Common Small Parts Pathology Test

Question 1

appearance of benign lesions of the breast

Answer 1

smooth rounded edges do not invade surrounding tissue rounded or oval long axis parallel to the chest wall isoechioc with normal breasat tissue

Question 2

appearance of malignant lesions of the breast

Answer 2

irregular walls often spiculated margins which are finger like extensions extending out in numerous directions from the mass disrupt normal breast tissue and cause nipple retraction and skin dimpling due to pulling on coopers ligament sharp angular margins microlobulations taller tan wide hypoechoic with weak internal echoes

Question 3

most common benign breast tumor

Answer 3

fibroadenoma growth stimulated with estrogen develop due to failure of the fibrous and epithelial cells to regress during the 2nd 1/2 of the menstrual cycle

Question 4

appearance of fibroadenoma

Answer 4

large rounded lobulations oval, homogenious, wider than tall

Question 5

appearance of malignant lymph node

Answer 5

changes from oval to round echogenic hilum becomes more difficult to detect same shape when you turn on it

Question 6

most frequent cause of hyperthyroidism

Answer 6

graves disease

Question 7

graves disease affects

Answer 7

women over 30

Question 8

appearance of graves disease

Answer 8

hypoechoic gland with diffuse enlargement no discrete nodules intense color doppler-thyroid storm inferno

Question 9

patient with graves disease

Answer 9

bulging eyes agitation weight loss

Question 10

treatment of graves disease

Answer 10

radioactive ablation with lifelong supplements of sinthroid

Question 11

most common form of thyroiditis

Answer 11

hashimoto’s disease

Question 12

hashimoto’s disease

Answer 12

affects middle aged women autoimmune disorder

Question 13

appearance of hashimoto’s disease

Answer 13

enlarged homogeneous hypoechic thyroid texture discrete nodules less common acute stage has less vascularity chronic stage will have increased color doppler when TSH elevates atrophic stage depicts small, heterogeneous gland that is hypovasvular

Question 14

appearance of thyroid adenoma

Answer 14

variable size homogenous not necessarily associated with thyroid enlargement range from anechoic to hyperechoic commonly have a peripheral halo hyperfunctioning adenomas can have increased blood flow

Question 15

appearance of mutinodular goiter (nodular hyperplasia)

Answer 15

variable sonographic appearance, usually enlarged, irregular, nodular, heterogeneous,and often not symmetrical most have similar appearance to thyroid adenomas, including halos and homogenous echogenicity nodules may also have cystic areas, calcifications an colloid cyst formation

Question 16

most common thyroid abnormality

Answer 16

nodular hyperplasia (multinodular goiter)

Question 17

most common benign tumor of the liver

Answer 17

cavernous hemangioma usually asymptomatic and discovered incidentally

Question 18

appearance of cavernous hemangioma

Answer 18

hyperechoic and typically has posterior enhancement usually the right lobe and near the dome

Question 19

2nd most common benign mass of the liver

Answer 19

focal nodular hyperplasia women under 40 and asymptomatic

Question 20

appearance of focal nodular hyperplasia

Answer 20

most in right lobe hyper to iso echoic many have central scar

Question 21

an acguired diffuse disorder resulting in an accumulation of triglycerides with the hepatocytes

Answer 21

fatty liver/fatty sparing

Question 22

appearance of fatty liver/fatty sparing

Answer 22

not always uniform and can present focal fatty liver (patchy distibution) focal sparing (mass like hypoechoic regions in and echogenic liver) often near the GB @ the porta hepatis, caudate lobe, and left lobe

Question 23

most important in making diagnosis of fatty liver

Answer 23

liver echogenicity compared to right kidney

Question 24

congenital varient of liver

Answer 24

riedels lobe

Question 25

appearance of riedels lobe

Answer 25

anterior projection of the liver extending to near the iliac crest not merely an elongated inferior posterior segment extending over the right kidney

Question 26

most common cancerous mass of the liver

Answer 26

metastatic disease

Question 27

metastatic disease of the liver most commonly from

Answer 27

GI including GB and pancreas, breast, and lung

Question 28

appearance of metastatic disease of liver

Answer 28

hyperechoic, hypoechoic, bulls eye, calcified, cystic, diffuse

Question 29

primary metastatic desease of the liver

Answer 29

hepatocellular carcinoma common in men associated with w/ chronic cirrhosis and Hep B and C

Question 30

appearance of hepatocellular carcinoma

Answer 30

isoechoic with halo, cotton balls, or can loot like lots of cysts

Question 31

accumulation of serous fluid in the peritoneal cavity

Answer 31

ascites

Question 32

appearance of ascites

Answer 32

echo free fluid regions indented and shaped by the surrounding organs 1st fills pouch of douglas before is ascend to the paracolic gutters, major flow from the pelvis is via the right side small bowel loops sink and float within the fluid

Question 33

occur in 5% of people over the age 50 often seen in patients with autosomal dominant polycystic kidney desease

Answer 33

hepatic cysts or liver cysts (IDK)

Question 34

appearance of liver cyst

Answer 34

smooth, thin, well defined walls round or oval anechoic increased posterior enhancement (though transmission) single or numerous

Question 35

irregular, hypoechoic lesion, dilated pancreatic duct, liver and para-aortic nodes

Answer 35

pancreatic adenocarcinoma most often in head and usually cause obstruction of CBD, GB, and hydrops and jaundice

Question 36

symptoms of pancreatic adenocarcinoma

Answer 36

ABD pain back pain painless jaundice weight loss

Question 37

pancreas appears inflamed and releases enzymes into the surrounding pancreatic tissue. Hypoechoic and edematous with irregular borders. Pancreatic duct may become enlarged

Answer 37

acute pancreatitis

Question 38

pancreas appears hyperechoic with echogenic foci andomly dispersed throughout the gland

Answer 38

chronic pancreatitis

Question 39

an accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum

Answer 39

pseudocysts

Question 40

common causes of pseudocysts

Answer 40

acute pancreatitis chronic panreatitis pancreatic trauma pancreatic ductal obstruction pancreatic neoplasms

Question 41

most common cause for pseudocysts in children

Answer 41

ABD trauma

Question 42

focal lesions in the spleen resulting from previous infections

Answer 42

splenic calcifications (granulomatous infection)

Question 43

appearance of granulomatous infection (splenic calcifications)

Answer 43

bright echogenic lesions with or without shadowing

Question 44

most common cause of spenic calcifications (granulomatous infections)

Answer 44

tuberculosis and histoplasmosis

Question 45

common congenital anomaly of the spleen

Answer 45

accessory spleen

Question 46

appearance of accessory spleen

Answer 46

well circumcised typically rounded and isoechoic with the spleen typically found at the lower splenic pole or near the hilum

Question 47

priminent infolding of the renal cortex which indents the renal medullary. Columns have an echogenicity similar to renal paenchyma and are continous with the renal cortex. Do not distort the renal cortex

Answer 47

column of bertin

Question 48

bulge of the renal cortex that occurs on the lateral border of the kidney. more often on the left than the right. identical echogenicity as renal corted and can mimic a cortical tumor. Cortical border is intact and hump will contain normal appearing pyramid structures. Little bit of fat in hump

Answer 48

dromedary hump

Question 49

developmental varient seen more in children and sometimes in adults. Typical smooth cortical border appears indented or undulated between the calyces, giving the kidney surface a lobulated appearance. Cortical borders are still intact and parenchymal thickness is uniform through kidney. Cases of renal scarring and/or insufficiency will demonstrate cortical thinning

Answer 49

fetal lobulation

Question 50

on both the long and transverse images the central renal sinus appears as two echogenic regions that are separated by a cleft or normal renal tissue. On continuous transverse imaging one image will appear to have no central medullary tissue only parenchymal tissue.

Answer 50

duplex collecting system

Question 51

triangular echogenic area in the upper pole of renal cortex. Not to be confused with angiomyolipoma which is a round echogenic parenchymal mass found anywhere within the renal parenchyma

Answer 51

junctional defect

Question 52

renal pelvis portion of the collecting system extends outside of the confines of the central renal sinus. Appears as a central cystic area that is either partially or entirely beyond the confines of the kidney

Answer 52

extrarenal pelvis

Question 53

most common renal problem

Answer 53

nephrolithiasis (kidney stone) more common in men

Question 54

appearance of nephrolithiasis

Answer 54

echogenic foci with posterior acoustic shadowing stones within the cortex are easier to distinguish than stones within the medullary and prominent renal sinus. Fat with weak shadowing can mimic stones

Question 55

Smooth thin well defined walls round or oval anechoic (low level echoes = artifact Vs pathology) increases posterior acoustic enhancement can be single or numerous, found anywhere in the kidney (exophoc, parenchymal, or medullary

Answer 55

simple cortacle renal cyst

Question 56

cysts within the renal collecting system (medullary)

Answer 56

parapelvic cysts

Question 57

appearance of parapelvic cysts

Answer 57

anechoic cyst located in the renal hilum will distort the renal sinus fat and does not communicate with the collecting system well defined but will have irregular borders caused from the compression of the adjacent renal sinus structures enlarge and cause renal obstruction

Question 58

fluid filled separation of the renal sinus with an appearance that conforms to the calyces and renal

Answer 58

obstructive hydornephrosis

Question 59

3 grades of obstructive hydronephrosis

Answer 59

1 small separation or splaying of the calyces 2 fluid extends into the major and minor calyces, bear claw effect, with minimal thinning of the cortex 3 massive dilation of the renal pelvis with significant loss of renal cortex

Question 60

criteria for differentiating hydro from para pelvic cysts

Answer 60

renal dilation must have connecting calyces to by hydro important to follow the renal dilation as distal as possible in an attempt to determine the cause and location of the hydro

Question 61

dilation of the renal sinus and pelvis without an actual blockage of the flow of urine into the bladder

Answer 61

nonobstructive hydronephrosis

Question 62

common causes of nonobstructive hydronephrosis

Answer 62

an overly distended bladder UTI or extrinsic blockage of the ureters and or bladder from retroperitoneal adenopathy pelvic masses/uterine fibroids pregnancy enlarged prostate

Question 63

what should you do when a dilation is noted

Answer 63

check for bilateral ureteral jets