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URR 77 Flashcards

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1
Q

A patient presents with moderate RLQ pain and a low grade fever. An US exam of the area demonstrates a 7mm thick aperistaltic tube that is noncompressible. Which of the following best describes the findings?
a. Crohn disease
b. intussusception
c. appendicitis
d. varicocele

A

c

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2
Q

Which of the following is not usually treated by surgical intervention?
a. pyloric stenosis
b. spigelian hernia
c. appendicitis
d. intussusception

A

d

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3
Q

Which of the following describes the sonographic appearance of adrenal hyperplasia?
a. thickened, echogenic cortex and loss of differentiation with the medulla
b. complex cystic mass formation in both glands
c. bilateral, diffuse gland enlargement
d. multiple small echogenic nodules in the affected gland

A

c

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4
Q

A 70 year old male presents for transrectal ultrasound due to PSA level of 7 ng/ml, urinary frequency and hematuria. The US exam demonstrates a 40cc prostate volume with heterogeneity and calcifications centrally. The peripheral zone appears normal. These findings are most consistent with:
a. normal prostate
b. prostatitis
c. benign prostatic hypertrophy
d. carcinoma of the prostate

A

c

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5
Q

Which of the following statements is true regarding rectus sheath hematomas?
a. an acute hematoma will appear hyperechoic compared to surrounding tissues
b. arcuate line stops the blood from extending across the midline
c. linea alba stops the blood from spreading into the pelvis
d. coumadin therapy is a common cause for hematoma formation

A

d

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6
Q

What causes symptoms in a patient with carpal tunnel syndrome?
a. impingement of the palmar arch
b. impingement of the median nerve
c. impingement of the radial nerve
d. impingement of the ulnar nerve

A

b

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7
Q

The development of scar tissue and fibrous plaque formation involving the tunica albuginea of the penis describes:
a. penile fracture
b. peyronie disease
c. priapism
d. squamous cell carcinoma of the penis

A

b

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8
Q

Acute pain in the RLQ is commonly associated with __, while acute pain in the LLQ is commonly associated with ___.
a. appendicitis, cecal colitis
b. appendicitis, diverticulitis
c. diverticulitis, irritable bowel syndrome
d. appendicitis, irritable bowel syndrome

A

b

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9
Q

__ is acute symptomatic inflammation of a tendon, while __ refers to asymptomatic degenerative changes in the tendon.
a. sprain, tear
b. tendinitis, tendinosis
c. tear, sprain
d. tendinosis, tendinitis

A

b

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10
Q

Retroperitoneal lymphadenopathy is an expected finding with what primary malignancy?
a. hepatitis
b. staghorn calculus
c. gastric carcinoma
d. renal cell carcinoma

A

d

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11
Q

A patient presents for a superficial ultrasound to rule out a foreign body in their foot. Which of the following statements is true regarding the evaluation of a this patient?
a. The radiologist should be consulted because MRI is preferred over sonography for foreign body detection
b. inflammation usually leads to a hypoechoic ring surrounding the foreign body
c. most foreign bodies are echogenic with significant posterior enhancement
d. improved visualization of the foreign body occurs as the US beam becomes more parallel to the structure

A

b

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12
Q

A right sided pheochromocytoma will displace the ipsilateral kidney __.
a. medially
b. superiorly
c. anteriorly
d. inferiorly

A

d

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13
Q

Which of the following is NOT required when reporting a suspected hernia?
a. tenderness of the area of interest
b. reducibility
c. contents of the hernia sac
d. suspected age of the hernia

A

d

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14
Q

Which of the following is true regarding pyloric stenosis?
a. more common in females
b. presents as a short thick pyloric canal
c. abnormal muscle thickness >4mm
d. abnormal channel length >1mm

A

c

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15
Q

Which of the following correctly describes myelolipoma?
a. originate in the adrenal medulla
b. hypoechoic mass with extensive posterior enhancement
c. adrenal tumor that is composed of fat and bony elements
d. may see varied levels of attenuation lateral to the mass

A

c

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16
Q

Bacterial infection, internal bleeding, and viral infection typically share what ultrasound finding?
a. abscess formation
b. retroperitoneal fibrosis
c. free air in the peritoneal cavity
d. ascites with debris/septations

A

d

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17
Q

The diaphragm sign, displaced crus sign, and bare area sign are indicative of what abnormality?
a. diaphragmatic hernia
b. ascites
c. pneumonia
d. pleural effusion

A

d

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18
Q

Bacterial infection, internal bleeding, and viral infection typically share what abdominal ultrasound finding?
a. abscess formation
b. free air in the peritoneal cavity
c. retroperitoneal fibrosis
d. ascites with debris/septations

A

d

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19
Q

A hernia with a narrow neck:
a. should not be evaluated with the Valsalva maneuver
b. can be closed with compression therapy instead of surgery
c. is usually completely reducible with compression
d. is at an increased risk for incarceration and strangulation

A

d

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20
Q

A hematoma of the rectus abdominis muscle that occurs below the arcuate line can extend into:
a. the umbilicus
b. pouch of Douglas
c. Morison pouch
d. space of Retzius

A

d

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21
Q

What is the most accurate sonographic predictor of pyloric stenosis?
a. muscle wall thickness
b. gastric volume
c. channel length
d. cross-sectional diameter

A

a

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22
Q

A doctor refers an infant for a chest ultrasound exam due to a history of a chest mass seen in the left lower lobe on an x-ray. A well defined hypoechoic mass is identified in the area of interest. Color Doppler demonstrates arterial supply to the mass from a branch of the aorta. These findings are most suggestive of:
a. hemothorax
b. pneumonia
c. pulmonary sequestration
d. atelectasis

A

c

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23
Q

Creeping fat is a sign of:
a. Wilson disease
b. Crohn disease
c. Pancreatic adenocarcinoma
d. mesenteric ischemia

A

b

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24
Q

Which of the following is a common cause of exudate pleural effusion?
a. kidney failure
b. congestive heart failure
c. malignancy
d. cirrhosis

A

c

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25
Most malignant tumors will demonstrate __ flow on Doppler evaluation. a. low resistance b. increased diastolic flow reversal c. high resistance d. absent
a
26
Which of the following describes the best way to image the patellar tendon with ultrasound? a. patient must be evaluated with the leg fully extended b. due to the proximity of the tendon to the bone, the patellar tendon cannot be evaluated with US c. evaluate the patellar attachments from an anterior approach d. the central portion of the tendon is best imaged from the posterior approach
c
27
Which of the following is the most common cancer of the GI tract? a. Kaposi sarcoma b. Krukenberg tumor c. Adenocarcinoma d. Gastric sarcoma
c
28
Priapism is an abnormality of: a. the testicles b. the urinary bladder c. the prostate d. the penis
d
29
What congenital defect presents as a blind-ended, fluid filled bowel loop connected to a normal peristalsing small bowel loop? a. Meckel diverticulum b. appendicitis c. pyloric stenosis d. epiploic appendagitis
a
30
Which of the following is a malignant mass of the retroperitoneum that is composed of muscle tissue? a. mesothelioma b. rhabdomyosaroma c. fibrosarcoma d. liposarcoma
b
31
When diaphragmatic paralysis is suspected, a. the diaphragmatic thickness should be measured during inspiration and expiration b. thick linear calcifications form in the affected side c. the patient should be evaluated for free air in the abdomen d. the patient should be evaluated for free air in the chest
a
32
What is the primary reason a retroperitoneal lymph node dissection is performed? a. to determine the extent of a systemic infection b. to determine if systemic chemotherapy is needed c. to prevent lymphocele formation on an upcoming renal transplant d. to evaluate the lymph tissue for functionality
b
33
Which of the following correctly describes penile cancer? a. most common type of penile cancer is transitional cell carcinoma b. associated with inguinal lymphadenopathy c. usually found on the proximal shaft in circumcised men d. most commonly demonstrates a complex cystic mass
b
34
__ refers to a collection of serous fluid in the popliteal fossa. a. arthroma b. ganglion cyst c. Thompson cyst d. Baker cyst
d
35
Which of the following statements is true regarding retroperitoneal lymph nodes? a. both normal and abnormal lymph nodes exhibit mild posterior shadowing b. normal lymph nodes exhibit posterior shadowing c. abnormal lymph nodes exhibit posterior enhancement d. a lymph node is considered abnormally enlarged once it reaches 3 cm in length
c
36
Phlegmon formation, abscess formation, prominent pericecal fat and loculated pericecal fluid collections are sonographic findings that are most suggestive of: a. acute pancreatitis b. mononucleosis c. Addison disease d. appendiceal perforation
d
37
An enlarged, rounded lymph node with loss of hilar definition is most suggestive of associated __, while an enlarged, oval lymph node with normal hilar characteristics is most suggestive of associated __. a. bacterial infection, viral infection b. infection, malignancy c. malignancy, infection d. viral infection, bacterial infection
c
38
Zenker diverticulum can be mistaken for: a. the appendix b. a thyroid mass c. a bowel obstruction d. a dilated bile duct
b
39
A mass is identified in the left testicle. It is rounded with well-defined borders. There are internal rings of hyperechoic and hypoechoic tissues giving the appearance of an onion. No color flow is demonstrated within the mass. These findings are most consistent with: a. sperm granuloma b. dilated rete testes c. testicular infarct d. epidermoid cyst
d
40
Aneurysms of the iliac and popliteal arteries are commonly associated with: a. pancreatic pseudocysts b. aortic aneurysm c. prostate carcinoma d. renal failure
b
41
Which of the following statements best describes the Doppler tracing found in the stalk of a pseudoaneurysm? a. phasic forward flow b. high resistance to and fro flow c. continuous forward flow d. low resistance to and fro flow
b
42
A 16 year old male presents with acute onset of significant left scrotal pain. The US exam reveals a 1cm hypoechoic, heterogeneous mass located between the head of the epididymis and the testicle. The mass demonstrates no vascularity with color Doppler evaluation. Normal flow is demonstrated in the epididymis and testicle. These findings are most suggestive of: a. sarcoidosis b. seminoma c. torsion of the appendix testis d. adenomatoid tumor
c
43
A patient presents with a fever, fatigue, hoarseness, and a painful thyroid on clinical examination. The lab test results indicate low levels of thyroid stimulating hormone and high levels of T3 and T4. These findings are most suggestive of: a. De Quervain thyroiditis b. Grave disease c. Sjrogen disease d. Hashimoto thyroiditis
a
44
A 1 year old presents for a testicular sonogram due to a palpable lump. The lab work in the chart indicates high levels of alpha fetoprotein. A mostly solid intratesticular mass is identified in the right testicle. There is small area of possible necrosis centrally. These findings are most consistent with: a. lymphoma b. yolk sac tumor c. epidermoid cyst d. seminoma
b
45
A patient presents for a thyroid US due to increased T3 and T4 levels in the blood. Additional symptoms include weight loss, night sweats, and exophthalmos. The thyroid demonstrates an increase in size, and a diffuse decrease in echogenicity with a coarse, heterogeneous texture. Which of the following best describes these findings? a. Hurthle cell cancer b. Graves' disease c. Goiter d. Hashimoto disease
b
46
Leydig cell tumors of the testicle will demonstrate high serum levels of __ which can lead to __. a. testosterone, precocious puberty b. AFP, cancer c. hematocrit, thrombus formation d. bHCG, cancer
a
47
A solid nodule in the left lobe of the thyroid that measures 2cm AP and 1cm width is most suggestive of: a. papillary carcinoma b. adenoma c. anaplastic carcinoma d. colloid cyst
a
48
Which of the following is the most commonly occurring germ cell tumor of the testicle? a. choriocarcinoma b. embryonal cell tumor c. teratoma d. seminoma
d
49
A small, hypoechoic testicular mass with a large calcification in a patient with gynecomastia is most likely a: a. leukemia b. lymphoma c. Sertoli cell tumor d. Seminoma
c
50
A patient presents for a neck ultrasound that has a history of papillary carcinoma and bilateral thyroidectomy. What area of the neck is most commonly involved in recurrence? a. Level I lymph nodes below mylohyoid muscle to the lower margin of the hyoid bone b. Level VI lymph nodes from the inferior margin of hyoid bone to the manubrium c. Level VII lymph nodes infraclavicular and anterior mediastinal d. Level III and IV lymph nodes between the carotid artery and the sternocleidomastoid muscle
d
51
The most common cause of acute scrotal pain in post pubertal men is: a. acute epididymitis b. orchitis c. hydrocele d. torsion
a
52
Which testicular tumor is composed of bone, cartilage and smooth muscle fibers? a. yolk sac tumor b. teratoma c. choriocarcinoma d. seminoma
b
53
Extrinsic compression of the IVC is an expected finding with: a. congestive heart failure or large AAA b. large AAA or large hepatoma c. congestive heart failure or mass in the diaphragmatic crura d. pancreatic pseudocyst or portal HTN
b
54
The halo sign is a sonographic characteristic of what thyroid abnormality? a. germ cell tumor b. adenoma c. complex cyst d. papillary carcinoma
b
55
A vein in the pampiniform plexus is considered abnormally dilated when the diameter exceeds: a. 8mm b. 6mm c. 2mm d. 4mm
c
56
When evaluating a patient with an aortic endograft, an increase in the aortic sac size of __ or more, suggests an endoleak is present. a. 1.5 cm b. 0.2 cm c. 0.9 cm d. 0.6 cm
d
57
Median arcuate ligament syndrome involves compression of which vessel during respiration? a. celiac axis b. main portal vein c. superior mesenteric artery d. inferior mesenteric artery
a
58
Gonadal stromal tumors should be suspected in a patient with a painless testicular mass and: a. elevated AFP levels b. hematuria c. scrotal varicosities d. gynecomastia
d
59
Which type of thyroid cancer is most lethal? a. follicular b. medullary c. anaplastic d. papillary
c
60
Which of the following is a common complication of a Leydig cell tumor? a. metastasis b. gynecomastia c. cellulitis d. varicocele
b
61
The most common benign, solid lesion of the thyroid is ___. a. adenoma b. cyst c. hematoma d. goiter
a
62
Which of the following correctly describes Marfan syndrome? a. abdominal situs defects are common b. genetic disorder that affects connective tissues of the heart, vessels, and bones c. patients are usually less than 48 inches tall with foreshortened limbs and digits d. genetic weakness of all arterial walls resulting in the formation of aneurysms throughout the systemic circulatory system
b
63
A patient with a seminoma of the left testicle will usually be treated by __, while a patient with a non-seminomatous tumor of the left testicle will usually be treated by __. a. bilateral orchiectomy, unilateral orchiectomy b. unilateral orchiectomy, radiation therapy and unilateral orchiectomy c. chemotherapy, radiation therapy d. unilateral orchiectomy and chemotherapy, unilateral orchiectomy
d
64
Which of the following is most suggestive of Ormond disease? a. bilateral staghorn calculi and posterior urethral valves b. extrinsic compression of the celiac artery c. aortic arche aneurysm formation d. pedal edema and scrotal swelling
d
65
What therapeutic device is implanted inside the distal IVC? a. pacemaker b. greenfield filter c. stent d. catheter
b
66
Which of the following statements best describes the appearance of color Doppler evaluation of a testicular abscess? a. There will be focal areas of increased vascularity in the central abscess and limited color flow demonstrated at the periphery of the abscess b. due to fluid accumulation with inflammation, color Doppler does not usually demonstrate flow around or within an abscess c. there will be no color flow demonstrated centrally with increased color flow displayed around the periphery of the absces d. there will be a significant increase in vascularity within the abscess due to inflammation
c
67
Epididymitis most commonly results from __ in males 14-35 years and __ in men over 35 years. a. poor hygiene, torsion b. torsion, poor hygiene c. bladder infection, sexually transmitted disease d. sexually transmitted disease, bladder infection
d
68
The bell clapper deformity is a predisposing factor for testicular torsion. It is defined as: a. the tunica albuginea completely encircles the epididymis, distal spermatic cord, and testis b. the testicles are connected by thick dermal tissue and cannot move separately c. the epididymis floating freely in the scrotal sac d. the tunica vaginalis completely encircles the epididymis, distal spermatic cord, and testis
d
69
Hashimoto disease is the most common type of __ and leads to __. a. hyperthyroidism, goiter formation b.. hypothyroidism, diffuse enlargement of the gland c. hypothyroidism, nodule formation d. hyperthyroidism, diffuse enlargement of the thyroid
b
70
You are scanning a patient that had a bilateral thyroidectomy 3 years ago. There are 3 round, anechoic lymph nodes identified between the mid common carotid artery and the sternocleidomastoid muscle. How will you report these findings? a. possible abnormal lymph nodes in level III b. possible abnormal lymph nodes in level I c. possible abnormal lymph nodes in level V d. possible abnormal lymph nodes in level VII
a
71
A benign thyroid adenoma is associated with __ calcifications, while malignant adenomas are associated with __ calcifications. a. punctate, coarse b. large, coarse c. punctate, fine d. eggshell, punctate
d
72
The most common location for an aortic aneurysm is: a. juxtarenal b. suprarenal c. aortic arch d. infrarenal
d
73
Which of the following correctly describes how to aid in differentiation of a thyroid adenoma in the lower pole from a parathyroid adenoma? a. thyroid adenomas are hypovascular and parathyroid adenomas are hypervascular b. thyroid adenomas are hypoechoic and parathyroid adenomas are hyperechoic c. thyroid adenomas are homogeneous and parathyroid adenomas are heterogeneous d. thyroid adenomas are hyperechoic and parathyroid adenomas are hypoechoic
a
74
A right renal mass will displace the IVC: a. superiorly b. laterally c. medially d. inferiorly
c
75
According to the DeBakey Classification system, what type of aortic dissection is most commonly associated with Marfan syndrome? a. Type III b. Type I c. Type IV d. Type II
d
76
A significant increase in blood supply/drainage to thyroid will be seen with thyroiditis. This can be demonstrated with __ Doppler and is called the __ sign. a. color, inferno b. PW, color flash c. color, string of pearls d. color, flame
a
77
Which of the following statements is correct regarding testicular seminoma? a. most common in African American males b. unresponsive to radiation and chemotherapy c. spreads to liver first with metastasis d. associated with cryptorchidism, trisomy 21, Klinefelter syndrome, and smoking
d
78
All of the following are associated with an increased risk of thyroid malignancy, except: a. intranodular flow patterns b. psammoma bodies c. wider than tall mass orientation d. absence of the halo sign
c
79
Which of the following has the highest risk of developing thyroid cancer? a. Graves' disease b. Cirrhosis c. Hashimoto thyroiditis d. parathyroid adenoma
c
80
A patient presents for their annual screening ultrasound after a complete thyroidectomy due to papillary carcinoma. You identify a 1cm uniformly hypoechoic mass lateral to the trachea. The mass is painful with transducer pressure and pain radiates to the head and chest. These findings are most suggestive of: a. parathyroid adenoma b. abnormal lymph node c. post-traumatic neuroma d. parathyroid carcinoma
c
81
Bacterial orchitis is most commonly caused by __, while viral orchitis is most commonly caused by __. a. trauma, HIV b. trauma, recent vasectomy c. sexually transmitted disease, mumps d. recent vasectomy, sexually transmitted disease
c
82
The most common secondary malignancy of the testicles is: a. leukemia b. myeloma c. hypernephroma d. lymphoma
d
83
A patient presents with a small, palpable extratesticular mass on the left side. The US exam demonstrates a mobile, hyperechoic mass with posterior shadowing. Which of the following best describes the findings? a. microlithiasis b. scrotal pearl c. abscess d. adenomatoid tumor
b
84
Chronic moderate congestive heart failure can cause this tributary of the IVC to be visualized sonographically due to the formation of a collateral pathway. a. coronary vein b. umbilical vein c. portal vein d. azygous vein
d
85
A thyroglossal duct cyst is most commonly found: a. posterior to the ear at the level of the thyroid gland b. within the isthmus of the thyroid gland c. near the angle of the mandible d. on the midline neck, superior to the thyroid gland
d
86
A patient presents with mild testicular pain that has increased over the last few months. The US exam demonstrates a normal right testicle. The left testicle demonstrates many tiny cysts clustered centrally along the mediastinum. No color flow is identified within the cystic structures. Which of the following best describes the findings? a. spermatocele b. tubular ectasia c. cystadenoma d. varicocele
b
87
Which of the following correctly describes papillary thyroid cancer? a. has a very high mortality rate b. associated with colloid cyst formation c. most masses are complex cysts with thick septations and nodule formation d. most commonly presents as a hypoechoic mass with calcifications
d
88
Increased thyroid volume is associated with: a. chronic hepatitis b. thyroxine treatment c. chronic renal failure d. radioactive iodine treatment
c
89
Which of the following Doppler findings is most consistent with uncomplicated epididymo-orchitis? a. high resistance flow; resistive index 0.2 b. low resistance flow; resistive index 0.4 c. low resistance flow; resistive index 0.8 d. high resistance flow; resistive index 1.0
b
90
Graves' disease refers to a type of: a. hyperthyroidism b. carcinoma c. multinodular goiter d. hypothyroidism
a
91
Which of the following is most likely to be affected by a mumps infection? a. parotid gland b. renal vein c. prostate d. thyroid gland
a
92
What technique can be used to differentiate a seminoma and an adenomatoid tumor? a. apply gentle transducer pressure to the affected testicle b. ask the patient to perform the Valsalva maneuver c. scan the patient in the Trendelenburg position d. scan the patient in standing position
a
93
The most common extra-testicular neoplasm is: a. hamartoma b. AV malformation c. adenomatoid tumor d. lipoma
c
94
The most common cause for fluid collection in the perirenal space is __. The most common cause for fluid collection in the posterior pararenal space is __. a. aortic disease, renal abnormalities b. small bowel infection, colitis c. renal abnormalities, aortic disease d. pancreatic disease, renal disease
c
95
Serpiginous vessels are identified on the examinations of patients with: a. portal HTN or testicular varicoceles b. situs inversus and organ agenesis c. renal or liver transplants d. renal artery and mesenteric artery stenosis
a
96
Retrograde flow in the common hepatic artery and splenic artery is highly suggestive of: a. mesenteric ischemia b. SMA occlusion c. celiac artery occlusion d. portal HTN
c
97
A patient presents with an enlarged left scrotum and palpable mass. The US demonstrates an intratesticular mass that is hypoechoic and heterogeneous with multiple coarse calcifications. There is also an irregular central cystic area. These findings are most suggestive of: a. teratoma only b. seminoma only c. embryonal cell tumor or teratoma d. seminoma, embryonal cell tumor or teratoma
c
98
What is the best way to differentiate an undescended testicle from other inguinal masses? a. identify the presence of internal vascularity b. identify the epididymis c. identify the spermatic cord extending to the scrotal sac d. identify the mediastinum testis
d
99
A patient presents with an acute onset of left scrotal pain this morning. The US exam demonstrates a small hydrocele and an enlarged body and tail of the epididymis. There is very minimal flow demonstrated in the body and tail but the head appears normal. These findings are most suggestive of: a. focal epididymitis of the head b. focal epididymitis of the bod and tail c. torsion of the epididymal body d. sperm granuloma
c
100
Which of the following vessels are a common source for a Type II endoleak? a. inferior mesenteric artery and lumbar arteries b. left gastric artery and right hepatic artery c. celiac axis and superior mesenteric artery d. common iliac artery and gonadal arteries
a

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