URR 39 Flashcards
(100 cards)
1
Q
Clinical symptoms of leukemia
A
night sweats
fatigue and weakness
unintentional weight loss
painless, swollen lymph nodes
enlargement of liver or spleen
fever or chills
2
Q
cancer of myeloid cells (immature blood cells)
A
myelogenous leukemia
3
Q
most common leukemia
A
acute myelogenous leukemia
4
Q
cancer of the lymphocytes; acute or chronic
A
lymphocytic leukemia
5
Q
lab testing associated with leukemia
A
complete blood count
low platelet count
low RBC count
high WBC count
low sedimentation rate
6
Q
Leukemia is treated with ___, ___, ___
A
chemotherapy
radiation therapy
stem cell transplant
7
Q
primary malignant neoplasm of the spleen; very aggressive malignancy
A
Angiosarcoma
8
Q
Angiosarcoma has a high rate of ____ and has a ____ prognosis
A
metastases
poor
9
Q
Angiosarcoma arises from:
A
vascular epithelium
10
Q
Clinical symptoms of angiosarcoma
A
anemia
LUQ pain
malaise
fever
weight loss
11
Q
Angiosarcomas have a high incidence of:
A
splenic rupture
12
Q
Sonographic appearance of angiomyosarcoma
A
splenomegaly
heterogeneous echotexture
complex mass with cystic and solid components
increased vascularity
13
Q
most likely primary cancer to spread to the spleen, but occurs less frequently than other primary cancers
A
melanoma
14
Q
most common primary carcinomas seen with splenic metastasis
A
lung
breast
15
Q
Metastasis may occur with:
A
lung
breast
lymphoma
leukemia
melanoma
ovary
pancreas
stomach
16
Q
sonographic appearance of metastasis to spleen
A
hypoechoic, most common bulls eye appearance
can also be cystic or hyperechoic
17
Q
Lesions of the ___, ___, ___, and ____ may impinge upon the spleen and mimic primary splenic disease
A
pancreas
left kidney
left adrenal
left lobe of liver
18
Q
Lesions of the body and tail of the pancreas may mimic:
A
primary splenic process
19
Q
Lesions may occur along the _____ ligament
A
splenorenal
20
Q
The ___ pole of the left kidney impinges on the splenic hilum
A
upper
21
Q
The ___ surface of the spleen is cupped around ____ border of kidney
A
medial
lateral
22
Q
The splenorenal ligament provides the attachment between ___, ___, and ____
A
left kidney
perirenal space
splenic capsule
23
Q
A ____ may indent the splenic parenchyma
A
renal cyst
24
Q
A ____ or ____ of the kidney may extend along the splenorenal ligament to enter the spleen
A
neoplasm
inflammatory process
25
The ____ may be the source of tumor or cyst that intrinsically compresses the spleen
left adrenal gland
26
Hemorrhage of the adrenal is usually confined to:
perirenal area
27
most common congenital anomaly of the spleen
accessory spleen
28
Hereditary Hemolytic Anemia is more common in ___
African Americans
29
Acquired hemolytic anemia is more common in ___ patients
AIDS
30
most common type of abdominal branch aneurysm
splenic artery aneurysm
31
most common cause of splenomegaly
portal hypertension
32
most common splenic abnormality
splenomegaly
33
Splenomegaly is most commonly caused by:
portal hypertension with cirrhosis
34
most common causes of splenic calcifications
histoplasmosis
tuberculosis
35
Splenic abscess is most commonly associated with:
endocarditis
septicemia
trauma
36
most common benign tumor of the spleen
hemangioma
37
most common splenic malignancy
lymphoma
38
most common type of splenic malignancy
non-hodgkin lymphoma
39
most likely to metastasize to the spleen
melanoma
40
Most common primaries to metastasize to the spleen
lung
breast
41
Which of the following is a correct method for assessment of splenomegaly?
a. >13cm in length
b. upper border of the spleen extends across the anterior aorta by more than 2 cm
c. spleen extends past the lower pole of the left kidney
d. all the above
d
42
What is the most common cause of splenomegaly?
a. AIDS
b. polycythemia vera
c. portal hypertension
d. mononucleosis
c
43
A hypoechoic enlarged spleen is typically caused by ___, while a hyperechoic enlarged spleen is typically caused by ___.
a. malignancy, infection
b. portal hypertension, malignancy
c. infection, infarction
d. mononucleosis, AIDS
a
44
Massive splenomegaly (>20cm) is caused by all of the following, except:
a. thalassemia major
b. lymphoma
c. AIDS
d. Gaucher disease
c
45
The most common splenic infarction in an AIDS patient is ____ and the most common malignancy of the spleen in AIDS patient is ___.
a. mononucleosis, adenocarcinoma
b. pneumocystis carinii, Kaposi sarcoma
c. viral, lymphoma
d. fungal, leukemia
b
46
Gamna Gandy bodies are most commonly seen with:
a. mononucleosis
b. tuberculosis
c. AIDS
d. portal hypertension
d
47
Which of the following is a common cause of splenic abscess?
a. endocarditis
b. mononucleosis
c. portal hypertension
d. Gaucher disease
a
48
What splenic abnormality is associated with Kasabach-Merritt Syndrome and Klippel-Trenaunay-Weber syndrome?
a. infarction
b. hemangioma
c. hamartoma
d. Gaucher disease
b
49
What splenic abnormality is associated with tuberous sclerosis or Wiskott-Aldrich syndrome?
a. infarction
b. hemangioma
c. hamartoma
d. Gaucher disease
c
50
What lab testing values can be used to identify lymphoma?
a. red blood cell count
b. white blood cell count
c. LDH
d. all the above
d
51
Hodgkin lymphoma typically causes lymphadenopathy in the ____, while Non-hodgkin lymphoma typically causes lymphadenopathy in the ____.
a. upper body, whole body
b. upper body, abdomen
c. lower body, upper body
d. lower body, abdomen
a
52
Leukemia causes:
a. low platelet count
b. low RBC count
c. high WBC count
d. all the above
d
53
Patients with angiosarcoma have an increased risk of:
a. abscess formation
b. lymphoma formation
c. splenic rupture
d. aortic aneurysm
c
54
Which of the following is the most common primary malignancy to spread to the spleen?
a. lung cancer
b. stomach adenocarcinoma
c. pancreatic adenocarcinoma
d. hepatocellular carcinoma
a
55
Which of the following is associated with prolonged fasting?
a. splenosis
b. steatosis
c. pyloric stenosis
d. gallbladder sludge
d
56
A hematoma of the rectus abdominis muscle that occurs below the arcuate line can extend into:
a. the umbilicus
b. space of Retzius
c. pouch of Douglas
d. Morison pouch
b
57
Anemia is least likely to be related to abnormalities of which of the following organs
a. esophagus
b. thyroid
c. spleen
d. aorta
b
58
Which scrotal arteries penetrate the testicular parenchyma to supply oxygenated blood?
a. centripetal
b. deferential
c. cremasteric
d. capsular
a
59
Schistosomiasis is an ____ cause of portal hypertension. Budd Chiari syndrome is an ____ cause of portal hypertension.
a. intrahepatic presinusoidal, extrahepatic presinusoidal
b. intrahepatic presinusoidal, intrahepatic presinusoidal
c. intrahepatic presinusoidal, extrahepatic postsinusoidal
d. extrahepatic presinusoidal, intrahepatic postsinusoidal
b
60
An US demonstrates a non-shadowing, non-mobile, echogenic foci within the GB that most likely represents:
a. calculus
b. sludge ball
c. polyp
d. porcelain GB
c
61
Which of the following scrotal abnormalities would be better displayed if the patient performed the valsalva maneuver?
a. varicocele and scrotoliths
b. inguinal hernia and adenomatoid tumors
c. testicular torsion and inguinal hernia
d. varicocele and inguinal hernia
d
62
Hypoalbuminemia associated with cirrhosis leads to:
a. nodule formation
b. liver capsule contraction and surface irregularities
c. hepatomegaly
d. gallbladder and bowel wall thickening
d
63
When evaluating an infant hip, the transducer is placed ___, but for a pediatric hip evaluation the transducer is placed ___.
a. on the anterior hip, on the lateral hip
b. on the lateral hip, on the anterior hip
c. on the lateral hip, on the posterior hip
d. on the anterior hip, on the posterior hip
b
64
If tardus parvus waveforms are identified in the intrahepatic artery waveforms of a transplant, this finding is ____. If biphasic waveforms are identified in the right and left hepatic arteries, the finding is ____.
a. suspicious for hepatic artery stenosis, normal
b. suspicous for hepatic artery stenosis, suspicious for organ rejection
c. normal, suspicious for hepatic artery stenosis
d. suspicious for organ rejection, suspicious for hepatic artery stenosis
b
65
The diameter of the normal aorta is greatest at the level of the:
a. renal arteries
b. iliac bifurcation
c. superior mesenteric artery
d. celiac axis
d
66
Which of the following techniques will lead to a degraded lateral resolution?
a. trapezoidal field of view on linear array
b. increased probe frequency
c. none of the above
d. increase in number of focal zones
a
67
Which of the following is most commonly found in the pancreatic body or tail and secretes hormones?
a. microcystic cystadenoma
b. islet cell tumor
c. pseudocyst
d. macrocystic cystadenoma
b
68
A patient presents with a palpable round lump on the midline anterior neck about 2cm below the jaw. The structure appears anechoic with thin, smooth walls on ultrasound. Which of the following is the most likely explanation for the findings?
a. pharyngeal pouch cyst
b. nasopharyngeal duct cyst
c. thyroglossal duct cyst
d. ectopic thyroid cyst
c
69
A patient presents for a renal ultrasound due to a recent diagnosis of staphylococcus aureus infection, right flank pain, and microscopic hematuria. The chart states the referring physician suspects a renal carbuncle has formed. How will this abnormality be identified sonographically?
a. a single large calculus obstructing the renal pelvis with severe hydronephrosis
b. a hyperechoic mass of fibrous tissue replaces the tissue of the renal sinus causing significant outflow obstruction
c. 1.5 cm complex mass located within the renal pelvis that is causing renal vein thrombosis
d. 1.5 cm complex mass with ring down and dirty shadowing located within the renal parenchyma
d
70
Loculated fluid in the abdomen usually ___, while free fluid in the abdomen will ___.
a. is resorbed over time by the body, require a paracentesis to remove the fluid
b. displaces adjacent structures, fills spaces around structures
c. fills spaces around structures, displaces adjacent structures
d. indicates a benign process, indicates a malignant process
b
71
Which of the following correctly describes AFP?
a. Normal lab testing should show no amount of AFP in the blood
b. liver metastasis causes the most significant increase in AFP levels
c. increased AFP levels are associated with primary liver cancer in adults and children
d. AFP levels are elevated with a fungal infection in the body
c
72
What is the most common primary renal malignancy?
a. Wilms tumor
b. transitional cell carcinoma
c. cystadenocarcinoma
d. renal cell carcinoma
d
73
When evaluating the venous outflow of a liver transplant patient, it is most important to check surgical history to find ____ before scanning.
a. what segment of the portal vein was attached to the hepatic veins
b. the type of surgical anastamosis
c. the patients current LFT levels and prothrombin time
d. what segment of the portal vein was attached to the IVC
b
74
An increase in which of the following hormones causes increased calcium resorption in the small intestines?
a. parathyroid stimulating hormone
b. T4
c. calcitonin
d. thyroid stimulating hormone
a
75
A right adrenal mass will displace the IVC:
a. anteriorly
b. superiorly
c. inferiorly
d. posteriorly
a
76
Which of the following results from embryonic failure of fusion of the pancreas tissue?
a. ectopic pancreas tissue
b. whipple pancreas
c. pancreas divisum
d. annular pancreas
c
77
A small, hyperechoic, round mass with no associated shadowing is seen in the cortex of the kidney. These findings are most consistent with:
a. staghorn calculus
b. angiomyolipoma
c. renal calculus
d. nephrocalcinosis
b
78
The term allograft refers to:
a. the bypass graft used in arterial revascularization of an organ
b. the native organ that will be replaced by a transplanted organ
c. the transplanted organ
d. an external portal shunt
c
79
A female patient presents with 8 days of abdominal pain, fever, and nausea. The symptoms started 2 days after returning from a business trip to Hong Kong. Recent lab values demonstrated increased levels of direct serum bilirubin, alkaline phosphatase, and WBCs. Alpha fetoprotein levels are normal. These clinical findings are most suggestive of:
a. pneumobilia
b. cholangitis
c. hemolytic anemia
d. primary gb carcinoma
b
80
Bacterial infection, internal bleeding, and viral infection typically share what ultrasound finding?
a. free air in the peritoneal cavity
b. retroperitoneal fibrosis
c. abscess formation
d. ascites with debris/septations
d
81
An infant is referred for an abdominal sonogram due to prolonged jaundice after birth. A small triangular echogenic area is identified at the portal vein bifurcation, but no definite extrahepatic duct is noted. The gallbladder is very small and abnormally shaped. These findings are most suggestive of:
a. biliary ascariasis
b. choledochal cyst
c. biliary atresia
d. Caroli disease
c
82
When removing a protective gown:
a. untie the strings, roll the gown upward from the bottom edge to turn it inside out, pull it from the shoulders and off the arms, remove your gloves, wash your hands
b. remove your gloves, untie the strings, pull the gown forward from the center of the front of the gown to remove it with the exposed side out, roll it into a ball, wash your hands
c. untie the strings, pull the gown forward from the shoulders using the neck strings to turn it inside out as it is removed, remove your gloves, wash your hands
d. remove your gloves, untie the strings, pull the gown forward from the shoulders using the neck strings, grab the inside shoulder seams to pull it off the arms and turn it inside out as it is removed, wash your hands
d
83
Which of the following patients would benefit from a FAST exam?
a. patient with suspected prostate cancer
b. patient with history of abdominal pain after a fall from a ladder yesterday
c. patient with a history of RUQ pain after eating
d. patient with abdominal bruit, weight loss, and postprandial pain
b
84
Most patients with adrenal corticol cancer have associated:
a. Conn disease
b. Addison disease
c. Cushing syndrome
d. Budd Chiari Syndrome
c
85
Analgesic abuse is the most common cause of what renal abnormality?
a. papillary necrosis
b. glomerulonephritis
c. nephrocalcinosis
d. acute renal failure
a
86
How many layers are identified in the normal sonographic "gut signature"?
a. 3
b. 8
c. 6
d. 5
d
87
A patient presents with increasing RUQ pain and vomiting after a recent liver biopsy. An irregular mass with internal debris and an overall heterogeneous appearance is noted in the right lobe. The mass also demonstrates several echogenic foci with ringdown artifact. These findings are most suggestive of:
a. lymphocele
b. pseudoaneurysm
c. hematoma
d. abscess
d
88
Which muscle group is located anterolateral to the lobes of the thyroid gland?
a. longus colli muscle
b. strap muscles
c. trachea muscles
d. sternocleidomastoid
d
89
A 45 year old patient presents with increased serum BUN and creatinine, a recent history of oliguria and bilateral flank pain. The US exam demonstrates bilateral hydronephrosis and hydroureter, but the bladder is nearly empty. Which of the following statements is true regarding this patient and the findings?
a. acute intrinsic renal failure is present that is most likely due to acute tubular necrosis
b. the patient will most likely return for a follow up exam in 7-10 days after anticoagulant treatment
c. acute postrenal failure is present and the radiologist should review the case immediately
d. the patient has a neurogenic bladder and the radiologist should review the case immediately
d
90
The splenic artery courses across the ___ surface of the pancreas.
a. anterior inferior
b. posterior superior
c. posterior inferior
d. none of the above
b
91
In order to assess low velocity flow, which of the following operator adjustments should be made?
a. decrease wall filter setting and compression
b. increase scale setting
c. decrease compression
d. decrease the rejection and wall filter setting
d
92
The US exam of patient's liver demonstrates a patent umbilical vein. The most common cause of this recanalization is:
a. portal hypertension
b. hepatitis
c. ascites
d. abscess
a
93
Which of the following describes how to differentiate a ventral hernia from diastasis recti?
a. ventral hernias never contain bowel loops, diastisis recti always contain bowel loops
b. ventral hernias are a weakening of the anterior abdominal wall, diastasis recti is a weakening of the lateral abdominal wall
c. ventral hernias require an increase in abdominal pressure for visualization, diastasis recti is best visualized with the patient relaxed
d. ventral hernias have an associated fascial defect, but there is no defect with diastasis recti
d
94
The spleen's normal echotexture is:
a. homogeneous with portal echoes seen throughout
b. homogeneous throughout
c. homogeneous and hyperechoic compared to the sinus of the left kidney
d. mildly inhomogeneous
b
95
Which of the following lists an advantage of fine needle capillary technique over a fine needle aspiration technique?
a. FNC aspirates a smaller but more concentrated sample of cells than FNA
b. FNC is less traumatic to the tissues than FNA
c. FNC does not require local anesthetic and FNA does
d. FNC collects a tissue core while FNA collects a small amount of cells
a
96
Bacterial cholangitis is nearly always seen with:
a. ulcerative colitis
b. biliary ascariasis
c. HIV cholangitis
d. ductal obstruction by a stone or tumor
d
97
A patient presents with a history of hepatitis C and you identify a solid liver mass with a hypoechoic halo. This finding is most consistent with:
a. hepatic metastasis
b. hepatocellular carcinoma
c. focal nodular hyperplasia
d. hepatic adenoma
b
98
Branches of the which of the following vessels supply the pancreas with blood?
a. superior mesenteric artery and right gastric artery
b. proper hepatic artery and superior mesenteric artery
c. gastroduodenal artery and proper hepatic artery
d. superior mesenteric artery and gastroduodenal artery
d
99
A 43 year old female with a history of hepatitis C presents with jaundice, increased abdominal girth, and pain. The most probable US finding in the liver will be:
a. metastasis from GI tract
b. schistosomiasis and splenic atrophy
c. fatty infiltration
d. cirrhosis and ascites
d
100
Which of the following would be an unexpected finding in a patient that had a vasectomy 4 years ago?
a. spermatoceles
b. atrophied epididymis
c. dilated vas deferens
d. tubular ectasia of the epididymis
b
