URR 78 Flashcards by Billie Harney

A hypoechoic thyroid mass with microcalcifications, hypervascularity and no halo sign is most consistent with:
a. papillary carcinoma
b. hyperfunctioning adenoma
c. neuroma
d. goiter

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Regarding the aorta, fusiforrm aneurysm formation usually occurs in the __ while dissecting aneurysms usually occur in the ___.
a. distal abdominal aorta, thoracic aorta
b. proximal abdominal aorta, thoracic aorta
c. distal abdominal aorta, aortic arch
d. aortic arch, distal abdominal aorta

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An abdominal US is ordered for a patient with bilateral pedal edema. The abdomen demonstrates mild ascites but otherwise normal organs. The IVC appears prominent with a constant diameter of 2.8 cm. These findings are most suggestive of:
a. congestive heart failure
b. malignant HTN
c. portal HTN
d. all of the above

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A right adrenal mass will displace the IVC:
a. posteriorly
b. superiorly
c. inferiorly
d. anteriorly

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A referring doctor requests a scrotal US to rule out orchitis. Which of the following is an expected sonographic finding for this abnormality?
a. multiple small cysts within the testicle
b. increased intratesticular vascularity
c. hyperechoic testicle
d. hematocele

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Which of the following describes tubular ectasia of the rete testis?
a. bilateral and associated with spermatocele formation
b. unilateral and associated with gynecomastia
c. unilateral and associated with chronic bacterial infection
d. bilateral and has a strong association with malignant transformation

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Which of the following is an intratesticular mass associated with Cushing syndrome and adrenal hyperplasia?
a. mixed germ cell tumor
b. adrenal rest
c. yolk sac tumor
d. epidermoid cyst

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A 30 year old male presents with fever, malaise, and mild to moderate right scrotal pain that began 3 days ago. Lab results indicate leukocytosis is present. The right testicle demonstrates mild diffuse heterogeneity. PW Doppler evaluation of the affected side produces a waveform with peaked antegrade systolic flow and diastolic flow reversal. These findings are most suggestive of:
a. partial torsion
b. acute orchitis with venous infarction
c. uncomplicated acute orchitis
d. testicular rupture

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Lack of tapering of the aorta as it travels distally, without focal dilatation, indicates:
a. fusiform aneurysm
b. Marfan syndrome
c. retroperitoneal fibrosis
d. ectasia

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A scrotal pearl refers to:
a. a large intra-testicular calcification
b. a large extra-testicular calcification
c. testicular prosthesis
d. microlithiasis formation only in the central portion of the teste adjacent to the rete testes

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Which of the following statements describes the appearance of a testicular prosthetic on the US image?
a. round structure with reflective borders and an anechoic lumen
b. solid, oblong structure with homogenous, hypoechoic texture compared to the native teste
c. homogenous, hypoechoic structure with sound attenuation posteriorly causing decreased visibility of the posterior borders of the prosthesis
d. solid, round structure with homgenous, hypoechoic texture compared to the native testes

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Which of the following describes an adenomatoid tumor?
a. hypovascular testicular tumor
b. hypervascular testicular tumor
c. a benign intratesticular tumor
d. a benign intrascrotal tumor

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Which testicular tumor will cause b-hCG levels to rise but AFP levels will be normal?
a. epidermoid cyst
b. embryonal cell carcinoma
c. choriocarcinoma
d. yolk sac tumor

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If an abdominal aortic aneurysm is identified, what two other vessels should be evaluated for associated aneurysm formation?
a. common femoral and popliteal arteries
b. bilateral renal arteries
c. celiac axis and superior mesenteric aneurysm
d. inferior and superior vena cava

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__ artery aneurysms are commonly associated with pancreatitis and peptic ulcer disease, while __ artery aneurysms are usually caused by cystic medial necrosis.
a. celiac, superior mesenteric
b. celiac, hepatic
c. hepatic, splenic
d. splenic, superior mesenteric

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The most common location of ectopic thyroid tissue formation outside the neck is in the __.
a. base of skull
b. chest
c. groin
d. shoulder

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Which of the following is true regarding hydrocele formation?
a. usually contains mucinous fluid
b. most hydroceles are due to infection
c. most common cause of acute scrotal pain
d. accumulation of serous fluid between the two layers of the tunica vaginalis

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Which of the following Doppler findings is most suggestive of partial testicular torsion?
a. antegrade flow throughout the cardiac cycle
b. increased diastolic flow velocities with a very low resistive index on the affected side
c. increased diastolic flow velocities with a very high resistive index on the affected side
d. asymmetic resistive indices on the intratesticular Doppler evaluations

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Primary testicular carcinoma is usually __ and secondary testicular malignancy is usually __.
a. heterogeneous, isoechoic
b. hypoechoic, isoechoic
c. unilateral, bilateral
d. hypervascular, hypovascular

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Which of the following are the most common primary carcinomas to metastasize to the thyroid?
a. lung and bone
b. liver and spleen
c. stomach and gallbladder
d. breast and lung

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The IVC is dilated and the spontaneous contrast phenomenon is seen in the proximal segment. Which of the following is the most likely cause?
a. congestive heart failure
b. portal HTN
c. hemophilia
d. dehydration

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Which of the following correctly describes a difference between De Quervain and Hashimoto thyroiditis?
a. De Quervain thyroiditis is considered painless, Hashimoto thyroiditis causes a painful, tender neck
b. De Quervain thyroiditis is caused by a virus, Hashimoto thyroiditis is caused by bacteria
c. De Quervain thyroiditis has no effect on TSH levels, Hashimoto thyroiditis causes a significant decrease in TSH levels
d. De Quervain thyroiditis is a much more common cause of hypothyroidism than Hashimoto thyroiditis

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Medullary carcinoma of the thyroid is a common occurrence with:
a. Von Hippel Lindau Syndrome
b. MEN syndrome
c. Marfan syndrome
d. Zollinger-Ellison syndrome

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A 28 year old presents for a testicular sonogram due to a palpable lump. The lab work in the chart indicates high levels of alpha fetoprotein and b-hCG. A mostly solid intratesticular mass is identified in the right testicle that disrupts the smooth contour of the teste. There is a small cystic are centrally. These findings are most suggestive of:
a. lymphoma
b. embryonal cell carcinoma
c. yolk sac tumor
d. seminoma

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All of the following are risk factors for thyroid cancer, except: a. diagnosis of MEN syndrome b. personal history of previous papillary cancer c. personal history of radiation treatment of a cerebral malignancy d. family history of hypercalcemia

Which of the following is NOT a medication that can be used to treat patients with hypothyroidism? a. iron supplements b. levothyroxine c. iodine supplements d. coumadin

Patients with __ have a significantly increased risk of developing a seminoma. a. varicocele b. hydrocele c. cryptorchidism d. diabetes

Which of the following correctly describes how a Sonographer can differentiate a neuroblastoma from a nephroblastoma on an abdominal US? a. the neuroblastoma will not distort the renal contour or disrupt the capsule. The nephroblastoma will distort the renal contour and disrupt the capsule. b. the neuroblastoma is highly vascular while the nephroblastoma is mainly necrotic due to limited vascular supply c. the nephroblastoma will not distort the renal contour or disrupt the capsule. The neuroblastoma will distort the renal contour and disrupt the capsule d. it is not possible to differentiate these two tumors sonographically

Schistosomiasis and chronic cystitis are commonly associated with what Sonographic findings in the urinary bladder? a. bladder wall atrophy due to reduced arterial supply b. the bladder lumen is filled with numerous non-shadowing stones c. diffuse bladder wall calcification d. ureterocele formation

Analgesic abuse is the most common cause of what renal abnormality? a. nephrocalcinosis b. papillary necrosis c. glomerulonephritis d. acute renal failure

An ultrasound exam demonstrates a 1.8 cm renal cyst in the upper pole of the left kidney with debris that layers in the dependent portion of the cyst when the patient changes position. These findings are most suggestive of: a. milk of calcium cyst b. infected cyst c. renal abscess d. porcelain cyst

Tumor invasion into the urinary bladder is most commonly caused by __ in females and by ___ in males. a. ovarian cancer, testicular cancer b. uterine cancer, colon cancer c. uterine cancer, prostate cancer d. colon cancer, prostate cancer

How does a junctional parenchymal defect appear on ultrasound examination? a. triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney b. thicker cortex on the lateral aspect of the left kidney c. narrowing or obstruction of the junction of the renal pelvis and ureter d. prominent renal cortical parenchyma located between 2 medullary pyramids

Hepatic fibrosis and portal HTN area seen with which of the following? a. perinatal autosomal recessive polycystic kidney disease b. acute hydronephrosis c. multicystic dysplastic kidney disease d. juvenile autosomal recessive polycystic kidney disease

A patient presents for a renal ultrasound due to a recent diagnosis of staphylococcus aureus infection, right flank plank and microscopic hematuria. The chart states the referring physician suspects a renal carbuncle has formed. How will this abnormality be identified sonographically? a. 1.5 cm complex mass with ring down and dirty shadowing located within the renal parenchyma b. a single large calculus obstructing the renal pelvis with severe hydronephrosis c. 1.5 cm complex mass located within the renal pelvis that is causing renal vein thrombosis d. a hyperechoic mass of fibrous tissue replaces the tissue of the renal sinus causing significant outflow obstruction

A renal transplant is usually positioned in the right lower quadrant with an arterial connection with what native artery? a. external iliac b. internal iliac c. aorta d. inferior mesenteric artery

The most common place for an ectopic kidney to be located is: a. connected to the lower pole of the opposite kidney b. right or left lower quadrant, slightly off midline c. mid-epigastric region posterior to bowel d. adjacent to the opposite kidney in the same quadrant

Fluid dilatation of the renal pelvis and calyces is called: a. pyonephrosis b. hydronephritis c. hydronephrosis d. pyelonephrosis

The renal collecting system is dilated and contains mildly echogenic material with fluid-debris levels. This most likely represents: a. hydronephrosis b. tubular sclerosis c. staghorn calculus d. pyonephrosis

___ is the most common renal tumor in neonates, while __ is the most common renal tumor in pediatric patients. a. mesoblastic nephroma, nephroblastoma b. nephroblastoma, mesoblastic nephroma c. mesoblastic nephroma, angiomyolipoma d. nephroblastoma, neuroblastoma

Which of the following is a Doppler indication of acute renal vein thrombosis? a. enlarged kidney b. increased diastolic flow c. decreased cortical resistance d. resistive index >0.7 in the cortex

Increased resistive index in the renal parenchyma arteries is an expected finding with: a. acute renal artery occlusion and acute renal failure b. renal allografts placed less than 1 week ago c. acute tubular necrosis and renal vein thrombosis d. infrarenal aortic aneurysms

How does significant hydronephrosis affect the blood flow in the renal cortex? a. decreases the resistive index in the parenchymal arteries b. increases the resistive index in the parenchymal arteries c. increases diastolic flow d. increases systolic flow

In an otherwise normal kidney, an angiomyolipoma is __ to the renal cortex and __ to the renal sinus. a. isoechoic, hyperechoic b. hyperechoic, hypoechoic c. hyperechoic, isoechoic d. hypoechoic, isoechoic

While scanning the urinary bladder using color Doppler, the right urinary jet is detected, but is partially obstructed by a thin membrane that balloons into the bladder lumen. What is the finding displayed? a. ureterocele b. posterior urethral valves c. UPJ obstruction d. urethrocele

The renal anomaly where the kidneys demonstrate congenital duplication of the renal pelvis/calyces is called: a. renal agenesis b. ectopic kidney c. duplicated collecting system d. horseshoe kidney

Which of the following is the most common cause of acute renal failure in an allograft? a. polycystic disease b. multicystic kidney disease c. renal artery stenosis d. acute tubular necrosis

Which of the following is correct regarding acute pyelonephritis? a. critical finding that requires immediate nephrectomy to prevent sepsis b. usually treated with antibiotics c. diffuse involvement will demonstrate prominent distinction of the renal sinus echoes in affected kidney/segment d. focal involvement will demonstrates a hyperechoic ovoid segment of parenchyma

A large calculus located in the renal pelvis area is called: a. parapelvic stone b. staghorn calculi c. gerota calculi d. parapelvic stone or staghorn calculus

Which renal condition is always fatal? a. horseshoe kidney b. unilateral renal agenesis c. autosomal recessive polycystic disease d. autosomal dominant polycystic disease

Which of the following is an expected sonographic finding with complete duplication of the collecting system of the kidney? a. circumferential cortex at the mid pole b. circumferential cortex at the upper and lower poles only c. circunferential cortex at the lower pole d. circumferential cortex at the upper pole

What bacteria is responsible for most infectious processes that affect the kidneys? a. staphylococcus aureus b. staphylococcus epidermis c. escherichia coli d. methicillin-resistant staphyloccocus areus

Extrinsic compression, pregnancy, stone, and mass formation are all causes o what urinary abnormality? a. medullary sponge kidney b. hydronephrosis c. renal carbuncle d. renal artery stenosis

The most common cause of acute renal failure is ___ and the most common cause of chronic renal failure is ___. a. renal artery stenosis, renal vein thrombosis b. trauma, renal vein thrombosis c. acute tubular necrosis, renal artery stenosis d. acute tubular necrosis, diabetes mellitus

Accessory renal arteries: a. always enter the hilum adjacent to the main renal artery b. usually originate from the contralateral renal artery c. must be documented prior to renal resection or transplantation d. demonstrate the flow pattern as lumbar arteries

Which of the following are commonly associated findings with horseshoe kidneys? a. calculi and hydronephrosis b. bilateral renal atrophy and echogenic cortex c. emphysematous pyelonephritis and ureterocele d. renal cell carcinoma and oncocytoma

A 4 year old presents for a renal ultrasound with a suspected mass on the lateral aspect of the left kidney seen on a KUB xray. The ultrasound reveals a focal outward thickening of the normal renal cortex near the mid pole of the kidney. Which of the following best describes the finding? a. Wilm's tumor b. dromedary hump c. column of Bertin d. duplicated collecting system

What is the most common primary renal malignancy? a. wilm's tumor b. cystadenocarcinoma c. renal cell carcinoma d. transitional cell carcinoma

Which of the following correctly describes Xanthogranulomatous pyelonephritis? a. caused by recurrent severe dehydration b. prevalent in males and HIV patients c. most commonly bilateral and fatal d. most cases demonstrate a staghorn calculus and thinned renal cortex

Sonographic signs of chronic renal failure include a/an __ in size and a/an __ in echogenicity a. decrease, increase b. decrease, decrease c. increase, increase d. increase, decrease

A small, hyperechoic round mass with no associated shadowing seen in the cortex of the kidney. These findings are most consistent with: a. staghorn calculus b. nephrocalcinosis c. renal calculus d. angiomyolipoma

Which of the following is associated with echogenic debris/calcification in the renal pyramids? a. papillary necrosis b. hyperthyroidism c. hydronephrosis d. angiomyolipoma

The most common location for a urinary obstruction caused by a renal calculus is in the __. a. distal ureter b. distal urethra c. proximal ureter d. trigone of the bladder

A 62 year old presents with urinary incontinence after a recent hysterectomy. The bladder ultrasound demonstrated a normally distended bladder and fluid filled vaginal canal. Post void images demonstrate an empty bladder with normal wall thickness and resolution of the fluid in the vagina. These findings are most consistent with: a. vesicovaginal fistula b. vesicourethral reflux c. hydrocolpos d. transitional cell carcinoma

__ transplant rejection appears as swollen kidney, loss of corticomedullary definition, enlarged renal pyramids, compression of the renal sinus, and decreased blood flow with increased RI value. a. chronic b. acute c. chronic or acute, stages of rejection are not able to be differentiated with sonography d. rejection of a renal allograft is not usually evaluated by sonography

What renal abnormality is suspected when sloughed papilla are identified in the urine? a. nephrocalcinosis b. acute pyelonephritis c. papillary necrosis d. hydronephrosis

If Doppler evaluation of the parenchymal artery of a kidney demonstrates a resistive index of 0.25, the findings are considered: a. suspicious for chronic renal failure b. normal c. suspicious for acute renal failure d. suspicious for proximal renal artery stenosis

The term allograft refers to: a. the bypass graft used in arterial revascularization of an organ b. the transplanted organ c. the native organ that will be replaced by a transplanted organ d. an external portal shunt

Which of the following Doppler criteria is used to evaluate the parenchymal flow in a renal allograft? a. SD ratio b. resistive index c. peak systolic velocity d. renal aortic ratio

A patient presents for a renal ultrasound to rule out renal artery stenosis. A wedge shaped hypoechoic area is noted within the parenchyma of the upper pole of the left kidney and no arcuate flow is detected in the area with color Doppler. The findings are most consistent with: a. nephrocalcinosis b. acute pyelonephritis c. medullary sponge kidney d. renal infarct

A patient presents with a history of high fever, HTN, nausea and vomiting. Lab results indicate the presence of white blood cells, pus and bacteria in the urine. A small, shrunken, mishapen left kidney with no evidence of shadowing or fluid collection and a normal right kidney are documented on the ultrasound exam. What are these findings most suggestive of? a. acute glomerulonephritis b. acute renal failure c. chronic pyelonephritis d. emphysematous pyelonephritis

A 30 year old man presents with pelvic discomfort. He has a 2 year history of HIV infection and is an insulin dependent diabetic. When evaluating the urinary bladder, you identify a mobile, round, hyperechoic solid mass with no posterior shadowing. What is the most likely diagnosis for these findings? a. bladder stone b. squamous cell carcinoma c. transitional cell carcinoma d. fungal ball

A 55 year old male presents with mild flank pain. The right kidney measures 13 cm and demonstrates 3 cysts. The left kidney measures 13.8 cm and demonstrates 2 cysts. Which of the following is the most likely explanation of the findings? a. multicystic dysplastic kidney disease b. autosomal dominant polycystic kidney disease c. autosomal recessive polycystic kidney disease d. acquired cystic kidney disease

Which of the following lists the most common ultrasound findings with acute glomerulonephritis? a. small, smooth echogenic kidneys b. unilateral renal enlargement with decreased cortical echogenicity c. bilateral microcyst formation that causes increased cortical echogenicity d. bilateral renal enlargement with increased cortical echogenicity

What type of aneurysm is most commonly associated with autosomal dominant polycystic kidney disease? a. saccular b. fusiform c. pseudoaneurysm d. berry

If a patient complains of a recent onset of uncontrollable systemic HTN with average BP readings exceeding 170/90 mmHg, what vascular cause should be suspected? a. portal HTN b. hepatic congestion c. subclavian stenosis d. renal artery stenosis

A patient is referred for a renal ultrasound due to suspected cross fused renal ectopia. What is the expected ultrasound finding for this condition? a. both kidneys are located on the same side of the body and fused together at varied locations b. there is a single kidney located in the midline pelvic region c. the kidneys are in their normal position but the upper poles of the kidneys are joined across the midline, usually anterior to the mid aorta d. the kidneys are in their normal position but the lower poles of the kidneys are joined across the midline, usually anterior to the aorta

Unilateral renal agenesis is associated with what anomaly in women? And in men? a. bicornuate uterus, agenesis of the seminal vesicles b. ovarian agenesis, testicular agenesis c. ovarian agenesis, agenesis of the seminal vesicles d. uterine agenesis, testicular agenesis

If a pregnant patient has unilateral hydronephrosis, what is the preferred method to rule out an obstructive ureteral calculus as the cause? a. obstructive ureteral calculi cannot be evaluated in a pregnant patient. A CT abdomen and pelvis exam with contrast is required. b. Apply color Doppler to identify the ureteral jets c. Ask patient to empty bladder and apply color Doppler to locate a stone with twinkling artifact d. Obstructive ureteral calculi cannot be evaluated in a pregnant patient. An intravenous pyelogram is required.

On ultrasound, a mycetoma appears as: a. a hyperechoic mass without posterior shadowing b. a hypoechoic mass that causes propagation artifact c. a hyperechoic mass with posterior enhancement d. a hypoechoic mass that causes reverberation artifact

The most common site for renal artery stenosis is: a. in the segmental artery of the upper pole b. at the renal hilum c. at the origin of the renal artery d. in the segmental artery of the lower pole

Which of the following describes a tardus parvus waveform? a. low velocity with late systolic peak b. high velocity with sharp peak c. low velocity with diastolic flow reversal d. high velocity with diastolic flow reversal

A 72 year old patient presents for an abdominal ultrasound for epigastric pain. You note a 3 cm cyst on the periphery of the right kidney and 3 smaller cortical cysts on the left kidney. The cysts are anechoic with smooth borders. Both kidneys are normal in size and echotexture. These findings are most consistent with: a. autosomal dominant polycystic kidney disease b. acquired cystic disease c. multicystic dysplastic kidney disease d. simple cortical cysts

Which congenital renal anomaly is commonly associated with ureterocele formation? a. horseshoe kidney b. dromedary hump c. renal agenesis d. duplicated collecting system

Which of the following will demonstrate the lowest resistive index value in the parenchymal arteries? a. acute renal artery occlusion b. acute renal failure c. renal vein thrombosis d. acute tubular necrosis

Which of the following renal tumors is a hypoechoic mass most commonly found in the renal pelvis? a. oncocytoma b. transitional cell carcinoma c. adenoma d. renal cell carcinoma

Which of the following best describes the ultrasound appearance of nephrocalcinosis? a. multiple linear calcifications within the renal parenchyma b. three or more renal calculi identified in each pole of the kidney c. a large calculus within the renal pelvis causing hydronephrosis d. hyperechoic renal pyramids that may shadow

Oncocytoma, renal cell carcinoma, and focal nodular hyperplasia share what sonographic characteristic? a. posterior enhancement b. central scar c. invasion of vasculature d. thick septations within the mass

What is the most common congenital anomaly of the urinary system? a. ectopic kidney b. pancake kidney c. duplicated collecting system d. dromedary hump

Which of the following can be treated using lithotripsy techniques? a. renal artery stenosis b. staghorn calculus c. Budd Chiari Syndrome d. lymphoma

A urinary tract infection is most commonly caused by __ and starts in the __. a. bacteria from the intestinal tract, kidney b. bacteria from the intestinal tract, bladder c. bacteria from the vagina, kidney d. bacteria from the vagina, bladder

Which of the following is a sonographic characteristic of acute tubular necrosis? a. atrophied kidney b. increased diastolic flow in the arcuate arteries c. prominent, echogenic renal pyramids d. cortical thickness <1 cm

Which of the following renal pathologies will appear the same sonographically as focal acute pyelonephritis? a. renal infarct b. renal adenoma c. angiomyolipoma d. acute hydronephrosis

Which of the following renal disorders is usually detected in utero due to oligohydramnios? a. horseshoe kidney b. autosomal recessive polycystic kidney disease c. duplicated collecting system d. multicystic dysplastic kidney disease

Which of the following sonographic characteristics is an expected finding in a patient with acute renal vein thrombosis? a. increased antegrade diastolic flow in the renal arteries b. enlarged kidney with mottled echogenicity c. high velocity, continuous venous flow within the kidney d. prominent corticomedullary definition

An asymptomatic patient presents for a renal US for size evaluation due to chronic systemic HTN. The right kidney demonstrates a 1cm rounded hyperechoic mass within the renal cortex. There is no posterior enhancement or shadowing noted with the mass. Which of the following can be used to describe the US findings? a. angiomyolipoma or lipoma b. adenoma or fibroma c. oncocytoma d. hepatoma

Which of the following correctly describes transitional cell carcinoma? a. most commonly presents as diffuse bladder wall thickening with multiple masses within the wall b. always causes bilateral hydronephrosis c. most common cause encountered on the adrenal gland d. urinary incontinence is the most common symptom

A patient presents for a renal ultrasound due to a history of tuberous sclerosis. What is the doctor looking for? a. angiomyolipomas b. autosomal dominant polycystic kidney disease c. hydronephrosis d. renal artery stenosis

Which of the following would indicate chronic renal disease in both kidneys? a. bilateral renal cysts causing renal enlargement b. bilateral hydronephrosis c. unilateral hydronephrosis d. atrophied, echogenic kidneys

Which congenital anomaly is associated with hydronephrosis of the upper OR lower pole of the kidney? a. duplicated collecting system b. column of Bertin c. UPJ obstruction d. posterior urethral valves

URR 78 Flashcards

(100 cards)