Pathology #4 Flashcards by lindsay crouse

Which of the following describes the sonographic appearance of the pancreas with chronic cystic fibrosis?

decreased size and increased overall echogenicity

decreased size with hypoechoic nodularity throughout the gland

increased size with mottled echogenicity, no definite nodules

increased size with nodule and calcification formation

decreased size and increased overall echogenicity

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Where is the abnormality located within the spleen, if the image displayed is a left lateral approach with coronal view?

there is a splenic infarct present in the anterior, medial splenic tissue

there is a splenic infarct present in the lateral, inferior splenic tissue

there is a splenic infarct is present in the anterior, superior splenic tissue

there is a splenic infarct present in the superior, medial splenic tissue

there is a splenic infarct present in the lateral, inferior splenic tissue

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What congenital anomaly of the pancreas results in two separate ductal systems that drain the pancreas?

pancreas divisum
aberrant pancreatic tissue
pancreatic sequestration
annular pancreas

pancreas divisum

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Glandular atrophy, dilated main duct, and intraductal calculi are hallmark signs of:

chronic cholecystitis
cholangitis
chronic renal failure
chronic pancreatitis

chronic pancreatitis

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A pseudocyst most commonly forms in which retroperitoneal space?

posterior pararenal space
anterior pararenal space
omental bursa
perinephric space

anterior pararenal space

**they are seen in the omental bursa but that is within the peritoneal sac not the retroperitoneal space

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All of the following are considered indirect signs of pancreatic adenocarcinoma, EXCEPT:

biliary ductal dilatation
hypoechoic mass in the pancreatic head
palpable GB
liver metastasis

hypoechoic mass in the pancreatic head

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The double duct sign refers to the dilatation of:

the main pancreatic duct and accessory pancreatic duct
the CBD and cystic duct
right and left hepatic ducts
the CBD and duct of Wirsung

the CBD and duct of Wirsung

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What do pancreatic adenocarcinoma and focal pancreatitis have in common?

both are usually treated using the Whipple procedure
both most commonly occur in the pancreatic head
both most commonly occur in the pancreatic tail
both cause a significant increase in AFP levels

both most commonly occur in the pancreatic head

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Biliary atresia and congenital absence of the GB are associated with which complex congenital defect?

asplenia
pancreas divisum
polysplenia
annular pancreas

polysplenia

** aka double-left sidedness
associated with the formation of multiple spleens, right sided defects such as interrupted IVC, biliary atresia and absence of the GB

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Which of the following is the cause of the findings on the images?

cholelithiasis
pancreatic adenocarcinoma
portal thrombosis
klatskin tumor

pancreatic adenocarcinoma

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The most common cause of splenomegaly is ___.

PHTN
malignant HTN
AIDS
mononucleosis infection

PHTN

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A patient tells you that they have undergone the Whipple procedure. What have they done?

liver resection
thyroidectomy
renal transplant
partial removal of the pancreas

partial removal of the pancreas

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Which type of pancreatic mass has a strong risk of malignant conversion?

macrocystic cystadenoma
gastrinoma
insulinoma
microcystic cyst

macrocystic cystadenoma

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What effect does polycythemia vera have on the sonographic appearance of the spleen?

diffuse increase in echogenicity and hypervascularity
multiple hypoechoic masses less than 1cm in diameter
multiple echogenic foci in an atrophied spleen
marked splenomegaly with normal echogenicity

marked splenomegaly with normal echogenicity

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A patient presents for an abdominal ultrasound due to a history of elevated amylase. She was diagnosed 5 years ago with Von Hippel Lindau syndrome. You identify a round, lobulated hyperechoic mass in the body of the pancreas. Mild posterior enhancement is present. These findings are most suggestive of:

sphincter of oddi carcinoma
adenocarcinoma
microcystic cystadenoma
pseudocyst

microcystic cystadenoma

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Which of the following correctly describes angiosarcoma of the spleen?

arises from the vascular endothelium and demonstrates increased vascularity

most common primary malignancy of the spleen

usually presents as a homogenous hyperechoic mass near the periphery of the spleen

very responsive to chemotherapy with good prognosis

arises from the vascular endothelium and demonstrates increased vascularity

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When pancreatic enzymes leak into the peritoneal space, a ___ forms.

phlegmon
pseudocyst
cystadenoma
biloma

pseudocyst

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Which of the following describes splenomegaly?

the spleen extends to a position immediately adjacent to the pancreatic tail

the spleen extends below the lower pole of the left kidney

the spleen extends below the upper pole of the left kidney

the spleen extends below the mid pole of the left kidney

the spleen extends below the lower pole of the left kidney

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Massive splenomegaly is defined as a spleen that exceeds ___ in length.

15cm
13cm
23cm
18cm

18cm

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A fluid collection between the diaphragm and splenic capsule may represent:

subphrenic abscess
subcapsular hematoma
pericardial effusion
pleural effusion

subphrenic abscess

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A patient presents for a post-transplant evaluation of the pancreas. Where is the most common location for the allograft?

epigastric area
LLQ
right iliac fossa
periumbilical area

right iliac fossa

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A patient presents with LUQ pain, loss of appetite and elevated levels of LDH. The findings on the image are most suggestive of:

mononucleosis
Non-Hodgkin lymphoma
granulomas
hamartomas

Non-Hodgkin lymphoma

**multiple hypoechoic nodules throughout the enlarged spleen, perisplenic lymph nodes visible outside the spleen, causes elevated LDH levels

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Which of the following is associated with an autosplenectomy?

splenic hamartoma
wandering spleen
splenic lymphoma
sickle cell anemia

sickle cell anemia

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It may be difficult to differentiate a ___ from splenic disease process at the hilum.

liver mass in the caudate lobe
duodenal tumor
pancreatic pseudocyst
right renal cyst in the upper pole

pancreatic pseudocyst

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Gamna-Gandy bodies results in: splenic calcifications hypothyroidism aneurysm formation in the splenic artery aneurysm formation in the AO

splenic calcifications

A pseudocyst has no ___, which helps to differentiate it from a true pancreatic cyst. pancreatic enzymes within it epithelial lining posterior shadowing posterior enhancement

epithelial lining

When inflammation from pancreatitis extends into the tissues surrounding the pancreas, this called: pseudocyst cystadenoma biloma phlegmon

phlegmon

A patient presents with congenital absence of the spleen, this condition is called: accessory spleen splenomegaly asplenia hamartoma

asplenia

Which of the following are vascular complications seen with pancreatitis? progression of Budd Chiari and the development of CHF cholecystitis and phlegmon formation thrombosis of the splenic vein or pseudoaneurysm of the splenic artery PHTN and biliary strictures

thrombosis of the splenic vein or pseudoaneurysm of the splenic artery

Spontaneous splenic rupture is associated with all of the following, EXCEPT: mononucleosis trauma HIV splenosis

trauma

Weakened gastrosplenic and splenorenal ligaments can lead to: polysplenia situs inversus asplenia wandering spleen

wandering spleen

Alcohol abuse is the most common cause for: acute pancreatitis renal failure cholecystitis chronic pancreatitis

chronic pancreatitis

A disorder that affects the pancreas by causing it to excrete a thick mucus-like substance that inhibits the exocrine function is called: tuberculosis pancreatitis insulinoma cystic fibrosis

cystic fibrosis

Asplenia is associated with all of the following, EXCEPT: congenital heart defects AO on the right side of the body absence of the spleen liver on the right, GB on the left

liver on the right, GB on the left **midline liver and GB

RCC, insulinoma, and pancreas cystadenoma are associated with what syndrome? Beckwith-Wiedemann syndrome multiple endocrine neoplasia syndrome Gaucher disease Von Hippel Lindau syndrome

Von Hippel Lindau syndrome

A patient presents with a recent history of a histoplasmosis infection. The referring doctor would like to evaluate the abdomen for residual effects from the infection. Which sonographic findings in the abdomen would be consistent with this type of infection? mild to moderate ascites and splenomegaly multiple echogenic foci in the liver and or spleen parenchyma dilated ductal system of the liver with inflammation (cholangitis) significant amount of loculated ascites in the bilateral paracolic gutters

multiple echogenic foci in the liver and or spleen parenchyma

Retrograde flow in the splenic artery would most likely indicate: chronic systemic HTN left gastric artery occlusion mild PHTN celiac axis occlusion

celiac axis occlusion

___ refers to a rare genetic disorder characterized by visceral cysts, renal and pancreatic cysts, benign masses, and the potential for malignant transformation in multiple organ systems. Von Hippel Lindau syndrome Edwards syndrome Osler-Weber-Rendu syndrome polycystic disease

Von Hippel Lindau syndrome

Splenic vein thrombosis and splenic artery pseudoaneurysm formation are vascular complications seen with: RA stenosis pancreatitis cirrhosis Zollinger Ellison syndrome

pancreatitis

Which of the following correctly describes the findings on the image? portal thrombosis lymphadenopathy klatskin tumor normal anatomy

lymphadenopathy

All of the following are potential malignant features of a pancreatic cyst, EXCEPT: cyst size <3cm increase in cyst size on serial exams thickened septations internal nodule

cyst size <3cm **cysts >3cm should be suspected as malignant

A patient presents for an abdominal ultrasound with a history of a renal and pancreatic transplant. What chronic medical condition is the primary reason for the double transplant? pancreatic adenocarcinoma chronic pancreatitis hypertension type I diabetes

type I diabetes

The splenic vein measures 5mm in diameter. If the diameter remains constant with deep inspiration: PHTN should be suspected the celiac axis should be evaluated for obstruction duodenal obstruction should be suspected the response is normal

PHTN should be suspected **splenic vein diameter increases 50-100% from deep inspiration, if increase <20% PHTN should be suspected

A 56 year old male presents with acute onset of epigastric pain that has persisted for about 2 days. His lab tests demonstrate elevated amylase and lipase. Multiple mobile echogenic foci are present in the GB with a wall thickness of 2.4mm. The CBD measures 6mm and appears patent. The pancreas is mildly enlarged with posterior enhancement. Which of the following best describes these findings? cystic fibrosis with cholelithiasis acute pancreatitis with cholelithiasis chronic pancreatitis with cholelithiasis adenomyomatosis with cholelithiasis and cholecystitis

acute pancreatitis with cholelithiasis

Which of the following is commonly associated with pancreatitis? pancreatic divisum high fat diet low fat diet annular pancreas

pancreatic divisum

Which of the following is considered a direct sign of pancreatic adenocarcinoma? hypoechoic mass in the pancreatic head palpable GB liver metastasis biliary ductal dilation

hypoechoic mass in the pancreatic head

The image demonstrates the most common form of pancreatic endocrine tumor (PET) of the pancreas. What type of PET is displayed? insulinoma pseudocyst fibroma adenoma

insulinoma **3 types of PET, formerly known islet cell tumors (insulinoma, gastrinoma, glucagonoma)

A patient presents with LUQ pain after a fall. Which of the following describes of findings seen on the image? the spleen capsule has ruptured and hematoma formation has occurred the spleen capsule is intact but there is an intraparenchymal and subcapsular hematoma present splenic veins are dilated at the hilum and within the spleen, most likely related to PHTN the spleen is surrounded by ascites

the spleen capsule is intact but there is an intraparenchymal and subcapsular hematoma present

Tuberculosis and ___ will demonstrate similar ultrasound findings in the spleen. infarction hamartoma hemangioma sarcoidosis

sarcoidosis

Which of the following statements regarding insulinomas is true? commonly associated with peptic ulcer most patients require an insulin pump to counteract the effects of the tumor on the serum glucose levels they commonly occur in the head of the pancreas patients are usually hypoglycemic

patients are usually hypoglycemic

Splenic vein thrombosis is a common finding in patients with: pancreatic divisum splenic infarct chronic pancreatitis splenic hemangioma

chronic pancreatitis

A patient presents with a history of fever and vomiting with increased serum levels of amylase and lipase. While scanning the abdomen you note a complicated cyst in the anterior pararenal space on the left side. These findings are most consistent with: pancreatic pseudocyst splenic aneurysm GI tract mass splenic varices

pancreatic pseudocyst

Splenic torsion is most commonly associated with: asplenia accessory spleen Gaucher disease ectopic spleen

ectopic spleen

Splenic vein thrombosis can lead to what life threatening condition? GI bleed from gastric varices CHF splenic artery stenosis splenic artery pseudoaneurysm

GI bleed from gastric varices

Which of the following is a malignant splenic neoplasm? hamartoma granuloma lymphoma hemangioma

lymphoma

Pseudoaneurysm formation, biliary obstruction and phlegmon are complications of: alcoholic cirrhosis insulinomas pancreatitis non-alcoholic steatosis

pancreatitis

The most likely primary malignancy to metastasize to the spleen is ___. The most common malignancies that do metastasize to the spleen are ___. breast cancer; melanoma and HCC melanoma; lung and breast cancer RCC; breast and thyroid adenocarcinoma lung cancer; breast and parathyroid adenocarcinoma

melanoma; lung and breast cancer

Which of the following is most commonly found in the pancreatic body or tail and secretes hormones? islet cell tumor microcystic cystadenoma pseudocyst macrocystic cystadenoma

islet cell tumor

When a pancreas transplant has enteric drainage: the urinary bladder should be evaluated for abnormalities the allograft will be located in the chest bowel should be evaluated for obstruction it is common for the stomach to be dilated with pancreatic juices

bowel should be evaluated for obstruction

Splenic atrophy in adults is often associated with: tuberculosis typhoid fever splenitis sickle cell anemia

sickle cell anemia

Splenic calcifications are commonly seen with what type of infection? parasitic echinococcal granulomatous AIDS

granulomatous

A patient presents with a recent diagnosis of AIDS. Which of the following statements is true regarding the sonographic appearance of spleen in this patient? the spleen will be severely enlarged with numerous punctuate calcifications the splenic hilum should be evaluated for varices multiple hypoechoic tumors will be present causing marked increase in size the spleen will be mild-moderately enlarged with a homogeneous texture

the spleen will be mild-moderately enlarged with a homogeneous texture

Which of the following usually affects the pancreatic head? adenocarcinoma and cystadenoma focal pancreatitis and adenocarcinoma pseudocyst and focal pancreatitis cystadenoma and islet cell tumors

focal pancreatitis and adenocarcinoma

What congenital anomaly of the pancreas results in duodenal obstruction? pancreas divisum aberrant pancreatic tissue annular pancreas pancreatic sequestation

annular pancreas

Which of the following is a common cause of a splenic abscess? endocarditis PHTN cholecystitis Gaucher disease

endocarditis **endocarditis, septicemia, and trauma are the most common causes of splenic abscess endocarditis = infection of the lining of the heart and valves

The X indicates what structure? dilated CBD dilated splenic vein dilated duct of wirsung dilated duct of santorini

dilated duct of wirsung

Which of the following is an expected finding with asplenia? liver on the right, GB on the left presence of multiple spleens IVC on the left side of the body AO on the left side of the body

IVC on the left side of the body

Which statement best describes the images displayed? the mass in the pancreas is most likely pseudocyst because of the adjacent infection identified in the liver the mass in the pancreas is most likely a pancreatic endocrine tumor because of the adenomas also identified in the adjacent liver the mass in the pancreas is most likely thrombosis of the splenic vein because of portal branch thrombosis seen in the liver the mass in the pancreas is most likely adenocarcinoma because of the metastasis identified in the liver

the mass in the pancreas is most likely adenocarcinoma because of the metastasis identified in the liver

The splenic vein measures 5mm in diameter. If the diameter increases to 10mm with deep inspiration: duodenal obstruction should be suspected the celiac axis should be evaluated for obstruction the response is normal PHTN should be suspected

the response is normal

Which of the following patients would most likely demonstrate a 10cm spleen with homogenous echotexture? 5'10" 250lb male born with homozygous sickle cell anemia 50 year old with splenic artery aneurysm 65 year old female with mononucleosis 30 year old female with lymphoma

50 year old with splenic artery aneurysm

Which of the following is a common complication of cystic fibrosis? renal calculi AAA PHTN meconium ileus

meconium ileus

Which of the following is an acquired abnormality of the spleen? ectopic spleen splenomegaly splenunculi agenesis

splenomegaly

A splenic ___ is a cartilaginous tumor chondroma fibroma hamartoma osteoma

chondroma

What causes pseudopancreatitis? fatty liver cholecystitis polycystic liver disease hepatitis

fatty liver

A patient presents with a recent diagnosis of lymphoma. Which of the following is an expected finding on ultrasound? multiple splenic varices at the hilum multiple solid tumors are present causing marked increased in spleen size solitary hyperechoic mass with peripheral hypervascularity mildly enlarged spleen due to fluid accumulation

multiple solid tumors are present causing marked increased in spleen size

Why does the spleen have increased risk of infarction compared to the other abdominal organs? because there is only one intrasplenic artery because the intrasplenic arteries do not have communicating branches because of the small size of the splenic vein and increased risk of stasis thrombosis because it is non-encapsulated

because the intrasplenic arteries do not have communicating branches

What are the two most common causes of the abnormality displayed? steroid and ibuprofen abuse choledocholithiasis and alcoholism hepatitis and cholecystitis cirrhosis and gastric carcinoma

choledocholithiasis and alcoholism

A patient presents with LUQ pain and no lab findings. He had a splenectomy 4 years ago after a car accident. There are 2 homogenous masses with smooth borders measuring <3cm located lateral and anterior to the pancreas tail. Internal vascularity is identified. These findings are most suggestive of: splenosis circumscribed hematomas abscess formation lymphatic adenopathy

splenosis

Which of the following statements is true regarding the image displayed of the pancreas? amylase and lipase will be increased pancreas is decreased in size and echogenicity pancreas is increased in size and echogenicity amylase levels will be increased, lipase levels will be decreased

amylase and lipase will be increased

Chronic infection in soft tissue organs typically leads to: the development of cavernous transformation there is a small bowel obstruction at the duodenum resulting in fecalith formation around the head of the pancreas the development of systemic HTN the formation of calcifications

the formation of calcifications

What is the most common abdominal lesion seen with Von Hippel Landau syndrome? fatty liver sparing pancreatic cysts liver adenoma RCC

pancreatic cysts

If a peripheral, wedge-shaped, hypoechoic lesion is identified in the spleen, what should be the first diagnosis considered? hamartoma tuberculosis Hodgkin lymphoma infarction

infarction

Which of the following splenic tumors is associated with tuberous sclerosis of Wiskott-Aldrich syndrome? chrondroma hamartoma hemangioma cystic lymphangioma

hamartoma

Which of the following describes the sonographic appearance of acute pancreatic allograft rejection? small atrophied gland with numerous cysts within the parenchyma high resistance flow in the transplant arteries with numerous calcifications within the parenchyma high resistance flow in the transplant arteries and heterogeneous appearance of the gland small atrophied gland with numerous calcifications within the parenchyma

high resistance flow in the transplant arteries and heterogeneous appearance of the gland

A 56 year old male presents with epigastric pain, nausea and a chronic history of alcoholism. Lab values demonstrate increased levels of amylase and lipase. Hematocrit levels are below normal values. The US exam demonstrates a hypoechoic, enlarged pancreas with perpendicular fluid. Which of the following best describes the findings? phlegmon acute pancreatitis hemorrhagic pancreatitis chronic pancreatitis

hemorrhagic pancreatitis

Which of the following statements is true regarding the image displayed? there is a cyst in the posterior left lobe of the liver there is a simple cyst in the body of the pancreas there is a septated cyst in the tail of the pancreas the SMA is dilated to a size similar to the AO

there is a simple cyst in the body of the pancreas

All of the following are associated with gastrinoma formation in the pancreas EXCEPT: symptoms include indigestion and esophageal reflux significantly decreased levels of amylase production associated with Zollinger-Ellison syndrome increased serum levels of gastrin

significantly decreased levels of amylase production

Which of the following statements is true regarding pancreatic masses? a pancreatic tail mass is commonly mistaken for a mass in the caudate lobe a round mass with smooth borders is usually a malignant process the location of a mass in the head of the pancreas usually indicates a malignant process the location of a mass in the tail of the pancreas usually indicates a malignant process

the location of a mass in the head of the pancreas usually indicates a malignant process

Congestive splenomegaly is an expected finding in patients with: ADPKD CHF and splenic thrombosis multicystic kidney disease lymphoma and leukemia

CHF and splenic thrombosis **congestive splenomegaly (Banti syndrome) caused by excessive pooling of blood in the splenic tissues - caused by PHTN, CHF or splenic thrombosis

Which of the following results from embryonic failure of fusion of the pancreas tissues? annular pancreas pancreas divisum ectopic pancreas tissue Whipple pancreas

pancreas divisum

A patient suffers from multiple endocrine neoplasm syndrome. The findings on the image are most suggestive of: islet cell tumor cystadenocarcinoma lymphoma pheochromocytoma

islet cell tumor

What are the two most common infections that cause granuloma formation in the spleen? mononucleosis and syphilis colitis and cholecystitis tuberous sclerosis and mononucleosis tuberculosis and histoplasmosis

tuberculosis and histoplasmosis

The bright band sign is a characteristic of: splenic infarction biliary tree dilatation rectus abdominis hematoma hepatitis

splenic infarction

Gastrinomas are the most common islet cell tumor seen with: Epstein Barr syndrome MEN syndrome cystic fibrosis Kasabach-Merritt syndrome

MEN syndrome

Which of the following correctly describes Non-Hodgkin lymphoma? more commonly affects lymph nodes in the arms, upper chest and neck average patient age 20 years old usually affects the retroaortic and pelvic lymph nodes first much less responsive to treatment than Hodgkin type

much less responsive to treatment than Hodgkin type **most common type average patient age 60 years old occurs in any lymph nodes throughout the body

Splenosis is a complication of: PHTN splenic infection splenic trauma sickle cell anemia

splenic trauma

Pathology #4 Flashcards

(96 cards)