ARDMS > URR 80 > Flashcards

URR 80 Flashcards

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1
Q

Which acoustic property causes the echogenic appearance of the diaphragm related to surrounding structures?
a. specular reflection
b. attenuation
c. refraction
d. non-specular reflection

A

a

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2
Q

Placement of a Linton or Warren shunt is a method used to:
a. reroute blood flow around a large aortic aneurysm
b. streamline blood flow through a large aortic aneurysm
c. reduce portal hypertension
d. relieve significant hydronephrosis

A

c

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3
Q

Which of the following statements best describes the Doppler tracing found in the stalk of a pseudoaneurysm?
a. high resistance to and fro flow
b. phasic forward flow
c. continuous forward flow
d. low resistance to and fro flow

A

a

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4
Q

Time gain compensation is necessary due to:
a. the inability of high frequency transducers to penetrate the body effectively
b. reflection, refraction, and scatter
c. the non-linear behavior of sound waves
d. sound impedance difference between transducer and skin

A

b

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5
Q

Glandular atrophy, dilated main duct, and intraductal calculi are hallmark signs of:
a. chronic renal failure
b. chronic cholecystitis
c. chronic pancreatitis
d. cholangitis

A

c

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6
Q

Which of the following would cause an increase in serum AST levels with normal serum ALT levels?
a. metastasis
b. hepatitis
c. cirrhosis
d. congestive heart failure

A

d

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7
Q

Which of the following describes the Doppler appearance of liver transplant rejection?
a. high resistance flow in the hepatic artery
b. mottled appearance of the liver parenchyma with ascites
c. low resistance flow in the portal veins
d. nodular formations within the liver parenchyma

A

a

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8
Q

Acute cholecystitis is associated with gallbladder wall thickening ___. Cholangitis is associated with ductal wall thickening __.
a. >3mm, >5mm
b. >6mm, >3mm
c. >2mm, >3mm
d. >3mm, >2mm

A

d

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9
Q

Several simple cysts are identified in the liver of a 38 year old male patient. What structures in the abdomen should also be evaluated for related findings?
a. kidneys, pancreas, and ovaries
b. kidneys and pancreas
c. abdominal aorta and renal arteries
d. kidneys and thyroid

A

b

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10
Q

Which renal arterial branches are preferred for accurate assessment of parenchymal resistance?
a. interlobar or arcuate arteries
b. intralobular or segmental arteries
c. segmental or interlobar arteries
d. segmental or arcuate arteries

A

a

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11
Q

While scanning

A
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12
Q

Power Doppler:
a. is less sensitive than color Doppler when evaluating renal transplant perfusion
b. is preferred for evaluation of blood flow in a patient with suspected portal HTN
c. display is not dependent on incident beam angle
d. is preferred for evaluation of blood flow in a TIPS shunt

A

c

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13
Q

Which of the following normally secretes moderate amounts of mucus?
a. bronchial aveoli
b. duodenum
c. seminal vesicles
d. pancreas

A

b

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14
Q

Red currant jelly stool is a common clinical finding associated with:
a. intussusception
b. mesenteric ischemia
c. appendicitis
d. pyloric stenosis

A

a

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15
Q

Which of the following correctly describes the pediatric pancreas?
a. cystic fibrosis leads to the production of mucus and the gland is reduced in echogenicity
b. the ducts are dilated at <2mm at birth and decrease in size throughout the first year
c. pancreatic echogenicity increases with age
d. it normally decreases in echogenicity as the patient reaches adulthood

A

c

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16
Q

In a patient with complete situs inversus, the liver will be:
a. divided into 3 separate lobes
b. absent
c. located in the RLQ
d. located in the LUQ

A

d

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17
Q

A 30 year old male 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. fungal ball
b. transitional cell carcinoma
c. bladder stone
d. squamous cell carcinoma

A

a

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18
Q

Epididymitis most commonly results from __ in males 14-35 years old and __ in men over 35 years.
a. sexually transmitted disease, bladder infection
b. poor hygiene, torsion
c. torsion, poor hygiene
d. bladder infection, sexually transmitted disease

A

a

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19
Q

__ merge to form the ampulla of Vater just prior to the duct entering the second portion of the duodenum.
a. the CBD and duct of Wirsung
b. The CBD and the cystic duct
c. The CHD and cystic duct
d. The CBD and CHD

A

a

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20
Q

The right common carotid artery is a branch of what artery?
a. aortic arch
b. innominate artery
c. right subclavian artery
d. right vertebral artery

A

b

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21
Q

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

A

a

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22
Q

The superior mesenteric vein:
a. joins the splenic vein anterior to the neck of the pancreas
b. joins the splenic vein posterior to the neck of the pancreas
c. joins the portal vein to form the splenic vein
d. lies to the left of the superior mesenteric artery

A

b

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23
Q

Accessory spleens are usually seen:
a. adjacent to the inferior pole of the left kidney
b. at the posterior aspect of the spleen
c. near the porta hepatis
d. near splenic hilum

A

d

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24
Q

What type of liver infection/abscess is commonly associated with immunocompromised patients?
a. pyogenic
b. schistosomiasis
c. candidiasis
d. amebic

A

c

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25
The majority of the liver is covered by a thick capsule composed of fibrous and elastic elements called __ a. Glisson capsule b. Bowman capsule c. Morrison pouch d. Gerota fascia
a
26
Which of the following correctly describes how to differentiate cholangitis from cholangiocarcinoma? a. cholangitis leads to dilated extrahepatic ducts while cholangiocarcinoma leads to dilated intrahepatic ducts b. cholangitis leads to dilated intrahepatic ducts while cholangiocarcinoma leads to dilated extrahepatic ducts c. cholangitis is a diffuse disease process while cholangiocarcinoma causes focal mass formation d. cholangitis is a focal disease process while cholangiocarcinoma causes diffuse mass formation
c
27
Which of the following is a potential collateral pathway formed in patients with cirrhosis? a. blood moves from the coronary and short gastric veins into the esophageal veins b. blood moves from the emissary veins into the umbilical vein c. blood moves from the splenic vein into the coronary vein d. blood moves from the gastric vein into the splenic vein
a
28
Which of the following would be associated with posterior enhancement artifact in the liver tissues? a. dilated intrahepatic ducts b. lymphoma c. large lipoma d. fatty infiltration
a
29
Which of the following Doppler parameters is most commonly used when evaluating the common hepatic artery in patient with a liver transplant? a. pulsatility index b. peak systolic velocity c. S/D ratio d. Resistive index
d
30
A non-infectious cause of acalculous cholecystitis is __ and an infectious cause of acalculous cholecystitis is __/ a. HIV, viscous bile b. viscous bile, Mirizzi syndrome c. total parenteral nutrition, HIV d. congestive heart failure, total parenteral nutrition
c
31
A patient presents for a follow up ultrasound due to Budd Chiari syndrome. Which of the following is an expected finding on the exam? a. pancreatic head mass and dilated intrahepatic ducts b. adrenal adenoma and/or kidney stones c. thrombosis of the hepatic veins with hepatic congestion d. prostatitis and neurogenic bladder
c
32
You are attempting to scan the spleen with the patient in the RLD position and using a coronal view. The spleen is obscured by the left lung. What can you to do obtain a better view of the spleen? a. have the patient drink water and repeat the image from the same patient and probe position b. turn the patient to the LLD position c. scan the patient at full expiration d. scan the patient at full inspiration
c
33
Which of the following statements is true regarding rectus sheath hematomas? a. linea alba stops the blood from spreading into the pelvis b. Coumadin therapy is a common cause for hematoma formation c. an acute hematoma will appear hyperechoic compared to surrounding tissues d. arcuate line stops the blood from extending across the midline
b
34
The most common cause of small bowel obstruction in adults is __. The most common cause of small bowel obstruction in an infant is: a. bezoars, pyloric stenosis b. adhesions, intussusception c. extrinsic compression by pelvic mass, intussusception d. diverticulitis, pyloric stenosis
b
35
When a patient presents with acute scrotal pain, the Sonographer should always begin the scrotal ultrasound by: a. imaging the groin area b. imaging the unaffected side c. imaging the epididymis on the affected side d. imaging the testicle on the affected side
b
36
A contrast agent that consists of a cellulose suspension is administered to a patient to better visualize: a. non-functioning adrenal adenomas b. an aortic aneurysm c. the pancreatic tail d. functioning thyroid nodules
c
37
The __ region is identified by the orifices of the two ureters and the urethral outlet. a. trigone b. base c. dome d. fundus
a
38
Which of the following lab values would be elevated with a biliary obstruction due to a hepatocellular carcinoma, but not with a biliary obstruction due to choledocholithiasis? a. conjugated bilirubin b. gamma glutamyl transpeptidase c. alpha feto-protein d. alkaline phosphatase
c
39
Which of the following ultrasound exams requires the patient to be NPO for accurate results? a. abdominal ultrasound for possible Crohn disease b. Abdominal ultrasound for possible rectus sheath hematoma c. RUQ ultrasound for possible hepatoma d. RUQ ultrasound for possible cholecystitis
d
40
The bright band sign is a characteristic of: a. biliary tree dilatation b. hepatitis c. splenic infarction d. rectus abdominis hematoma
c
41
Hypersplenism and anemia are common findings in cases of: a. asplenia b. cirrhosis c. celiac disease d. inflammatory bowel disease
b
42
If an inguinal hernia does not increase in size with valsalva strain, __ should be suspected. a. malignancy b. infection c. spontaneous closure d. strangulation
d
43
Reye syndrome will demonstrate features on liver ultrasound that are similar to: a. metastasis b. advanced cirrhosis c. steatosis d. autosomal dominant polycystic disease
c
44
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 the another image at the start of the procedure c. allow the patient to take a 15 to 20 minutes 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
45
Overgaining on an US exam can cause __. a. increased posterior shadowing b. underestimation of arterial stenosis c. overestimation of Doppler velocity d. blood to appear anechoic
c
46
If a solid renal mass is identified in the right kidney on an US exam, which of the following should also be closely evaluated for associated findings? a. portal veins b. renal veins c. hepatic veins d. mesenteric veins
b
47
Which of the following liver tumors is usually treated by surgical resection due to risk of hemorrhage and malignant transformation? a. hemangioma b. adenoma c. pyogenic abscess d. lipoma
b
48
A large angiomyolipoma in the right kidney is most commonly associated with what acoustic artifact? a. propagation speed artifact b. reverberation c. mirror image d. comet tail artifact
a
49
Liver elastography is used for: a. staging of primary malignancy b. staging of secondary malignancy c. staging of steatosis d. staging of fibrosis
d
50
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. left paracolic gutter b. left inguinal canal c. right paracolic gutter d. right inguinal canal
b
51
The common bile duct is formed by: a. cystic duct + duct of Wirsung b. right and left hepatic ducts + the cystic duct c. varies per patient d. common hepatic duct + the cystic duct
d
52
What patient age is preferred for performing ultrasound of the infant hips? a. >6 months b. 4-6 weeks c. 4-6 months d. 1-2 weeks
b
53
Which type of transducer would be used to evaluate a palpable lump in the neck? a. 12 MHz sector phased array b. 12 MHz curvilinear phased array c. 12 MHz linear phased array d. 3 MHz curvilinear sequential array
c
54
Which imaging plane is most commonly used to obtain the length of the spleen during an abdominal ultrasound? a. coronal b. transverse c. sagittal d. axial
a
55
Which of the following will increase the amount of color displayed in the abdominal aorta? a. decrease color priority b. decrease color gain c. increase frame rate d. increase wall filter
c
56
Which imaging plane can demonstrate the IVC and the aorta on the same image in a normal patient? a. coronal and transverse b. coronal only c. transverse only d. mid sagittal only
a
57
__ occurs posterior to highly attenuating structures. a. shadowing b. refraction c. enhancement d. speckle
a
58
Harmonic imaging: a. uses information from reflections created by the non-linear behavior of sound waves to form the image b. degrades spatial resolution but improves temporal resolution c. is not recommended for use of fetal exams due to increased beam intensity d. improves spatial resolution but causes degradation of contrast resolution
a
59
Which of the following machine adjustments will produce a more black and white 2D image? a. increasing compression b. reducing monitor contrast c. reducing overall gain d. increasing dynamic range
a
60
Harmonic imaging leads to: a. reduced signal to noise ratio b. reduced appearance of lobe artifact c. increased image noise d. improved axial but degraded lateral resolution
b
61
Harmonic imaging will: a. allow for deeper penetration with improved spatial resolution b. improve temporal resolution c. reduce the appearance of microbubble contrast on a contrast echo d. degrade lateral resolution and improve axial resolution
a
62
All of the following techniques will aid in the visualization of a small renal calculi with questionable shadowing, except? a. decreasing transducer frequency b. using multiple scanning planes to evaluate the kidney c. reducing the dynamic range d. rescanning the patient in the decubitus position
a
63
Color Doppler demonstrates the: a. direction of flow only b. peak velocity of flow only c. average velocity and direction of flow d. peak velocity and direction of flow
c
64
In order to assess low velocity flow, which of the following operator adjustments should be made? a. decrease wall filter setting and compression b. increase scale setting c. decrease compression d. decrease the rejection and wall filter setting
d
65
When you change the angle on the Doppler cursor, the __ also changes. a. amplitude of the reflected signal b. the volume of flow interrogated c. the wall filter settings also change d. flow velocity displayed
d
66
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. increase the transducer frequency b. ask the patient to perform the Valsalva maneuver c. apply color doppler d. ask the patient to fast for 3-4 more hours and rescan the GB for changes
a
67
You are evaluating an obese patient with a known AAA. While using color Doppler to assess flow within the aneurysm, minimal flow is detected in the anechoic lumen. You decrease the color sale and increase the color gain but there is no improvement. Which of the following adjustments will most improve the color display on this exam? a. increase color sample size b. switch from a 4MHz curved array to a 4 MHz linear array c. decrease the color threshold d. increase the color threshould
d
68
What system control should be turned off when trying to differentiate a small stone in the gallbladder from a sludge ball? a. compound imaging b. time gain compensation c. harmonic imaging d. focal zone
a
69
All of the following are characteristics of Power Doppler, except: a. demonstrates organ perfusion better than Color Doppler b. demonstrates velocity flow within the organ c. demonstrates presence or absence of flow d. more sensitive to slow flow than color Doppler
b
70
Increasing the wall filter setting could reduce the display of all the following, except: a. clutter artifact b. aliasing artifact c. beam width artifact d. cross talk artifact
b
71
Propagation speed artifact, reverberation artifact, and the bayonet artifact are acoustic artifacts seen with: a. needles b. abdominal aortic aneurysms c. pneumothorax d. abscess formation
a
72
If there is no diastolic flow demonstrated on a doppler tracing of the interlobar artery of the upper pole of the right kidney, what will the resistive index be? a. 1.0 b. 0 c. 0.5 d unable to calculate the RI, not enough information is given
a
73
Which transducer would be best suited to rule out appendicitis in an average sized patient? a. 5 MHz curvilinear b. 3 MHz curvilinear c. 5 MHz linear d. 12 MHz linear
c
74
Which of the following will improve the color Doppler visualization of flow in the arcuate arteries? a. reduced color gain b. larger color sample size c. smaller packet size d. increased transducer frequency
d
75
When performing a Doppler evaluation of the renal arteries the cursor angle should be set at __ degrees or less for the main renal arteries and __ degrees or less for the intraparenchymal arteries. a. 20, 0 b. 60, 20 c. 45, 60 d. 60, 45
b
76
Which of the following correctly describes why the arcuate arteries are not easily or accurately evaluated by PW doppler? a. the renal capsule attenuates the Doppler signal so only limited information is reflected to the probe b. because the blood flows perpendicular to the Doppler sound beam. c. because the blood flows parallel to the Doppler sound beam d. because the flow is very low resistance
b
77
Which imaging plane can produce a longitudinal image of the IVC and the aorta on the same image? a. coronal and transverse b. mid sagittal only c. coronal only d. transverse only
c
78
A contrast agent that consists of a cellulose suspension is administered to a patient better visualize: a. an aortic aneurysm b. non-functioning adrenal adenomas c. the pancreatic tail d. functioning thyroid nodules
c
79
Which of the following correctly describes the location of the right hepatic vein? a. courses inferiorly through the falciform ligament b. courses superiorly through the main lobar fissure c. courses superiorly through the right intersegmental fissure d. courses superiorly through the falciform ligament
c
80
Which of the following hepatic ligaments separate the medial and lateral left lobes of the liver? a. ligamentum venosum b. broad ligament c. falciform ligament d. triangular ligament
c
81
An ERCP is commonly performed to evaluate: a. pyloric stenosis b. right renal vein c. the Ampulla of vater d. left renal vein
c
82
__ is produced by the exocrine function of the pancreas and __ is produced by the endocrine function of the pancreas. a. insulin, trypsin b. amylase, lipase c. sodium bicarbonate, amylase d. sodium bicarbonate, insulin
d
83
In the porta hepatis, what structure is anterior to the portal vein and lateral to the proper hepatic artery? a. common hepatic artery b. common hepatic duct c. duct of wirsung d. cystic duct
b
84
All of the following are intrasegmental vessels of the liver, except? a. portal veins b. hepatic arteries c. bile ducts d. hepatic veins
d
85
The ligamentum venosum travels between: a. the right portal vein and the IVC b. the left portal vein and the IVC c. the main portal vein and the IVC d. caudate lobe and the right lobe
b
86
The cystic artery originates at the __ and the cystic vein empties into the ___. a. right hepatic artery, right hepatic vein b. left hepatic artery, left portal vein c. common hepatic artery, main portal vein d. right hepatic artery, right portal vein
d
87
Which of the following correctly lists the structures found in an intrahepatic portal triad? a. hepatic vein, proper hepatic artery, and bile duct b. portal vein, proper hepatic artery, and bile duct c. portal vein, hepatic vein, and bile duct d. common hepatic artery, hepatic vein, and portal vein
b
88
In a normal adult patient, the intrahepatic common hepatic duct lumen measures less than or equal to __. a. 4mm b. 2cm c. 6mm d. 2mm
a
89
The right and left hepatic ducts come together to form the common hepatic duct: a. inside the liver, near the porta hepatic b. deep within the liver parenchyma c. at the level of the Ampulla of Vater d. at the pancreas head
a
90
Normal hepatic venous flow will demonstrate: a. two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction b. two large retrograde diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction c. two large antegrade diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction d. two large retrograde diastolic and systolic waves followed by a small retrograde component that corresponds with atrial contraction
a
91
What structure prevents free fluid in Morison pouch from moving into the subphrenic space? a. right coronary ligament b. right hepatoduodenal ligament c. falciform ligament d. ligamentum teres
a
92
Which of the following correctly describes the ducts of Luschka? a. bile thickening occurs within them b. associated with porcelain gallbladder and gallbladder carcinoma c. only visible in obese patients d. located within the 3rd segment of the duodenum
a
93
Which of the following statements correctly describes imaging of the dome of the liver? a. the portal confluence should be used to locate the dome of the liver b. intercostal scanning is the preferred scanning approach to evaluate the dome of the liver c. deep inspiration is required to evaluate this portion of the liver d. because the dome is bordered superiorly by the diaphragm, lobe artifact commonly inhibits complete evaluation of this portion of the liver
c
94
The pancreatic tail in anterior to all of the following, except: a. upper pole of the left kidney b. left adrenal gland c. lesser omental sac d. splenic hilum
c
95
The IVC is located posterior to the pancreatic __. a. neck b. tail c. body d. head
d
96
The majority of the liver is covered by a thick capsule composed of fibrous and elastic elements called __. a. gerota fascia b. Bowman capsule c. Morrison pouch d. Glisson capsule
d
97
The __ can be identified anterolateral to the pancreas tail. a. left kidney b. hepatic flexure of the colon c. superior mesenteric artery d. stomach
d
98
The formation of a Hartmann pouch usually occurs in what portion of the gallbladder? a. fundus b. neck c. cystic duct d. body
b
99
The caudate lobe occupies much of the __ surface of the liver. a. anterior inferior b. anterior superior c. posterior inferior d. posterior superior
d
100
Which of the following ligaments separates the medial and lateral left lobes of the liver? a. coronary ligament b. ligamentum teres c. ligamentum venosum d. broad ligament
b
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