Questions to Study Flashcards
1
Q
Landmarks at RT/LT Liver Division
A
IVC, Mid HV, GB, and MPV bifurcation
2
Q
Liver segments/HVs from RT to LT
A
RT post - RHV- RT ant - MHV - LT med - LHV - LT lat
3
Q
Caudate lobe blood vascularity
A
Receives blood from both RT/LT PVs
Drained by small emissary veins into IVC
4
Q
Caudate lobe landmarks
A
LT medial lobe; IVC; Lig. Venosum
5
Q
If Caudate enlarges…
A
IVC may compress
6
Q
Vessels of portal triad
A
MPV; Proper HA; CHD
7
Q
Main Lobar Fissure
A
Divides RT/LT liver (on image- line between GB and LT/RT PV junction)
8
Q
LT Intersegmental Fissure
A
Divides LT med and LT lat
Contains Lig. Teres
Falc. Lig. connects to anterior ab wall
Falc; Lig Ter.; LT HV; Ascend. PV
9
Q
Ligamentum Venosum
A
Divides LT and Caudate lobes
Remnant of ductus venosus
From LT PV to IVC
10
Q
Ligamentum Teres
A
Divides LT lobe into med/lat
Remnant of umbilical vein
From umbilicus to LT PV
May recanalize w/portal HTN
11
Q
Fetal circulation liver
A
Umbilical vein - LT PV - Duct. Ven. - IVC
12
Q
Focal Nodular Hyperplasia (FNH) has a
A
Central scar
13
Q
Schistomiasis
A
Parasitic worm
Occlusion of PVs due to larvae
PV HTN
14
Q
Hydatid (Ecchinochocal) Cyst
A
In liver Cysts within cyst or Water Lily May cause shock w/rupture Lab- indirect hemagglutination Casoni Skin Test
15
Q
Improve prothrombin time with
A
Vitamin K
16
Q
Albumin
A
Synthesized by liver
Transports unconjug. bilirubin
Decrease leads to ascites
17
Q
Hepatic Adenoma
A
Assoc. w/oral contraception and glycogen storage disease
18
Q
Liver lipoma
A
Hyperechoic
Cause Prop speed artifact
19
Q
TIPS
A
Transjugular Intrahepatic Portosystemic Shunt
20
Q
Fungal Abscess
A
Wheel within wheel… Hypo-hyper-hypo
21
Q
Intrahepatic portal gas in neonates due to
A
Necrotizing entercolitis
22
Q
Hypo mass adjacent to GB
A
Focal fatty sparing
23
Q
Increased AFP
A
HCC; Hepatoblastoma; yolk sac tumor
24
Q
Worm-like venous collateral parallel to thrombosed PV
A
Cavernous transformation
25
PV flow directions
Hepatopetal normal
w/patent TIPS-
MPV hepatopetal; RT/LT PV hepatofugal
26
ALT increases with
Any liver cell pathology (highly concentrated in liver so high levels mean breakdown of hepatocytes.)
27
Bull's eye/target liver mets assoc with
Lung CA
28
Most common cause of portal HTN
US- cirrhosis
| World- Schistosomiasis
29
Most common primary malignant liver tumor
Peds- hepatoblastoma
| Adults- HCC
30
Hepatitis US appearance
Acute- HYPO; enlarged; prominent vessel walls
Chronic- Hyper; small; disappearance of vessel walls
31
Peds PT w/painful abdominal mass that looks like concentric rings
Intussusception
32
Gamma glutamyl transpeptidase elevated with
HCC; Biliary obstruction
It's normal w/pregnancy and bone disease.
33
Fibrous covering of liver and PVs
Glisson's capsule
34
Portal blood O2
80% oxygenated
| Supplies 60% of liver's O2
35
Increases w/biliary obstruction
GGT; ALP; conjugated bilirubin
36
Pheochromocytoma
Adrenal medulla
Secrete catecholamines (norepi and epi)
Can cause uncontrolled HTN
37
Normal HV waveforms
Venous flow with triphasicity due to RT atrial contractions
38
Budd-Chiari
HV thrombosis
| Portal HTN; Ascites; inc. abdominal girth; enlarged caudate
39
Pyogenic Abscess
Most common
Fever, leukocytosis
Air within mass
40
ALP found in
Liver, bone, placenta
41
Quadrate lobe location
OLD term!
| Inferior aspect of LT medial liver
42
US liver assoc w/immunodeficiency
Diffuse, nonshadowing, hyperechoic foci
| Pneumocystic (carinii) jiroveci
43
Acute RUQ pain and decreased hematocrit
Hemorrhagic liver cyst
44
Most common causes of extrahepatic cholestasis (obstructive jaundice)
Common duct stone
| Panc CA
45
Increased unconjugated bilirubin from
1. Hemolysis
| 2. Decreased ability of liver to conjugate
46
Shotgun sign structures
RT PV; RT HA; RT HD
47
Mickey Mouse Sign
MPV; CHD; PHA
48
Courvoisiers GB
Painless jaundice
| Panc CA
49
Most common causes of acute pancreatitis
Biliary stones and Alcohol abuse
50
Cystic fibrosis effect on Panc
Increased echogenicity
| Atrophy
51
Hartmann's pouch
At neck of GB near cystic duct
52
Folds of GB
Phrygian cap-Fundus
| Junctional fold-Neck
53
Gallbladder CA
Mass-filled GB w/associated liver mets
54
How GB contracts
Release of CCK due to fatty food ingestion stimulates GB
55
Panc ducts
Main- Wirsung
| Accessory- Santorini
56
Walled off panc secretions
Panc pseudocysts (prevent further autodigestion of peripanc tissue
57
Define cholangiocarcinoma
```
Elev ALP
Klatskin's tumor at hepatic hilum
Assoc w/parasitic infection
Biliary obstruction
Commonly extrahepatic
```
58
Hydropic GB
GB obstruction without inflamed or edematous wall
59
Sclerosing cholangitis
Thick-walled intrahepatic ducts
Incr. ALP and bilirubin
50% also have ulcerative colitis
60
Bile ducts after fatty meal
Unchanged or decrease when normal
| Dilate w/distal obstruction
61
Adenomyomatosis
Rokitansky Aschoff sinus (small diverticuli in wall of GB)
| Stones in the wall cause comet tail or reverb artifact
62
Pancreatitis
Pseudocysts, elev. amylase, and inflammatory masses.
Panc duct calcs w/CHRONIC
63
Radiographic affect on duct measures
X-ray results in a degree of magnification making ducts larger
64
Choledochal cysts
Most common is in CBD
Intrahepatic duct dilation
Prevalant in Asia (33-50% cases from Japan)
65
Polysplenia associated with
Multiple LUQ spleens
Biliary atresia
Intestinal malrotation
Cardiac defects
66
Ascariasis of biliary tract
Obstruction due to round worm parasitic infection
67
Panc location
In anterior pararenal space of retroperitoneum
68
Associated w/Von Hippel-Lindau
RCC; pheochromocytoma; islet cell tumors; pancreatic and renal cysts
69
Mirizzi syndrome
CHD obstruction due to extrinsic compression of a cystic duct stone.
70
Most common islet cell tumor
Insulinoma
71
Hyperechoic, shadowing fluid-fluid layer in GB
Milk of calcium bile
72
Second most common islet-cell tumor
Gastrinoma
| Zollinger-Ellison syndrome
73
Caroli's disease
Saccular, communicating intrahepatic bile duct ectasia.
Cystic dilatations of intrahepatic biliary tree.
Results in cirrhosis and liver failure
74
May be elevated from saliva gland tumor
Amylase
75
Conjugated bilirubin excretion
Released into intestines; absorbed into bloodstream; filtered by kidneys; excreted through urine
76
Order of structures at renal hilum A-P
RV ; RA; ureter (VAU)
77
Most common malignant bladder tumor
TCC
78
Chronic pyelonephritis leads to
end-stage renal disease; USA small hyperechoic kidney
79
Resistive index with acute hydronephrosis
Greater than 0.7
80
Most common site of obstructing calculi in urinary system
Ureterovesicle junction
81
Encloses the perirenal space which contains the kidneys and adrenal glands
Gerota's fascia
82
Medullary sponge kidney USA
Calcified equally spaced medullary pyramids due to ectatic collecting tubules
83
Typical place of transplanted kidneys
Retroperitoneum
84
ARPKD
Neonatal PT w/no urine output; large hyperechoic kidneys bilaterally
85
Transplanted kidney waveform in acute rejection
Decreasing diastole resulting in increasing RI
86
Complete duplication of renal collecting system
```
Hydro of upper pole
2 renal sinuses separated by renal cortex
2 ureters/2 sinuses
Ureterocele
Hydroureter
```
87
Multiple noncommunicating cysts w/absence of renal parenchyma in a newborn
Multicystic dysplastic kidney
88
Papillary necrosis
Calcification or sloughing of the papilla of the medullary pyramids;
Assoc with analgesic drug abuse, diabetes, and sickle cell
May present as prominent round or triangular cystic pyramids
89
Most common malignant renal tumor
RCC
90
Ureter landmarks
From kidneys anterior to psoas muscle into pelvis; enter pelvis and travel anterior to iliac artery and vein; insert on trigone of bladder
91
Findings with Acute tubular necrosis
Prominent medullary pyramids, high resistance intraparenchymal waveform, and increased renal size
92
There is an increased incidence of ... associated with ADPKD
Cerebral aneurysms
93
What is associated with multicystic dysplastic kidney?
Contralateral UPJ obstruction
94
Normal renal RI
Less than 0.7
95
Associated with ARPKD
Pulmonary hypoplasia, dilated collecting system, oligohydramnios
96
Acquired cystic kidney disease
Formation of renal cysts from chronic hemodialysis
97
Most common childhood tumor
Wilms' tumor (nephroblastoma)
98
Tuberous sclerosis has an increased risk of
Angiomyolipomas, RCCs, and renal cysts
99
Renal lymphoma presents as
Bilaterally large hypoechoic kidneys with loss of corticomedullary boundary
100
Azotemia
Increased serum nitrogen
101
RA waveform with RV thrombosis
RA is highly resistive with absent or reversed end diastolic flow
102
Horseshoe Kidney
Location more inferior than normal
Lower poles typically fused
Isthmus anterior to aorta
Urinary obstruction
103
Pyonephrosis
Accumulation of pus due to infection in an obstructed kidney
104
Acute Pyelonephritis
Assoc with incr. renal size, loss of corticomedullary boundary, bacteruria, and leukocytosis
105
Urachal cyst
Cystic structure superior to midline bladder, with or without internal echoes
106
Most common cause of acute rejection of transplanted kidney
Acute tubular necrosis
107
Most common cause of acute rejection of transplanted kidney
Acute tubular necrosis
108
What drains into the LT renal vein?
LT ovarian/testicular vein and the LT suprarenal (adrenal) vein
109
USA of acute rejection transplanted kidney
Increasing renal volume and length, loss of corticomedullary junction, and thickened cortex
110
Associated with Hypercalcimia (causing neprocalcinosis)
Vitamin D intoxification, malignancy, and hyperparathyroidism
111
Mycetoma (fungal balls)
Hyperechoic mass within renal collecting system. (Papillary necrosis, AML, and blood clots diff. diagnosis)
112
Glomerular filtration rate decreases...
Creatinine increases
113
Associated with a higher incidence of RCC
Von Hippel, tuberous sclerosis, and ACDK
114
Labs for chronic renal failure
Increased serum creatinine and urea
115
Associated with polysplenia
Multiple LUQ spleens, left-sided azygos, biliary atresia, and absent GB
116
Most common solid breast mass
Fibroadenoma- benign, solid tumors in women under 35; influenced by estrogen. Hypo, oval discrete masses
117
Most common thyroid malignancy
Papillary carcinoma
118
Excessive cortisol excretion due to increase in ACTH from a pituitary tumor
Cushing's Disease
119
Common site for benign prostatic hyperplasia (BPH)
Transitional Zone
120
Most common testicular CA
Seminoma
121
Adrenal cortex secretes
Aldosterone and cortisol
122
Most common breast CA
Infiltrating ductal carcinoma
123
Haustra are found in ...
Colon
124
Testicular arteries branch off the ...
Aorta
125
Adrenal medulla secretes...
Epi and NorEpi (catecholamines)
126
Fibromuscular stroma
Anterior, non-glandular part of prostate; not affected by CA, prostatitis, or hyperplasia
127
Associated with cryptorchidism (nondescended testicle)
Incr risk of CA; Incr incidence with premature birth; infertility; commonly found in inguinal canal
128
Acute hematomas appear
Hyperechoic (due to fibrin)
129
Peripheral, wedge-shaped hypo lesion of spleen
Infarct
130
Associated with Asplenia
Rt-sided aorta, horseshoe kidney, midline liver location
131
Fibrous capsule of testicle
Tunica Albuginea
132
Ejaculatory duct
Vas deferens joins the seminal vesicles to form;
| ED transverses the central zone of prostate
133
Longus colli
Muscle located post. to thyroid and adjacent to vert body
134
Thyroglossal duct cyst
Midline subcutaneous anechoic neck mass; (dilation of the primitive thyroglossal duct)
135
Results from adrenal adenoma, producing hyperaldosteronism
Conn's syndrome
136
Arcuate line
Point at which posterior rectus sheath ends (between umbilicus and symphysis pubis)
137
Thyroid mass associated with MEN syndrome
Medullary carcinoma
138
Most intratesticular lesions are
Malignant
| Most extratest. are benign
139
Chronic renal failure leading to secondary hyperparathyroidism results in
Chronic hypocalcemia due to unable to synthesize vitamin D
140
Leydig cell tumor
Benign in children
| Produces testosterone causing precocious puberty
141
Chronic mesenteric ischemia
Postprandial abdomen pain
Weight loss
Fear of food
142
Dissecting aneurysms typically originate at the
Aortic arch in the thorax
143
USA of Graves' disease
Diffuse thyroid enlargement with extensive hypervascularity
144
Echogenic central linear structure of adrenal gland
Adrenal medulla
145
Primary hyperparathyroidism
Elev serum calcium due to parathyroid adenoma
146
Have a tendency to invade the IVC
Renal and adrenal cancers
147
"In anatomical position, what structures would be directly under transducer?"
```
Corpus spongiosum (urethra won't be a choice)
Scanned with penis up on abdomen
```
148
Bell clapper deformity
Testicle not attached to tunica vaginalis and rotates freely.
Leads to torsion
149
Hypertrophic pyloric stenosis wall greater than
4 mm
| And diameter greater than 1.5 cm
150
MEN associated with
Pheochromocytomas, medullary thyroid CA, and parathyroid hyperplasia
151
Remnant of Mullerian duct
Appendix testis
152
Seminal vesicles located
Sup to prostate
Inf to bladder
Ant to rectum
153
Most common site for prostate CA
Peripheral zone
154
Mantle sign
aka Sandwich sign
| Perivessel lymphadenopathy
155
Acute appendicitis
Diameter greater than 6mm
Appendicolith
RLQ pain
Noncompressible
