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URR 38 Flashcards

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1
Q

develops as a result of hepatocellular disease such as cirrhosis, hepatitis, fatty liver, diffuse metastatic disease

A

intrahepatic portal hypertension

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2
Q

can occur secondary to CHF, constrictive pericarditis, Budd-Chiari syndrome, or suprahepatic IVC obstruction

A

post hepatic (extrahepatic) hypertension

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3
Q

In the later stages of portal hypertension, reversal of flow in the portal vein occurs, which produces:

A

splenomegaly

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4
Q

MPV caliber normally changes with:

A

respiration

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5
Q

____ MPV diameter with held inspiration and ____ diameter with expiration

A

increased
decreased

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6
Q

MPV caliber will not vary with respiration in patients with:

A

portal hypertension

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7
Q

If the MPV measures over ___, the patient has portal hypertension

A

13mm

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8
Q

If the splenic vein or superior mesenteric vein measure over ___ in diameter the patient has portal hypertension

A

1 cm

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9
Q

The splenic vein should be measured in the ____ plane

A

transverse

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10
Q

The superior mesenteric vein is measured in the ____ plane

A

sagittal

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11
Q

overproduction of red blood cells that causes hypercoaguability of blood

A

polycythemia vera

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12
Q

Decreased PT and INR values =

A

fast clotting, abnormal clotting

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13
Q

Polycythemia vera causes:

A

splenomegaly

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14
Q

Polycythemia vera is associated with ___, ____, ____, ____

A

splenic infarcts
renal vein thrombosis
portal vein thrombosis
Budd Chiari Syndrome

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15
Q

Which of the following is associated with asplenia?
a. duplicated IVC
b. biliary atresia
c. absence of the gallbladder
d. intestinal malrotation

A

a

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16
Q

Which of the following is associated with polysplenia?
a. right sided aorta
b. interrupted IVC
c. midline liver
d. horseshoe kidneys

A

b

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17
Q

A round, homogeneous mass that is isoechoic to the spleen identified at the splenic hilum is most suggestive of:
a. normal lymph node
b. abnormal lymph node
c. lymphoma
d. accessory spleen

A

d

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18
Q

What causes a wandering spleen?
a. abnormal migration of the spleen during development
b. abnormal migration of the spleen due to weak splenic ligaments
c. abnormal migration of the spleen due to portal hypertension
d. abnormal migration of the spleen due to left kidney mass formation

A

b

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19
Q

What is the hallmark sign of hemolytic anemia?
a. increased indirect bilirubin levels
b. markedly high levels of hemoglobin
c. markedly high levels of RBC in blood
d. markedly high levels of hematocrit

A

a

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20
Q

What biliary abnormality is common in patients with hemolytic anemia?
a. carcinoma
b. adenomyomatosis
c. cholelithiasis
d. cholecystitis

A

c

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21
Q

Which of the following is an autosomal recessive disorder that causes massive hepatomegaly and splenomegaly?
a. gaucher disease
b. mononucleosis
c. AIDS
d. infarction

A

a

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22
Q

Which of the following correctly describes a splenic artery aneurysm?
a. most common type of abdominal branch aneurysm
b. associated with pregnancy and pancreatic pseudocyst formation
c. the risk of rupture makes it a critical finding requiring immediate intervention
d. all the above

A

d

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23
Q

What is a fatal complication of splenic vein thrombosis?
a. pulmonary embolism
b. formation and rupture of gastric varices
c. splenic infarction
d. venous aneurysm

A

b

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24
Q

A splenic hematoma located within the splenic tissue is called:
a. subcapsular
b. intraparenchymal
c. perisplenic
d. intraperitoneal

A

b

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25
A splenic hematoma located between the capsule and the splenic tissue is called: a. subcapsular b. intraparenchymal c. perisplenic d. intraperitoneal
a
26
What lab value is evaluated in cases of splenic hematoma or rupture? a. alkaline phosphatase b. calcium c. hematocrit d. white blood cell count
c
27
Which of the following can be used to describe a splenic infarct? a. wedge shaped with the broad base on the surface of the spleen b. round hyperechoic mass near the hilum c. round isoechoic mass near the hilum d. wedge shaped with the broad base as the hilum of the spleen
a
28
How does congestive splenomegaly affect the flow in the splenic artery? a. lowers resistance and loss of spectral window b. increases resistance and diastolic flow c. increases resistance with diastolic flow reversal d. lowers resistance and larger spectral window
c
29
If splenic varices are identified at the hilum, what should be evaluated as the cause? a. spleen size b. splenic artery flow c. portal system d. splenic capsule integrity
c
30
Which of the following is associated with polycythemia vera? a. splenic infarcts b. renal vein thrombosis c. portal vein thrombosis d. all the above
d
31
Splenomegaly measurement
>13cm in length
32
Most frequent LUQ mass
splenomegaly
33
Most common splenic abnormality
splenomegaly
34
Splenomegaly is most commonly caused by:
portal hypertension with cirrhosis
35
Splenomegaly is usually caused by:
pathological processes outside of the organ
36
in the supine position in the transverse plane, if the upper border of the spleen extends across the anterior by more than 2cm
Asher sign
37
If the spleen extends past the ___ pole of the left kidney, splenomegaly is present
lower
38
Splenomegaly is present is spleen width is >__cm
5
39
The spleen appears hypoechoic with ____
malignant processes
40
The spleen appears hyperechoic with ____ and in _____patients
inflammatory processes radiation therapy
41
The spleen enlarges ___ and ___
inferiorly medially
42
Mild to moderate splenomegaly can be caused by ___, __,___
infection portal hypertension AIDS
43
Marked splenomegaly can be caused by ___, ___, ____, ___
hematologic disorders lymphoma leukemia myelofibrosis
44
Massive splenomegaly length measurement
>20 cm
45
Massive splenomegaly can be caused by ____. ____, ____, ____
thalassemia major myelofibrosis lymphoma Gaucher disease
46
During the aging proces we may see the spleen ___ in size, form calcifications and cysts
decrease
47
Inflammatory disease that causes cell clumping in certain organs
sarcoidosis
48
The immune system is overactive and produces clumps of cells
sarcoidosis
49
The clumps of cells from sarcoidosis form splenic nodules called:
granulomas
50
Sarcoidosis will cause multiple ____ nodules throughout the spleen
hypoechoic
51
When granulomas heal, they become ____
calcified
52
Spleen function includes ____ and ____
WBC production filtration
53
mononucleosis is associated with"
Epstein Barr virus
54
Moderate splenomegaly is seen in about __-__% of AIDS patients
50 70
55
Splenomegaly is noted more in patients with ___ HIV than those acquiring the disease through ____
sexually transmitted IV drug use
56
associated with: hepatomegaly hepatitis candidiasis pneumocystis carinii fatty infiltration of the liver Kaposi sarcoma cholangitis acalculous cholecystitis non-hodgkin lymphoma hemolytic anemia
AIDS
57
most common infection of AIDS patient, causes pneumonia
pneumocystis carinii
58
most common malignant tumor of the liver and spleen in AIDS
Kaposi Sarcoma
59
a systemic fungal respiratory disease caused by a bird, bat, and other animal droppings
granulomatous infections
60
most common causes of granulomatous infections
histoplasmosis tuberculosis
61
causes of granulomatous infections of the spleen
histoplasmosis tuberculosis sarcoidosis brucellosis
62
Typically causes multiple hypoechoic nodules <1cm in size; when nodules heal, multiple echogenic foci form in the spleen and liver
granulomatous infections
63
increased blood volume in the spleen with portal hypertension
portal hypertension
64
caused by microhemorrhaging and infarction
Gamna-Gandy bodies
65
organized foci of hemorrhage in the spleen most commonly seen with portal hypertension
Gamna-Gandy bodies
66
Gamna-gandy bodies contain:
hemosiderin fibrous tissue calcium
67
diffuse, echogenic foci within splenic tissue, with or without shadowing, may see twinkle artifact on Color Doppler
splenic calcifications
68
rare; may see them status post splenectomy
splenic abscess
69
Splenic abscesses are most commonly associated with ____, ____, and ___
endocarditis septicemia trauma
70
Symptoms of splenic abscesses
pain dizziness faintness
71
lab testing associated with splenic abscesses
decreased hematocrit fever increased WBC possible septicemia
72
Sonographic appearance of splenic abscess
complex fluid collection with internal echoes; irregular borders; may see septations and pleural effusion; dirty shadowing from gas producing organisms
73
most common benign tumor of the spleen
cystic cavernous hemangioma
74
composed of a high concentration of vascular tissues and located in the spleen
cystic cavernous hemangioma
75
Cystic Cavernous Hemangiomas are associated with ____ and ____
Kasabach-Merritt Syndrome Klippel-Trenaunay-Weber Syndrome
76
usually a solitary mass but can cause the formation of multiple nodules in patients with tuberous sclerosis or Wiskott-Aldrich syndrome
hamartoma
77
round, well-circumscribed, unencapsulated bulging nodules found in the spleen
hamartoma
78
usually present as hypoechoic, homogeneous solid masses within the spleen with hypervascularity
hamartoma
79
massive splenomegaly due to hypersplenism; can see multiple well defined, hypoechoic nodules; requires splenectomy
Gaucher Disease
80
mass in the spleen that comes from bone disease
osteoma
81
mass in the spleen made from fibrous tissues
fibroma
82
mass in the spleen made up on cartilaginous tissue
chondroma
83
congenital defect in lymphatic vessels in the spleen
cystic lymphangioma
84
calcifications of the spleen
granulomas
85
most common splenic malignancy
Lymphoma
86
Lymphoma is a tumor of the ____ system
lymphatic
87
Lymphoma that most commonly occurs in patients age 15-24 years and over age 60
Hodkin lymphoma
88
Hodgkin lymphoma is marked by mature, malignant B cells called:
Reed-Sternberg cells
89
Lymphoma can cause ___ and ___
leukocytosis anemia
90
Hodgkin lymphoma more commonly affects lymph nodes in the ___, ____, and ___
arms upper chest neck
91
Considered one of the most treatable cancers
Hodgkin lymphoma
92
most common type of lymphoma
Non-Hodgkin lymphoma
93
Average patient age for Non-Hodgkin lymphoma
60
94
Lab testing associated with Non-Hodgkin lymphoma
elevated LDH anemia leukopenia
95
Non-hodgkin lymphoma more commonly affects what lymph nodes?
no pattern for lymph node involvement; occurs in any lymph nodes throughout the body
96
Non-Hodgkin lymphoma is much ____ responsive to treatment than Hodgkin lymphoma
less
97
four sonographic patterns of lymphoma
diffuse, marked splenomegaly, patchy inhomogeneity multiple small hypoechoic lesions, miliary nodules multiple large lesions 1-10cm single bulky solid mass
98
Marked splenomegaly in lymphoma is due to:
tumor formation
99
What other locations should be evaluated in a patient with lymphoma?
abdomen for lymphadenopathy splenic and renal hilum areas porta hepatis para-aortic areas
100
cancer of the white blood cells
leukemia

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