MISC

Question 1

If there is gas within an abscess what kind of artifact may be present?

Answer 1

reverberation (comet-tail) artifact

Question 2

Most reliable finding in patients with abscesses

Answer 2

presence of fever

increased WBC

Question 3

The sonographic apperance of an abscess can be variable but typically is

Answer 3

complex mass, cystic and solid with possible debris, septations, and gas seen within

Question 4

Depending on the sytic component of an abscess they typically demonstrate

Answer 4

posterior enhancement

Question 5

How is the distinction made between a hematoma and an abscess is there is no air present in the abscess?

Answer 5

percutaneous aspiration

Question 6

Biloma

Answer 6

extrahepatic collections of extravasated bile

Question 7

Bilomas are most commonly assoicated with ____ _____ but can also be found with _____ ______ and _____ ______

Answer 7

biliary surgery
abdominal trauma
GB disease

Question 8

Predominant cytsic mass located in the RUQ

Answer 8

biloma

Question 9

What are lymphoceles complications of

Answer 9

renal tx
gyn surgery
vascular surgery
urological surgery
-caused by leakage of lymph from a renal allograft or by a surgical disruption of the lymphatic channels

Question 10

DDx of a lymphocele includes any fluid collection such as

Answer 10

loculated ascites
urinoma
hematoma
abscess
-internal echoes within the collection is more consistent with an abscess or hematoma than a lymphocele

Question 11

Urinomas are most commonly associated with

Answer 11

renal tx
posterior uretheral valve obstruction
(renal trauma/surgery or oustide obstruction )

Question 12

____ is a collection of urine which is located outside the of the kidneys, bladder/urinary tract

Answer 12

urinoma

Question 13

How soon after a renal tx can a urinoma developm

Answer 13

directly after due to an anastomotic leak of the ureter

Question 14

The sonograhic appearance of a urinoma is similar to a

Answer 14

lymphocele

Question 15

Lymphoma encompasses two types of neoplasms, which are

Answer 15

non-hodgkin lymphoma (NHL)

Hodgkin’s disease

Question 16

lymphoma is the abonormal proliferation of mature lymphocyte population. The most common subtype is the

Answer 16

diffuse large B-cell lymphoma

Question 17

Lymphoma is clinically assoicated with what viral infections

Answer 17

Epstein-Barr virus
Human T-lymphotropic virus 1
HIV
Hep C
HSV

Question 18

classic sonographic signs of lymphoma

Answer 18

sandwhich or mantle sign is teh sign of perivessel lymphoma

Question 19

Where does lymphatous nodules typically collect in lymphoma

Answer 19

typically cluster anterior and posterior to linear structures such as the Ao, IVC, SMA

Question 20

Lymphoma is noted to displace the IVC and SMA ____.

Answer 20

anteriorly

-finding can be clinically important as it is found more frequently with non-hodgkin’s

Question 21

Symptoms associated with lymphoma

Answer 21

fever
night sweats
weight loss

Question 22

Ascites is the excessive accumulation of serous fluid in the peritoneal cavity. Two mechanisms that produce ascites are

Answer 22

low serum osmotic pressure (protein loss)

high portal venous pressure

Question 23

Casues of asciets include

Answer 23

cirrhosis
renal failure
congetsive heart failure
cancer (malignant ascites)

Question 24

Most common cause of ascites

Answer 24

cirrhosis

Question 25

Hypoalbuminemia (low protein) can be the result of

Answer 25

liver failure nephrotic syndrome malnutrition

Question 26

Ascites is commonly found at

Answer 26

the inferior aspect of the right lobe of the liver Morison's pouch pelvic cul de sac paracolic gutters

Question 27

T/F - GB thickening is seen with ascites

Answer 27

T

Question 28

Malignancy characterized by the progressive accumulation of mucus-secreting tumor cells within the peritoneum. Most commonly associated with the appednix. Bowel loops are seen matted to the posterior abdominal wall

Answer 28

Pseudomyxoma pertonei

Question 29

Abdominal paras have to be careful to avoid the ______ vessels bilateral on the mammary line. Puncturing laterally to the mammary line is common.

Answer 29

epigastric

Question 30

For paras, lidocaine is used to anesthitize the area dow to the _____ ______ and for a therapeutic para, a ____ guage cannula is used to vacuum aspirate from teh peritoneal cavity

Answer 30

parietal peritoneum | 14-guage

Question 31

Pleural effusions are an accumulation of fluid in the ______ space and are often _________.

Answer 31

pleural | asymptomatic, although they can produce dyspnea and peluritic chest pain

Question 32

Pleural effusions are classified as _____ or _______ based on Light's criteria which compares pleural fluid and blood chemistries (protein, LDH)

Answer 32

transudates | exudates

Question 33

Transudative effusions are caused by

Answer 33

increased hydrostatic pressure and decreased plasma oncotic pressure (pressure infiltration)

Question 34

In trasudative effusions, what causes the pressure infiltration

Answer 34

``` heart failure (most common) liver failure (cirrhosis) renal failure (nephrotic syndrome) ```

Question 35

Exudative effusions are caused by

Answer 35

increased capillary permability (inflammation)

Question 36

In exudative effusions, the inflammation is due to

Answer 36

pneumonia cancer pulmonary embolism

Question 37

Lab analysis for thorax includes

Answer 37

``` total protein LDH cell count and diff gram stain aerobic and anaerobic bacterial cultures cytology ```

Question 38

How is a pneumothorax identified

Answer 38

abscence of gliding of the parietal and visceral pleura and the presence of a comet tail artifact between these layers patient in supine position, air can be located on the anterior medial location of the throax

Question 39

Throacentesis aspirates fluid from the pleural space of the chest, either for ______ purposes or to relieve ______. It is typically performed with the patient sitting at the edge of the bed leaning over a table with their spine rounded. It is also possible to perform with teh patient in the ____ _____ _____ position

Answer 39

diagnostic dyspnea LLD

Question 40

A dorsal intercostal space is selected superior to the diaphragm for a throa. ______ time should be checked before performing. The needle is inserted in the ____ aspect of the rib as vessels are located on the _____ aspect.

Answer 40

Bleeding time superior inferior

Question 41

In a throa, fluid is aspirated slowly, n ot to exceed _____ liters per day to avoid hypotension and pulmonary edema

Answer 41

1.5liter

Question 42

_____ occurs as the lung expands post thora becasue the visceral and parietal pleura rub together reuslting in pain

Answer 42

coughing

Question 43

_______ _______ is a collection of synovial fluid in the popliteal fossa and is commonly located on the _____ aspect of the fossa. They can also extend down into the _____

Answer 43

baker's cyst medial calf muscles

Question 44

Causes of a BAker's cyst

Answer 44

rheumatoid arthritis osteoarthritis overuse of the knees

Question 45

Nosocomial infections include

Answer 45

central line assoc bloodstream infections catheter associated UTIs ventilaer assoc pneumonia surgical site infection