Practice Questions Flashcards
(144 cards)
Name two abdominal organs that can be affected by polycystic disease
Liver, spleen, pancreas, kidneys
- Scarred gb wall
- Smaller gb in fully fasted pt
- No/min pericholecystic fluid
- Cholelithiasis/calculi/echogenic foci
Chronic cholecystitis
- Hyperechoic parenchyma
- Hypoechoic & oedematous parenchyma
- Homogenous parenchyma
- Enlarged pancreas
- Peripancreatic fluid
- Irregular pancreatic outline
Acute pancreatitis
A 46 yr old woman presents for an abdominal ultrasound with the following clinical indications:
Prev. cholecystectomy 13 years ago, RUQ pain last 2/12; ↑ALT, AST, LDL; ↓HDL; nil ETOH; no fever
a) What is the most likely pathological condition?
b) What sonographic appearances do you expect to see when scanning this patient?
a) Non-alcoholic fatty liver disease
b)
- Enlarged/well rounded liver
- Highly echogenic/hyperechoic
- Very attenuating
Within parenchyma of kidney
May infiltrate into pelvis of kidney
Varies in echogenicity (mostly iso or hyper/echogenic)
Can spread via veins, to renal vein & IVC
Can extend from IVC into contralateral renal vein
Solid mass
Irregular borders
RCC
- Within the collecting system of the kidney
- Does not infiltrate into parenchyma
- Compresses adjacent parenchyma
- Can spread from kidney into ureter
- Can spread from ureter to UB
- Finger-like projections into bladder
- Usually hypoechoic, heterogenous
- Solid lesion/mass
- Irregular borders
- Possible hydronephrosis
- Originates within renal pelvis or calyx
TCC
List the pathology process and effects on the liver in a patient with portal hypertension liver portal hypertension, including sonographic appearances
Small cirrhotic liver, nodular surface, fibrosis
OR
Large liver (post-hepatic cause), abnormal texture
MPV dilated >15mm, hepatofugal flow, cavernous transformation
Varices near porta hepatis, hepatopetal flow
Paraumbilical vein, patent, branching from left portal vein
Ascites, anechoic fluid around liver
A patient presented for an upper abdominal ultrasound with the following information on her referral:
Mr Tony Martin
DOB 31/8/1975
Generalised fatigue FI
Document:
- Patient details,
- Clinical information
- Ultrasound measurement
- Sonographic characteristics
- PDx
A patient presented for an abdominal aorta ultrasound with the following information on her referral:
Joan Venning
DOB 28/9/1945
Patient feels pain in abdomen.
Palp mass lower abdomen FI
Document:
- Patient details
- Clinical Information
- Measurements
Under “additional comments”:
- PDx
What does AML stand for when used in terms of abdominal ultrasound?
Angiomyolipoma
- Well defined
- Hyperechoic mass
- Homogenous
- Possible acoustic shadowing
- Located cortex of kidney most commonly, liver second most commonly
Angiomyolipoma
How can liver steatosis cause RUQ pain
Cause of pain:
- Liver enlargement, inflammation
- Puts pressure on surrounding structures
List the abdominal organs that can develop fatty infiltration
- Liver
- Pancreas
- Kidneys
- Spleen
List the THREE sonographic characteristics that are common to all organs that can have fatty infiltration disorder
- Increased echogenicity
- Ill-defined borders
- Enlargement
- Thickened odeamatous wall (>3mm)
- Calculi/sludge/fluid/pericholecystic fluid
- Distended / irregular lumen
- Murphy’s sign
Acute cholecystitis
List the THREE main sonographic characteristics that are used to identify chronic pancreatitis.
Chronic pancreatitis
When scanning the common bile duct, you notice a solid area within the lumen that has a homogenous texture and mid-level echoes with no posterior shadowing. Provide TWO differential diagnoses.
- Biliary sludge
- Cholangiocarcinoma
- Bile duct obstruction
When scanning the urinary bladder, you notice a highly echogenic focus with posterior shadowing, that moves freely around the bladder. After thoroughly assessing and imaging the bladder, where else would you need to check for similar foci in this patient?
- Kidneys
- Ureters
- Prostate
- Urethra
Name the TWO most commonly occurring primary renal malignancies.
- Renal cell carcinoma
- Transitional cell carcinoma
Name the two most common metastatic sites for TCC and RCC
- Lungs
- Bones
List the TWO most common abdominal organs that can be affected by portal hypertension.
- Liver
- Spleen
- Hyperechoic/increased echogenicity
- smooth / normal size
- Heterogenous echotexture
Focal steatosis of liver
Increased echogenicity
Hepatorenal contrast loss
Normal/smooth margins
Liver enlargement
Posterior attenuation
Diffuse steatosis of liver
What sonographic features are present with an inflammatory AAA that are not present in a normal AAA?
- Sonolucent halo
- Aneurysmal dilatation, thickened adventitia
- Hypoechoic surrounding fibrosis
- Sparing of posterior wall
