Spleen

Question 1

A 15 year old male patient presents to the sonography department with a history of left sided trauma 5 years earlier. He currently has no LUQ discomfort. The sonographic findings of the spleen include a mass that contains calcification producing distinct posterior shadowing. What is the most likely diagnosis?

splenic hemangioma
splenic hamartoma
splenic lymphangioma
splenic hematoma

Answer 1

splenic hematoma

Question 2

A 25 year old female patient presents to the sonography department for a complete abdominal sonogram. She complains of RLQ pain and nausea. The RUQ appears normal. A small mass is noted in the area of the splenic hilum. This mass appears isoechoic to the spleen. What does this most likely represent?

pancreatic cystadenocarcinoma
splenic hemangioma
accessory spleen
neuroblastoma

Answer 2

accessory spleen

Question 3

a rare malignant tumor of the spleen that consists of blood vessels is a/an:

lymphoma
angiosarcoma
hemangioma
granuloma

Answer 3

angiosarcoma

Question 4

A 48 year old male with a history of severe, sudden onset of LUQ pain without trauma presents to the sonography department for a sonogram of the spleen. You visualize a wedge-shaped, hypoechoic area within the spleen. This most likely represents a:

splenic infarct
splenic hematoma
splenic hemangioma
splenic metastasis

Answer 4

splenic infarct

Question 5

a patient with a wandering spleen would have an increased risk for:

splenic infection
splenosis
splenic carcinoma
splenic torsion

Answer 5

splenic torsion

Question 6

what is the most common sonographic appearance of a splenic hemangioma?

echogenic
hypoechoic
anechoic
complex

Answer 6

echogenic

Question 7

the process of making RBCs is termed:

erythropoiesis
leukopoiesis
histopoiesis
anemia

Answer 7

erythropoiesis

Question 8

multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most likely represent:

sarcoidosis
granulomas
lynphangiomas
hemangiomas

Answer 8

granulomas

Question 9

the splenic artery marks the:

posterior aspect of the pancreatic body and tail

superior aspect of the pancreatic body and tail

medial surface of the pancreatic body and tail

lateral aspect of the pancreatic body and tail

Answer 9

superior aspect of the pancreatic body and tail

Question 10

the most common cause of splenomegaly is:

hepatitis
PHTN
lymphoma
trauma

Answer 10

PHTN

Question 11

the splenic hamartoma may be discovered more often in individuals with a history of:

HIV
splenic carcinoma
tuberous sclerosis
Meckel-Gruber syndrome

Answer 11

tuberous sclerosis

Question 12

the type of tissue within the spleen that is responsible for its phagocytic function is the:

red pulp
white pulp
culling pulp
pitting pulp

Answer 12

red pulp

Question 13

An evaluation of the spleen reveals a 1cm, rounded, echogenic mass that does not produce acoustic shadowing. What is the most likely diagnosis?

pheochromocytoma
lipoma
splenic metastasis
hemangioma

Answer 13

hemangioma

Question 14

which of the following is a benign lesion that is a congenital malformation of the lymphatic system:

lymphangioma
hemangioma
angiosarcoma
myeloma

Answer 14

lymphangioma

Question 15

the spleen is a/an:

intraperitoneal organ
retroperitoneal organ

Answer 15

intraperitoneal organ

Question 16

the type of tissue within the spleen that is responsible for its lymphatic function is the:

red pulp
white pulp
culling segment
putting segment

Answer 16

white pulp

Question 17

which of the following children would least likely to suffer from sickle cell anemia?

african american
caucasian
middle eastern
mediterranean

Answer 17

caucasian

Question 18

the splenic vein marks the:

posterior aspect of the pancreatic body and tail

anterior aspect of the pancreatic body and tail

medial surface of the pancreatic body and tail

lateral aspect of the pancreatic body and tail

Answer 18

posterior aspect of the pancreatic body and tail

Question 19

all of the following are functions of the spleen except:

storage of iron
defense against disease
blood reservoir
destruction of phagocytic cells

Answer 19

destruction of phagocytic cells

Question 20

A 26 year old patient with a long-standing history of multiple sickle cell crises and subsequent splenic infarctions presents for an abdominal sonography. After thoroughly evaluating the LUQ, only a fraction of the splenic tissue can be identified. This describes the process of:

splenomegaly
asplenia
splenosis
autosplenectomy

Answer 20

autosplenectomy

Question 21

where is the most common location of an accessory spleen?

superior to the spleen
medial to the diaphragm and Lt kidney
splenic hilum
anterior to the pancreatic body

Answer 21

splenic hilum

Question 22

all of the following can be associated with splenomegaly EXCEPT:

trauma
hemolytic abnormalities
mononucleosis
pancreatitis

Answer 22

pancreatitis

Question 23

what is the splenic process of cleaning RBCs of unwanted material?

pitting
plucking
culling
coring

Answer 23

pitting

Question 24

diffuse involvement of lymphoma or leukemia of the spleen will often lead to:

splenomegaly
splenic atrophy
Epstein-Barr infection
splenic torsion

Answer 24

splenomegaly

Question 25

the splenic artery originates at the: SMA inferior phrenic artery celiac trunk gastroduodenal artery

Answer 25

celiac trunk

Question 26

which of the following is a congenital anomaly in which the spleen is divided into two portions by a band of tissue? splenic infarct splenic cleft splenosis splenic imperfecta

Answer 26

splenic cleft

Question 27

A 35 year old male patient presents for an abdominal sonogram with a history of abdominal pain and histoplasmosis. What are you more likely to identify within the spleen? multiple histomas multiple hemangiomas multiple metastatic lesions multiple granulomas

Answer 27

multiple granulomas

Question 28

A 14 year old male present for an ultrasound after falling from his bicycle. An abdominal sonogram reveals a complex-appearing mass within the spleen. This most likely represents a: splenic hemangioma splenic granuloma splenic hematoma splenic infarct

Answer 28

splenic hematoma

Question 29

a sickle cell crisis will often lead to: splenic metastasis sarcoidosis splenomegaly wandering spleen

Answer 29

splenomegaly

Question 30

Epstein-Barr infection is best described as: a herpes virus that can lead to infectious mononucleosis a herpes virus that is often associated with splenic granulomatous disease an infection that results in sickle cell anemia in children an infection within a splenic hematoma following blunt trauma

Answer 30

a herpes virus that can lead to infectious mononucleosis

Question 31

the spleen removes irregular cells from the bloodstream through a process called: pitting culling crimping amassing

Answer 31

culling

Question 32

an area within the spleen that has become necrotic because of a lack of oxygen is referred to as a: splenic hemangioma splenic hematoma splenic infarct granuloma

Answer 32

splenic infarct

Question 33

what systemic disease results in the development of granulomas within the spleen and throughout the body? granulomatosis sarcoidosis sickle cell anemia Beckwith-Weismann syndrome

Answer 33

sarcoidosis

Question 34

a complex cyst that results from the parasitic infestation of the spleen by a tapeworm is the: bacterial endocarditis cyst cholecdochal cyst hydatid cyst candidiasis

Answer 34

hydatid cyst

Question 35

what is the most likely clinical finding of a patient who has a splenic hemangioma? fever decreased hematocrit elevated WBC count asymptomatic

Answer 35

asymptomatic

Question 36

in a patient with suspected lymphoma, the presence of Reed-Sternberg cells indicates: Hodgkin lymphoma Non-hodgkin lymphoma metastatic liver disease splenic infarction

Answer 36

Hodgkin lymphoma

Question 37

which of the following describe the implantation of ectopic splenic tissue possibly secondary to splenic rupture? splenosis polysplenia asplenia wandering spleen

Answer 37

splenosis

Question 38

all of the following are true of the spleen EXCEPT: it is the largest structure of the reticuloendothelial system the primary objective of the spleen is to filter peripheral blood the spleen has a convex inferior margin and concave superior border the spleen is considered the largest lymphatic organ

Answer 38

the spleen has a convex inferior margin and a concave superior border

Question 39

the splenic vein joins with what structure posterior to the pancreatic neck to form the portal vein? IMA SMV cephalic vein main hepatic vein

Answer 39

SMV

Question 40

small echogenic foci scattered throughout the spleen most likely represents: multiple benign hemangioma multiple benign hematomas multiple benign granulomas malignant lymphoma

Answer 40

multiple benign granulomas

Question 41

which of the following structures is in contact with the spleen? left hemidiaphragm stomach pancreas splenic flexure of the colon all of the above

Answer 41

all of the above

Question 42

what view provides the best long-axis image of the spleen? sag view from anterior position with patient supine intercostal coronal view with patient supine coronal view with patient in LLD anterior sag view with patient in LLD posterior sag view with patient in prone position

Answer 42

intercostal coronal view with the patient supine

Question 43

which of the following is a cause of mild to moderate splenomegaly? A. PHTN B. infection C. AIDS D. lymphoma A, B, and C only

Answer 43

A, B, and C only

Question 44

what is the most common finding in the spleen in patients with AIDS? abscess metastasis accessory spleen moderate splenomegaly lymphoma

Answer 44

moderate splenomegaly

Question 45

which of the following would be most helpful in improving diagnostic confidence in splenic infarction? have the patient perform valsalva maneuver evaluate the lesion in both inspiration and expiration evaluate lesion with color doppler have the patient drink 48oz of water and rescan rescan the patient in an upright position

Answer 45

evaluate the lesion with color doppler

Question 46

During splenic sonography, you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum. What condition do you suspect? PHTN histoplasmosis lymphoma splenic rupture splenic pseudocyst

Answer 46

PHTN

Question 47

which structure will you detect at the splenic hilum? diaphragm splenic vein left kidney duodenum LLL

Answer 47

splenic vein

Question 48

what is the relationship of the pancreatic tail to the spleen? superior and lateral superior and medial anterior inferomedial posterior

Answer 48

inferomedial

Question 49

which can be used to describe the normal sonographic appearance of the splenic parenchyma? heterogenous with mid to low level echogenicity homogenous with mid to low level echogenicity homogenous with echogenicity exceeding that of the liver heterogenous with mixed echogenicity normal spleen has varied appearance on ultrasound

Answer 49

homogenous with mid to low level echogenicity

Question 50

what transducer provides the highest resolution images of the spleen? 2.25 MHz linear array 3.5 MHz phased array 5.0 MHz curved linear array 3.5 MHz curved linear array 2.25 MHz phased array

Answer 50

5.0 MHz curved linear array

Question 51

which of the following is NOT true regarding the spleen? located in the LUQ is a retroperitoneal structure lies between the fundus of the stomach and diaphragm average adult spleen measures 12 cm in length normal spleen decreases in size and weight with advanced age

Answer 51

the spleen is NOT a retroperitoneal structure

Question 52

which of the following is a pitfall you might encounter in ultrasound scanning of the the spleen? intercostal scanning may produce rib shadows obscuring the splenic parenchyma in hepatomegaly, the LLL may be mistaken for the spleen a mass on the tail of the pancreas may be confused with a splenic mass an accessory spleen may be confused with an enlarged lymph node all of the above

Answer 52

all of the above

Question 53

You are performing and abdominal ultrasound on a patient with histoplasmosis. What findings of the spleen are commonly seen with this condition? small, shrunken spleen multiple hypoechoic masses throughout the spleen splenic abscess multiple focal, bright echogenic granulomatous lesions throughout the spleen solitary cyst with calcified walls

Answer 53

multiple focal, bright echogenic granulomatous lesions throughout the spleen

Question 54

the splenic vein drains into the what vein? IMV SMV PV LRV IVC

Answer 54

PV

Question 55

You are performing an ultrasound study on a patient with a history of recent blunt left-sided trauma in a motor vehicle accident. Which finding below is NOT associated with this history? splenic laceration subcapsular hematoma of the spleen free fluid perisplenic hematoma calcified splenic cyst

Answer 55

calcified splenic cyst

Question 56

You are performing an ultrasound study on a patient with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents: histoplasmosis tuberculosis pseudocyst metastasis infarction

Answer 56

metastasis

Question 57

During abdominal sonography of a patient with PHTN and splenomegaly, you detect a calcified ring at the splenic hilum. What should you do? evaluate the area with color doppler roll the patient into a decubitus position to see if the structure moves have the patient drink 24 oz. of water and rescan have the patient return for a repeat study in 1 week for comparison. nothing, as this is not a significant finding

Answer 57

evaluate the area with color doppler

Question 58

which of the following is NOT a feature you would detect in a splenic cyst? smooth border posterior acoustic enhancement anechoic appearance increased attenuation rounded shape

Answer 58

increased attenuation