Test 3: Chapter 11 - Slpeen, Chapter 12 - Pancreas, and Chapter 13 - Gastrointestinal Tract

Question 1

Which one of the following statements is false?
A. the uncinate process is posterior to the superior mesenteric artery.
B. The head of the pancreas is superior to the caudate lobe
C. The gastroduodenal artery is the anterolateral border of the head
D.The head of the pancreas is anterior to the IVC

Answer 1

B

Question 2

The head of the pancreas is inferior to the ________ of the liver?
A. right lobe
B. Caudate lobe
C. Right lateral fissure
D. Left lateral fissure

Answer 2

B

Question 3

The ________ passes through a groove posterior to the pancreatic head.
A. Gastroduodenal artery
B. Superior mesenteric vein
C. Hepatic duct
D. Common bile duct

Answer 3

D

Question 4

The tail of the pancreas is located:
A. anterior to the right kidney, near the liver hilum
B. anterior to the left kidney, near the splenic hilum
C. posterior to the right kidney, near the liver hilum
D. posterior to the left kidney, near the splenic hilum

Answer 4

B

Question 5

The primary pancreatic duct is the duct of __________.
A. Ampulla
B. Santorini
C. Wrisung
D. Vater

Answer 5

C

Question 6

An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His hematocrit and hypotension levels are decreased. Your differential diagnosis should include:
A. chronic pancreatitis
B. hemorrhagic pancreatitis
C. pseudocyst
D. cholecystitis

Answer 6

B

Question 7

A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for:
A. Cholecystitis
B. Adenocarcinoma of the pancreas
C. Pancreatic pseudocyst
D. Pancreatitis

Answer 7

B

Question 8

The sonographic appearance of a normal pancreas is typically _______ or ______ to the liver?
A. isoechoic;hyperechoic
B. Hypoechoic;anechoic
C. isoechoic;hypoechoic
D. hyperechoic;anechoic

Answer 8

A

Question 9

Clinical signs and symptoms in acute pancreatitis include all of the following except:
A. elevated amylase
B. nasuea and vomiting
C. severe abdominal pain radiating to the back
D. severe abdominal pain radiating to the right shoulder

Answer 9

D

Question 10

A most common cause of acute pancreatitis in the United States is:
A. colitis
B. biliary tract disease
C. pancreatic malignancy
D. alcohol intake

Answer 10

B

Question 11

What are the cells that perform exocrine function?
A. Amylase
B. Acini cells
C. Lipase
D. Pseudocyst

Answer 11

B

Question 12

What is the enzyme secreted by the pancreas to aid in the digestion of carbohydrates?
A. Lipase
B. Amylase
C. Hypercalcemia
D. SMA

Answer 12

B

Question 13

What is the portion of the pancreas that has an endocrine function and produces insulin, glucagon, and somatostatin?
A. Body of the pancreas
B. SMA
C. Islets of Langerhans
D. Acini cells

Answer 13

C

Question 14

What is the pancreatic enzyme that breaks down fats; enzyme is elevated in pancreatitis and remains increased longer than amylase?
A. amylase
B. acini cells
C. lipase
D. pseudocyst

Answer 14

C

Question 15

What is the condition in which fat levels are elevated contributing to pancreatitis?
A. Hypercalcemia
B. Hyperlipidemia
C. Lipase
D. Amylase

Answer 15

B

Question 16

What is a space or cavity that contains fluid?
A. Pseudocyst
B. Body of pancreas
C. SMA

Answer 16

A

Question 17

What are elevated levels of calcium in the blood?
A. Hyperlipidemia
B. Hypercalcemia

Answer 17

B

Question 18

What lies in the mid epigastrium anterior to the SMA, SMV, AO, and IVC.
A. Body of the pancreas
B. Tail of the pancreas
C. Head of the pancreas

Answer 18

A.

Question 19

What serves as the posterior border to the body of the pancreas?
A. SMV
B. SMA
C. PV
D. CBD

Answer 19

B

Question 20

What serves as the lateral border of the heead of the pancreas?
A. Loop of the duodenum
B. Body of the pancreas
C. Tail of the pancreas
D. Head of the pancreas

Answer 20

A

Question 21

What is the small accessory duct found in the head of the pancreas?
A. Duct of Wirsung
B. Duct of Santorini
C. Common bile duct

Answer 21

B

Question 22

What is the largest duct that drains the tail, body and head of pancreas; joins the common bile duct to enter the duodenum through ampulla of vater?
A. Duct of santorini
B. Hepatic duct
C. CBD
D. Duct of Wirsung

Answer 22

D

Question 23

What is the union of the superior mesenteric vein and splenic vein to form the main portal vein?
A. CBD
B. Portal confluence
C. SV
D. HV

Answer 23

B

Question 24

What is the production of the hormone insulin?
A. Endocrine
B. Exocrine

Answer 24

A

Question 25

What is the production and digestion of pacreatic juice? A. Endocrine B. Exocrine

Answer 25

B

Question 26

What is the hormone that causes glycogen formation from glucose in the liver and allows cells within insulin receptors to take up glucose? A. Insulin B. Glucagon C. Lipase D. Amylase

Answer 26

A

Question 27

What stimulates the liver to convert glycogen to glucose? A. Glucagon B. Insulin C. Amylase D. Lipase

Answer 27

A

Question 28

What is the small opening in the duodenum in which the pancreatic and common bile duct enter to release secretions? A. CBD B. CHD C. Ampulla of Vater D. Sphincter of Oddi

Answer 28

C

Question 29

What is the small muscle that guards the ampulla of vater? A. Ampulla of vater B. Sphincter of oddi C. Glucagon D. Acini cells

Answer 29

B

Question 30

Which one of the following statements about the spleen is false? A. The spleen lies inferiror to the diaphragm B. The spleen lies posterior to the hypochondrium C. The spleen is located within the retroperitoneum D. The normal adult spleen measures approx 7 cm in width

Answer 30

C

Question 31

Splenomegaly may result from all of the following except: A. Congestion B. Trauma C. Subphrenic abscess D. Collagen vascular disease

Answer 31

C

Question 32

The normal sonographic appearance of the splenic parenchyma is: A. Homogeneous and similar to the liver B. Heterogeneous C. Hyperechoic compared with the liver D. Hypoechoic compared with the kidney

Answer 32

A

Question 33

When accessory spleens are present, they are usually located: A. near the kidney B. near the hilum of the spleen C. at the inferior margin of the spleen D. on the posterior aspect of the spleen

Answer 33

B

Question 34

The splenic vein courses along the posterior border of the: A. pancreas B. adrenal gland C. spleen D. kidney

Answer 34

A

Question 35

Which one of the following may cause a splenic rupture? A. hemangioma B. Infarction C. Complicated cyst D. Metastic tumor

Answer 35

A

Question 36

A spleen that has migrated from its normal location is termed a(n): A. Splenomegaly B. Accessory spleen C. Ectopic spleen D. Wandering spleen

Answer 36

D

Question 37

Massive splenomegaly is most likely the result of: A. Infection B. Myelofibrosis C. Leukemia D. Portal hypertension

Answer 37

B

Question 38

Primary tumors that may metastasize to the spleen originate from all of the following strutures except the: A. Brain B. Kidney C. Ovary D. Stomach

Answer 38

A

Question 39

The best patient position to evaluate the spleen is: A. left posterior oblique B. right decubitus C. supine D. left lateral decubitus

Answer 39

B

Question 40

Which one of the following structures is often visualized on a saittal ultrasound as a "bulls-eye" or target pattern anterior to the aorta and posterior to the left lobe of the liver? A. Common bile duct B. Gastroesophageal juction C. Ligamentum teres D. Pancreatic duct

Answer 40

B

Question 41

Small bowel obstruction is associated with: A. dilation of the bowel loops distal to the site of the obstruction B. dilation of the bowel loops proximal to the site of the obstruction C. collapsed bowel loops proximal to the site of the obstruction D. polypoid masses throughout the obstruction

Answer 41

B

Question 42

Acute appendicitis may be seen on a transverese sonogram as a ________ mass. A. Target-shaped B. hyperechoic C.hypoechoic D. Anechoic

Answer 42

A

Question 43

The _______ has a target shape and is located in the midline anterior to the pancreas body. A. fundus B. gastric antrum C. pyloric canal D. body

Answer 43

B

Question 44

The appendix is located at: A. Mubarney's point B. McBurney's point C. Iliac crest D. McBurney's sign

Answer 44

B

Question 45

The maximum outer diameter of the normal appendix can measure up to _______ millimeters (mm). A. 6 B. 3 C. 5 D. 4

Answer 45

A

Question 46

A diverticulum is most common in the: A. small intestines B. ileum C. stomach D. colon

Answer 46

D

Question 47

The most common tumor of the gastrointestinal tract in children under 10 years of age is: A. leiomyoma B. lymphoma C. fecalith D. polyp

Answer 47

B

Question 48

The celiac axis, superior mesenteric artery, and _________ artery supply both the small and large intestines. A. renal B. splenic C. lumbar D. inferior mesenteric

Answer 48

D

Question 49

The progression of acute appendicitis to frank perforation is more rapid in: A. preschool children B. senior citizens C. adults D. elementary school children

Answer 49

A

Question 50

Symptoms of appendiceal mucoceles may include all of the following except: A. sepsis B. bloating C. urinary symptoms D. asymptomatic

Answer 50

B

Question 51

Gastrointestinal leiomyosarcomas most commonly occur in the: A. jejunum B. ascending colon C. ileum D. duodenum

Answer 51

C

Question 52

What is known as the digestive tract; includes mouth, pharynx, esophagus, stomach, duodenum, small and large intestine. A. Pyloric canal B. Villi C. Alimentary canal D. Cardiac orifice

Answer 52

C

Question 53

What is the entrance of the esophagus into the stomach? A. Rugae B. Villi C. Cardiac orifice D. Pyloric canal

Answer 53

C

Question 54

What is the normal segmentation of the wall of the colon? A. Villi B. Rugae C. Mesentary D. Haustra

Answer 54

D

Question 55

What is the canal located between the stomach and proximal duodenum? A. Alimentary canal B. Pyloric canal

Answer 55

B

Question 56

What are the inner folds of the stomach? A. rugae B. villi C. haustra D. mesentary

Answer 56

A

Question 57

What are the inner folds of the small intestine? A. rugae B. mesentary C. villi D. haustra

Answer 57

C

Question 58

What projects from parietal peritoneum and attaches to the small intestine, anchoring it to the posterior abdominal wall? A. Accessory spleen B. Mesentery C. Villi D. Polyp

Answer 58

B

Question 59

What results from he failure of fusion of separate splenic masses forming on the dorsal mesograstricum; A. No spleen B. Accessory spleen C. Wandering spleen D. Leukopenia

Answer 59

B

Question 60

What are phagocytic cells found in the liver and spleen comprising the reticuloendothelial system; plays a role in the synthesis of blood? A. Reticuloendothelial cells B. Leukopenia C. Villi

Answer 60

A

Question 61

What is an abnormal decreases in white blood cells? A. leukopenia B. phagocytosis C. polycythemia D. wandering spleen

Answer 61

A

Question 62

What is the spleen that has migrated from its normal location in LUQ? A. Accessory spleen B. Wandering spleen C. No spleen

Answer 62

B

Question 63

What is the definition of new growth?

Answer 63

Neoplasm

Question 64

What is a rare congenital abnormality that is most likely inherited? A. Caoli's disease B. Dilated biliary ducts C. Extrahepatic biliary obstruction

Answer 64

A

Question 65

What is the classic sign for Caroli's disease dilated duct surrounding the adjacent hepatic atery and portal vein? A. Central dot B. Target sign C. Murphy's point

Answer 65

A

Question 66

Hepatic duct _______ mm or more is suspicious and requires further investigation. A. 5 B. 6 C. 8 D. 9

Answer 66

B

Question 67

What are the three primary areas for obstruction to occur?

Answer 67

Intrahepatic, suprapancreatic, and porta hepatic

Question 68

What is a uncommon cause for extrahepatic biliary obstruction and patients presents with painful jaundice?

Answer 68

Mirizzi Syndrome

Question 69

What is a normal size of a hepatic duct? A. < 9 mm B. 6 mm C. < 7 mm D. 10 mm

Answer 69

C

Question 70

Sonographic findings: - intrahepatic duct dilation - normal size CBD - large stone in neck of GB or cystic duct What is it?

Answer 70

Mirizzi syndrome

Question 71

What is primary choledocholithiasis? A. stones formed in ducts secondary to structures or dilation of bile ducts leading to bile stasis B. stones migrated from GB

Answer 71

A

Question 72

What is secondary choledocholithiasis? A. stones formed in ducts secondary to structures or dilation of bile ducts leading to bile stasis B. stones migrated from GB

Answer 72

B

Question 73

What is blood in the biliary tree secondary to surgical intervention or liver biopsy, malignancy? A. hemobilia B. Pneuomobilia

Answer 73

A

Question 74

What is air in the biliary tree secondary to surgical intervention such as CBD stents, biliary-enteric anastomoses or emphysematous cholecystitis, prolonged acute cholecystitis. A. hemobilia B. pneuomobilia

Answer 74

B

Question 75

_________ cholangitis and ______ cholangitis are other names for cholangitis. A. bacterial; stones B. neoplasm; cysts C. sclerosing; AIDS D. AIDS; ascariasis

Answer 75

C

Question 76

Cholangitis is medical emergency as it develops increasing pressure in biliary tree with pus accumulation T or F

Answer 76

T

Question 77

What is a parasitic roundworm that uses fecal-oral route of transmission? A. Ascariasis B. Cholangiocarcinoma C. Caroli's disease D. Cholangitis

Answer 77

A

Question 78

What is the ascending colon arise from the right lower quadrant to ben at this point to form the transverse colon? A. Hepatic flexure B. Muscularis C. Splenic flexure D. Diverticulum

Answer 78

A

Question 79

What is the congenital sac or blind pouch found in the lower portion of the ileum? A. Morrison's pouch B. Muscularis C. Meckel's diverticulum D. Diaphragm

Answer 79

C

Question 80

What is the third layer of the bowel? A. Rugae B. Mesentery C. Muscularis D. Villi

Answer 80

C

Question 81

What is the transverse colon travels horizontally across the abdomen and bends at this point to form the descending colon? A. Splenic flexure B. Hepatic flexure

Answer 81

A

Question 82

What is fecalith or calcification located in the appendix? A. Rugae B. Appendicolith C. Choledocholithiasis

Answer 82

B

Question 83

What is located by drawing a line from the right anterosuperior iliac spine to the umbilicus; at approximately the midpoint of this line? A. McBurney's point B. Murphys point C. McBurney's sign

Answer 83

A

Question 84

What is a rare malignancy that originates within large bile ducts? A. Cholangiocarcinoma B. HCC C. Adenoma D. RCC

Answer 84

A

Question 85

What is the least common location for cholangiocarcinoma? A. intrahepatic B. extrahepatic

Answer 85

A

Question 86

Intrahepatic Cholangiocarcinoma is the second most common primary malignancy of the liver? T or F

Answer 86

T

Question 87

What is another name for Hilar Cholangiocarcinoma? A. Klatskin's tumor B. Wilms tumor C. Nephroblastoma

Answer 87

Klatskin's tumor

Question 88

Hilar cholangiocarcinoma or Klatskin's tumor occurs at the bifurcation of CHD T or F

Answer 88

T

Question 89

The pancreas is a retroperitoneal cavity t or f

Answer 89

T

Question 90

What is the primary duct extending the length of the pancreas? A. duct of wirsung B. duct of santorini

Answer 90

A

Question 91

What is the secondary duct that drains upper anterior head of pancreas? A. duct of wirsung B. duct of santorini

Answer 91

B

Question 92

What is the normal length for the pancreas? A. 12-18 cm B. 25 cm C. 10 cm D. 8 cm

Answer 92

A

Question 93

Branches of _________ feed the body and tail A. splenic artery B. celiac axis C. pancreaticoduodenal artery D. superior mesenteric artery

Answer 93

A

Question 94

Branches of ___________ arteries supply the head of the pancreas A. Splenic artery B. Pancreaticoduodenal artery C. Hepatic artery D. Splenic vein

Answer 94

B

Question 95

What is the most common primary neoplasm of the pancreas? And is the most common non-function islet cell-tumor and is malignant? A. Adenocarcinoma B. Insulinoma C. Gastrionoma

Answer 95

A

Question 96

What is the most common functioning islet-cell tumor and usually benign? A. Gastrionoma B. Insulinoma

Answer 96

B

Question 97

What is the 2nd most common islet cell functioning tumor that is usually malignant? A. Insulinoma B. Gastrionoma

Answer 97

B

Question 98

You can't live without a spleen T or F

Answer 98

F

Question 99

What is a rare medical disease caused by the loss or weakening of the ligaments that help to hold the spleen stationary?

Answer 99

Wandering spleen

Question 100

What happens when there is caudal displacement of the spleen? A. LUQ masses B. Splenic cyst C. Left pleural effusion D. All of the above

Answer 100

D

Question 101

What happens when there is cephalic displacements of the spleen? A. Volume loss of left lung B. left lobe pneumonia C. Paralysis of the left hemi-diaphragm D. Large abdominal mass E. All of the above

Answer 101

E

Question 102

The accessory spleen is the most common anomaly T or F

Answer 102

T

Question 103

What is the spleen's main function?

Answer 103

Its filtering process

Question 104

What does the spleen serve as a reservoir for?

Answer 104

Blood and filters and purifies the blood and lymph fluid that flows through it.

Question 105

What are the functions related to erythrocytes (RBC's) A. reservoir and storage B. recycling and filtering C. Disposal and cleansing D. All of the above

Answer 105

D

Question 106

The splenic vein travels horizontally and _____ to join the ____ to form the MPV A. laterally; SMA B. anteriorly; HPV C. medially; SMV D. posteriorly; PV

Answer 106

C

Question 107

The upper limit of normal for an adult spleen is less than ____ cm? A. 12 B. 9 C. 7 D. 13

Answer 107

D

Question 108

The spleen is a retroperitoneal organ? T or F

Answer 108

F it is intraperitoneal

Question 109

Splenic abscess are uncommon T or F

Answer 109

T

Question 110

What are the clinical findings for a splenic abscess?

Answer 110

May be subtle, fever, LUQ, tenderness, abdominal pain, left shoulder and flank pain, splenomegaly

Question 111

What is the most common cause is occlusion of the major splenic artery or any of its branches? A. splenic infarction B. AIDS C. Hepatosplenic candidiasis

Answer 111

A

Question 112

Splenic cysts are classified as ______ or _______ in origin A. anechoic; isoechoic B. heterogenous; hyperechoic C. parasitic; nonparasitic D. parascitic; hyperechoic

Answer 112

C

Question 113

Echinococcus is the only parasite that forms splenic cysts T or F

Answer 113

T

Question 114

What are the differential diagnoses of hemangioma

Answer 114

Hydatid cyst, abscess, dermoid cyst, metastasis

Question 115

Patient is asymptomatic. Tumor may be solitary or multiple and is considered well-defined but not encapsulated. A. Hamartoma B. Hemangiosarcoma C. Lymphoma D. Cyst

Answer 115

A

Question 116

What is a malignant neoplasm arising from the vascular endothelium of the spleen? A. Lymphoma B. Hemangiosarcoma C. Carcinoma D. HCC

Answer 116

B

Question 117

The spleen is commonly invloved with lymphoma T or F

Answer 117

T

Question 118

The spleen is the 5th most common site of metastases T or F

Answer 118

F it is the tenth

Question 119

What size in length is considered enlargement of the spleen? A. > 9 cm B. > 20 cm C. > 13 cm D. 8cm

Answer 119

C

Question 120

Gaucher disease is pediatric focused primarily T or F

Answer 120

T