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My Ultrasound Tutor- Abd Flashcards

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1
Q

What is the most common diffuse liver disease?

A

Fatty liver infiltration aka hepatic steatosis

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2
Q

65 year old male presents to the clinic for abdominal ultrasound. Diagnosis shows elevated liver function test. When scanning you see a focal hypoechoic area next to the Gallbladder. What is the most likely diagnosis?

A

Fatty liver infiltration

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3
Q

What is the most common cause of cirrhosis?

A

Alcoholism

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4
Q

What is the most common cause of portal hypertension?

A

Cirrhosis

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5
Q

While scanning a patient you notice hepatofugal flow and a MPV measuring greater than 13mm. What is the most likely diagnosis?

A

Portal hypertension

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6
Q

To normalize blood flow in portal hypertension what is a common treatment?

A

TIPS

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7
Q

What vessels are connected when using a TIPSS?

A

Portal vein and hepatic vein

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8
Q

What is the most common cause of a portal vein obstruction?

A

Tumor or lymphadenopathy

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9
Q

What is the difference between portosystemic collaterals and cavernous transformation?

A

Portosystemic collaterals are due to portal HTN and reroute blood AWAY from the liver while cavernous transformation is rerouting the blood TOWARD the liver

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10
Q

What syndrome causes occlusion of the hepatic veins and possibly IVC?

A

Budd-Chiari syndrome

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11
Q

With Budd-Chiari syndrome what are sonographic findings you will see?

A

Hepatomegaly, enlarged caudate lobe and absent flow in the hepatic veins

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12
Q

What type of infections occur in the liver?

A

Acute hepatitis and abscess

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13
Q

What is the difference between acute hepatitis and an abscess?

A

Hepatitis is a diffuse infection so LFTs will always be abnormal. An abscess is focal so LFTs may be normal

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14
Q

What are the most common hepatitis?

A

Hep A and B

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15
Q

Which type of hepatitis is most likely the cause if needing liver transplant?

A

Hep C

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16
Q

Cyst in the liver are associated with what disease?

A

PKD ( poly cystic kidney disease)

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17
Q

What is the most common benign liver tumor?

A

Cavernous hemangioma

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18
Q

What does a cavernous hemangioma look like sonographically?

A

Echogenic solid mass

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19
Q

What focal mass in the liver is associated with oral contraceptives?

A

Hepatocellular adenoma

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20
Q

What is the 2nd most common benign liver tumor?

A

Focal modular hyperplasia

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21
Q

What is a common sonographic finding with focal nodular hyperplasia?

A

Central scar with vascularity

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22
Q

What is the most common primary liver cancer

A

Hepatocellular carcinoma

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23
Q

What tumor marker will be elevated with HCC?

A

Elevated AFP (alphafetoprotein)

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24
Q

What sonographic findings do you see with HCC?

A

Hypoechoic mass usually solitary and ascites

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25
What is the most common location for metastasis?
Liver
26
When Mets are found in the liver what organs are common sources?
Lung, colon and breast
27
What is hepatoblastoma?
It is the pediatric version of HCC
28
Patient with Beckwith-Wiedemann syndrome have an increased for what cancer?
Hepatoblastoma
29
After a liver transplant what is the most common vascular complication?
Hepatic artery thrombosis
30
Is the gallbladder an intraperitoneal or extraperitoneal organ?
Intraperitoneal
31
What is the function of the gallbladder?
Gallbladder stores and concentrates bile
32
What hormone causes the gallbladder to contract and release the bile?
Cholecystokinin (CCK)
33
What allows the cystic duct to not leak out bile until gallbladder contracts?
Spiral valves of heister
34
What are the parts of the gallbladder?
Neck, body, fundus
35
What part of the gallbladder is the most dependent?
Fundus
36
What is the most common variant of the gallbladder?
Phrygian cap
37
What is a Phrygian cap?
Fold of fundus over body
38
What gallbladder variant causes outpouching of the neck?
Hartmann pouch
39
What kind of preparation does a patient need to do when coming for a gallbladder ultrasound?
Patient needs to be NPO for minimum 6 hours
40
What does normal gallbladder wall thickness measure?
Up to 3mm
41
What are tissue projections from gallbladder wall with no mobility called?
Gallbladder polyps
42
What is adenomyomatosis?
Muscular layers form little pockets called rokitansky-Aschoff sinuses
43
What is the calcification of the gallbladder wall called?
Porcelain gallbaldder
44
What is another name for gallbladder sludge?
Viscid bile
45
What causes gallbladder sludge?
Biliary Statis, bile not flowing
46
What are the 6 Fs more prone to gallbladder stones?
Fat, female, fertile, flatulent, fair and forty
47
What is the most common location in the gallbladder for stones?
Fundus due to dependency
48
Gallbladder packed with stones will likely show what sonographic finding?
WES (wall echo shadowing) only showing anterior wall and solid shadowing
49
When documenting gallbladder stones it is important to show what?
Prove mobility by placing patient in at least one other position other than supine
50
What are gallstones in bile ducts called?
Choledocholithiasis
51
When obstruction in gallbladder occurs what clinical findings will you see?
Elevated ALP and Bilirubin
52
What is the most common cause of biliary obstruction?
Choledocholithiasis
53
What is courvosier gallbladder?
Enlarged GB caused by pancreatic head mass
54
What does a hydropic GB measuring more than 4cm indicate?
Obstruction of distal biliary tree
55
What is the most common cause of acute cholecystitis?
obstructive gallstones
56
Key symptoms when there's an infection?
Fever, leuko, and pain
57
What is the most common cause of gallbladder infection?
Obstructive gallstone
58
What are sonographic symptoms of acute cholecystitis?
Thickened GB wall, pericholecystic fluid, stone and sludge
59
Diabetic patients have an increased risk for what acute gallbladder complication?
Emphysematous cholecystitis
60
What is the most common cancer of the biliary tract?
Gallbladder carcinoma
61
What is the most common type of cholangiocarcinoma?
Klatskin tumor
62
What is cholangiocarcinoma?
Cancer within the bile ducts
63
Where is the most common location for a pancreatic carcinoma mass?
Pancreatic head
64
What is biliary atresia?
Narrowing or absence of biliary tree
65
What is the most common type of choledochal cyst?
Cystic dilatation of CBD
66
What is Caroli disease?
Segmental dilatation if the intrahepatic ducts
67
Is the pancreas an intraperitoneal or retroperitoneal organ?
Retroperitoneal
68
What endocrine function does the pancreas have?
It produces hormones from the isles of langerhans
69
What is the main pancreatic duct?
Duct of Wirsung
70
What vessel supplies the pancreas head with blood?
Gastroduodenal artery
71
The splenic artery and SMA supply what part of the pancreas with blood?
Body and tail
72
The main pancreatic duct should measure:
Less than or equal to 2mm
73
What is the most common variant of the pancreas?
Pancreatic divisum
74
What pancreatic variant causes the pancreas head to wrap around the duodenum?
Annular pancreas
75
What is the most common cause of acute pancreatitis?
Choledocholithiasis
76
Chronic pancreatitis is most commonly found in cases of pancreatitis caused by what?
Alcohol abuse
77
What is a whipple procedure?
Removal of pancreas head, duodenum, GB and bile duct
78
What is the most common islet cell tumor?
Insulinoma
79
Where does the splenic artery arise from?
Celiac trunk
80
Where are the splenic artery and vein in relation to the pancreas?
Splenic artery travels superiorly to body and tail of pancreas. Splenic vein travels posterior to body and tail of pancreas
81
What is the most common variant of the spleen and what are the various names for it?
Accessory spleen, splenunculus, splenule and supernumerary spleen
82
What is the most common abnormality of the spleen?
Splenomegaly
83
What is the most common cause of splenomegaly?
Portal hypertension
84
What is the most common primary cancer of the spleen?
Angiosarcoma
85
Are the kidneys intraperitoneal or retroperitoneal organs?
Retroperitoneal
86
What are the 2 main components that filter and produce urine?
The parenchyma and sinus
87
Where are the cortex and medulla located?
Parenchyma of kidney
88
What is the functional unit of the kidney?
Nephron
89
What forms the outer rim of the kidney?
Cortex
90
What is the medulla made up of?
Pyramids
91
What helps divide the pyramids and is made up of cortical tissue?
Columns of berlin
92
What is the most common variant of the kidneys?
Duplicated collecting system
93
Where is the most likely location to find an ectopic kidney?
Pelvis
94
What variant will cause the kidneys to fuse at the lower poles?
Horse shoe kidneys
95
What is the difference between the parenchyma of the kidney and the collecting system?
Parenchyma is the functional part of the kidney where as the collecting system is a series of tubes
96
What are the renal function test?
Blood urea nitrogen (BUN) and creatinine
97
What is the most common cause of acute renal failure?
Acute tubular necrosis
98
What is the most common cause of chronic renal failure?
Diabetes mellitus
99
Chronic renal failure patients are at risk for what disease due to the chronic hemodialysis?
Acquired renal cystic disease
100
What patients are affected by autosomal recessive poly cystic kidney disease?
Neonates only
101
When would patients with autosomal dominant polycystic kidney disease start developing cyst?
Mid age (40-50s)
102
What is the most common renal mass?
Cysts
103
What is the most common benign renal tumor?
Angiomyolipoma
104
What is the most common cause of pyelonephritis?
Ascending UTI from bladder
105
What most common cause of glomerulonephritis?
Throat (strep) infection
106
What is the most common cause of fungal UTI?
Candida albicans
107
What is the most common renal cancer?
Renal cell carcinoma
108
When scanning a patient you see a solid renal mass, what is the most likely diagnosis?
Renal cell carcinoma
109
What is the most common bladder cancer?
Transitional cell carcinoma
110
What is the most common renal tumor in kids?
Wilms tumor or nephroblastoma
111
Renal artery stenosis is most commonly caused by?
Artherosclerosis
112
What is the most common vascular complication after a renal transplant?
Renal artery stenosis
113
When scanning a patient, you Doppler the renal artery and get a tardus parvus wave form, what is the most likely diagnosis?
Renal artery stenosis
114
What is the most common location for urinary tract obstruction in pediatrics?
UPJ ureteropelvic junction
115
In an adult what is the most common location for urinary tract obstruction?
UVJ ureterovesicular junction
116
What does nephrolithiasis refer to?
Kidney stone
117
Are the adrenal glands intraperitoneal or retroperitoneal organs?
Retroperitoneal
118
What other organ controls the adrenal glands?
Anterior pituitary gland
119
The cortex of the adrenal glands produce what hormones?
Aldosterone, androgens and cortisol
120
What hormones does the medulla of the adrenal glands produce?
Epinephrine and norepinephrine
121
What is Addison disease?
Adrenal insufficiency
122
What is the most common benign solid mass of adrenal glands?
Adenoma
123
What is Cushing syndrome?
Hypercortisolism, too much cortisol
124
What is conn syndrome?
Hyperaldosteronism, too much aldosterone
125
What is pheochromocytoma?
Hyper function medullary tumor causing too much epinephrine and norepinephrine
126
What is pheochromocytoma?
Hyper function medullary tumor causing too much epinephrine and norepinephrine
127
What is the most common extracranial malignancy in pediatrics?
Neuroblastoma

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