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ARDMS ABD REVIEW > Pathology #1 > Flashcards

Pathology #1 Flashcards

1
Q

A patient presents with moderate RLQ pain and a low grade fever. An US exam of the area demonstrates a 7mm thick aperistaltic tube that is noncompressible. Which of the following best describes the findings?

appendicitis
Crohn disease
intussusception
varicocele

A

appendicitis

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2
Q

Primary sclerosing cholangitis is usually seen in patients with:

pancreatic head mass
HIV infection
ulcerative colitis
biliary ascariasis

A

ulcerative colitis

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3
Q

What is the most common retroperitoneal mass?

rhabdomyosarcoma
fibroma
liposarcoma
myxoma

A

liposarcoma - malignant fatty mass

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4
Q

Which of the following is NOT required when reporting a suspected hernia?

tenderness at the area of interest
suspected age of the hernia
contents of the hernia sac
reducibility

A

suspected age of the hernia

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5
Q

A doctor refers an infant for a chest ultrasound exam due to a history of a chest mass seen in the left lobe on x-ray. You identify a well defined hypoechoic mass in the area of interest. Color Doppler demonstrates arterial supply to the mass from a branch of the AO. These findings are most suggestive of:

hemothorax
pneumonia
pulmonary sequestration
atelectasis

A

pulmonary sequestration

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6
Q

Malignant ascites is described as:

anechoic fluid with free-floating bowel loops
hyperechoic fluid with septations
anechoic fluid with free-floating bowel loops and septations
complex fluid collection with matted bowel loops

A

malignant ascites = complex fluid collection with matted bowel loops

benign ascites = anechoic fluid with free-floating bowel

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7
Q

Ascites is usually associated with all of the following, EXCEPT:

CHF
hepatoma
renal failure
oncocytoma

A

oncocytoma

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8
Q

An enlarged, rounded lymph node with loss of hilar definition is most suggestive of associated ___, while an enlarged, oval lymph node with normal hilar characteristics is most suggestive of associated ___.

malignancy, infection
infection, malignancy
viral infection, bacterial infection
bacterial infection, viral infection

A

malignancy, infection

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9
Q

An incidentaloma is:

an aggressive splenic carcinoma
an unexpected mass on an imaging exam
always a critical finding
an aggressive adrenal carcinoma

A

an unexpected mass on an imaging exam

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10
Q

___ is the most common malignant neoplasm found in the prostate.

adenocarcinoma
transitional zone sarcoma
metastasis
central zone sarcoma

A

adenocarcinoma

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11
Q

What causes symptoms in a patient with carpal tunnel syndrome?

impingement of the median nerve
impingement of the palmar arch
impingement of the ulnar nerve
impingement of the radial nerve

A

impingement of the median nerve

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12
Q

What is the most significant complication of a hernia?

ascites
lymphadenopathy
recanalization of the umbilical vein
strangulation

A

strangulation - if bowel becomes strangulated, infarction can occur

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13
Q

The arrow on the attached image demonstrates:

ascites in the perirenal space
ascites in the subphrenic space
ascites in the subhepatic space
ascites in the paracolic gutter

A

ascites in the paracolic gutter

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14
Q

You identify free fluid above the right diaphragm that contains internal debris and septations. The fluid collection has a honeycomb appearance. These findings are most suggestive of:

exudative pleural effusion
pneumothorax
transudative pleural effusion
hemothorax

A

exudative pleural effusion

**transudative pleural effusions don’t have septations

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15
Q

Bilateral ureteral obstruction can be caused by?

retroperitoneal fibrosis
splenic varices
RCC of the left kidney
liver mass in the posterior right lobe

A

retroperitoneal fibrosis

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16
Q

What is the primary reason a retroperitoneal lymph node dissection (RLND) is performed?

to determine if systemic chemotherapy is needed
to determine the extent of a systemic infection
to prevent lymphocele formation on an upcoming renal transplant
to evaluate the lymph tissue for functionality

A

to determine if systemic chemotherapy is needed

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17
Q

Which of the following is the most likely cause of the findings on the image of abdomen?

trauma
metastasis
primary malignancy
metastasis and primary malignancy

A

trauma

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18
Q

Which zone of the prostate has the highest risk for carcinoma development?

transitional
stromal
peripheral
central

A

peripheral (70%)

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19
Q

All of the following are signs of pyloric stenosis, EXCEPT:

cervix
olive
doughnut
McBurney

A

McBurney

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20
Q

Which of the following describes how to differentiate a ventral hernia from diastasis recti?

ventral hernias are a focal weakening on the abdomen wall, diastasis recti is a diffuse defect of the abdominal wall

ventral hernias have an associated fascial defect, but there is no defect with diastasis recti

ventral hernias require an increase in abdominal pressure for visualization, diastasis recti is best visualized with the patient relaxed

ventral hernias never contain bowel loops, diastasis recti always contain bowel loops

A

ventral hernias have an associated fascial defect, but there is no defect with diastasis recti

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21
Q

What penile structure is usually fractured with penile trauma?

corpus spongiosum
glans penis
corpus cavernosum
pampiniform plexus

A

corpus cavernosum

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22
Q

Bacterial infection, internal bleeding and viral infection typically share what ultrasound finding?

retroperitoneal fibrosis
free air in the peritoneal cavity
abscess formation
ascites with debris/septations

A

ascites with debris/septations

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23
Q

The diaphragm sign, displaced crus sign, and bare area sign are indicative of what abnormality?

pneumonia
diaphragmatic hernia
pleural effusion
ascites

A

pleural effusion

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24
Q

Which of the following statements is true regarding rectus sheath hematomas?

linea alba stops the blood from spreading into the pelvis

an acute hematoma will appear hyperechoic compared to surrounding tissues

arcuate line stops the blood from extending across the midline

coumadin therapy is a common cause for hematoma formation

A

coumadin therapy is a common cause for hematoma formation

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25
Q

Which of the following is a common cause of exudate pleural effusion?

cirrhosis
kidney failure
malignancy
CHF

A

malignancy

**exudate fluid is usually related to malignancy, lupus, pneumonia, and tuberculosis

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26
Q

The ___ zone is the prostate zone most commonly affected by BPH.

peripheral
central
paraprostatic
transitional

A

transitional

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27
Q

Loculated fluid in the abdomen usually ___, while free fluid in the abdomen will ___.

fills spaces around structures, displaces adjacent structures

displaces adjacent structures, fills spaces around structures

indicates a benign process, indicate a malignant process

is resorbed over time by the body, require a paracentesis to remove the fluid

A

displaces adjacent structures, fills spaces around structures

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28
Q

Adrenal gland hemorrhage:

in adults is usually related to trauma or hematologic disorders, such as thrombocytopenia

is very rare because the adrenal glands are hypovascular fatty organs

is associated with very high hematocrit levels

is most commonly seen in patients over 70 years of age

A

in adults is usually related to trauma or hematologic disorders, such as thrombocytopenia

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29
Q

Which of the following is true regarding pyloric stenosis?

abnormal muscle thickness >4mm
more common in females
presents as a short thick pyloric canal
abnormal channel length >1mm

A

abnormal muscle thickness >4mm

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30
Q

Which image demonstrates a lipoma?

A

top left = benign mass with lobulated borders
top right = lipoma
bottom left = hematoma in rectus abdominis muscle
bottom right = spigelian hernia

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31
Q

A 3 year old is scanned due to vomiting and a palpable lump in the abdomen. These findings are most suggestive of:

intussusception
biliary ascaris
pyloric stenosis
appendicitis

A

intussusception

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32
Q

A 50 year old male presents with RLQ pain, watery diarrhea and a low grade fever. The ultrasound exam demonstrates a prominent lymph node in the area of pain and the image below was also obtained at the area of pain. These findings are most consistent with:

colitis
irritable bowel syndrome
intussusception
appendicitis

A

colitis

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33
Q

Which of the following is most likely to be confused with a breast carcinoma?

multiple fibroadenomas in both breast
single 5cm fibroadenoma in the breast
fat necrosis after breast surgery
sebaceous cyst

A

fat necrosis after breast surgery

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34
Q

Which of the following is an expected sonographic characteristic of prostatitis?

homogenous gland
solid hypoechoic mass
diffuse hypervascularity
atrophied gland

A

diffuse hypervascularity

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35
Q

Which of the following is true regarding the image of the RUQ of a neonate?

the pylorus is thickened and the stomach is demonstrated medially

the pylorus is thickened with an adjacent solid mass

the pylorus and the stomach are both demonstrated normally on the image

the pylorus is not thickened but there is a fluid collection seen in the stomach

A

the pylorus is thickened and the stomach is demonstrated medially

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36
Q

When diaphragmatic paralysis is suspected,

the diaphragmatic thickness should be measured during inspiration and expiration

the patient should be evaluated for free air in the abdomen

the patient should be evaluated for free air in the chest

thick linear calcifications form in the affected side

A

the diaphragmatic thickness should be measured during inspiration and expiration

** thickening should occur during inspiration

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37
Q

The diaphragm sign, displaced crus sign, and bare are sign are indicative of what abnormality?

ascites
pleural effusion
pneumonia
diaphragmatic hernia

A

pleural effusion

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38
Q

Which of the following is caused by a pituitary tumor?

myelolipoma
conn syndrome
cushing disease
adrenal hemorrhage

A

cushing disease

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39
Q

What type of hernia is a delayed complication of upper abdominal surgery?

indirect inguinal hernia
direct inguinal hernia
amyand hernia
incisional hernia

A

incisional hernia

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40
Q

___ refers to a collection of serous fluid in the popliteal fossa

Baker cyst
ganglion cyst
arthroma
Thomposon cyst

A

Baker cyst

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41
Q

Which portion of the GI tract contains numerous valvulae conniventes that cause a feathery appearance of the structure on ultrasound?

ileum
duodenum
jejunum
ilium

A

jejunum

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42
Q

A 50 year old male presents with paraumbilical pain and a palpable mass. That findings on the image are most suggestive of:

a large rectus sheath lipoma
a large rectus sheath hematoma
abdominal wall hernia with no bowel protrusion
abdominal wall hernia with bowel protrusion

A

abdominal wall hernia with bowel protrusion

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43
Q

The ___ zone is the prostate zone most commonly affected by malignancy.

peripheral
transitional
central
paraprostatic

A

peripheral

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44
Q

What is a epiploic appendagitis?

another term to describe Crohn disease
inflammation of the thick fatty strands that attach to the serosal surface of the colon
a fatal type of diverticulitis
perforated appendix with pericolic fluid

A

inflammation of the thick fatty strands that attach to the serosal surface of the colon

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45
Q

Which of the following statements is true regarding retroperitoneal lymph nodes?

both normal and abnormal lymph nodes exhibit mild posterior shadowing

normal lymph nodes exhibit posterior enhancement

abnormal lymph nodes exhibit posterior enhancement

a lymph node is considered abnormally enlarged once it reaches a maximum dimension of 3 cm

A

abnormal lymph nodes exhibit posterior enhancement

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46
Q

Which of the following sonographic “signs” is displayed on the image?

murphy
olive
sandwich
double barrel

A

sandwich

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47
Q

___ is acute symptomatic inflammation of a tendon, while ___ refers to asymptomatic degenerative changes in the tendon.

tendonitis, tendinosis
sprain tear
tear, sprain
tendinosis, tendinitis

A

tendonitis, tendinosis

48
Q

The most common cause of small bowel obstruction in adults is ___. The most common cause of small bowel obstruction in an infant is ___.

adhesions, intussusception
bezoars, pyloric stenosis
diverticulitis, pyloric stenosis
extrinsic compression by pelvic mass, intussusception

A

adhesions, intussusception

49
Q

___ is one of the most common surgical procedure in the US and most patients are males, less than 1 years old.

herniorrhaphy
nephrectomy
cholecystectomy
appendectomy

A

herniorrhaphy (hernia repair)

50
Q

Priapism is an abnormality of

the urinary bladder
the penis
the prostate
the testicles

A

the penis

51
Q

The findings on the images are most suggestive of what penile abnormality?

penile fracture
penile cancer
priaprism
peyronie disease

A

peyronie disease - causes development of scar tissue and fibrous plaque formation that usually involves the tunica albuginea

52
Q

The image demonstrates a coronal view of the LUQ. Where is free fluid documented on the image?

subphrenic space and splenorenal space
subphrenic space and pleural space
subhepatic space and pleural space
subphrenic space and paracolic gutter

A

subphrenic space and pleural space

53
Q

Which of the following describes carpal tunnel syndrome?

damage to the median nerve by chronic compression between the metacarpal bones of the palm

damage to the cartilage between the carpal bones of the wrist causing swelling and pain with motion

compression of the median nerve by the carpal sheath causing numbness, weakness and pain

compression of the blood vessels as they enter/exit the wrist causing thrombus formation and emboli

A

compression of the median nerve by the carpal sheath causing numbness, weakness and pain

54
Q

Which of the following statements is correct regarding hernias?

herniorrhaphy is the most common surgical procedure performed on post-partum females

most hernias are closed using a skin graft taken from the opposite groin

varicose vein formation is the most significant complications of a hernia

patients with one hernia should be evaluated for other types of ipsilateral and contralateral groin or anterior abdominal hernias

A

patients with one hernia should be evaluated for other types of ipsilateral and contralateral groin or anterior abdominal hernias

55
Q

Which of the following is not an expected finding with adrenal myelolipoma?

increased echogenicity compared to adrenal and renal cortical tissues
comet tail artifacts
attenutation artifacts
propagation speed artifacts

A

comet tail artifacts

56
Q

Corpora amylacea is a benign condition of what organ?

prostate
kidneys
liver
spleen

A

prostate

57
Q

A patient with a history of Conn disease presents for an abdomen ultrasound exam. Two 1cm round hypoechoic tumors are identified in the left adrenal gland. These findings are most suggestive of:

aldosteronomas
adenomas
abscess formation
myelolipomas

A

aldosteronomas

58
Q

Which of the following foreign body types is better visualized on sonography than with radiography?

rose thorn
glass
broken needle
gravel

A

rose thorn

59
Q

Where is the most common location for the occurrence of retroperitoneal fibrosis?

at the level of the renal arteries
at the lateral borders of the kidneys
at the level of the aortic bifurcation
adjacent to the diaphragm surrounding AO

A

at the level of the aortic bifurcation

60
Q

What is one of the most common findings on a transrectal ultrasound in prostatitis?

heterogenous gland with hypovascularity
homogeneous gland with hypovascularity
multiple macrocalcifications
hypoechoic halo at the periurethral area

A

hypoechoic halo at the periurethral area

**heterogenous peripheral gland with a hypoechoic halo at the periurethral area, hypervascularity

61
Q

What congenital defect presents as a blind-ended, fluid filled bowel loop connected to a normal peristalsing small bowel loop?

appendicitis
pyloric stenosis
epiploic appendagitis
Meckel diverticulum

A

Meckel diverticulum

** most common congenital anomaly of the GI tract

62
Q

Pyloric stenosis is diagnosed when the muscle wall thickness exceeds:

6mm
2mm
8mm
4mm

A

4mm

63
Q

Which of the following correctly describes a mechanical bowel obstruction?

functional obstruction is much more common than mechanical obstruction

adhesions are the most common cause of mechanical obstruction in adults

paralysis of the wall muscles inhibit peristalsis and the progression of the luminal contents

best evaluated by US after patient drinks at least 32oz of water

A

adhesions are the most common cause of mechanical obstruction in adults

64
Q

The SMA is identified to the right of the SMV in a patient with acute abdomen symptoms. What should you suspect?

normal anatomy
intussusception
pyloric stenosis
midgut malrotation

A

midgut malroation

65
Q

Which of the following correctly describes myelolipoma?

adrenal tumor that is composed of fat and bony elements

originate in the adrenal medulla

may see varied levels of attenuation lateral to the mass

hypoechoic mass with extensive posterior enhancement

A

adrenal tumor that is composed of fat and bony elements

**originates in the adrenal cortex

66
Q

All of the following correctly describe a mechanical bowel obstruction, EXCEPT:

physical impediment to the progression of the luminal contents

adhesions are the most common cause in adults

best evaluated by US after patient drinks at least 32oz of water

assess GI tract caliber and content

A

best evaluated by US after patient drinks at least 32oz of water

**when mechanical obstruction is suspected, the patient should NOT consume any food or water until they have evaluated for the blockage

describe location of gut loops
evaluate the caliber of the segment and size of obstruction
describe the contents of the segment
assess peristalsis

67
Q

Phelgmon formation, abscess formation, prominent pericecal fat and loculated pericecal fluid collections are sonographic findings that are most suggestive of:

mononucleosis
appendiceal perforation
acute pancreatitis
Addison disease

A

appendiceal perforation

** pancreatitis has similar findings but normally found in the area of the cecum

68
Q

Which of the following describes a giant cell tumor of the hand?

anechoic structure that demonstrates posterior shadowing

moves with the adjacent tendon with flexion and extension

hypoechoic structure that demonstrates posterior enhancement

does not move with the adjacent tendon with flexion and extension

A

does not move with the adjacent tendon with flexion and extension

**hypoechoic mass with NO enhancement

69
Q

Where is the rectus sheath hematoma on the image?

A
70
Q

What is identified on the longitudinal intercostal image of the liver?

pleural effusion and ascites
renal failure
pleural effusion and renal failure
pleural effusion

A

pleural effusion and ascites

71
Q

Acute pain in the RLQ is commonly associated with ___, while acute pain in the LLQ is commonly associated with ___.

diverticulitis, IBS
appendicitis, cecal colitis
appendicitis, IBS
appendicitis, diverticulitis

A

appendicitis, diverticulitis

72
Q

A patient presents with right groin pain. You identify a hernia sac medial to the common femoral vein. What type of hernia is present?

umbilical
direct inguinal
spigelian
femoral

A

femoral

73
Q

Which of the following is a common cause of transudate pleural effusion?

CHF
malignancy
tuberculosis
pneumonia

A

CHF

74
Q

The term used to describe the involution of the small bowel upon itself is:

IBS
intussusception
crohn syndrome
colitis

A

intussusception

75
Q

Which of the following is not usually treated by surgical intervention?

spigelian hernia
intussusception
pyloric stenosis
appendicitis

A

intussusception

**air or contrast is administered through the rectum to push the involuted bowel back out of the colon

76
Q

A 70 year old male presents for transrectal ultrasound due to PSA level of 7ng/ml, urinary frequency and hematuria. The US exam demonstrates a 40cc prostate volume with heterogeneity and calcifications centrally. The peripheral zone appears normal. These findings are most consistent with:

prostatitis
BPH
carcinoma of the prostate
normal prostate

A

BPH

77
Q

A patient with diastasis recti will have an increased:

risk of developing HCC
distance between the bladder and rectum
risk of developing carpal tunnel syndrome
distance between the rectus abdominis muscles

A

distance between the rectus abdominis muscles

78
Q

All of the following correctly describe a scalp hematoma, EXCEPT:

sonographic appearance varies with age of the hematoma

caput succedaneum hematoma is associated with vacuum assisted delivery

described by their location related to the galea aponeurosis and skull periosteum

most commonly caused by motor vehicle trauma

A

most commonly caused by motor vehicle trauma

** hematoma due to birth trauma, most commonly causes by vacuum assisted delivery

79
Q

A 2 year old presents with a swollen abdomen and pain for 3 days. The doctor suspects an intussusception is present. How will this appear on the exam?

prominent focal area of concentric rings of bowel
fluid filled colon with inflamed walls
fluid filled colon with multiple intramural masses
thickened pylorus muscle

A

prominent focal area of concentric rings of bowel

80
Q

Which of the following is the most common cancer of the GI tract?

kaposi sarcoma
krukenberg tumor
adenocarcinoma
gastric sarcoma

A

adenocarcinoma

81
Q

Bacterial infection, internal bleeding and viral infection typically share what abdominal ultrasound findings?

retroperitoneal fibrosis
abscess formation
free air in the peritoneal cavity
ascites with debris/septations

A

ascites with debris/septations

82
Q

What is the sonographic appearance of pseudomyxoma peritonei?

mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall

multiple echogenic foci throughout the psoas muscle

mucinous secretions and tumor formation within abdomen that cause the liver to be pushed inferiorly against the diaphragm

multiple echogenic foci throughout the abdominal wall

A

mucinous secretions and tumor formation within the lower abdomen cause bowel to be matted down against posterior abdominal wall

83
Q

Massive adrenal gland enlargement, hepatomegaly and splenomegaly are common findings in what fatal autosomal recessive disorder?

Wilson disease
Wolman disease
Beckwith-Wiedemann syndrome
Marfan syndrome

A

Wolman disease - excessive lipid storage in the liver, spleen, and adrenal glands

84
Q

What changes occur on the US image when scanning breast tissue affected by acute mastitis?

dilated ductal system within normal breast tissues
decreased penetration due to tissue edema
improved visualization of the ductal system due to tissue edema
posterior enhancement due to tissue edema

A

decreased penetration due to tissue edema

85
Q

A hematoma of the rectus abdominis muscle that occurs below the arcuate line can extend into:

pouch of Douglas
the umbilicus
space of Retzius
Morison pouch

A

space of Retzius

86
Q

A right sided pheochromocytoma will displace the ipsilateral kidney ___.

anteriorly
medially
inferiorly
superiorly

A

inferiorly

87
Q

Adrenal hemorrhage is most commonly seen in ___.

adults over 50 years old
adults over 70 years old
newborns
juvenile patients with chromosomal defects

A

newborns

88
Q

Most patients with adrenal cortical cancer have associated:

Addison disease
Conn disease
Cushing syndrome
Budd Chiari syndrome

A

Cushing sydrome

89
Q

Which of the following correctly describes penile cancer?

usually found on the proximal shaft in circumcised men

most commonly demonstrates a complex cystic mass

associated with inguinal lymphadenopathy

most common type of penile cancer is TCC

A

associated with inguinal lymphadenopathy

90
Q

What is identified on the TRV subcostal image of the dome of the liver?

ascites/bowel
pleural effusion/lung tissue
ascites/large renal mass
pericardial effusion

A

pleural effusion/lung tissue

91
Q

Which statement is true regarding the image displayed?

the beta angle appears less than 43 degrees and the femoral head coverage is less than 50% which indicates dislocation

the infant hip appears normal with normal femoral head location within the acetebulum

the alpha angle will significantly exceed 60 degrees which indicates dislocation

the alpha angle appears less than 43 degrees and the femoral head coverage is less than 50% which indicates dislocation

A

the alpha angle appears less than 43 degrees and the femoral head coverage is less than 50% which indicates dislocation

92
Q

Concentric wall thickening of the terminal ileum, hyperemia and mesenteric fatty proliferation are signs of what GI tract abnormality?

colitis
diverticulitis
appendicitis
crohn disease

A

Crohn disease

93
Q

Which of the following is a malignant mass of the retroperitoneum that is composed of muscle tissue?

rhabdomyosarcoma
fibrosarcoma
mesothelioma
liposarcoma

A

rhabdomyosarcoma

94
Q

The blue arrow indicates the adrenal gland in a 30 year old male with a palpable flank mass and no other related history. Which of the following best describes the findings on the image demonstrated by the red arrows?

complex adrenal mass, most likely a lipoama

complex renal mass extending superior to the adrenal gland, most likely medullary sponge kidney

complex adrenal mass located superior to the gland, most likely cortical carcinoma

dilated bowel loops posterior tot he adrenal gland, most likely an intestinal hernia

A

complex adrenal mass located superior to the gland, most likely cortical carcinoma

95
Q

Which of the following is a common finding in hepatitis, cirrhosis and hepatic abscess formation?

ascites
PHTN
hydatid cyst
hepatoma

A

ascites

96
Q

Where is free fluid documented on the image?

pleural space
subhepatic space
subphrenic space
paracolic gutter

A

pleural space

** fluid above the diaphragm in the RUQ

97
Q

Retroperitoneal lymphadenopathy is an expected finding with what primary malignancy?

hepatitis
staghorn calculus
RCC
gastric carcinoma

A

RCC

98
Q

Which of the following describes the best way to image the patellar tendon with ultrasound?

the central portion of the tendon is best imaged from the posterior approach

evaluate the patellar attachments from an anterior approach

patient must be evaluated with the leg fully extended

due to the proximity of the tendon to bone, the patellar tendon cannot be evaluated with US

A

evaluate the patellar attachments from an anterior approach

99
Q

What is the most accurate sonographic predictor of pyloric stenosis?

channel length
muscle wall thickness
gastric volume
cross-sectional diameter

A

muscle wall thickness

100
Q

Creeping fat is a sign of:

Wilson disease
mesenteric ischemia
pancreatic adenocarcinoma
Crohn disease

A

Crohn disease

101
Q

Loculated ascites with echogenic debris and matted loops are most suggestive of:

PHTN
Budd Chiari
peritoneal metastasis
CHF

A

peritoneal metastasis

102
Q

Which of the following correctly describes a pneumothorax?

fluid accumulation between the visceral and parietal pleura

the lung-gliding sign is not present with free air in the chest

there are two types of pneumothorax, transudate and exudate

ultrasound is not able to demonstrate a pneumothroax

A

the lung-gliding sign is not present with free air in the chest

103
Q

What are the most common causes of ascites?

trauma and invasive procedures
urinary and biliary obstruction
cirrhosis and malignancy
CHF and hepatic congestion

A

cirrhosis and malignancy

104
Q

The most common benign mass is the ___ and the most common malignant breast mass is ___.

ductal carcinoma in situ, invasive ductal carcinoma
acute mastitis, chronic mastitis
lipoma, invasive lobular carcinoma
fibroadenoma, invasive ductal carcinoma

A

fibroadenoma, invasive ductal carcinoma

105
Q

A patient presents with a 2cm palpable reddened lump on the bottom of her foot. The patient states she accidentally stepped on a piece of broken glass. The doctor suspects there may be some glass remaining in her foot. Which of the following statements is true regarding the evaluation of this patient’s foot?

the radiologist should be consulted because MRI is preferred over sonography for foreign body detection

inflammation usually leads to a hypoechoic ring surrounding the foreign body

most foreign bodies are echogenic with significant posterior enhancement

improved visualization of the foreign body occurs as the US beam, becomes more parallel to the structure

A

inflammation usually leads to a hypoechoic ring surrounding the foreign body

106
Q

The development of scar tissue and fibrous plaque formation involving the tunica albuginea of the penis describes:

squamous cell carcinoma of the penis
Peyronie disease
priapism
penile fracture

A

Peyronie disease

107
Q

A hernia with a narrow neck:

is usually completely reducible with compression
should not be evaluated with the Valsalva maneuver
can be closed with compression therapy
is at an increased risk for incarceration and strangulation

A

is at an increased risk for incarceration and strangulation

108
Q

What is the key anatomic landmark in differentiating direct, indirect and spigelian hernias?

inferior epigatric artery
internal iliac artery
rectus abdominis muscles
linea alba

A

inferior epigastric artery

direct - medial to the IEA
indirect - lateral to IEA
spigelian - penetrated by the IEA

109
Q

A patient presents for a groin ultrasound with a history of right inguinal hernia repair 3 year ago. He’s currently having right groin pain. What should you do next for this patient?

because the patient had prior hernia repair in the right groin, no maneuvers are performed during imaging

because the highly reflective mesh will severely limit the US exam of the right groin, no maneuvers are performed during imaging

call the referring physician and get an order for an MRI because ultrasound cannot demonstrate recurrent hernias

assess the edges of the mesh in the groin while the patient performs the Valsalva maneuver

A

assess the edges of the mesh in the groin while the patient performs the Valsalva maneuver

110
Q

Most malignant tumors will demonstrate ___ flow on Doppler evaluation.

increased diastolic flow reversal
high resistance
absent
low resistance

A

low resistance

111
Q

How can you differentiate a ganglion cyst from a giant cell tumor of the hand?

giant cell tumors will move along with the adjacent tendon, ganglion cyst will not move with the adjacent tendon

giant cell tumor will demonstrate posterior enhancement, ganglion cyst will not

ganglion cyst will demonstrate posterior enhancement, giant cell tumor will not

ganglion cyst will demonstrate posterior enhancement, giant cell tumor will demonstrate posterior shadowing

A

ganglion cyst will demonstrate posterior enhancement, giant cell tumor will not

112
Q

Demonstration of gastrohepatic and retroperitoneal lymphadenopathy in a patient is most suggestive of:

RCC
lymphoma
GB carcinoma
IBS

A

lymphoma

113
Q

The Achilles’ tendon most commonly ruptures:

at the distal insertion point
about 4cm from the distal insertion point
mid-tendon
at the proximal insertion point

A

about 4cm from the distal insertion point

114
Q

A 55 year old female presents with a fever, leukocytosis, and LLQ pain. She states she suffers from Crohn disease. The exam demonstrates a 2.7cm ill-defined hypoechoic mass in the LLQ that is surrounded by a small amount of ascites. There is no flow within the mass and no movement with peristalsis. These findings are most suggestive of:

appendicitis
intussusception
abscess
retroperitoneal lymphadenopathy

A

abscess

115
Q

The image demonstrates a TRV view of the right and left side of the abdominal wall, about 5cm lateral to the umbilicus. Which of the following statements is true regarding the findings on the image?

there is a heterogenous, rounded mass located within the left rectus sheath, within the muscle layers and anterior to the peritoneal lining

there is a homogenous, rounded mass located within the left rectus sheath, anterior to the muscle layers and the peritoneal lining

there is a heterogenous, rounded mass located within the muscle layers and posterior to the peritoneal lining on the left side

the image demonstrates the normal appearance of the muscle structures of the anterior abdominal wall bilaterally

A

there is a heterogenous, rounded mass located within the left rectus sheath, within the muscle layers and anterior to the peritoneal lining

116
Q

Which of the following describes the sonographic appearance of adrenal hyperplasia?

bilateral, diffuse gland enlargement
complex cystic mass formation in both glands
thickened, echogenic cortex and loss of differentiation with the medulla
multiple small echogenic nodules in the affected gland

A

bilateral, diffuse gland enlargement

ARDMS ABD REVIEW (27 decks)

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