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Abdomen Review (Spring 18)
Abdomen Review (Spring 18)
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1
persistence of the dorsal and ventral pancreas with the head encircling the duodenum is called:
hypoplasia.
cystic fibrosis
annular pancreas
agenesis.
2
A dilated renal pelvis without ureteral dilation is observed in patients with:
ureteropelvic junction obstruction.
ureterocele
posterior urethral valve obstruction.
hydronephrosis.
3
The fossae of the right portal vein (RPV) and gallbladder are found in the:
left lobar fissure
left intersegmental fissure
right intersegmental fissure
main lobar fissure.
4
Hydronephrosis may be best demonstrated sonographically by which one of the following patterns?
Distorted shape of the kidney outline
Multiple cystic masses throughout the renal parenchyma
Hyperechoic pelvocaliceal collecting system
Fluid-filled pelvocaliceal collecting system
5
most common tumor sites that can spread carcinoma to the biliary tree include all except:
colon
kidney
breast
melanoma
6
Splenomegaly may result from all of the following except:
collagen vascular disease
subphrenic abscess
congestion
trauma
7
Gas-forming bacteria in the gallbladder appear on ultrasound as a:
bright echo with a ring down or comet-tail artifact.
nonshadowing echogenic mass.
localized dilation.
dilated round shape
8
A thick calcified gallbladder wall describes which one of the following conditions?
Gangrenous gallbladder
Porcelain gallbladder
Wall-echo-shadow (WES) sign
Emphysematous gallbladder
9
Budd-Chiari syndrome is a rare disorder caused by obstruction of the:
superior mesenteric vein
portal veins
splenic vein.
hepatic veins
10
The vessel seen posterior to the IVC on the sagittal scan represents the:
right renal artery.
left renal artery.
right adrenal artery.
left renal vein.
11
In the early stages of sickle cell anemia, the spleen generally appears:
atrophied
hyperechoic
heterogeneous
enlarged
12
All of the following sonographic appearances are found in cases of gallbladder carcinoma except
wall thickening
pericholecystic fluid.
cholelithiasis
intraluminal wall mass
13
Which one best describes nonshadowing, low-amplitude echoes in a dependent gallbladder?
Cholecystitis
Cholelithiasis
Porcelain gallbladder
Sludge
14
Metastases to adrenal gland are most commonly caused by primary carcinoma of ___, ____, &___
lung; breast; liver
kidney; colon; liver
lung; breast; stomach
breast; liver; kidney
15
The left renal vein courses:
anterior to the IVC.
anterior to the aorta.
posterior to the IVC.
anterior to the superior mesenteric artery.
16
A congenital obstruction found in utero and in infants is called a(n):
ureterocele.
ureteropelvic junction (UPJ) obstruction.
posterior urethral valve.
bladder diverticulum.
17
Which statements describes the correct anatomic location of structures adjacent to the spleen?
The right adrenal and kidney lie superior to the spleen.
fundus of stomach&lesser sac medial&posterior 2splenic hilum
diaphragm is anterior, lateral, and inferior to the spleen.
The left kidney lies inferior and medial to the spleen.
18
Which one of clinical findings is the most likely reason for a renal artery Doppler examination
Hematuria
Oliguria
Severe flank pain
Hypertension
19
Para-aortic lymphadenopathy generally displaces the kidney:
anteriorly
posteriorly
laterally
medially
20
A chronic disease of unknown causes that involves all bone marrow elements is:
thalassemia
leukemia
polycythemia vera.
Hodgkin disease
21
Lymph nodes emerge from the splenic hilum and course along the
splenic vein.
renal vein
splenic artery.
renal artery.
22
The most common primary retroperitoneal tumor is:
leiomyosarcoma
lymphoma
fibrosarcoma
germ cell tumor
23
Which one of the following statements is false?
The head of the pancreas is anterior to the (IVC).
The uncinate process is posterior to the SMV.
The head of the pancreas is superior to the caudate lobe.
gastroduodenal artery is anterolateral border of the head
24
What vessel runs posterior to the neck of the pancreas and anterior to the uncinate process?
Superior mesenteric vein
Splenic vein
Hepatic artery
Gastroduodenal artery
25
What adrenal tumor demonstrates intermittent hypertension and severe headaches?
Adenoma
Pheochromocytoma
Myolipoma
Neuroblastoma
26
The area between the bladder and rectum is called the _____________ space.
iliac
bilateral pararectal
rectovesical
presacral
27
An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His he
chronic pancreatitis
pseudocyst.
hemorrhagic pancreatitis
cholecystitis.
28
Which one of the following may cause a splenic rupture?
Metastatic tumor
Infarction
Complicated cyst
Hemangioma
29
Which one of the following is noted in type I glycogen storage disease
Normal texture and prominent intrahepatic biliary ducts
Normal texture and hepatomegaly
Small liver and hypoechoic parenchyma
Hyperechoic, attenuating liver and hepatomegaly
30
The amebic abscess may reach the liver through the
hepatorectal artery.
portal vein
hepatic artery
gastroduodenal artery
31
A condition that causes increased secretion of thick mucus by the exocrine glands is:
fibrocystic disease of the pancreas
cystic fibrosis.
diabetes
cystic mucosal disease.
32
The spleen has two components joined at the hilum; they are the ________and ________components.
superior; inferior
anterior; posterior
superolateral; inferomedial
superomedial; inferolateral
33
Common malignancies affecting the pediatric population include all of the following except:
hepatoblastoma
neuroblastoma
leukemia
Wilms tumor.
34
The primary pancreatic duct is the duct of ______________.
Vater
Santorini
Ampulla
Wirsung
35
The normal diameter of the common hepatic duct is approximately ________ millimeters (mm).
3
2
4
5
36
Atrophy of the spleen may be found in all of the following except:
normal individuals.
cirrhosis
wasting diseases
sickle cell anemia
37
Primary tumors that may metastasize to the spleen originate from all structures except the:
brain
stomach
ovary
kidney
38
Typical symptoms a patient may have with an abscess formation include all the following except
decreased white blood count
pain
fever
increased white blood count
39
type of hydronephrosis demonstrating dilatation of renal pelvis w/thinning of the renal cortex
Grade 6
Grade 0
Grade 4
Grade 3
40
Which one describes the most common sonographic appearance of gallbladder carcinoma?
Irregular echogenic mass projecting from gallbladder wall
Shadowing posterior to mobile echogenic mass
Comet tail shadowing posterior to a hyperechoic focus
“Comet tail” shadowing posterior to a hypoechoic focus
41
What benign liver tumor is located near the free edge of the liver and is solitary, well-circum
Adenoma
Cavernous hemangioma
Lipoma
Focal nodular hyperplasia (FHN)
42
A patient w/painless jaundice, weight loss, and a decrease in appetite should be evaluated for
pancreatic pseudocyst
cholecystitis
adenocarcinoma of the pancreas
pancreatitis.
43
Which one of the following statements about the spleen is false?
The normal adult spleen measures approximately 7 cm in width
The spleen lies inferior to the diaphragm.
The spleen lies posterior to the hypochondrium
The spleen is located within the retroperitoneum.
44
A fusiform dilation of the common bile duct is known as
adenomyomatosis
a choledochal cyst
cholangitis
a Phrygian cap
45
Dilated intrahepatic bile ducts may be seen with all of the following except:
gallstones in the fundus of the gallbladder.
lymphadenopathy in the porta hepatis.
obstructive stone in the cystic duct
intrahepatic mass in the area of the porta hepatis.
46
Echinococcal cysts have the highest incidence in countries in which:
sheep herding is common
rock climbing is prevalent
poultry is abundant
fishing is common
47
Adrenal hemorrhages are more common in
young adults
toddlers
neonates
older adults
48
extreme lg echogenic renal sinus appears to engulf entire renal parenchymal outline suggests
hydronephrosis
hypernephroma
nephrocalcinosis
lipomatosis
49
celiac axis is visualized,tech should move the transducer in ___direction to image pancreas.
inferior
superior
posterior
anterior
50
The most common benign tumor of the liver is:
adenoma
infantile hemangioendothelioma
cavernous hemangioma
mesenchymal hamartoma
51
Air within the biliary tree, secondary to common bile duct stents, is called
pneumothorax
cholangitis
hemobilia
pneumobilia
52
The distal duct lies ___________ with the anterior wall of the inferior vena cava (IVC).
perpendicular
horizontal
lateral
parallel
53
Clinical signs and symptoms in acute pancreatitis include all of the following except:
severe abdominal pain radiating to the back.
severe abdominal pain radiating to the right shoulder.
nausea and vomiting.
elevated amylase.
54
A common course of enzyme destruction via the pancreas is fluid accumulation in the:
lesser omentum
greater omentum.
lesser sac.
greater sac.
55
Classic symptoms of gallbladder disease include all of the following except:
right shoulder pain
hematuria
nausea and vomiting
right upper quadrant pain
56
A common finding in people over 50 years of age is:
renal cyst.
renal calculi.
hypernephroma
multicystic disease.
57
What benign liver tumor has been found in patients with type I glycogen storage disease?
Hamartoma
Lipoma
Adenoma
Cavernous hemangioma
58
In cases of acute pancreatitis, the parenchyma of the pancreas generally appears:
echogenic
homogeneous
calcified
hypoechoic.
59
Which one of the following structures is located in the anterolateral border of the pancreas?
Gastroduodenal artery
Superior mesenteric vein
Hepatic duct
Common bile duct
60
The normal dimension of the pancreatic head is usually less than ___________.
2-3 cm
3 mm
1 cm
2 cm
61
Elevation of alkaline phosphatase is associated with
biliary obstruction
fatty infiltration
simple hepatic cysts.
cavernous hemangioma.
62
The most common cause of biliary ductal obstruction is the presence of a ductal
cyst
stone
stricture
tumor
63
Which one of the veins courses in a sag plane & passes posterior to the neck of the pancreas?
Splenic
Main portal
Superior mesenteric
Inferior mesenteric
64
A serum ____________ level of twice normal usually indicates acute pancreatitis.
alkaline phosphatase
amylase
lipase
aspartate aminotransferase (AST)
65
Parapelvic cysts are located in the:
renal cortex.
lower pole.
renal sinus.
pararenal space.
66
The physiologic effect of a fatty meal includes all of the following except:
contraction of the gallbladder.
decreased bile flow to the liver
relaxation of the sphincter of Oddi
stimulation of cholecystokinin (CCK)
67
The normal size of the pancreatic duct at the pancreatic head is less than _____ mm.
5
1
3
9
68
Which one of the following is a function of the gallbladder?
Storage for enzymes
Reservoir for biliary salts
Reservoir for bile
Storage for extra cholesterol
69
Which one of the following tumors consists of large blood-filled spaces?
Hamartoma
Ewing angioma
Cavernous hemangioma
Adenoma
70
iliopsoas muscle, ureter, &branches of the IVC, aorta, and their lymphatics is in the:
anterior pararenal space.
perirenal space.
retrofascial space
posterior pararenal space
71
Which one of the following demonstrates an excessive secretion of epinephrine?
Adrenal adenoma
Adrenal cyst
Neuroblastoma
Medulla tumor
72
The tail of the pancreas is located:
posterior to the left kidney, near the splenic hilum.
anterior to the right kidney, near the liver hilum.
anterior to the left kidney, near the splenic hilum.
posterior to the right kidney, near the liver hilum.
73
Gallstones are present in 40% to 60% of patients with:
chronic pancreatitis
annular pancreas
acute pancreatitis.
cystic fibrosis
74
cystic duct connects the ___of the gallbladder with the common hepatic duct to form the ______.
fundus; common bile duct (CBD)
fundus; common hepatic duct (CHD)
neck; CBD
body; CHD
75
An abnormal decrease in platelets may be the result of a(n):
allergic reaction
bone marrow disorder
infection.
internal hemorrhage
76
The valves of Heister are tiny valves found within the:
cystic duct
common hepatic duct
common bile duct
pancreatic duct.
77
The right adrenal gland lies posterior to the:
liver
IVC
right kidney.
crus of the diaphragm.
78
The ___________ passes through a groove posterior to the pancreatic head.
superior mesenteric vein
hepatic duct
gastroduodenal artery
common bile duct
79
In a 50-year-old adult, the normal common bile duct should not measure more than _____ mm.
5
10
8
6
80
What sonographic signs are present in the patient with histoplasmosis?
Bright echoes
Adenomas
Atrophy
Cystic masses
81
The pancreas is found behind the ___________ omental sac
greater
superior
lesser
inferior
82
Elevation of serum bilirubin results in:
hepatocellular disease
ascites
jaundice
hemolysis
83
The kidneys are located in the:
perirenal cavity.
perirenal space.
retroperitoneal cavity.
peritoneal cavity.
84
All of the following describe normal portal venous flow except:
phasic flow.
hepatofugal flow.
spontaneous flow.
low-flow velocity.
85
The bright linear echo within the liver connecting the neck of the gallbladder and the right or
left lobar fissure.
ligamentum teres.
right lobar fissure
main lobar fissure
86
RUQ pain,small polypoid masses arise from GB wall demonstrating “comet tail” artifact is
cholesterosis
adenomyomatosis
choledocholithiasis
pruritus
87
Which one of the following disorders does not produce a complex sonographic pattern?
Congenital simple cyst
Hemorrhagic cyst
Hematoma
Infected cyst
88
Hepatocellular disease can be defined as a process that affects the:
phagocytes and does not interfere with liver function.
hepatocytes and interferes with liver function.
spherocytes and interferes with liver function.
phagocytes and interferes with liver function
89
Which one of the following statements about the adrenal medulla is true?
The medulla secretes a large range of steroids.
The medulla is not essential to life.
The medulla is the outer portion of the adrenal gland.
The medulla secretes estrogen.
90
Splenic infarction is most commonly the result of:
splenomegaly
splenic trauma
cardiac emboli.
pneumonia
91
When accessory spleens are present, they are usually located:
on the posterior aspect of the spleen.
at the inferior margin of the spleen.
near the kidney
near the hilum of the spleen
92
The splenic artery is considered to be along the _________________ border of the pancreas.
inferior
posterior
lateral
superior
93
The most echogenic portion(s) of the kidney is(are) the:
medullary pyramids.
sinus.
parenchyma
cortex.
94
Which one is the most common clinical presentation in patients with a splenic hamartoma?
Asymptomatic
Abdominal pain
Right upper quadrant pain.
Epigastric pain
95
The best patient position to evaluate the spleen is:
supine
left lateral decubitus
left posterior oblique.
right decubitus.
96
All statements are true about the features most often observed in an intrahepatic mass except:
displacement of the hepatic vascular radicles
external bulging of the liver capsule
anterior displacement of the right kidney
posterior shift of the IVC
97
Inflammation of the gallbladder is known as:
adenomyomatosis
cholesterosis.
choledocholithiasis
cholecystitis
98
The most common site for echinococcal virus growth is in the:
lungs
bones
brain
liver
99
The spleen is variable in size and is considered to be all of the following except:
orange segment
pentagonal
tetrahedral
triangular
100
A urinoma may be defined as a:
lymph-filled space without a distinct epithelial lining.
cystic space anterior to the aorta.
walled-off collection of extravasated urine
heterogeneous irregular mass
101
Other areas that should be examined when ruling out a splenic rupture include all except
renal gutter
liver and lesser sac.
pelvis
pericardium
102
Adrenal insufficiency is typically caused by:
adrenal adenoma.
adrenal cyst
lymphadenopathy
metastatic lesions
103
The most common adrenal tumor in infancy is the:
pheochromocytoma
neuroblastoma.
liposarcoma
adenoma
104
All of the following are functions of the spleen except:
destruction of red blood cells
production of plasma cells.
destruction of white blood cells.
production of lymphocytes
105
A Phrygian cap of the gallbladder is:
calcification of the gallbladder wall
partial septation.
folding of the gallblabber fundus
septations within the organ
106
A gallbladder with a small outpuch at the neck is called a:
Phyrgian cap.
Murphy sign.
Murphy pouch
Hartmann pouch
107
The major function of the spleen is:
to fight infection
to manufacture leukocytes
to filter the peripheral blood
hematopoiesis
108
A most common cause of acute pancreatitis in the United States is:
alcohol intake.
biliary tract disease.
pancreatic malignancy.
colitis
109
A spleen that has migrated from its normal location is termed a(n):
ectopic spleen
accessory spleen.
splenomegaly
wandering spleen
110
Autosomal dominant polycystic kidney disease may be characterized by all statements except
disease may be associated w/cysts in liver, pancreas&spleen
the disease is latent until the 4th or 5th decade of life
severity of the disease varies, depending on the genotype
the kidneys are small and extremely echogenic.
111
Which of the following muscles lie posterior to the kidneys?
Psoas and iliopsoas
Obturator internus and piriformis
Psoas and quadratus lumborum
Iliopsoas and levator ani
112
right&left hepatic ducts emerge from right lobe of the liver in the porta hepatis&unite to form
common hepatic duct
common pancreatic duct
common bile duct
cystic duct
113
The left kidney is in contact with the:
spleen, gallbladder, and duodenum
spleen, stomach, and pancreas.
pancreas, colon, and porta hepatis.
spleen, pancreas, and gallbladder.
114
The head of the pancreas lies:
medial to the duodenum.
anterior to the liver.
posterior to the aorta.
lateral to the inferior vena cava.
115
Which one of the following syndromes demonstrates a decrease in adrenal function?
Conn
Cushing
Addison
Adrenogenital
116
In a 50-year-old adult, the normal common bile duct should not measure more than _____ mm.
nonshadowing, mobile, hyperechoic focus.
immobile, echogenic focus demonstrating comet-tail artifact
mobile, hyperechoic focus demonstrating posterior shadowing
mobile, hypoechoic focus demonstrating posterior shadowing.
117
The majority of the pancreas lies within which abdominal cavity?
Retroperitoneum
Pericardium
Intraperitoneum
Perineum
118
All of the following structures are located in the retroperitoneum except the:
kidney
aorta
psoas muscle.
spleen
119
Ureteral jets are not visualized in patients with:
duplex collecting system.
obstruction
acute focal bacterial nephritis.
renal cell carcinoma.
120
Which of the following is an indirect, sonographic sign of renal function?
Angiomyolipoma
Obstructive uropathy
Ureteral jets
Cyst formation
121
Patients who have hepatocellular carcinoma are more likely to have had:
cirrhosis
adenosis
hemochromatosis
carcinosis
122
In cases of choledocholithiasis, stones tend to lodge in the:
pancreatic duct.
common bile duct
common hepatic duct.
ampulla of Vater
123
Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, a
Hepatic abscess
Amebic abscess
Echinococcal cyst
Hematoma
124
Which one of the following is the most common primary adrenal tumor?
Cyst
Adenoma
Carcinoma
Pheochromocytoma
125
Which one of the following describes the sonographic appearance of chronic pyelonephritis?
Echogenic foci in the medullary regions
Hypoechoic enlarged kidney
Echogenic cortex
Inability to distinguish the cortex from medullary regions
126
Dilation of the renal pelvis may be caused by all of the following except:
distended urinary bladder.
oliguria
pregnancy
reflux
127
Patients positive for AIDS are at risk for developing
cholangitis
nephritis
pancreatitis
hepatitis
128
Excessive secretion of aldosterone occurs in ____________ syndrome.
Waterhouse-Friderichsen
Addison
Cushing
Conn
129
The retroperitoneal space is the area between the:
ant portion of parietal peritoneum & ant abdom wall muscles
post portion of parietal peritoneum &post abdo wall muscles.
posterior portion of the visceral peritoneum
ant portion of parietal peritoneum &post abdom wall muscles.
130
The most common form of neoplastic involvement of the liver is
metastases
hepatoma
hamartoma
hepatocellular carcinoma
131
triangular-shaped defect located anteriorly in upper pole of kidney most likely represents a(n)
IVC compression.
junctional parenchymal defect.
artifact from rib.
renal tumor.
132
The hepatic duct is joined by the ______________ to form the ________________.
right hepatic duct; common bile duct
cystic duct; common bile duct
common bile duct; cystic duct
pancreatic duct; cystic duct
133
A positive Murphy sign is a clinical finding associated with:
cholecystitis
cholelithiasis
porcelain gallbladder.
adenomyomatosis
134
The duct of Santorini is a(n):
accessory duct to the pancreas.
small accessory duct to the gallbladder
small opening in the duodenum.
accessory duct to the cystic duct
135
Sonographic findings of acute hepatitis include:
A
D
C
B
136
In severe hepatocellular destruction, the (AST) & (ALT) levels are:
mild
moderate
high
moderately high
137
Massive splenomegaly is most likely the result of
myelofibrosis.
infection
portal hypertension.
leukemia
138
CBD is joined by main pancreatic duct. Together they open through the __ into the duodenal wall
ampulla of Vater
ampulla of Santorini
ampulla of Water
ampulla of Oddi
139
Which one of the following structures is not located in the anterior pararenal space?
Pancreas
Ascending colon
Duodenal sweep
Adrenal gland
140
anterior to the right kidney, near the liver hilum.
accessory duct
common bile duct
cystic duct
duct of Santolina
141
Diminished vascular structures within the liver parenchyma most likely represent:
cirrhosis
acute viral hepatitis
obstructive portal disease
Budd-Chiari syndrome.
142
The left adrenal gland lies lateral to the:
IVC
stomach
tail of the pancreas
crus of the diaphragm.
143
In the adult, splenomegaly is diagnosed when the length of the spleen exceeds _____ (cm).
12
11
13
14
144
Which one of the following syndromes is a result of excessive secretion of cortisol?
Conn
Addison
Waterhouse-Friderichsen
Cushing
145
All of the following statements about the kidneys are true except:
the kidneys are intraperitoneal in location.
the kidneys move with respiration.
average adult kidneys measure approximately 9-12 cm length
anteroposterior thickness of normal adult kid is app 4-5 cm.
146
falciform ligament extends from the umbilicus to diaphragm in parasagittal plane containing the
ligamentum venosum
ligamentum falciforme
quadratus ligamentum
ligamentum teres
147
Renal vein thrombosis may be visualized in patients with:
pyelonephritis
renal calculi.
renal cell carcinoma.
angiomyolipoma
148
All statements are true about the features most often observed in an extrahepatic mass except:
formation of a triangular fat wedge.
anteromedial shift of the IVC.
discontinuity of the liver capsule
internal invagination of the liver capsule
149
The splenic vein courses along the posterior border of the:
spleen
pancreas
kidney
adrenal gland
150
The process of disposing metabolic wastes is called:
excretion
urea
urination
deamination
151
The most common location of renal ectopia is the:
retroperitoneum
pelvis
intrathoracic
epigastric region
152
Which one of the following statements about the kidneys is false?
kidneys consist of internal medullary & ext cort substance
The kidneys are rigidly fixed on the abdominal wall
The kidneys rest on the psoas and quadratus lumborum muscles
Renal pyramids are found within the medullary region
153
The “sandwich” sign represents:
enlarged lymph nodes ant &post to the mesenteric vessels.
the complex appearance of adrenal hemorrhage.
enlarged lymph nodes in the renal hilar area.
image of lt adrenal gland between crus of diaphragm< kid
154
The exocrine function of the pancreas is performed by the:
Cooper ligaments
islets of Langerhans
fat between the lobules
acini cells
155
Which one of the following statements describes adrenal cysts?
Patients are typically asymptomatic.
Adrenal cysts are usually bilateral.
Male patients are affected more than female patients.
Adrenal cysts are a common finding.
156
Fatty infiltration may be observed in all patients except those with:
chronic alcoholism.
hepatoportal fistula.
diabetes mellitus
hepatitis
157
The normal sonographic appearance of the splenic parenchyma is:
heterogeneous
hyperechoic compared with the liver
hypoechoic compared with the kidney.
homogeneous and similar to the liver.
158
The splenic vein courses along the ____________________ of the pancreas.
inferior posterior border
superior border
posteromedial border
anterior border
159
In glycogen storage disease, type I is the most common and is also known as _________ disease.
von Gierke
von Gerpe
von Slurpie
von Gussel
160
Thickening of the gallbladder wall may be caused by all of the following except:
adenomyomatosis
cholecystitis
pancreatitis
hepatitis
161
The length of the normal adult adrenal gland is usually smaller than:
2 cm.
3 mm.
3 cm.
2 mm.