URR 79

Question 1

Which of the following would result in a 7 cm right kidney and a 9.8 cm left kidney in an average sized patient?
a. right renal artery stenosis
b. autosomal dominant polycystic kidney disease
c. acute thrombosis of the right renal vein
d. renal lymphoma

Answer 1

a

Question 2

In cases of moderate to severe medical renal disease the renal parenchyma will be __.
a. hypertrophied to >10 mm thickness
b. atrophied to <10 mm thickness
c. hypoechoic to the sinus
d. isoechoic to the liver

Answer 2

b

Question 3

Increased renal fat in the renal sinus with a thinned cortex indicates:
a. acute tubular necrosis
b. angiomyolipomatosis
c. sinus lipomatosis
d. chronic renal failure

Answer 3

c

Question 4

What two bladder abnormalities are most commonly associated with a duplicated collecting system?
a. ureterocele and vesicoureteral reflux
b. neurogenic bladder and posterior urethral valves
c. vesicoureteral reflux and bladder diverticulum
d. ureterocele and bladder diverticulum

Answer 4

a

Question 5

Clubbing of the renal calyces is a sign of:
a. chronic pyelonephritis and papillary necrosis
b. candidiasis infection and mycetoma formation
c. hypernephroma and candidiasis infection
d. transitional cell carcinoma and papillary necrosis

Answer 5

a

Question 6

A tardus parvus waveform is described as?
a. reduced systolic velocity with diastolic flow reversal
b. resistive index of 1.0 or greater
c. pronounced of early systolic peak and prolonged acceleration time
d. absence of early systolic peak and prolonged acceleration time

Answer 6

d

Question 7

Children with Beckwith Wiedemann Syndrome have a significant risk of developing:
a. nephroblastoma
b. portal HTN
c. cholelithiasis
d. hyperparathyroidism

Answer 7

a

Question 8

Which of the following are common causes for bilateral hydronephrosis?
a. bladder outlet obstruction and pregnancy
b. pancreatic pseudocyst and nephrolithiasis
c. vascular calcification and nephrolithiasis
d. Nutcracker syndrome and bladder obstruction

Answer 8

a

Question 9

Which of the following are complications associated with chronic hydronephrosis?
a. systemic HTN and renal failure
b. urinoma and hematoma
c. neurogenic bladder and medullary sponge kidney
d. portal thrombosis and pulmonary embolism

Answer 9

a

Question 10

Which of the following would normally present as a hypoechoic renal mass?
a. mycetoma
b. milk of calcium cyst
c. oncocytoma
d. angiomyolipoma

Answer 10

c

Question 11

Which of the following sonographic characteristics is most suggestive of acute renal vein thrombosis?
a. diastolic flow reversal in the renal arteries
b. atrophied kidney with mottled echogenicity
c. hyperarterial flow within the kidney
d. increased corticomedullary definition

Answer 11

a

Question 12

The renal anomaly where the kidneys do not separate completely during embryonic development is called:
a. ectopic kidney
b. duplicated collecting system
c. horseshoe kidney
d. renal agenesis

Answer 12

c

Question 13

Which of the following is most likely to produce posterior shadowing?
a. angiomyolipoma
b. mycetoma
c. renal lipoma
d. sloughed papilla

Answer 13

d

Question 14

Which of the following has the lowest risk of developing renal cell carcinoma?
a. patients with acquired cystic disease
b. patients with autosomal recessive PCKD
c. patients on long term dialysis
d. patients with tuberous sclerosis

Answer 14

b

Question 15

Multicystic dysplastic kidney disease is usually the result of:
a. autosomal recessive genetic disorder
b. chronic urinary tract infections as a child
c. autosomal dominant genetic disorder
d. an obstruction of the ureteropelvic junction in utero

Answer 15

d

Question 16

Acute occlusion of the main renal artery typically causes __ acute renal failure.
a. extrinsic
b. postrenal
c. prerenal
d. intrinsic

Answer 16

c

Question 17

Renal cell carcinoma is also called:
a. Wilm’s tumor
b. transitional cell carcinoma
c. nephroblastoma
d. hypernephroma

Answer 17

d

Question 18

Which of the following correctly describes the typical sonographic appearance of renal lymphoma?
a. bilateral renal enlargement
b. bilateral renal atrophy with renal failure
c. unilateral renal enlargement
d. unilateral renal atrophy

Answer 18

a

Question 19

Which of the following is true regarding a renal oncocytoma?
a. usually malignant and very aggressive
b. may have a central scar similar to renal cell carcinoma
c. easily differentiated from renal cell carcinoma by the presence of a central scar within the tumor
d. usually occur in pediatric patients

Answer 19

b

Question 20

What liver function level is the most sensitive indicator for alcoholism?
a. Aspartate aminotransferase
b. Gamma-glutamyl transpeptidase
c. alpha-fetoprotein
d. alanine aminotransferase

Answer 20

b

Question 21

On a scrotal ultrasound exam, how do you differentiate acute epididymitis from post-vasectomy enlargement of the epididymis?
a. use PW Doppler
b. use dual screen imaging
c. use a stand off pad
d. use color Doppler

Answer 21

d

Question 22

__ should be suspected in an infant with a large hepatic hemangioma and unexplained thrombocytopenia
a. cirrhosis
b. Budd Chiari Syndrome
c. Fragile X syndrome
d. Kasabach-Merritt Syndrome

Answer 22

d

Question 23

Which of the following correctly lists the structures found in an intrahepatic portal triad?
a. portal vein, hepatic vein, and bile duct
b. common hepatic artery, hepatic vein, and portal vein
c. portal vein, proper hepatic artery, and bile duct
d. hepatic vein, proper hepatic artery, and bile duct

Answer 23

c

Question 24

A patient with choledochal cysts has an increased risk of developing __.
a. portal HTN
b. cholangiocarcinoma
c. polycystic liver disease
d. biliary atresia

Answer 24

b

Question 25

The formation of a Hartmann pouch usually occurs in what portion of the gallbladder? a. neck b. cystic duct c. fundus d. body

Answer 25

a

Question 26

Sudden onset of hematuria, azotemia, and proteinuria is an indication of: a. oncocytoma b. acute glomerulonephritis c. tuberous sclerosis d. chronic renal failure

Answer 26

b

Question 27

You are scanning the gallbladder and there appears to be sludge within the lumen. Which of the following will aid in differentiating the sludge from artifact? a. apply color Doppler b. ask the patient to fast for 3-4 hours and rescan the GB for changes c. increase the transducer frequency d. ask the patient to perform the Valsalva maneuver

Answer 27

c

Question 28

Which probe position is used to demonstrate a longitudinal view of the main portal vein entering the liver? a. sagittal subcostal position just to the left of midline b. oblique subcostal approach with the transducer rotated slightly with the notch side of the transducer angled more inferiorly than the side of the probe without the notch c. oblique subcostal approach with the transducer rotated slightly with the notch side of the transducer angled more superiorly than the side of the probe without the notch d. sagittal subcostal position just to right of midline

Answer 28

c

Question 29

The renal anomaly where the kidneys do not separate completely during embryonic development is called: a. horseshoe kidney b. renal agenesis c. Duplicated collecting system d. ectopic kidney

Answer 29

a

Question 30

Which of the following vessels is not directly connected to the IVC? a. right suprarenal arteries b. right gonadal vein c. left gonadal vein d. right renal vein

Answer 30

c

Question 31

Which of the following correctly describes the preferred patient position for a renal biopsy? a. decubitus position with knees drawn to chest 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. posterior oblique with ipsilateral arm extended over the head

Answer 31

b

Question 32

A mother who is currently breastfeeding 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. paget disease d. inflammatory carcinoma

Answer 32

b

Question 33

Which of the following is most likely to produce posterior shadowing? a. sloughed papilla b. angiomyolipoma c. renal lipoma d. mycetoma

Answer 33

a

Question 34

The greatest advantage of ultrasound guided percuteaneous needle biopsy over biopsy performed with cat scan guidance is the: a. ability to view the biopsy needle passing into the mass in real time b. lack of radiation exposure c. decreased cost to the patient d. ability to take multiple samples during one procedure

Answer 34

a

Question 35

Increased serum levels of __ usually provide the first indication of an extrahepatic biliary obstruction. a. indirect bilirubin b. alkaline phosphatase c. direct bilirubin d. aldosterone

Answer 35

b

Question 36

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

Answer 36

c

Question 37

An impacted stone in the gallbladder neck increases the risk of developing: a. adenomyomatosis and polyp formation b. stones and dilatation in the intrahepatic ducts c. stones and dilatation in the extrahepatic ducts d. cholecystitis and gangrene

Answer 37

d

Question 38

You are performing a parathyroid ultrasound and cannot locate a known adenoma. Which of the following would be most helpful in locating the mass? a. use IV contrast to locate the blood supply of the mass b. ask the patient to swallow c. give the patient oral contrast to outline the trachea d. report the mass as unidentifiable so that a CT scan can be performed instead

Answer 38

b

Question 39

The most common extra-testicular neoplasm is: a. lipoma b. adenomatoid tumor c. AV malformation d. hamartoma

Answer 39

b

Question 40

The inguinal ligament extends: a. from the linea alba to the anterior superior iliac spine b. from the tip of the coccyx to the pubic tubercle c. from the anterior superior iliac spine to the pubic tubercle d. from the distal right oblique muscle to the distal left oblique muscle

Answer 40

c

Question 41

A 30 year old presents with history of a normal clinical exam of the scrotum and infertility. What is the referring doctor expecting to find on the exam? a. varicocele b. acute epididymitis c. torsion d. seminoma

Answer 41

a

Question 42

When trying to distinguish free fluid in the abdomen from the IVC, which of the following is true? a. The IVC will demonstrate respiratory changes in diameter, while fluid pocket size/shape will not vary with respiration b. The IVC will not demonstrate respiratory changes in diameter, while fluid pocket size/shape will vary with respiration c. Color Doppler is an effective tool in differentiating the IVC from free fluid d. The intrabdominal fluid is most commonly seen on the left side of the abdomen and the IVC is located on the right side of the abdomen

Answer 42

c

Question 43

What is the top normal post-residual volume in the bladder of patients 65 and older, if measuring within 5 minutes of voiding? a. < or equal to 500 ml b. <10 ml c. < or equal to 10 ml d. <50 ml

Answer 43

c

Question 44

Which of the following correctly describes the difference between the normal waveform in the renal artery and the external iliac artery? a. the renal artery is monophasic and the external iliac artery demonstrates triphasic flow b. the renal artery flow is triphasic and the external iliac artery demonstrates monophasic flow c. the renal artery flow is high resistance and the external iliac artery demonstrates low resistance flow d. the renal artery flow is laminar and the external iliac artery demonstrates non-laminar flow

Answer 44

a

Question 45

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

Answer 45

d

Question 46

Which of the following is demonstrated by the same color on an ultrasound image as on a CT image? a. cysts b. calcifications c. uncomplicated pleural effusion d. more than one of the above

Answer 46

b

Question 47

A patient presents with a history of AIDS and recent pneumocystitis carinii infection. What changes to the liver do you expect to see on the ultrasound exam? a. diffuse echogenic foci throughout the liver tissue b. formation of multiple abscesses within the liver tissue c. diffuse increase in liver tissue echogenicity with ascites d. gas-producing abscess near the porta hepatis

Answer 47

a

Question 48

Distal cholangiocarcinoma is most commonly found __ and a Klatskin tumor is most commonly found __. a. near the dome of the liver, in the CBD near the porta hepatis b. at the junction of the right and left hepatic ducts, outside the liver in the CBD c. in the left lobe, in the right lobe d. in the extrahepatic CBD near the porta hepatis, at the junction of the right and left hepatic ducts

Answer 48

d

Question 49

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

Answer 49

a

Question 50

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. hypertension medication c. aspirin d. lovenox

Answer 50

b

Question 51

The internal jugular vein merges with what vein to form the brachiocephalic vein? a. innominate vein b. brachial vein c. subclavian vein d. common carotid vein

Answer 51

c

Question 52

The liver measurement normally used to assess liver size is: a. measures from the transverse view at the midclavicular plane b. the medial to lateral dimension c. the superior inferior dimension d. overall volume l x w x h x 0.5

Answer 52

c

Question 53

What is one of the most common findings on a transrectal ultrasound in prostatitis? a. heterogeneous gland with hypovascularity b. homogeneous gland with hypovascularity c. hypoechoic halo at the periurethral area d. multiple macrocalcifications

Answer 53

c

Question 54

The radiologist asks you to set up the US room for a thyroid biopsy. Which probe should be covered with a sterile probe cover? a. linear 5MHz b. linear 10 MHz c. vector 10 MHz d. Curvilinear 8MHz

Answer 54

b

Question 55

Tumefactive sludge can be found in the: a. gallbladder b. paracolic gutters c. renal pelvis d. gastric antrum

Answer 55

a

Question 56

Which of the following would result in a 7 cm right kidney and a 9.8 cm left kidney in an average sized patient? a. renal lymphoma b. right renal artery stenosis c. autosomal dominant polycystic kidney disease d. acute thrombosis of the right renal vein

Answer 56

b

Question 57

The most common parasitic infection in humans is: a. pneumocystitis carinii b. hepatitis c. schistosomiasis d. hydatid disease

Answer 57

c

Question 58

A patient presents for an abdominal ultrasound with a history of renal and pancreatic transplant. What chronic medical condition is the primary reason for the double transplant? a. hypertension b. pancreatic adenocarcinoma c. type I diabetes d. chronic pancreatitis

Answer 58

c

Question 59

A patient presents with congenital absence of the spleen, this condition is called: a. accessory spleen b. hemartoma c. splenomegaly d. asplenia

Answer 59

d

Question 60

An otherwise asymptomatic patient presents for an abdomen ultrasound due to elevated LFTs. The gallbladder demonstrates thickened walls with an irregular internal contour. Several small echogenic foci are noted within the wall and each exhibits a comet tail artifact. Which of the following conditions is identified on this exam? a. emphysematous cholecystitis b. adenomyomatosis c. chronic cholecystitis d. cholesteral polyps

Answer 60

b

Question 61

A patient's chart indicates they have a history of cavernous transformation. Where does this abnormality form? a. Morrison pouch b. pancreatic tail c. gallbladder fossa d. porta hepatis

Answer 61

d

Question 62

Which of the following correctly describes angiosarcoma of the spleen? a. usually presents as a homogeneous hyperechoic mass near the periphery of the spleen b. very responsive to chemotherapy with good prognosis c. arises from the vascular endothelium and demonstrated increased vascularity d. most common primary malignancy of the spleen

Answer 62

c

Question 63

Applying compression using a curvilinear transducer with a large footprint is the key method used to best evaluate: a. the body of the pancreas b. a suspected thyroglossal duct cyst c. neonatal hips d. the scrotal wall thickness

Answer 63

a