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Flashcards in Rama Final Deck (50)
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1
Q

What is a hernia?

A

Protrusion of abdominal cavity (bowel or fat) through abdominal wall

2
Q

Name 3 types of hernia

A
inguinal 
femoral
umbilical
epigastric
semilunar
incisional
3
Q

What maneuver do you use to visualize hernias?

A

Valsalva maneuver

4
Q

Where does inguinal hernia appear?

A

in spermatic cord or round ligament

5
Q

Ultrasound appearance of hernia

A
interaction of peritoneal line
outline contents of mass
peristalsis (absent with incarceration)
valsalva
reducibility with pressure
6
Q

signs and symptoms of appendicitis

A
nausea
vomiting
RLQ or periumbilical pain
fever
elevated WBC
7
Q

Differential diagnosis for appendicitis

A

Crohn’s disease
ovarian pathology
lymphoma
neoplasm

8
Q

Evaluation/Protocol for appendix

A
compression at RLQ
longitudinal
transverse
peri-appendiceal fluid
measurements
9
Q

Landmark for appendix

A

Cecum

10
Q

Sonographic appearance of normal appendix

A

not visualized

11
Q

Transducer of choice for appendix

A

Linear 7.5-12.0 MHz

12
Q

Sonographic appearance of abnormal appendix

A
no peristalsis
bulbous tip
thickened wall
not compressible
>6mm diameter with compression
peri-appendiceal fluid
hyperemia
13
Q

What are the most important measurements in the carotid?

A

peak systolic and end diastolic

14
Q

What are random biopsies?

A

no mass, but you want a tissue sample. Usually due to abnormal blood/urine tests

15
Q

Where should the needle be places in relationship to the transducer

A

parallel to the transducer so you can see the entire length of the needle

16
Q

What should always be done prior to a biopsy

A

Blood work to check coagulation time

17
Q

What two tests are done/calculated to check for coagulation?

A

Prothrombin time (PT) and International Normalized Ration (INR)

18
Q

What are the reasons for liver biopsy?

A

To confirm malignancy
to determine whether lesion is primary or mets
to determine cause of transplant rejection

19
Q

Contraindication for US-guided procedures

A

uncorrectable bleeding disorder
lack of safe needle path
uncooperative patient

20
Q

What are biopsied used for

A

to determine whether mass is benign, malignant or infectious

21
Q

How much fluid do you need to drain for diagnosis

A

60cc

22
Q

Where is paracenthesis done?

A

LLQ or RLQ

paracolic gutters

23
Q

Benefits of using needle guides

A

faster learning curve
faster placement of needle
ability to keep needle going through anesthetized area for multiple passes

24
Q

Key roles of ultrasound testicular exam

A

rule out intra-testicular mass/pathology

elevate blood flow

25
Q

name for undescended testicles

A

chryptorchidism

26
Q

most common location of undescended testicle

A

inguinal/groin region

27
Q

surgery to free undescended testicle

A

orchiopexy

28
Q

Most common cause of acute pain in adolescence

A

testicular torsion

29
Q

Sonographic appearance of torsion

A
focal or diffusely hypoechoic
decrease in size 
Ischemia (decrease in blood flow)
spectral wall thickening 
associated hydrocele
30
Q

inflammation of epididymis

A

epididymitis

31
Q

presentation of epididymitis

A
fever and painful urination
swelling
asymmetry
hypoechoic testicle 
increased vascularity
associated hydrocele
32
Q

infection/inflammation of the testicle

A

orchitis

33
Q

presentation of orchitis

A
fever
elevated WBC
enlarged testicle
hypoechoic
increased vascularity
34
Q

Location and cause of epididymal cysts

A

head of epididymis

caused by obstructed ducts

35
Q

Spermatocele

A

cysts filled with non-viable sperm

common in the head

36
Q

hydrocele

A

collection of fluid between layers of tunic vaginalis

most common cause of painless swelling

37
Q

hematocele

A

collection of blood

38
Q

pyocele

A

pus containing collection

39
Q

Where does a varicocele occur?

A

pampiniform plexus

40
Q

What causes vericoceles?

A

incompetent valves in the spermatic vein

41
Q

Which side are varicoceles more common on?

A

left

42
Q

Appearance of a vericocele

A

tortuous tubular structures
increased size during valsalva
greater than 2mm

43
Q

True/False

intra-testicular masses are usually malignant and extra-testicular masses are usually benign

A

True

44
Q

What is the size of a normal testicle

A

3-5cm length
2-4cm width
3cm AP

45
Q

Where do hydroceles occur?

A

between visceral and parietal layers of tunica vaginalis

46
Q

location of epididymis

A

superior and posteriolateral to tesis

47
Q

Size of epididymal head

A

6-15mm

48
Q

What is acute appendicitis

A

result of laminal obstruction and inflammation leading to ischemia of the vermiform appendix

49
Q

symptoms of cute appendicitis

A
pain, rebound tenderness at McBurney's point
nausia
diarrhea
elevated WBC
fever
50
Q

Where do spermatoceles occur?

A

rete testis or epididymis