Miscellaneous

Question 1

What is an abscess?

Answer 1

A complex mass (solid, cystic, debris, septation, gas).

Question 2

What lab values are seen with an abscess?

Answer 2

Increase WBC and fever

Question 3

Gas within the abscess may produce what?

Answer 3

Reverberation artifact. (comet-tail)

Question 4

What is an extrahepatic collection of extravasated bile?

Answer 4

Biloma

Question 5

What causes bilomas?

Answer 5

Abdominal trauma, GB dz, Biliary surgery.

Question 6

What are biloma predominantly made up of and where are they located ?

Answer 6

cystic masses and RUQ

Question 7

What causes lymphoceles?

Answer 7

Leakage of lymph from a renal allograft or surgical disruption of the lymphatic system

Question 8

What types of surgeries causes lymphocele ?

Answer 8

Renal TX, GYN/vasc/Urology surgeries

Question 9

What is other differential diagnosis of a lymphocele?

Answer 9

Ascites, urinomas, hematoma, or abscess.

Question 10

What is a collection of urine located outside of the kidney or bladder?

Answer 10

Urinoma

Question 12

What causes a urinoma?

Answer 12

Renal TX and Posterior urethral valve obstruction

Question 13

What can a urinoma look similar to ?

Answer 13

Lymphocele

Question 14

What is DDH?

Answer 14

Development dysplasia of the hip
Prox femur and acetabulum that lead to the hip dislocation

Question 15

what are the risk factors of hip dysplasia?

Answer 15

female, first born, frank breech, family Hx
oligohydramnios

Question 16

when is a Hip ultrasound performed?

Answer 16

4 weeks of age

Question 17

Wha are the stress maneuvers for hip displasia?

Answer 17

Barlow and Ortolani

Question 18

What is the Barlow and Ortolani hip maneuvers?

Answer 18

Barlow (dislocating)- ADDucting and pushing the legs posterior

Ortolani (relocating)- ABDucting the hips into the socket. “clunk”

Question 19

What is lymphoma and what are the types of lymphomas?

Answer 19

proliferation of mature lymphocyte (b-cell)
Non-Hodgkins
Hodgkins

Question 20

What is clinically associated with lymphoma

Answer 20

various viral infections
- Espstein, Human immue/T-lmph, Hep C and herpes

Question 21

What is a sonographic sign of lymphoma?

Answer 21

sandwich or mantle

Question 22

Where is the sandwich or mantle sign seen at?

Answer 22

Clusters of lymph nodes seen anterior and posterior to AO, IVS and SMA.
- Displaces IVC and SMA anteriorly

Question 23

What are symptoms of lymphoma

Answer 23

Fever, night sweats, weight loss

Question 24

How is ascites produced ?

Answer 24

Low serum osmotic pressure (prtien loss)
High portal venous pressure

Question 25

What causes ascites?

Answer 25

Cirrhosis, Renal fail, CHF, and cancer

Question 26

What is the result of hypoalbuminemia ?

Answer 26

Liver fail, nephrotic syndrome, malnutrition

Question 27

where is ascites found?

Answer 27

Inf liver, Morison pouch, pelvic cul-de-sac, paracolic gutters.

Question 28

In the presents of ascites what happens to the Gb?

Answer 28

GB thickening

Question 29

what is the progressive accumulation of mucus-secreting tumor cells within the peritoneum

Answer 29

Pseudomxoma Peritonei (malignacy) - Appendix cancer matted loops of bowel

Question 30

what are the two types of pleural effusions?

Answer 30

Transudative and Exudative effusions

Question 31

what is Transudative and Exudative effusions

Answer 31

Transudative- pressure infiltration (heart, liver, kidney failure) Exudative- Inflammation (Pneumonia, cancer, PE)

Question 32

What is a Pneumothorax

Answer 32

Absence of gliding of the parietal and visceral pleura - comet tail artifact

Question 33

What is the limited of Thora fluid that can be taken off and to avoid what?

Answer 33

1.5L Avoid hypotension and pulmonary edema

Question 34

What is a baker cyst and what causes it?

Answer 34

Synovial fluid in the med aspect of pop Rheumatoid and osteoarthritis, overuse of knees

Question 35

What is a giant cell tumor?

Answer 35

solid mass of the tendon shealth found on hand and wrist. (similar to ganglion cyst)

Question 36

Internal echos within a fluid collection could be what ?

Answer 36

Abscess or hematoma.

Question 37

The rectus abdominus muscles extend longitudinally and connect to what ?

Answer 37

The zyphoid process and Public bone

Question 38

The rectus abdominus muscles are encases in a sheath that joins midline to form what?

Answer 38

Linea alba

Question 39

The ant and post rectus sheath extend from what two points?

Answer 39

Costal margin to the arcuate line

Question 40

Rectus sheath hematoma result of bleeding from what vessels?

Answer 40

Superior and inferior epigastric vessels

Question 41

If there is a rectus hematoma superior to the arcuate line what happens

Answer 41

Confined between ant and post sheaths and shouldnt move due to the linea alba.

Question 42

If there is a rectus hematoma inferior to the arcuate line what happens

Answer 42

Extend to the space of retzius and cause external compression of the bladder due to weak transvers fascia and no post sheath

Question 43

What happens in the result of extensive bleeding ?

Answer 43

decrease in hematocrit and hypovolemoc shock.

Question 44

What causes rectus sheath hematomas?

Answer 44

external/surgery trauma, vigorus muscle contration (vomiting/coaughing), pregnancy

Question 45

Rectus steath hematoma is a recognized complication of what?

Answer 45

Anticoagulation therapy

Question 46

Where is the space of retzius?

Answer 46

anterior tot bladder

Question 47

What is the most common hernia?

Answer 47

inginal hernia

Question 48

What is the difference between a Indirect and a Direct inguinal hernia?

Answer 48

Indirect is Lateral to inferior epigastric art Direct is Medial to inferior epigastric art Indirect goes into the scrotum Direct abdominal wall inside of indirect (IN-LAT) (D-MED)

Question 49

Where is a spigelian hernia?

Answer 49

In the lateral rectus abdominus muscle

Question 50

Where are the following hernais located? - epigastric - umbilical - Femorla - Obturator

Answer 50

- Epigastric- midline b/t breast bone and umbilicus - Umbilical near umbilicus (natural weakness of wall) - Femoral within femoral conal near FV ( pregnancy) - Obturator protudes from pelvic cavity through pelvic bone (difficult to diagnose)

Question 51

What is incarcerated hernias

Answer 51

trapped tissue and cannot be moved back to place (leads to obstruction and strangulation)

Question 52

what is strangulated hernia?

Answer 52

Cuts off blood flow

Question 53

What are the abdominal wall layers in the inguinal region

Answer 53

Skin, external & internal oblique muscles, transversus abdominus muscle, transversalis fascia, and peritoneum.

Question 54

What is another name for a parallell skeletal muscle and what is it

Answer 54

Fusiform long axis muscle fibers EX. biceps, sartorius

Question 55

What is another name for a convergent skeletal muscle and what is it?

Answer 55

Triangular muscle converge towards a single tendon EX. pectoralis major

Question 56

What is a pennate skeletla muscle

Answer 56

muscle fibers branch from central tendon diagonally (feather like) EX> rectus femoris, deltoid.

Question 57

What are major viruses to be concerned about ?

Answer 57

HIV, Hep B and C