Superficial Structures

Question 1

Gas causes what type of sonographic artifact

Answer 1

Reverberation (comet tail )

Question 2

Extra hepatic collection of bile

Caused by: trauma, gb disease, biliary sx

Answer 2

Biloma

Question 3

Sonographic findings of a biloma

Answer 3

Predominately cystic mass in ruq

Question 4

2 mechanisms that produce ascites

Answer 4

Decrease serum osmotic pressure

Increase in portal vein pressure

Question 5

Most common cause of ascites

Answer 5

Cirrhosis

Question 6

Causes of ascites

Answer 6

Cirrhosis
Hypoalbunemia
Budd-chiari
Heart failure
Cancer
Nephrotic syndrome (protein loss)

Question 7

Successful treatment of ascites

Answer 7

TIPSS

Question 8

Benign ascites

Answer 8

Free floating bowel

Question 9

Bowel loops tethered or matted to posterior abdominal wall with complex or loculated fluid collections

Answer 9

Malignant ascites

Question 10

Lymphoceles are caused by:

Answer 10

Lymph leakage from renal allograft & surgery disruption of lymphatic channels

Question 11

Lymphoceles differentials:
4

Presence of internal echoes are more consistent with_______&_______.

Answer 11

Any fluid collection: ascites
Urinoma
Hematoma
Abscess

Question 12

Tendon separation from distal pole of patella

Answer 12

Patellar tendon rupture

Question 13

Irregular borders , complex, debris, septations,and possible gas

Patient presents: fever with increased WBC

Answer 13

Abscess

Question 14

Cause of patellar tendon rupture :

Occurs more with systemic dz such as:____,____,&_____.

Answer 14

“Jumping”- sports

Lupus, renal failure, rheumatoid arthritis

Question 15

Patellar tendon rupture:

Pt is unable to______

Palpable defect known as______

Answer 15

Extend the knee

“Dimple sign”

Question 16

Achilles’ tendon rupture occurs where?

Answer 16

Approx. 3-4cm sup

Question 17

Thompson test

Answer 17

Prone position with knee at 90 degrees squeeze calf

Question 18

Sonographic presentation for Achilles’ tendon rupture

Answer 18

C/ or s/ fluid collection

Disrupted normal striations

Question 19

Pseudomyxoma peritonei : aka

Answer 19

Malignant ascites

Question 20

Pseudomyxoma peritonei: sonographic presentation

Causes:

Answer 20

Bowel loops matted to post abdominal wall

Mets
Rupture of mutinous cystadenocarcinoma of ovary
Mutinous tumor of appendix

Question 21

Hematoma:

Lab-

Fibrin invasion presentation-

Answer 21

Decrease in hematocrit

Hyperechoic

Question 22

Hematocrit :

Answer 22

Volume of RBC found in 100ml of blood

Question 23

Types of lymphoma

Answer 23

Non-hodgkins

Hodgkins

Question 24

Sonographic sign for lymphadenopathy

Answer 24

“Sandwich” or “mantle”

Question 25

Lymphoma displaces the IVC & SMA________.

Answer 25

Anteriorly

Question 26

Finding assoc. with Non-Hodgkin's lymphoma (5)

Answer 26

``` Lymphadenopathy Hsm Cytopenia Abd mass ( bowel obstruction) Hydronephrosis d/t retro nodes ```

Question 27

Causes of bakers cyst (3)

Answer 27

Rheumatoid arthritis Osteoarthritis Over use of knee

Question 28

2nd most common tumor of hand & (wrist) Presentation:

Answer 28

Giant cell tumor Solid

Question 29

Most common tumor of hand/wrist Presentation

Answer 29

Ganglion cyst Simple with enhancement

Question 30

Sheath encasing rectus bad onus from xiphoid to pubic bone

Answer 30

Linea alba

Question 31

Midway btwn umbilicus and symphysis pubis

Answer 31

Arcuate line

Question 32

Rectus muscle hematoma ____ to arcuate line should not move across the midline d/t the _________.

Answer 32

Superior Lines alba

Question 33

Rectus Muscle hematoma ______ will extend into the pelvis mimicking pelvic pathology

Answer 33

Inferior

Question 34

Rectus sheath hematoma lab value?

Answer 34

Decrease in hematocrit

Question 35

Causes of rectus sheath hematoma (5)

Answer 35

``` Trauma Sx trauma Muscle contraction Vassal a coughing/ vomiting Pregnancy ```

Question 36

``` Name in order of decreasing echogenicity: Spleen/liver Renal sinus Pancreas Renal cortex ```

Answer 36

Renal sinus Pancreas Spleen/liver Renal cortex

Question 37

Granulomas are caused by________or_________

Answer 37

Histoplasmosis or tuberculosis

Question 38

__________is common in North America in the Great Lakes basin and in mid-western US

Answer 38

Histoplasmosis

Question 39

Hepatitis may result in the elevation of these for lab values

Answer 39

Alt, ast, conjugated, unconjugated bilirubin

Question 40

Hep. Route of infection Hep a

Answer 40

Fecal/oral

Question 41

Hep. Route of infection Hep b

Answer 41

Blood/ body fluids (terminal)

Question 42

Hep. Route of infection Hep c

Answer 42

Blood/body fluids(terminal)

Question 43

Most frequent indication for liver transplant

Answer 43

Hcv- associated chronic liver disease

Question 44

Sonographic findings of acute hepatitis

Answer 44

"Starry night" peri portal cuffing Hypoechoic Enlarged liver size Hyperechoic pv walls

Question 45

Sonographic appearance of chronic hepatitis

Answer 45

Hyperechoic liver Small in size Decreased echo of pv wall

Question 46

Complex mass,echogenic gas,reverb artifact

Answer 46

Pyogenic (bacterial) abscess

Question 47

Symptoms of Pyogenic abscess

Answer 47

Run pain Leukocytosis Fever Elevated lft

Question 48

3 major forms of liver abscess

Answer 48

Pyogenic:( bacterial)-80% of cases in us Amebic: d/t entamoeba hyst. 10% Fungal: candida>10%

Question 49

Occurs when a parasite from the intestine reaches the portal vein. Occurs in immigrants and travelers : 8-12wks from date if travel.

Answer 49

Amebic abscess

Question 50

``` Ruq pain Diarrhea fever Leukocytosis Elev. lfts Elev. rt dome of diaphragm on x-Ray ```

Answer 50

Amebic abscess

Question 51

A fungal( mycotic) infection of blood that results in small abscess in the liver. Typically asymptomatic.

Answer 51

Fungal abscess (aka-candidias)

Question 52

Sonographic presentation of fungal abscess

Answer 52

"Wheel within a wheel" - earliest and most recognizable: anechoic center separates from mets. "Bulls eye"- calcified center "Uniformly hypoechoic focus"-most common presentation "Echogenic focus"