URR 74 Flashcards
(100 cards)
1
Q
A thickened area of normal renal parenchyma between 2 pyramids is called:
a. duplicated collecting system
b. dromedary hump
c. column of Bertin
d. fetal lobulation
A
c
2
Q
The aorta bifurcates:
a. at the level of the L4 vertebral body
b. at the level of the sacrum
c. 3-5 cm below the umbilicus
d. 3-5 cm below the SMA origin
A
a
3
Q
The renal arteries branch from the aorta just below the origin of the ___.
a. inferior mesenteric artery
b. gonadal arteries
c. celiac axis
d. superior mesenteric artery
A
d
4
Q
Hutch diverticula are identified in the:
a. gallbladder
b. large bowel
c. urinary bladder
d. small bowel
A
c
5
Q
Which of the following vessels is not directly connected to the IVC?
a. right suprarenal vein
b. right gonadal vein
c. left gonadal vein
d. right renal vein
A
c
6
Q
The term “splanchnic arteries” describes which of the following vessels?
a. celiac, SMA, and IMA
b. hepatic, renal, splenic, and celiac arteries
c. renal, suprarenal, splenic, and gastric arteries
d. all arterial branches of the abdominal aorta from the diaphragm to the umbilicus
A
a
7
Q
What vessel can be used to differentiate the left renal vein and splenic vein on the ultrasound exam?
a. right renal artery
b. superior mesenteric artery
c. superior mesenteric vein
d. left renal artery
A
b
8
Q
When evaluating an infant for pyloric stenosis, the infant should be placed in the ___ position for better visualization of the pylorus.
a. prone
b. left lateral decubitus
c. semi-erect
d. right lateral decubitus
A
b
9
Q
Which of the following describes the placement for the second line for measurement of the alpha angle during an infant hip evaluation?
a. extends from the bony edge of the acetabulum to the lateral aspect of the femoral head
b. extends from the iliac bone, along the labrum, and the medial aspect of the femoral head
c. extends from the iliac bone, along the labrum, and the lateral aspect of the femoral head
d. aligned with iliac bone and extends through the center of the femoral head
A
b
10
Q
Unintended weight loss is a common symptom in patients with:
a. hyperglycemia
b. carcinoma
c. ascites
d. hypothyroidism
A
b
11
Q
Cullen sign is hemorrhagic discoloration of the umbilical area caused by ___. Grey Turner sign is hemorrhagic discoloration of the left flank caused by ___.
a. rectus sheath hematoma, subcapsular renal hematoma
b. cavernous transformation, gastric varices
c. umbilical vein recanalization, gastric varices
d. intraperitoneal hemorrhage, hemorrhagic pancreatitis
A
d
12
Q
What patient age is preferred for performing ultrasound of the infant hips?
a. >6 months
b. 4-6 months
c. 4-6 weeks
d. 1-2 weeks
A
c
13
Q
Which of the following is an important part of a transrectal ultrasound performed prior to brachytherapy?
a. to measure the distance from the prostate to the anterior abdominal wall
b. to determine prostate size and volume
c. to locate the main arterial branch that is feeding the carcinoma
d. to obtain a PW Doppler signal from the base and apex of the gland
A
b
14
Q
Bowel peristalsis in the scrotal sac is a definitive sign of:
a. orchitis
b. umbilical hernia
c. varicocele
d. inguinal hernia
A
d
15
Q
When evaluating the achilles tendon, the thickness of the tendon should be obtained in what imaging plane?
a. oblique
b. transverse
c. coronal
d. sagittal
A
b
16
Q
A pituitary tumor that is causing Cushing disease will cause what lab value(s) to be increased?
a. adrenocorticotropic hormone only
b. aldosterone only
c. cortisol only
d. adrenocorticotropic hormone and cortisol
A
d
17
Q
Which of the following prostate abnormalities most significantly elevates the amount of serum prostate specific antigen in lab testing?
a. prostatitis
b. carcinoma
c. abscess
d. benign prostatic hypertrophy
A
b
18
Q
The Graf classification requires the measurement of __ to determine the presence of abnormal findings on the ultrasound exam.
a. vessel diameter
b. resistive index
c. end diastolic velocity
d. alpha and beta angles
A
d
19
Q
A mother presents with her 3 mo old infant due to excessive vomiting and crying for 3 days. The referring physician suspects a lactobezoar may be the problem. Where will you look for this abnormality?
a. anywhere along the digestive tract
b. the appendix
c. gallbladder
d. urinary bladder
A
a
20
Q
The __ sign is a clinical finding with pyloric stenosis, while the __ sign is a Sonographic sign of pyloric stenosis
a. olive, doughnut
b. bird, snowman
c. pseudokidney, yin yang
d. Murphy, Homan’s
A
a
21
Q
Which of the following is a stress maneuver performed when evaluating infant hips?
a. allis maneuver
b. Ortolani maneuver
c. Graf maneuver
d. Baker maneuver
A
b
22
Q
Which of the following is a stress maneuver performed when evaluating infant hips?
a. Baker maneuver
b. Graf maneuver
c. Allis maneuver
d. Barlow maneuver
A
d
23
Q
Which of the following chest masses would be most easily evaluated with ultrasound?
a. a mass located between the bronchial tubes
b. a mass located between the pleura and the chest wall
c. a mass located in the central portion of the lung
d. a mass located in the posterior lobes
A
b
24
Q
What patient position is used to evaluate the Achilles’ tendon with ultrasound
a. standing
b. seated, knee and ankle flexed
c. seat, knee flexed and ankle extended
d. prone, feet dangling
A
d
25
Excessive androgen production is commonly associated with adrenal hyperplasia, adrenal cortical cancer, and polycystic ovarian disease. How will these increased androgen levels present as a clinical finding?
a. pedal edema
b. hirsutism
c. excessive nausea and vomiting
d. alopecia
b
26
Sjrogen syndrome is an immune system disorder that commonly affects:
a. the salivary glands
b. bile ducts
c. adrenal glands
d. thyroid
a
27
Which of the following describes the proper technique for visualization of the bicep tendon?
a. longitudinal probe position on the posterior upper arm, just proximal to the elbow joint
b. oblique probe position with the notch turned 60 degrees medially; placed on the anterior upper arm, just proximal to the elbow joint
c. oblique probe position with the notch turned 30 degrees medially; placed on the posterior upper arm, just proximal to the elbow joint
d. scanning with the US beam as perpendicular to the tendon as possible to improve visualization
d
28
An average sized patient presents with a fever, acute RLQ pain and vomiting. The ER physician wants to rule out appendicitis in this patient. Which of the following techniques would be used in the US exam?
a. ask the patient to perform the Valsalva maneuver while scanning
b. use a stand-off pad to better visualize the superficial bowel loops
c. apply graded transducer compression to the area of interest
d. ask the patient to drink 32 oz of water and fill the bladder prior to the exam
c
29
When removing a protective gown:
a. 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
b. 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
c. 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
d. remove your gloves, untie the strings, pull the gown forward from the center of the gown to remove it with the exposed side out, roll it into a ball, wash your hands
b
30
Which of the following describes the patient position for a transrectal prostate ultrasound?
a. left lateral decubitus or lithotomy position
b. lithotomy or prone
c. trendelenburg or supine
d. prone or fowler
a
31
Chest sonography is a valuable tool that can be used to evaluate all of the following, except?
a. pulmonary sequestration
b. pleural effusion
c. the number of lobes in each lung
d. pneumothorax
c
32
A 55 year old male patient presents with a script that states "pelvic ultrasound; post biopsy, Gleason score of 8." What should you expect to find on the exam?
a. lymphadenopathy and metastasis related to transitional cell bladder cancer
b. lymphadenopathy and metastasis related to prostate cancer
c. inguinal hernia caused by recent bladder wall biopsy
d. bladder puncture caused by recent biopsy of the seminal vesicle
b
33
Which of the following is a symptom of Addison Disease?
a. hyperkalemia
b. hernatremia
c. weight gain
d. hypertension
a
34
Which of the following is a contraindication for transrectal ultrasound?
a. significant prostatitis
b. lesions of the ileocecal valve
c. Crohn disease
d. hepatitis
a
35
A patient presents with a history of Conn Syndrome. Which of the following hormone levels will be increased?
a. aldosterone
b. epinephrine
c. cortisol
d. adrenocorticotropic hormone
a
36
Which of the following patients would need a guardian to sign an informed consent form for a liver nodule ablation?
a. a patient that does not speak english
b. a patient with Alzheimer disease
c. A patient with Parkinson disease
d. A blind patient
b
37
Which of the following abnormalities would benefit the most from the administration of a water enema during the ultrasound evaluation?
a. distal abdominal aorta
b. pancreatic adenocarcinoma (head)
c. adenocarcinoma of the descending colon
d. gastric sarcoma
c
38
What clinical symptoms are common with adrenal hemorrhage?
a. jaundice and low hematocrit
b. weight loss and edema
c. nausea and vomiting
d. hyperkalemia and dysuria
a
39
If you are unable to locate the prostate on transrectal ultrasound:
a. have the patient drink water and partially fill their bladder
b. ask the patient to perform the Valsalva maneuver
c. use firm pressure to insert the transducer 2-3 inches further into the rectum
d. introduce 30-50 cc of air into the probe cover
a
40
Red currant jelly stool is a common clinical finding associated with:
a. pyloric stenosis
b. mesenteric ischemia
c. intussusception
d. appendicitis
c
41
If a patient has a non-reactive Thompson Test, what problem do they have?
a. complete tear of the Achilles tendon
b. fungal abscess of the liver
c. hydatid cyst of the liver
d. baker cyst in the popliteal fossa
a
42
Chronic steroid use is the most common cause of:
a. Cushing disease
b. Cushing syndrome
c. Conn disease
d. Addison disease
b
43
All of the following are common symptoms of colitis, except:
a. watery diarrhea
b. low grade fever
c. bloody diarrhea
d. hemoptysis
d
44
You are providing instructions for a patient that needs a core needle biopsy. Which of the following medications should be taken as initially prescribed until the day of the procedure?
a. ibuprofen
b. aspirin
c. lovenox
d. hypertension medication
d
45
Which of the following structures can be used as an acoustic window when evaluating the pediatric mediastinum?
a. lung pleura
b. diaphragm
c. thymus
d. thyroid
c
46
Which of the following are clinical findings related to a pheochromocytoma?
a. bradycardia and fatigue
b. palpitations and skin discoloration
c. hirsutism and bilateral pedal edema
d. increased adrenaline and anxiety
d
47
The most common use of chest sonography is to evaluate:
a. a known pulmonary embolism
b. a complete or partial radiopaque hemithorax
c. suspected lung cancer
d. suspected atelectasis
b
48
Which of the following describes the placement for the first line for measurement of the alpha angle during an infant hip evaluation?
a. extends from the bony edge of the acetabulum to the medial aspect of the femoral head
b. extends from the bony edge of the acetabulum to the lateral aspect of the femoral head
c. extends from the iliac bone along the labrum
d. aligned with iliac bone and extends through femoral head
d
49
Hyperpigmentation of the skin that results in brownish discoloration is a clinical sign of:
a. Addison disease
b. Adrenal hemorrhage
c. Cushing syndrome
d. Conn disease
a
50
What does McBurney point refer to?
a. the point of greatest tenderness in the RUQ in a patient with cholecystitis
b. an ectopic mass of endometriosis on the right kidney
c. an ectopic ridge of thyroid tissue in the chest
d. the most common location of the appendix
d
51
Prostatic Acid Phosphatase (PAP) levels are increased with:
a. prostatitis
b. prostate carcinoma
c. BPH
d. prostate calcifications
b
52
Which of the following is a symptom of Addison disease?
a. hypertension
b. hypokalemia
c. hyponatremia
d. weight gain
c
53
Which of the following arteries are evaluated during a penile duplex exam for erectile dysfunction?
a. dorsal
b. ventral
c. cavernosal
d. urethral
c
54
A 40 year old male presents for an abdominal US exam with a history of anxiety, headaches, and excessive sweating. His current BP is 175/90 mmHg with a pulse of 102 bpm. What is the referring doctor expecting to find?
a. aortic aneurysm
b. adenoma
c. Budd Chiari syndrome
d. Pheochromocytoma
d
55
A patient presents with a history of Addison disease. Which of the following hormone levels will be increased?
a. adenocorticotropic hormone
b. cortisol
c. aldosterone
d. epinephrine
a
56
When evaluating an infant hip, the transducer is placed __, but for a pediatric hip evaluation the transducer is placed __.
a. on the lateral hip, on the posterior hip
b. on the anterior hip, on the posterior hip
c. on the lateral hip, on the anterior hip
d. on the anterior hip, on the lateral hip
c
57
Which of the following are common symptoms of Cushing syndrome?
a. hypotension and fever
b. hyperglycemia and hirsutism
c. anorexia and vomiting
d. cholecystitis and ascites
b
58
A mother who is currently breast feeding presents with a painful and reddened area on the UOQ of the right breast. She states that she first noticed it two days ago. what is the most likely finding on her exam?
a. cyst
b. peurperal mastitis
c. inflammatory carcinoma
d. paget disease
b
59
A patient presents with a history of Cushing syndrome and an adrenal tumor. What lab results are expected in the clinical findings?
a. elevated serum levels of ACTH and elevated cortisol in urine
b. elevated epinephrine levels in the urine
c. elevated serum levels of aldosterone
d. normal serum ACTH and elevated cortisol levels in the urine
d
60
Which of the following sonographic techniques is most helpful to evaluate a possible inguinal hernia?
a. color doppler
b. tissue doppler
c. pw doppler
d. m-mode
a
61
When the prostate is enlarged, what other structures should be evaluated for related findings?
a. renal veins for Nutcracker syndrome
b. kidneys for hydronephrosis
c. portal vein for thrombosis
d. renal arteries for thrombosis
b
62
Decreased hematocrit is associated with which of the following?
a. dehydration
b. adrenal hemorrhage
c. polycythemia vera
d. living at high altitude
b
63
Which of the following indicates a serious complication associated with a bowel obstruction?
a. visualization of the hastral markings
b. lack of color display of the vascularity of the bowel wall
c. visualization of the plicae circulares
d. increased color display of the vascularity of the bowel wall
b
64
A positive Tinel sign indicates:
a. pyloric stenosis
b. ruptured Achilles' tendon
c. patellar tendinosis
d. carpal tunnel syndrome
d
65
Which of the following describes the proper technique for the evaluation of a pediatric hip for suspected transient arthritis?
a. a 3 MHz or lower transducer is recommended to penetrate the bony structures of the hip
b. a stand off pad is required for evaluation of the superficial structures of the hip joint
c. comparison views of the unaffected hip should always be obtained
d. the curved array is used for the best evaluation of the curved structures in the boney hip
c
66
Hypernatremia and hypokalemia are clinical signs of:
a. adrenal hemorrhage
b. addison disease
c. conn syndrome
d. adrenal myelolipoma
c
67
All of the following are clinical signs of congenital hip dysplasia, except:
a. Allis sign
b. asymmetric skin folds of the hip and thigh
c. Barlow sign
d. palpable clunking sound on physical exam
c
68
Purple stretch marks (striae) on the lateral and lower abdomen can be a clinical sign of:
a. Addison disease
b. Adrenal hemorrhage
c. Conn disease
d. Cushing syndrome
d
69
Internal rotation of the arm is preferred for evaluation of the __ tendon, while external rotation of the arm is preferred for evaluation of __ tendon.
a. flexor, biceps
b. subscapularis, supraspinatus
c. long bicep, short bicep
d. spuraspinatus, subcapsularis
d
70
A patient presents for a neck ultrasound due to swelling under the angle of the jaw and anterior to the ear. She also complains of a dry mouth, dry cough, and dry eyes. These clinical findings are most suggestive of:
a. hemolytic anemia
b. Hashimoto thyroiditis
c. Sjogren syndrome
d. Graves' disease
c
71
Which of the following will cause elevated serum amylase?
a. use of anabolic steroids and parathyroid adenoma
b. chronic pancreatitis and pyelonephritis
c. tumor of the submandibular gland and use of oral contraceptives
d. parathyroid adenoma and renal cell carcinoma
c
72
Which of the following should always be included on the technologist worksheet that is given to the radiologist with the images?
a. limitations of exam performance
b. differential diagnoses for abnormal findings
c. follow up recommendations
d. thermal index setting during the exam
a
73
A patient is referred to rule out cryptorchidism. You evaluate the scrotal sac with US and demonstrate the presence of a right testicle only. Where will you look first for the left testicle?
a. right paracolic gutter
b. left paracolic gutter
c. left inguinal canal
d. right inguinal canal
c
74
Which of the following correctly describes a way to tell the difference between a vasovagal response and anaphylaxis caused by contrast injection?
a. hypertension is a sign of vasovagal response, while hypotension is a sign of anaphylaxis
b. pallor is a sign of vasovagal response while erythema is a sign of anaphylaxis
c. tachycardia is a sign of vasovagal response, while bradycardia is a sign anaphylaxis
d. a feeling of impending doom is a sign of a vasovagal response, while dizziness and near syncope are signs of anaphylasis
b
75
Why is it necessary to obtain the PT and INR lab values prior to a liver biopsy?
a to assess the patient's risk for post procedure thrombosis of the portal vein
b. to assess the extent of cirrhosis within the liver
c. to assess the patient's risk for post procedure hemorrhage
d. to assess the patient's risk for post procedure infection
c
76
Which of the following is not a symptom of hyperthyroidism?
a. increased heart rate
b. excessive sweating
c. weight gain
d. weight loss
c
77
Which of the following describes the table placement for performing an ultrasound exam?
a. the table should be placed in the reverse trendelenburg position to assist in moving blood flow into the cerebral vessels
b. the table should be placed in the trendelenburg position to assist in moving blood flow into the cerebral vessels
c. table height should allow the sonographers arm to be slightly adducted with the wrist fully flexed toward the side being examined
d. table height should allow sonongraphers arm to be slightly abducted with the wrist fully extended
d
78
Which of the following would be an unexpected finding in a patient that had a vasectomy 4 years ago?
a. tubular ectasia of the epididymis
b. spermatoceles
c. dilated vas deferens
d. atrophied epididymis
d
79
A 3cm hypoechoic mass is identified in the right testicle. The radiologist requests that you perform an abdominal US. What are you looking for?
a. renal vein tumor invasion
b. periaortic lymphadenopathy
c. associated Crohn disease
d. other manifestations of acute tubular necrosis
b
80
Which of the following correctly describes the preferred patient position for a renal biopsy?
a. posterior oblique with ipsilateral arm extended over the head
b. prone with a pillow under the abdomen to accentuate the normal curvature of the spine
c. supine with a pillow under the back to accentuate the normal curvature of the spine
d. decubitus position with knees drawn to chest
b
81
The blue dot sign is a clinical finding of:
a. thyroid adenoma
b. torsion of the testicular appendage
c. bladder calculi
d. testicular varicocele
b
82
A patient is scheduled for a liver biopsy with the radiologist in the morning. What lab values will the doctor want to see before the procedure is performed?
a. RBC and platelet count
b. prothrombin time and INR
c. WBC count
d. BUN and creatinine
b
83
What ultrasound guided procedure is performed using the area lateral to the rectus abdominis muscle in the left lower abdomen as the most common puncture site?
a. ethanol ablation
b. lovenox injection
c. thoracentesis
d. paracentesis
d
84
Which of the following describes the best patient position for a thoracentesis?
a. left lateral decubitus
b. semi-erect with the knees raised towards the chest
c. right lateral decubitus
d. seated leaning forward over a table
d
85
When using color Doppler to compare testicular perfusion, you should always:
a. document flow after the Valsalva release
b. document normal flow in one testicle and then adjust color scale and wall filter settings to demonstrate the same amount of flow in the other testicle
c. document flow during the Valsalva strain
d. use the dual screen function to demonstrate an image of both testicles
d
86
The National Patient Safety Standards recommend a "time out" period prior to the start of an invasive procedure. How will you comply with this recommendation during a renal biopsy?
a. Record an image that says "time out" when the radiologist is adjusting the needle
b. record a blank image that says "time out" after the consent form is signed and then another image at the start of the procedure
c. allow the patient to take a 15-20 minute walk/ break before they are set up for the procedure
d. allow the patient to take a break between biopsy samples and record the downtime in the patient chart
b
87
Uncomplicated cysts and fluid collections will appear black on ultrasound and ___ on CT scan.
a. light gray
b. black
c. white
d. dark gray
d
88
Which of the following patients would benefit from a FAST examination?
a. patient with suspected prostate cancer
b. patient with a history of abdominal pain after a fall from a ladder yesterday
c. patient with abdominal bruit, weight loss, and post prandial pain
d. patient with history of RUQ pain after eating
b
89
Air in the gallbladder wall will be demonstrated as areas of hyperechogenicity with posterior dirty shadowing and ring down artifact on sonography. How is this demonstrated on a CT exam?
a. the gallbladder will demonstrate linear spokes of shadowing from the pockets of air in the wall
b. the gallbladder will demonstrate black areas within the wall where air is present
c. the gallbladder will demonstrate no discernible changes on a CT scan with the presence of air in the wall
d. the gallbladder will demonstrate bright white areas within the wall were air is present.
b
90
A patient scheduled for a transrectal prostate biopsy must perform all of the following prior to the exam, except:
a. begin taking several day course of antibiotics
b. nothing to eat or drink at least 8 hours before the procedure
c. have lab testing for PT/INR levels
d. perform a cleansing enema
b
91
All of the following correctly describe proper behavior related to a sterile field, except:
a. hands and elbows must be kept above the level of the table
b. when in doubt about sterility, discard the potentially contaminated item and begin again
c. sterile gloves must be used to open the procedure tray
d. sterile individuals must pass each other back to back when moving around the procedure room
c
92
Which of the following is a contraindication for a renal biopsy?
a. polycystic kidney disease
b. AIDS
c. current Warfarin use
d. current antibiotic treatment
c
93
An obese patient has a known hepatoma in the posterior aspect of the right lobe of the liver. Which probe would you use to assist the radiologist in performing a biopsy?
a. 2.25 MHz, long focus
b.3.5 MHz, long focus
c. 5 MHz, short focus
d. 2.25 MHz, short focus
a
94
Which of the following would be considered a critical finding on a Point of Care Ultrasound Exam?
a. nonobstructive renal calculi
b. pneumothorax
c. severe pericardial effusion
d. 4 cm abdominal aortic aneurysm
c
95
Prehn sign is used to differentiate what two abnormalities?
a. renal cell carcinoma and oncocytoma
b. seminoma and yolk sac tumor
c. testicular torsion and epididymo-orchitis
d. fungal liver abscess and amoebic liver abscess
c
96
A patient presents for a thyroid ultrasound due to an incidental finding on a nuclear medicine exam. The report states there is a 2 cm hot nodule in the upper left lobe. Which of the following is the most likely finding on the ultrasound exam?
a. complex cyst with peripheral hypervascularity
b. solid mass with hypoechoic halo
c. cystic mass
d. solid mass with microcalcifications and irregular margins
b
97
A patient presents with mild scrotal pain and swelling on the left side that started 2-3 days ago. The patient awoke this morning with a slight fever and increased swelling. All of the following should be a suspected cause for the symptoms, except:
a. orchitis
b. epididymitis
c. hydrocele
d. testicular infarct
d
98
Patients with new onset of secondary hyperparathyroidism will demonstrate:
a. increased serum calcium, vitamin D and PTH
b. increased vitamin K and D levels
c. low serum calcium and vitamin D levels with high PTH levels
d. increased vitamin D levels, normal calcium and PTH levels
c
99
Hypophophatemia is a clinical finding that is most suggestive of:
a. hyperthyroidism
b. renal failure
c. hyperparathyroidism
d. internal hemorrhage
c
100
Which of the following would improve the visualization of the thyroid isthmus?
a. transducer with a deep focus
b. color doppler
c. stand-off pad
d. curvilinear transducer
c
