US

Question 1

Earliest sonographic evidence of normal IUP?

Answer 1

intradecidual sign

Question 2

what is intradecidual sac sign?

Answer 2

• early gestational sac
• intrauterine fluid collection
• echogenic area of markedly thickened decidua on one side of uterine cavity

Question 3

intradecidual sac sign –> threshold level? discriminatory level?

Answer 3

• as early as 24 days GA

- should definitely see by 47 days GA

Question 4

carotid US –> asymmetric flow –> velocity difference?

Answer 4

20cm/sec or greater

Question 5

carotid dissection –> imaging study of choice –> US –> T/F?

Answer 5

F

Question 6

common carotid artery –> normal flow velocity?

Answer 6

> 45 cm/sec

Question 7

carotid US –> asymmetric flow –> possible etiologies? (4)

Answer 7

• normal
• proximal stenosis
• distal obstruction
• carotid dissection

Question 8

carotid US –> high flow velocity?

Answer 8

> 135 cm/sec

Question 9

carotid US –> bilateral high flow velocity –> possible etiology (2)?

Answer 9

• HTN –> high cardiac output

- young athlete

Question 10

carotid US –> low flow velocity?

Answer 10

<45 cm/sec

Question 11

carotid US –> bilateral low flow velocity –> possible etiology (3)?

Answer 11

• cardiomyopathy –> poor cardiac output
• heart valve disease
• extensive MI

Question 12

carotid US –> ICA/CCA peak systolic velocity ratio –> measures low and then high –> what is going on?

Answer 12

patient has arrhythmia

Question 13

what is tardus-parvus waveform? indicates what?

Answer 13

prolonged systolic acceleration time with low peak systolic velocity

severe proximal stenosis

Question 14

carotid US –> single patent vessel beyond carotid bifurcation –> how can tell if ICA or ECA?

Answer 14

ECA: ECA branches

Question 15

ICA total occlusion –> US findings? (4)

Answer 15

• “thud flow”: to and fro flow pattern at point of occlusion
• absent flow
• damped resistive flow in CCA
• thrombus

Question 16

ICA –> no stenosis:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 16

• ICA PSV: <125 cm/sec

- ICA/CCA PSV ratio: <2.0

Question 17

ICA –> <50% stenosis:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 17

• ICA PSV: <125 cm/sec

- ICA/CCA PSV ratio: <2.0

Question 18

ICA –> 50-69% stenosis:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 18

• ICA PSV: 125-230 cm/sec

- ICA/CCA PSV ratio: 2.0-4.0

Question 19

ICA –> >70% stenosis:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 19

• ICA PSV: >230 cm/sec

- ICA/CCA PSV ratio: >4.0

Question 20

ICA –> near occlusion:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 20

• ICA PSV: high, low, or undetectable

- ICA/CCA PSV ratio: variable

Question 21

ICA –> total occlusion:

• ICA PSV?
• ICA/CCA PSV ratio?

Answer 21

• ICA PSV: undetectable

- ICA/CCA PSV ratio: N/A

Question 22

what is subclavian steal?

Answer 22

proximal subclavian A stenosis/occlusion –> retrograde flow of ipsilat vertebral A

Question 23

complete subclavian steal –> vertebral A –> waveform finding?

Answer 23

reversed/retrograde flow

Question 24

partial subclavian steal (aka early/occult/latent subclavian steal, “presteal” state)–> vertebral A –> waveform findings?

Answer 24

• bunny waveform sign: biphasic –> midsystolic deceleration –> late systolic antegrade flow
• exercise arm: retrograde late systolic velocity (indicate subclavian steal)

Question 25

ectopic preg --> MC location?

Answer 25

fallopian tube ampulla

Question 26

what US criteria correlates with severity of renal A stenosis?

Answer 26

peak systolic velocity in stenotic portion

Question 27

postmenopausal & vag bleeding --> normal endometrial thickness?

Answer 27

<5mm

Question 28

postmenopausal & no vag bleeding --> normal endometrial thickness?

Answer 28

<8mm

Question 29

Diethylstilbestrel (DES) exposure --> uterus findings? (2)

Answer 29

- hypoplastic uterus | - T-shaped endometrial contour

Question 30

Diethylstilbestrel (DES) exposure --> complication?

Answer 30

clear cell vaginal CA

Question 31

What ultrasound criterion can predict the degree of renal artery stenosis?

Answer 31

Elevated velocity in the stenotic portion of the vessel

Question 32

resistive index (RI) --> normal range?

Answer 32

0.55-0.7

Question 33

low RI --> ddx? (2)

Answer 33

- prox stenosis | - distal vascular shunt

Question 34

What is the minimal threshold beta hCG level at which an intrauterine gestational sac should be visualized by transvaginal ultrasound?

Answer 34

2000 IU

Question 35

When does a corpus luteal cyst of pregnancy typically resolve or regress?

Answer 35

14wk

Question 36

In acute pyelonephritis, what is the most common finding on ultrasound?

Answer 36

normal

Question 37

HIV --> gallbladder --> marked wall thick --> no stones, no perichol fluid --> HIV cholangiopathy --> MC org?

Answer 37

cryptosporidium, CMV, microsporidium

Question 38

An acceleration time of >.07 seconds is the threshold commonly used to define a tardus parvus waveform --> T/F?

Answer 38

T

Question 39

Gastroschisis is associated w cardiac abnormalities --> T/F?

Answer 39

F

Question 40

Gastroschisis is associated w chromosomal abnormalities --> T/F?

Answer 40

F

Question 41

Gastroschisis is associated w GI atresias --> T/F?

Answer 41

T

Question 42

omphalocele --> incidence of associated anomalies >75% --> T/F?

Answer 42

T