URR 83 Flashcards by Billie Harney

Which of the following would indicate a normal Doppler evaluation of an intrahepatic shunt?
a. hepatofugal flow in the main portal vein
b. peak flow velocity of 25 cm/s
c. hepatofugal flow in the left portal vein
d. peak flow velocity of 230 cm/s

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A 10 year old presents for an abdominal ultrasound with a palpable RUQ mass. He has no history of liver disease and alpha-fetoprotein levels are normal. You identify a 9cm mass in the right lobe that demonstrates punctate calcifications and a central scar. These finding are most suggestive of?
a. hepatoma
b. metastasis
c. hepatoblastoma
d. fibrolamellar carcinoma

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Hepatic artery hypertrophy is a common finding with:
a. celiac axis occlusion
b. cholecystitis
c. cirrhosis
d. splenic vein thrombosis

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High-intensity transient signals (HITS) are seen on the Doppler evaluation of a patient with:
a. critical renal artery stenosis
b. significant aortic stenosis
c. hyperfunctioning adenoma
d. portal venous gas

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

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Which of the following correctly describes how contrast enhanced ultrasound can be used to differentiate benign and malignant masses?
a. Benign nodules usually demonstrate isovascular enhancement while malignant tumors usually demonstrate hypervascular enhancement
b. benign nodules usually demonstrate hypervascular enhancement while malignant tumors usually demonstrate hypovascular enhancement
c. significant contrast uptake occurs in malignant nodules, while no contrast uptake is seen in benign nodules
d. significant contrast uptake occurs in benign nodules, while no contrast uptake is seen in malignant nodules

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Which of the following Doppler characteristics of the hepatic arteries will be seen in a normal liver transplant?
a. diastolic flow reversal
b. increased resistive index
c. prolonged acceleration time
d. sharp systolic upstroke

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__ abscesses are most commonly found in countries outside the US. __ abscesses are most commonly seen in immunocompromised patients.
a. amebic, fungal
b. fungal, amebic
c. fungal, pyogenic
d. pyrogenic, amebic

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Which of the following describes the sonographic appearance of focal nodular hyperplasia?
a. single or multiple hypoechoic, rounded masses with mild posterior shadowing within the liver parenchyma
b. diffuse echogenic nodules or foci scattered throughout the liver parenchyma
c. a single hyperechoic mass most commonly found adjacent to the porta hepatis
d. a single mass <5cm with a central scar and prominent central and radial vascularity

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Which of the following correctly describes peliosis hepatis?
a. blood filled cavities of varied size and echotexture form in the liver tissue
b. infection of the cystic duct that transfers to the pancreas
c. numerous AV fistulas form throughout the liver
d. numerous cysts form that connect to the extrahepatic portal vein

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Schistosomiasis is an __ cause of portal HTN. Budd Chiari syndrome is an __ cause of portal HTN.
a. extrahepatic presinusiodal, intrahepatic postsinusoidal
b. intrahepatic presinusoidal, extrahepatic postsinusoidal
c. intrahepatic presinusoial, intranhepatic post sinusoidal
d. intrahepatic presinusoidal, extrahepatic presinusoidal

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While scanning the liver in a patient with chronic cirrhosis, you notice a tubular vessel connecting to the left portal vein and exiting the liver coursing inferiorly. Flow within the vessel is very low velocity, continuous and moving in a caudal direction. Which of the following explains the ultrasound findings?
a. a dilated SMV is present with flow reversal which is a common complication of cirrhosis
b. a dilated umbilical vein is present which is a common complication with cirrhosis
c. A dilated coronary vein is present which is a common complication of cirrhosis
d. the ductus venosus is dilated with antegrade flow which is a common complication of cirrhosis

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Which of the following describes the appearance of the liver in a patient in the later stages of cirrhosis caused by viral hepatitis?
a. multiple nodules usually 1-5 cm in size
b. significant hepatomegaly with diffuse decrease in hepatic echotexture
c. diffuse coarse liver texture with no nodule formation
d. multiple nodes usually 1 cm in size

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__ can lead to air within the portal venous system and __ can lead to air within the biliary tree.
a. an ERCP, ulcerative colitis
b. ulcerative colitis, appendicitis
c. Diverticulitis, ulcerative colitis
d. ulcerative colitis, an ERCP

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Which liver disorder leads to the sonographic appearance of hepatomegaly with decreased echogenicity and scattered bright portal reflections within the parenchyma?
a. chronic viral hepatitis
b. cirrhosis
c. hydatid disease
d. acute viral hepatitis

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What abnormalities causes focal developmental lesions of the liver and is associated with congenital hepatic fibrosis, autosomal dominant polycystic disease and cholangiocarcinoma?
a. candidiasis
b. biliary hamartomas
c. Wilson disease
d. schistosomiasis

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

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A cyst within a cyst (daughter cyst) is a classic sign of:
a. Polycystic liver disease
b. Hydatid cyst or fungal abscess
c. echinococcal cyst or pyogenic abscess
d. hydatid cyst or echinococcal cyst

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If a liver transplant patient has an interposition anastamosis, how does this affect your evaluation?
a. there will be two anastamosis sites in the IVC that must be evaluated
b. the hepatic artery anastamosis will not be able to be visualized because it is located deep within the liver tissue
c. each hepatic vein is connected to the native IVC separately, so there will be three anastamosis sites in the IVC that must be evaluated
d. there will be two anastamosis sites in the main portal vein that must be evaluated

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__ usually presents as multiple target lesions in the liver.
a. Klatskin tumor
b. Metastasis
c. Fungal abscess
d. Hydatid disease

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Reye Syndrome will demonstrate features on liver ultrasound that are similar to:
a. metastasis
b. advanced cirrhosis
c. steatosis
d. autosomal dominant polycystic disease

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Contrast enhanced ultrasound is used to determine the outcome of tumor ablation in the liver. If the procedure was a success, what are the expected findings on the image?
a. contrast uptake occurs during the venous phase
b. no contrast enters the lesion during the cardiac cycle
c. contrast uptake occurs during the arterial phase
d. consistent contrast uptake occurs during the arterial and venous phases

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All of the following statements correctly describe infantile hemangioendothelioma, except:
a. highly aggressive liver malignancy seen early in life
b. usually spontaneously regresses before age 2yrs
c. most common benign vascular tumor of the liver in infants and toddlers
d. can lead to cardiac failure if associated with an AV malformation within the tumor

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What lab value increases with gallbladder cancer, cholecystitis or prolonged biliary obstruction?
a. CA-125
b. alpha-fetoprotein
c. lactic dehydrogenase
d. prothrombin time

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Which of the following sonographic characteristics is associated with Budd Chiari syndrome? a. dilated IVC b. portal system aneurysm c. agenesis of the hepatic artery d. atrophied hepatic veins

What is caput medusae? a. formation of splenorenal varices b. formation of gastroesophageal varices c. tortuous vessels around the umbilicus caused by portal HTN d. failure of a TIPS shunt

Which of the following is a contraindication to placement of a TIPS shunt? a. splenic varices b. portal thrombosis c. cirrhosis d. hepatic artery aneurysm

Budd Chiari syndrome, portal thrombosis, and splenomegaly are complications of: a. increased prothrombin time b. anemia c. polycythemia vera d. steatosis

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

Which of the following describes a technique that can be used to locate a collapsed gallbladder in a patient with chronic cholecystitis? a. have the patient perform the Valsalva maneuver to force bile into the gallbladder for improved visualization b. locate the right portal vein and the main lobar fissure, trace the fissure to the gallbladder neck c. use color Doppler to identify the associated hypervascularity seen with wall inflammation d. locate the umbilical vein and trace it to the ligamentum teres to locate the gallbladder neck just medial to the proximal ligamentum

A patient with multiple gastrinomas will usually present with what other GI tract issue? a. esophageal and gastric varices b. mesenteric ischemia c. intussuscpetion d. peptic ulcer formation

Dark urine and pale stool are indications of: a. hyperbilirubinemia b. diverticulitis c. ulcerative colitis d. renal cell carcinoma

A low albumin/globulin ratio usually indicates: a. cirrhosis b. impacted stone as the gallbladder neck c. primary carcinoma of the gallbladder d. partial obstruction of the ampulla of Vater

Which of the following lab values will increase with mucinous cystadenocarinoma of the pancreas? a. alanine aminotransferase b. hematocrit c. carcioembryonic antigen d. alkaline phosphatase

While scanning the liver, you identify a small focal area of intrahepatic ductal dilatation in the right lobe of the liver. The CBD measures 5mm in diameter and the gallbladder appears normal. The liver demonstrates mild fatty infiltration and the pancreas and kidneys appear within normal limits. Which of the following correctly describes the laboratory findings that correlate with these findings? a. increased indirect bilirubin, increased LFTs b. increased direct bilirubin, normal LFTs c. increased LFTs, normal direct bilirubin d. increased LFTs, increased bilirubin

A patient presents with mildly increased levels of ALT and significantly increased levels of AST. Which of the following is the most likely finding on the ultrasound exam? a. Mirizzi syndrome b. choledocholithiasis c. acute viral hepatitis d. cirrhosis

Which of the following pancreatic abnormalities are most associated with an increase in amylase and lipase levels in the blood? a. pseudocyst, acute pancreatitis, and chronic pancreatitis b. pseudocyst and adenoma c. chronic pancreatitis and pseudocyst d. acute pancreatitis and pseudocyst

Sulfur colloid imaging is: a. a type of contrast used in MR imaging b. used to evaluate autosomal polycystic liver disease c. a type of contrast used in CT imaging d. used to evaluate suspected focal nodular hyperplasia

Which of the following lab values is usually unaffected by an isolated acute biliary duct obstruction? a. aspartate aminotransferase b. gamma glutamyl transpeptidase c. total bilirubin d. alkaline phosphatase

A 60 year old male presents for an abdominal ultrasound for recurrent epigastric pain. The patient tells you that this is the fourth time he has been hospitalized for pancreatitis and the medications are just not working. What is the expected appearance of his pancreas on ultrasound? a. increased size with decreased echogenicity b. enlarged and edematous with a hyperechoic appearance c. atrophied with multiple cysts and hypervascularity of the parenchyma d. atrophied with calcifications in the parenchyma

The liver measurement normally used to assess liver size is: a. measured 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)

What lab test is used to evaluate the endocrine function of a pancreas transplant? a. anodal trypsinogen levels b. amylase levels c. hematocrit levels d. glucose levels

Which of the following is required when performing liver elastography? a. the region of interest box should be placed on the liver tissue within 2cm of the diaphragm b. patient should perform a neutral breath hold for a few seconds when recording measurements c. patient should perform valsalva manuever for a few seconds when recording measurements d. the region of interest box should be placed on the liver tissue within 2cm of the skin surface

Serum amylase will be increased with all of the following, except: a. tumor of the submandibular gland b. parathyroid adenoma c. acute pancreatitis d. use of oral contraceptives

Which of the following will cause a moderate increase in alpha-fetoprotein values in an adult? a. hepatocellular carcinoma b. glycogen storage disease c. adenoma d. hepatoblastoma

Cullen sign is hemorrhagic discoloration of the umbilical area caused by __. Grey Turner sign in hemorrhagic discoloration of the left flank caused by ___. a. cavernous transformation, gastric varices b. intraperitoneal hemorrhage, hemorrhagic pancreatitis c. umbilical vein recanalization, gastric varices d. rectus sheath hematoma, subcapsular renal hematoma

When evaluating an infant for pyloric stenosis, the infant should be placed in the __ position for better visualization of the pylorus. a. left lateral decubitus b. prone c. semi-erect d. right lateral decubitus

The most common use of chest sonography is to evaluate: a. suspected lung cancer b. suspected atelectasis c. a complete or partial radiopaque hemithorax d. a known pulmonary embolism

When evaluating an infant hip, the transducer is placed __, but for a pediatric hip evaluation the transducer is placed __. a. on the anterior hip, on the posterior hip b. on the lateral hip, on the anterior hip c. on the anterior hip, on the lateral hip d. on the lateral hip, on the posterior hip

A patient presents with a history of Conn syndrome. Which of the following hormone levels will be increased? a. aldosterone b. cortisol c. adenocorticotropic hormone d. epinephrine

Which of the following describes the proper technique for visualization of the bicep tendon? a. longitudinal probe position on the posterior upper arm, just proximal to the elbow joint b. oblique probe position with the notch turned 60 degrees medially; placed on the anterior upper arm, just proximal to the elbow joint c. oblique probe position with the notch turned 30 degrees medially; placed on the posterior upper arm, just proximal to the elbow joint d. scanning with the us beam as perpendicular to the tendon as possible to improve visualization

Increased levels of Prostatic Acid Phosphatase (PAP) are most suggestive of: a. prostatitis b. BPH c. prostate calcifications d. prostate carcinoma

A mother presents with her 3mo old infant due to excessive vomiting and crying for 3 days. The referring physician suspects a lactobezoar may be the problem. Where will you look for this abnormality? a. anywhere along the digestive tract b. gallbladder c. the appendix d. urinary bladder

A patient presents with a history of Addison's disease. Which of the following hormones levels will be increased? a. cortisol b. aldosterone c. adrenocorticotropic hormone d. epinephrine

Which of the following is a symptom of Addison disease? a. hypertension b. hyperkalemia c. weight gain d. hypernatremia

Which of the following is a stress maneuver performed when evaluating infant hips? a. Baker maneuver b. Graf maneuver c. Barlow maneuver d. Allis maneuver

Which of the following is an important part of a transrectal ultrasound performed prior to brachytherapy? a. to locate the main arterial branch that is feeding the carcinoma b. to determine prostate size and volume c. to obtain a PQ Doppler signal from the base and apex of the gland d. to measure the distance from the prostate to the anterior abdominal wall

All of the following are clinical signs of congenital hip dysplasia, except: a. Barlow sign b. palpable clunking sound on physical exam c. Allis sign d. asymmetric skin folds of the hip and thigh

Hypernatremia and hypokalemia are clinical signs of: a. Conn Syndrome b. Adrenal hemorrhage c. Addison disease d. Adrenal myelolipoma

Which of the following describes the placement for the second line for measurement of the alpha angle during an infant hip evaluation? a. extends from the bony edge of the acetabulum to the lateral aspect of the femoral head b. extends from the iliac bone, along the labrum, and the medial aspect of the femoral head c. aligned with iliac bone and extends through the center of the femoral head d. extends from the iliac bone, along the labrun, and the lateral aspect of the femoral head

What patient position is used to evaluate the Achilles' tendon with ultrasound? a. seated, knee flexed, and ankle extended b. standing c. prone, feet dangling d. seated, knee and ankle flexed

Which of the following arteries are evaluated during a penile duplex exam for erectile dysfunction? a. ventral b. urethral c. cavernosal d. dorsal

A patient presents with a history of Cushing syndrome and an adrenal tumor. What lab results are expected in the clinical findings? a. Normal serum ACTH and elevated cortisol levels in the urine b. Elevated epinephrine levels in the urine c. elevated serum levels of ACTH and elevated cortisol in urine d. elevated serum levels of aldosterone

A pituitary tumor that is causing Cushing disease will cause what lab value(s) to be increased? a. Cortisol only b. adrenocorticotropic hormone and cortisol c. aldosterone only d. adrenocorticotropic hormone only

Which of the following structures can be used as an acoustic window when evaluating the pediatric mediastinum? a. thyroid b. diaphragm c. lung pleura d. thymus

A 55 year old male patient presents with a script that states "pelvic ultrasound; post biopsy, Gleason score of 8". What should you expect to find on the exam? a. inguinal hernia caused by recent bladder wall biopsy b. lymphadenopathy and metastasis related to prostate cancer c. lymphadenopathy and metastasis related to transitional cell bladder cancer d. bladder puncture caused by recent biopsy of the seminal vesicle

Which of the following indicates a serious complication associated with a bowel obstruction? a. visualization of the plicae circulares b. lack of color display of the vascularity of the bowel wall c. increased color display of the vascularity of the bowel wall d. visualization of the haustral markings

A patient scheduled for a transrectal prostate biopsy must perform all of the following prior to the exam, except: a. have lab testing for PT/INR levels b. perform a cleansing enema c. nothing to eat or drink at least 8 hours before the procedure d. begin taking a several day course of antibiotics

A patient presents for a thyroid ultrasound due to an incidental finding on a nuclear medicine exam. The report states there is a 2 cm hot nodule in the upper left lobe. Which of the following is the most likely finding on the ultrasound exam? a. complex cyst with peripheral hypervascularity b. cystic mass c. solid mass with microcalcifications and irregular margins d. solid mass with hypoechoic halo

When preparing the sterile tray for a liver biopsy, the cover on the tray should be opened: a. no more than 2 hours before the procedure begins b. while wearing sterile gloves c. by pulling the far corner of the cover toward you d. by the radiologist

Patients with new onset of secondary hyperparathyroidism will demonstrate: a. increased vitamin K and D levels b. increased serum calcium, vitamin D, and PTH c. low serum calcium and vitamin D levels with high PTH levels d. increased vitamin D levels, normal calcium and PTH levels

A patient has a history of thyroid cancer and bilateral thyroidectomy 3 years ago. What lab values should be reviewed before starting the annual post-surgical neck ultrasound? a. serum levels of thyroglobulin b. serum levels of CEA 123 c. serum levels of T3 d. serum levels of T4

Uncomplicated cysts and fluid collections will appear black on ultrasound and __ on CT scan. a. black b. light gray c. dark gray d. white

What transducer would be preferred for the evaluation of sialolithiasis on an average sized patient? a. 5-7 MHz linear b. 3-5 MHz sector c. 10-12 MHz linear d. 3-5 MHz curvilinear

Which type of thyroid cancer is most associated with elevated calcitonin? a. anaplastic b. medullary c. papillary d. follicular

Which of the following will cause elevated serum amylase? a. chornic pancreatitis and pyelonephritis b. use of anabolic steroids and parathyroid adenoma c. tumor of the submandibular gland and use of oral contraceptives d. parathyroid adenoma and renal cell carcinoma

An area of plaque or thrombus in an artery will be demonstrated as ___ on angiography. a. an area of absence of contrast material b. an area of increased concentration of contrast materal c. a highly reflective area within the vessel d. a dark black area within the vessel

A 65 year old female presents for a neck ultrasound with a script that states hypophosphatemia and hypercalcemia. What do you expect to find on the exam? a. papillary thyroid cancer b. medullary thyroid cancer c. atrophied thyroid gland d. enlarged parathyroid glands

Patients diagnosed with a multinodular goiter will also have: a. increased T3 and T4, Normal TSH b. Increased TSH, Normal T3 and T4 c. Decreased T3 and T4, Normal TSH d. Increased TSH, decreased T3 and T4

An obese patient has a known hepatoma in the posterior aspect of the right lobe of the liver. Which probe would you use to assist the radiologist in performing a biopsy? a. 3.5 MHz, long focus b. 2.25 MHz, short focus c. 5 MHz, short focus d. 2.25 MHz, long focus

In patients with primary hyperparathyroidism, levels of parathyroid hormone will increase and: a. T4 levels will increase b. serum calcium levels will increase c. serum calcium levels will decrease d. T3 levels will increase

Hypertension, nephrolithiasis, osteopenia, weakness, and malaise are common symptoms of: a. hyperparathyroidism b. hypoparathyroidism c. hypothyroidism d. hyperthyroidism

Which of the following would be an unexpected finding in a patient that had a vasectomy 4 years ago? a. spermatoceles b. atrophied epididymis c. tubular ectasia of the epididymis d. dilated vas deferens

A patient presents with mild scrotal pain and swelling on the left side that started 2-3 days ago. The patient awoke this morning with a slight fever and increased swelling. All of the following should be a suspected cause for the symptoms, except: a. orchitis b. epididymitis c. hydrocele d. testicular infarct

Air in the gallbladder wall will be demonstrated as areas of hyperechogenicity with posterior dirty shadowing and ring down artifact on sonography. How is this demonstrated on a CT exam? a. the gallbladder will demonstrate black areas within the wall where air is present b. the gallbladder will demonstrate no discernable changes on a CT scan with the presence of air in the wall c. the gallbladder will demonstrate linear spokes of shadowing from the pockets of air in the wall d. the gallbladder will demonstrate bright white areas within the wall where air is present

Which of the following lists an advantage of fine needle capillary technique over a fine needle aspiration technique? a. FNC does not require local anesthetic and FNA does b. FNC aspirates a smaller but more concentrated sample of cells than FNA c. FNC is less traumatic to the tissues than FNC d. FNC collects a tissue core while FNA collects a small amount of cells

Which of the following would be considered a critical finding on a Point of Care Ultrasound exam? a. nonobstructive renal calculi b. pneumothorax c. 4cm abdominal aortic aneurysm d. severe pericardial effusion

Which of the following correctly describes a way to tell the difference between a vasovagal response and anaphylaxis caused by contrast injection? a. Hypertension is a sign of vasovagal response, while hypotension is a sign of anaphylaxis b. Pallor is a sign of vasovagal response, while erythema is a sign of anaphylaxis c. A feeling of impending doom is a sign of vasovagal response, while dizziness and near syncope are signs of anaphylaxis d. Tachycardia is a sign of vasovagal response, while bradycardia is a sign of anaphylaxis

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

Which of the following exam results is most likely to end up with an ultrasound guided biopsy of the area of the interest? a. cold thyroid nodule seen on nuclear medicine exam b. a spiculated lung mass seen on a CT exam of the chest c. an irregular liver mass that is contiguous with the diaphragm seen on CT exam of the abdomen d. hot thyroid nodule seen on nuclear medicine exam

Which of the following correctly describes proper ergonomics during a Sonography exam? a. Position your wrist to allow for full flexion during imaging b. Adjust the table height to maintain a minimum of 90 degree angle of the elbow joint c. Place the transducer cord around your neck to provide support for the weight of the probe d. Choose a seat that allows your knees to fall below the levels of your hips

A patient presents for a renal ultrasound due to high serum levels of anti-diuretic hormone, low urine output, and a recent pulmonary embolism. These clinical findings are most suggestive of: a. renal vein thrombosis b. formation of a renal carbuncle c. obstructure bladder calculi d. abscess formation in the renal pelvis

What is the preferred position of a patient having a transplant kidney biopsy? a. prone with a pillow under the abdomen b. Trendelenburg c. semi-erect d. supine

Which of the following are commonly associated with retroperitoneal fibrosis? a. hydronephrosis and ureterocele formation b. scrotal calcifications and cryptorchidism c. pedal edema and portal HTN d. scrotal swelling and pedal edema

A 45 year old patient presents with increased serum BUN and creatinine, a recent history of oliguria and bilateral flank pain. The US exam demonstrates bilateral hydronephrosis and hydroureter, but the bladder is nearly empty. Which of the following statements is true regarding this patient and the findings? a. The patient has a neurogenic bladder and the radiologist should review the case immediately b. The patient will most likely return for a follow up exam in 7-10 days after anticoagulant treatment c. Acute postrenal failure is present and the radiologist should review the case immediately d. Acute intrinsic renal failure is present that is most likely due to acute tubular necrosis

Which of the following describes how to correctly measure the AP diameter of the iliac artery? a. longitudinal view, outer wall to outer wall b. transverse view, outer wall to inner wall c. transverse view, outer wall to outer wall d. longitudinal view, outer wall to inner wall

Which renal arteries are evaluated with Doppler in an ultrasound exam that is used to perform a direct evaluation for renal artery stenosis? a. main renal artery b. aorta c. segmental and arcuate arteries d. main renal artery, segmental, and arcuate arteries

URR 83 Flashcards

(100 cards)