pocket of urine more than one of the above

more than one of the above

All of the following are signs and symptoms related to the abnormality seen on the images, EXCEPT hematuria leukocytosis rebound tenderness in RLQ nausea and vomiting

hematuria appendicitis is associated with rebound tenderness, leukocytosis, nausea and vomiting

Unintended wight loss is a common symptom in patients with: ascites hypothyroidism hyperglycemia carcinoma

carcinoma

When an epigastric hernia is suspected in this patient, where will you look?

What patient position is used to evaluate the Achilles' tendon with ultrasound? prone, feet dangling seated, knee and ankle flexed seated, knee flexed and ankle extended standing

prone, feet dangling

Cullen sign is hemorrhagic discoloration of the umbilical area caused by ___. Grey Turner sign is hemorrhagic discoloration of the left flank caused by ___. cavernous transformation, gastric varices rectus sheath hematoma, subcapsular renal hematoma intraperitoneal hemorrhage, hemorrhagic pancreatitis umbilical vein recanalization, gastric varices

intraperitoneal hemorrhage, hemorrhagic pancreatitis

Which of the following is a stress maneuver performed when evaluating infant hips? Allis maneuver Ortolani maneuver Baker maneuver Graf maneuver

Ortolani maeuver

If a patient has a non-reactive Thompson Test, what problem do they have? hydatid cyst of the liver complete tear of the Achilles tendon fungal abscess of the liver Baker cyst in the popliteal fossa

complete tear of the Achilles tendon

Which of the following sonographic techniques can be used to evaluate a possible inguinal hernia? Valsalva maneuver tissue Doppler color Doppler PW Doppler

color Doppler

A mother who is currently breast feeding presents with a painful and reddened area on the UOQ of the right breast. She states that she first noticed it two days ago. What is the most likely finding on her exam? cyst puerperal mastitis inflammatory carcinoma Paget disease

puerperal mastitis

Decreased hematocrit is associated with which of the following? dehydration polycythemia vera living at high altitude hemorrhagic cyst of the kidney

hemorrhagic cyst of the kidney

When evaluating the Achilles tendon, the thickness of the tendon should be obtained in what imaging plane? coronal transverse oblique sagittal

transverse

When a right spigelian hernia is suspected in the this patient, where will you look?

The image displayed is an infant hip ultrasound with measurements added. Which letter indicates where the beta angle is measured? A B C D

D angle formed between the vertical cortex of the iliac bone and the triangular labral fibrocartilage

Which of the following is a stress maneuver performed when evaluating infant hips? Graf maneuver Baker maneuver Allis maneuver Barlow maneuver

Barlow maneuver

Chronic steroid use is the most common cause of: Conn disease Cushing disease Cushing syndrome Addison disease

Cushing syndrome

Which of the following describes the placement for the second line for measurement of the alpha angle during an infant hip evaluation? extends from the iliac bone, along the labrum, and the lateral aspect of the femoral head extends from the iliac bone, along the labrum, and the medial aspect of the femoral head aligned with iliac bone and extends through the center of the femoral head extends from the bony edge of the acetabulum to the lateral aspect of the femoral head

extends from the iliac bone, along the labrum, and the medial aspect of the femoral head

If you are unable to locate the prostate on transrectal ultrasound: ask the patient to perform the Valsalva maneuver use firm pressure to insert the transducer 2-3 inches further into the rectum have the patient drink water and partially fill their bladder introduce 30-50cc of air into the probe cover

have the patient drink water and partially fill their bladder

An average sized patient presents with a fever, acute RLQ pain and vomiting. The ER physician wants to rule out appendicitis in this patient. Which of the following techniques would be used in the US exam? use a stand off pad to better visualize the superior bowel loops ask the patient to drink 32oz of water and fill the bladder prior to the exam apply graded transducer compression to the area of interest ask the patient to perform the Valsalva maneuver while scanning

apply graded transducer compression to the area of interest

Which of the following describes the patient position for transrectal prostate ultrasound? prone or fowler trendelenburg or supine LLD or lithotomy position lithotomy or prone

LLD or lithotomy position

The most common use of chest sonography is to evaluate: a complete or partial radiopaque hemithorax suspected atelectasis a known pulmonary embolism suspected lung cancer

a complete or partial radiopaque hemithorax

Purple stretch marks (striae) on the lateral and lower abdomen can be a clinical sign of: Addison disease Conn disease adrenal hemorrhage Cushing syndrome

Cushing syndrome

Clinical #2 Flashcards

(70 cards)