Ardms Abdomen Board Review Exam Questions and Complete Solutions Graded A+, Exams of Medicine

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Ardms Abdomen Board Review Exam Questions and Complete Solutions Graded A+ [Document subtitle] Denning [Date] [Course title]

the normal AP ddimension of the aorta lumen should not exceed - Answer: 3 cm the celiac trunk is the first _____ branch of the aorta - Answer: anterior the celiac trifurcates into...? - Answer: the common hepatic artery the left gastric artery the splenic artery the gastroduodenal artery is a branch of the...? - Answer: the common hepatic artery this artery branches off the anterior aspect of the aorta and travels vertically anterior and parallel to the aorta - Answer: the superior mesenteric artery which renal artery has a more complicated course? - Answer: the right renal artery an arterial disease in which the vessel wall loses its elasticity and becomes hardened - Answer: arteriosclerosis dilatation of a segment of a vessel wall caused by a weakness of all three layers of the vessel wall..? - Answer: aneurysm majority of aneurysms are located below...? - Answer: the level of the renal arteries the most common type of a true aneurysm is...? - Answer: fusiform tear of the intima layer of the vessel wall is a... - Answer: dissecting aneurysm aneurysm caused by arterial catheterization or trauma - Answer: pseudo aneurysm which renal vein has the more complicated course? - Answer: the left renal vein

the right gonadal vein empties directly into the IVC but the left gonadal vein empties... - Answer: into the left renal vein which then empties into the IVC a liver measurement greater than ____ - ____ cm is considered hepatomegaly - Answer: 15- normal variant of the right lobe of the liver extends inferiorly and may be mistaken for hepatomegaly - Answer: Riedel's Lobe the liver is almost completely covered by... - Answer: Glisson's Capsule arrange these in order from most echogenic to least echogenic: pancreas, spleen, renal medullary pyramids, liver, renal sinus, renal cortex - Answer: renal sinus > pancreas > liver > or = spleen > renal cortex > renal medullary pyramids the liver is composed of three lobes... - Answer: left lobe, right lobe, caudate lobe the middle hepatic vein divides the liver into ... - Answer: right lobe and left lobe the right hepatic vein divides the... - Answer: right lobe into anterior and posterior segments the left hepatic vein divides the... - Answer: left lobe into medial and lateral segments these veins drain blood from the caudate lobe - Answer: the right and left hepatic veins the ligamentum venosum divides the... - Answer: caudate lobe and the left lobe the ligamentum teres divides the... - Answer: left lobe into medial and lateral segments the falciform ligament divides the ... - Answer: right and left lobe

the coronary ligament connects the liver to... - Answer: the diaphragm the main lobar fissure divides... - Answer: right and left lobe the portal triad is... - Answer: the portal vein, the hepatic artery, and the common bile duct AST is increased with... - Answer: hepatocellular disease this lab value is useful in detecting acute hepatitis before jaundice occurs and following in the course of hepatitis - Answer: AST this lab test rises higher than AST and takes longer to return to normal - Answer: ALT alkaline phosphatase is increased in... - Answer: obstruction of the biliary system decrease in liver function with an increase in the liver enzymes due to the amount of necrosis is known as... - Answer: diffuse hepatocellular disease accumulation of fat within the hepatocytes... - Answer: fatty liver diffuse inflammatory process of the liver - Answer: acute hepatitis diffuse fibrotic process that involves the entire liver.. - Answer: cirrhosis autosomal recessive liver disorder of carbohydrate metabolism.... - Answer: glycogen storage disease portal vein is considered enlarged if it measures over...? - Answer: 13mm

obstruction of the hepatic veins caused by thrombosis or compression from a liver mass is known as..? - Answer: Budd-Chiari Syndrome the gallbladder wall should not exceed... - Answer: 3 mm the gallbladder is divided into three segments called..? - Answer: neck, body, fundus where are the spiral valves of Heister located? - Answer: in the cystic duct the three functions of the gallbladder: - Answer: concentrate bile, store bile, transport bile what hormone causes the gallbladder to contract? - Answer: cholecystokinin (CCK) a fold or septum on the posterior wall between the body and neck is called? - Answer: Junctional Fold fold located in the fundal portion of the gallbladder? - Answer: phrygian cap small sac located between the junctional fold and the neck of the gallbladder is called? - Answer: Hartman's Pouch calcification of the wall of the gallbladder is called? - Answer: porcelain gallbladder a hyperplastic change in the gallbladder wall is known as..? - Answer: adenomyomatosis when a stone obstructs the cystic duct, this is known as..? - Answer: Mirizzi Syndrome inflammation of the gallbladder wall with decreased gallbladder function is..? - Answer: acute cholecystitis most common of the benign gallbladder tumors, frequently located in the fundus - Answer: adenoma

the common bile duct should not exceed... - Answer: 8 mm the most common fatal liver disorder in children - Answer: biliary atresia genetic trait characterized by a segmental saccular dilatation of the intrahepatic ducts that leads to bile stasis, bacterial growth, abscesses, cholangitis, formation of stones, and decreased liver function caused by the compression of the hepatocytes is called? - Answer: Caroli's Disease inflammation of the biliary tract caused by bacterial infection of the biliary tract - Answer: cholangitis stones in the common bile duct - Answer: choledocholithiasis inflammation and fibrosis of bile duct commonly associated with intrahepatic calculi complications is called.. - Answer: sclerosing cholangitis this is caused by the absence of blood supply to the gallbladder? - Answer: Gangrene of the Gallbladder a shotgun sign is seen when... - Answer: bile ducts are dilated carcinoma that arises at the union of the right and left hepatic ducts... - Answer: klatskin tumor the head of the pancreas is ______ to the inferior vena cava and the right renal vein - Answer: anterior the common bile duct is in the __________ _________ margin of the pancreatic head - Answer: posterior lateral the ________ artery may be visualized at the anterior lateral margin of the pancreatic head - Answer: gastro-duodenal

tongue-like extension of the pancreatic neck - Answer: uncinate process a prominent uncinate process will displace the ________ ________ artery and vein _______ to the pancreas - Answer: superior mesenteric, anterior largest portion of the pancreas - Answer: the body the splenic vein courses along the _________ margin of the pancreas - Answer: posterior the portal confluence is _________ to the neck of the pancreas - Answer: posterior the main pancreatic duct is also known as - Answer: the duct of wirsung the accessory duct is called - Answer: duct of santorini true or false, the duct of wirsung and the duct of santorini enter the duodenum together - Answer: false true of false, the pancreas has endocrine and exocrine functions - Answer: true what are the three different types of cells within the islet cells of Langerhans - Answer: alpha, beta, delta which cells secrete insulin? - Answer: beta which cells secrete glucagon? - Answer: alpha which cells secrete somatostatin - Answer: delta the exocrine function of the pancreas secretes these enzymes that aid in digestion - Answer: amylase, lipase, trypsin

diffuse inflammatory process of the pancreas - Answer: pancreatitis this form of pancreatitis occurs when the pancreas goes through inflammatory changes and interstitial edema - Answer: edematous this form of pancreatitis occurs when there is a rapid progression of the disease caused by autodigestion of the pancreatic tissue, which causes area of fat necrosis - Answer: hemorrhagic form of pancreatitis where inflammation can extend outside the pancreas - Answer: phlegmonous encapsulated pancreatic enzymes that are commonly found in the lesser sac? - Answer: pseudocyst the spleen is a part of the ________ system - Answer: reticuloendothelial breakdown of hemoglobin, formation of bile pigment, formation of antibodies, production of lymphocytes and plasma cells, resevoir for blood, blood formation in the fetus are all functions of... - Answer: the spleen spleen in the ectopic location - Answer: wandering spleen failure of the spleen to develop - Answer: aplasia what are the three layers of protection the kidneys have from outside to inside? - Answer: Gerota's Fascia, perirenal fat, true capsule true or false, gerotas fascia encloses both the kidney and the adrenal gland - Answer: true maintaining salt and water balance, regulate the fluid volume, maintain acid and base balance are the functions of... - Answer: the kidneys

renal dysfunction will cause this lab value to be elevated - Answer: serum creatinine this lab value is elevated when acute or chronic renal disease is present, urinary obstruction, decreased with overhydration, liver failure, pregnancy - Answer: Blood Urea Nitrogen least common and most fatal autosomal recessive, more common in females, bilateral echogenic enlarged kidneys with cysts - Answer: infantile polycystic kidney disease (IPKD) or autosomal recessive polycystic kidney disease (ARPKD) autosomal dominant disease, relatively frequent, may be latent for years and not show symptoms until 4th decade, decreasing renal function, hypertension, flank pain, bilateral large kidneys with randomly distributed cortical cysts of various sizes, kidneys loose shape in advanced stages - Answer: adult polycystic kidney disease (APKD) or autosomal dominant polycystic kidney disease (ADPKD) kidneys inability to filter metabolites from the blood resulting in decreased renal function - Answer: renal failure most common cause of acute renal failure, destruction of the tubular epithelial cells of the proximal and distal convoluted tubules - Answer: acute tubular necrosis most common disease of the urinary tract, and the combination of parenchymal, caliceal, and pelvic inflammation - Answer: pyelonephritis perinephric fluid collections commonly associated with transplanted kidneys - Answer: hematoma, abscess, urinoma, lymphocele two most common places for obstruction in the ureter? - Answer: ureto-pelvic junction (UPJ) , and ureto-vesical junction (UVJ) where is the bladder located? - Answer: directly posterior to the pelvic bone the apex points anteriorly and is connected to the umbilicus by the... - Answer: umbilical ligament

the area of the bladder between the neck and apex - Answer: the trigone the bladder wall should measure between - Answer: 3 to 6 mm the adrenal glands are part of which system? - Answer: the endocrine system this adrenal gland lies lateral to the right crus of the diaphragm - Answer: the right adrenal gland will the IVC be displaced if there is pathology present in the right adrenal gland - Answer: yes true or false, the splenic vein will be displaced if there is pathology present in the left adrenal glad? - Answer: true what are the three zones of the adrenal cortex from outer to inner - Answer: zona glomerulosa, zona fasiculata, zona reticularis which zone of the adrenal cortex produces glucocorticoids - Answer: zona fasiculata which zone of the adrenal cortex produces mineralcorticoids - Answer: zona glomerulosa which zone of the adrenal cortex produces gonadocorticoids - Answer: zona reticularis the adrenal hormones are regulated by... - Answer: adrenocorticotropic homones (ACTH) epinephrine and norepinephrine is produced by... - Answer: the adrenal medulla the 5 layers of the GI tract in order from inner to outer - Answer: mucosa, submucosa, muscularis, serosa, mesothelium three part of the small intestine in order - Answer: duodenum, jejunum, and ileum

the ascending colon into the transverse colon is called - Answer: the hepatic flexure the transverse colon into the descending colon is called - Answer: the splenic flexure the thyroid gland is consider this type of gland - Answer: endocrine what are the three major hormones the thyroid secretes - Answer: thyroxine, triidothyronine, calcitonin which two major vessels lie posterior lateral to the thyroid - Answer: common carotid artery and internal jugular vein which strap muscle lies anterior and slightly lateral to the thyroid - Answer: sternohyoid muscle which strap muscle is posterior to the sternohyoid - Answer: sternothyroid muscle this strap muscle is adjacent to the trachea and is posterior to the thyroid and the common carotid arteries - Answer: longus colli muscle this gland produces thyroid stimulating hormone - Answer: the anterior pituitary gland painless diffuse enlargement of the thyroid gland is known as - Answer: Hashimotos Thyroiditis enlarged tender neck and the patient has a fever, signs and symptoms of... - Answer: thyroiditis multiple adenomas associated with hyperthyroidism - Answer: goiter autoimmune disease characterized by thyrotoxicosis - Answer: graves disease

septum that divides the scrotum is called - Answer: median raphe the lining of the inner wall of the scrotum is comprised of - Answer: a double layer of peritoneum and the tunica vaginalis true or false, the double layer of peritoneum that lines the inner wall of the scrotum will normallly contain a small amount of fluid - Answer: true the dense white fibrous capsule that encases each testicle - Answer: tunica albiguina the two primary functions that occur in the cone shaped lobules of the testicles - Answer: spermatogenesis and testosterone secretion production of spermatozoa is called - Answer: spermatogenesis what is the name is the cells that secrete testosterone - Answer: leydig cells the epididymis run into this duct - Answer: ductus vas deferens the draining veins of the scrotum, nerves, and lymphatics form this - Answer: spermatic cord the spermatic cord joins with a duct from the seminal vesicle to form this duct - Answer: the ejaculatory duct the space between the liver and the diaphragm and is a common site for abscess - Answer: subphrenic space which crus of the diaphragm is visualized anterior to the aorta above the level of the celiac artery? - Answer: the left crus the right crus is seen where? - Answer: posterior to the caudate lobe and IVC

abnormal accumulation of serous fluid in the peritoneum secondary to a pathological process - Answer: ascites anechoic freely mobile usually benign ascites - Answer: transudative internal echoes, loculated, associated with infection and malignancy ascites - Answer: exudative in cases of massive ascites this will also be present - Answer: respiratory distress fluid accumulations in order in the supine patient (5 areas) - Answer: inferior tip (right lobe liver), superior portion (right flank), pelvic cul-de-sac, right paracolic gutter (lateral and anterior to liver), Morrison's pouch encased collection of pus - Answer: abscess this type of abscess is associated with cholangitis, sepsis, and penetrating trauma to the liver - Answer: intrahepatic this type of abscess is associated with cholecystectomy - Answer: subhepatic this type of abscess is associated with bacterial spill into peritoneum, bowel rupture, peptic ulcer perforation, trauma - Answer: subphrenic how to tell the difference between ascites and abscess - Answer: move the patient erect, ascites will move to the dependent portion what are the three areas of the retroperitoneum - Answer: anterior perirenal space, perirenal space, posterior perirenal space what organs lie in the anterior perirenal space - Answer: retroperitoneal portion of the intestines and the pancreas

what organs lie in the perirenal space - Answer: kidneys, ureters, adrenal glands, aorta, IVC, retroperitoneal nodes what organs lie in the posterior perirenal space - Answer: posterior abdominal wall, iliopsoas muscle, quadratus muscle originates from fat, has complex echogenic pattern with thick walls - Answer: liposarcoma originates from connective tissue, has complex sonolucent pattern, invading surrounding tissues - Answer: fibrosarcoma originates from muscle, occurs as a solid, complex, or homogeneous echogenic mass, invading surrounding tissue - Answer: rhabdomyosarcoma originates from smooth muscle, occurs as a complex echodense mass that may have areas of necrosis and cystic degeneration - Answer: leiomyosarcoma originates from all three germ cell layers, most occur in the area of the upper pole of the left kidney, 90% are benign, complex with echogenic and cystic areas, 50% occur in children - Answer: teratoma originate from nerve tissue and occur mostly in the paravertebral region, heterogeneous and echogenic

• Answer: neurogenic tumor formation of thick sheets of connective tissue extending from the perirenal space to the dome of the bladder - Answer: retroperitoneal fibrosis lymphatic vessels assist these vessels - Answer: veins lymphocytes and reticulum cells make up - Answer: lymph nodes two functions of the lymph nodes - Answer: filtration and production of lymphocytes and antibodies

normal lymph node size - Answer: less than 1 cm enlarged nodes posterior to the aorta or will displace the great vessels away from the spine - Answer: floating aorta sign nodes that surround the mesenteric vessels - Answer: sandwich sign anterior renal displacement, anterior dilated ureter displacement, anterior displacement of the retroperitoneal fat ventrally and often cranially, anterior vascular displacement are characteristics of a mass located... - Answer: in the retroperitoneum a 2-year old boy presents with hematuria and a palpable left flank mass. An ultrasound examination is performed, and a solid renal mass is identified. This finding is most characteristic of which of the following choices? hypernephroma, wilm's tumor, neuroblastoma, infantile polycystic kidney disease, renal infarction - Answer: Wilm's tumor a patient presents with ampulla of Vater obstruction, distension of the gallbladder, and painless jaundice. this is associated with which of the following choices? hydropic gallbladder, choledochal cyst, courvoisers sign, hartmann's pouch, kehrs sign - Answer: courvoisiers sign long standing cystic duct obstruction will give rise to which of the following? porcelain gallbladder, hydropic gallbladder, septated gallbladder, gallbladder septations, gallbladder contraction - Answer: hydropic gallbladder while performing an ultrasound examination, the sonographer finds that both kidneys measure 5 cm in length. They are very echogenic. One should consider the possibility of all of the following except: chronic glomerulonephritis, chronic pyelonephritis, renal vasular disease, renal vein thrombosis - Answer: renal vein thrombosis a common cause of acute pyelonephritis?

hypertension, pyogenic bacteria, renal cell carcinoma, hydronephrosis - Answer: pyogenic bacteria the largest zone of the prostate? peripheral zone, transiton zone, periurethral zone, central zone - Answer: peripheral zone diffuse thickening of the gallbladder wall can be seen sonographically in all of the following except: acute cholecystitis, hepatitis, congestive heart failure, ascites, portal hypertension - Answer: portal hypertension adult polycystic kidney disease may be characterized by all of the following except: it is autosomal dominant disease, it may be associated with cysts in the liver pancreas and spleen, bilateral small and echogenic kidneys, usually does not produce any symptoms until the third or fourth decade of life, the kidneys lose their reniform shape - Answer: bilateral small and echogenic kidneys a patient in the late stages of sickle cell anemia will have a spleen that is: enlarged and lobulated, enlarged and echogenic, small and hypoechoic, small and echogenic - Answer: small and echogenic cllinical signs of renal disease includes all of the following except: oliguria, palpable flank mass, generalized edema, hypertension, jaundice - Answer: jaundice acute hydroceles may be caused by all of the following except: infarction, tumor, testicular torsion, trauma, infection of the testis or epididymis - Answer: testicular torsion the most common location for a spermatocele is: head of the epididymis, body of the epididymis, tail of the epididymis, tunica vaginalis, mediastinum testis - Answer: head of the epididymis a 60-year old man presents with hematuria and nocturnal urination. The ultrasound findings include an enlarged symmetrical homogeneous prostate. This is most characteristic of:

seminal vesicle disease, acute prostatitis, benign prostatic hyperplasia, carcinoma of the prostate, normal prostate - Answer: benign prostatic hyperplasia a retroperitoneal abscess may be found in all of the following except: rectus abdominus muscle, psoas muscle, iliacus muscle, quadratus lumborum muscle - Answer: rectus abdominus muscle a 42 year old female presents postcholecystectomy with right-upper quadrant pain, eleveated serum bilirubin (mainly conjugated), and bilirubin in her urine. This is best characteristic of: hepatitis, stone tumor or stricture causing obstruction of the bile duct, small common duct stone less then 5 mm in diameter, alkaline phophatase will be normal, pancreatic pseudocyst - Answer: stone, tumor, or stricture causing obstruction of the bile duct in comparison to the normal adult, the pancreas in children will be relatively: more echogenic, less echogenic, the same echogenicity, larger and less echogenic, complex - Answer: larger and less echogenic the largest major visceral branch of the inferior vena cava is the: portal vein, hepatic veins, renal veins, inferior mesenteric vein, gonadal veins - Answer: hepatic veins the spleen is variable in size, but considered to be: concave superiorly and inferiorly, convex superiorly and concave inferiorly, concave superiorly and convex inferiorly, convex superiorly and inferiorly - Answer: convex superiorly and concave inferiorly a malignant solid renal mass can be all of the following except: renal cell carcinoma, adenocarcinoma of the kidney, oncocytoma, transitional cell carcinoma - Answer: oncocytoma which of the following is not a remnant of the fetal circulation: ligamentum teres, ligamentum venosum, falciform ligament, coronary ligament - Answer: coronary ligament

a 44 year old patient presents with painless jaundice and a palpable right upper quadrant mass. This is most characteristic of: acute hepatitis, cirrhosis, porcelain gallbladder, courvoisier gallbladder, klatskin tumor - Answer: courvoisier gallbladder one can image all of the following in a case of end-stage liver disease except: ascites, small atrophied liver, biliary dilatation, portal hypertension, echogenic nodular liver - Answer: biliary dilatation chronic active hepatitis is a progressive destructive liver disease that eventually leads to: liver cysts, hepatoma, cirrhosis, pancreatitis, liver metastases - Answer: cirrhosis the seminal vesicles: produce sperm located within the prostate, produce sperm located posterior to the urinary bladder, are the reservoir for sperm and are located posterior to the urinary bladder, are the reservoir for sperm and are located between the mediastinum testes and the pampiniform plexus, are the reservoir for sperm and located in the peripheral zone of the prostate - Answer: are the reservoir for sperm and are located posterior to the urinary bladder a 35 year old woman presents with a tender neck, and on physical exam an enlarged thyroid is found. An enlarged inhomogeneous thyroid with irregular borders is seen on the sonogram. This is most characteristic of: a malignant lesion, graves disease, cyst, adenomatous hyperplasia, hashimotos thyroiditis - Answer: hashimotos thyroiditis identify the laboratory values, which are most consistent for a patient with acute pancreatitis: creatinine and BUN will both rise but creatinine remains higher for a longer period of time, amylase and alkaline phosphatase will both rise but amylase remains higher for longer period of time, amy and lipase rise at the same rate but lipase remains higher for a longer period of time, insulin and glucose will both rise but glucose will remain higher for a longer period of time, epinephrine and norepinephrine will both rise and stay elevated for the same period of time - Answer: amylase and lipase rise at the same rate but lipase remains higher for a longer period of time when hypertrophic pyloric stenosis is imaged in the short axis the muscle wall measures at least:

2 mm, 4 mm, 6 mm, 8 mm, 12 mm - Answer: 4 mm an abdominal sonogram is performed on a 35 year old male with a history of primary cancer of the liver now presents with abdominal pain and increasing abdominal girth. this is most consistent with: cholecystitis, pancreatitis, portal hypertension, budd chiari syndrome, renal failure - Answer: budd chiari syndrome one method to diagnose renal obstruction is to document the resistive index (RI) greater than: 0.07, 0.09, 0.30, 0.50, 0.70 - Answer: 0. islet cell tumors of the pancreas are most likely to be located in the pancreatic: head and neck, neck and tail, uncinate process, body and tail, head and body - Answer: body and tail the membrane that lines the abdominal cavity is the: visceral peritoneum, parietal peritoneum, pleura, endometrial lining, serosal lining - Answer: parietal peritoneum the quadratus lumborum muscles are located: medial to the lumbar spine, in the anterior abdominal wall, between the kidneys and the adrenal glands, posterior to the kidneys, perirenal - Answer: posterior to the kidneys all of the following are associated with cirrhosis except: ascites, splenomegaly, jaundice, hepatomegaly, collateral vessel development - Answer: hepatomegaly a cystic mass that extends from the renal pelvis to outside the renal capsule is: a parapelvic cyst, an extrarenal pelvis, a renal artery aneurysm, a grade 2 hydronephrosis, duplex collecting system - Answer: an extrarenal pelvis a 1 week old male infant presents with a left flank mass. an IVP demonstrates a normal right kidney, but there is no visualization of the left kidney. A sonogram is performed and numerous noncommunicating round cystic structures are demonstrated in the left renal fossa, the largest of which is located laterally. No renal parenchyma is identified. The right kidney is normal. This most probably represents:

severe hydronephrosis, polycystic kidneys, a multicystic kidney, nephroblostoma, unilateral renal agenesis - Answer: a multicystic kidney all of the following statements concerning the sonographic patterns of periaortic lymph nodes are correct except: they may drape or mantle the great vessels anteriorly, they may displace the superior mesenteric artery posteriorly, they may displace the great vessels anteriorly, they may have lobar smooth or scalloped appearance, as mesenteric involvement occurs the adenopathy may fill most of the abdomen in an irregular complex pattern - Answer: they may displace the superior mesenteric artery posteriorly the presenting symptom of a testicular malignant tumor may be: para-aortic lymphadenopathy, acute scrotal pain, leukemia, retroperitoneal lymphadenopathy, all of the above - Answer: all of the above the head of the pancreas is located to the right of the: celiac axis, inferior vena cava, gastroduodenal artery, common bile duct, portal splenic confluence - Answer: portal splenic confluence crohns disease is: a mass in the stomach, a parasitic condition, an inflammation of the bowel, loculated fluid in the peritoneal cavity, a mass relating to the pancreas and biliary system - Answer: an inflammation of the bowel a resistive index (RI) greater than 0.70 in a kidney is consistent with early: obstructive jaundice, obstructive hydronephrosis, renal cell carcinoma, benign renal cyst, polycystic renal disease - Answer: obstructive hydronephrosis the doppler characteristic of the venous blood flow in a varicocele is: increased blood flow, irregular waveform, triphasic flow, no change in flow, no blood flow - Answer: increased blood flow a jaundiced male child with a hemolytic disorder may be found to have a(n):

increase in direct bilirubin, increase in indirect bilirubin, increase in alphafetoprotein, increase in prothrombin time, normal liver function tests - Answer: increase in indirect bilirubin a condition that may affect the adrenal gland: neonatal hypotension, severe fulminant tuberculosis infection, malignant lung carcinoma, breast carcinoma, all of the above - Answer: all of the above identify the vessel with a postprandial low-resistive blood flow: celiac artery, hepatic artery, splenic artery, superior mesenteric artery, aorta - Answer: superior mesenteric artery all of the following will increase the chance of documenting shadowing posterior to a small renal stone except: decrease gain, focal zone set at the level of the calculi, increase the transducer frequency, use a linear probe, tissue harmonics - Answer: use a linear probe parathyroid adenomas may be associated with: hypercalcemia, hypertension, bloating, acne, headaches - Answer: hypercalcemia carcinoma of the gallbladder would most likely appear as a(n): thin-walled gallbladder, small gallbladder with thickened walls, large gallbladder with a halo surrouding it, diffusely thickened gallbladder with gallstones, echogenic mass with no distinguishing features of a gallbladder - Answer: diffusely thickened gallbladder with gallstones weakening of the arterial wall - Answer: cystic medial necrosis extremely tall and lanky double jointed people with a progressive stretching disorder existing in all arterial vessels causing abnormal dilation, weakened walls, and eventual dissection, rupture - Answer: Marfans Syndrome this will appear as a continuation of the left portal vein and extends down the anterior abdominal wall to the umbilicus - Answer: paraumbilical vein

this shut helps drain blood from the liver - Answer: TIPS transjugular intrahepatic portosystemic shunt how many segments is the liver divided into with couinauds system of hepatic nomenclature - Answer: eight what are the liver's four functions - Answer: metabolism, digestion, storage, detoxification hepatocellular diseases occur when - Answer: the liver cells are the immediate problem obstructive disease occurs when - Answer: bile excretion is blocked metabolism: the liver converts glucose to - Answer: glycogen metabolism: the liver converts excess amino acids to - Answer: fatty acids and urea metabolism: the liver also removes ____ from the blood and ______ bacteria and worn out red blood cells - Answer: nutrients, phagocytizes Digestion: the liver secretes - Answer: bile Storage: the liver stores - Answer: iron and certain vitamins hypoglycemia - Answer: glucose deficient hyperglycemia - Answer: uncontrolled increase of glucose hypoalbuminemia - Answer: low serum albumin

vitamin k is essential in - Answer: coagulation in hepatocellular disease which of the following enzymes increase, and which ones decrease? bilirubin, serum albumin, AST, ALT, Alkaline Phosphatase - Answer: Increase - bilirubin (severe), AST (severe), ALT (severe), Alkaline Phophatase (modertate) decrease - serum albumin in obstruction which of the following enzymes increase and which ones decrease? bilirubin, serum albumin, AST, ALT, alkaline phosphatase - Answer: increase - bilirubin (severe), AST (mild), ALT (mild), alkaline phosphatase (severe) serum albumin will remain normal gastrointestinal hemorrhage frequently leads to toxic levels of _____ in the blood - Answer: NH4 (ammonia) this type of bilirubin predominates in hepatocellular disease and obstruction - Answer: direct or conjugated indirect or unconjugated bilirubin predominates in - Answer: hemolysis fatty stools - Answer: steatorrhea rare disease of iron metabolism characterized by excess iron deposits throughout the body may lead to cirrhosis and portal hypertension - Answer: hemochromatosis infectious cystic disease common in sheep herding areas of the world - Answer: echinococcal cyst tumor of the glandular epithelium, mostly found in women, related to contraceptive usage, increased incidence in patients with von gierkes disease, "bulls eye or halo" appearance - Answer: liver cell adenoma

second most common benign liver mass after hemangioma, seen with central scar - Answer: focal nodular hyperplasia extrahepatic mass compressing the common bile duct is known as - Answer: courvoisiers gallbladder adrenocortical insufficiency characterized by atrophy of the adrenal cortex with decreased cortisol and aldosterone - Answer: Addisons disease excessive secretion of sex hormones - Answer: adrenogenital syndrome excessive secretion of aldosterone - Answer: conns syndrome excessive secretion of glucocorticoids - Answer: cushings syndrome excessive secretion of epinephrine and norepinephrine - Answer: pheochromocytoma most common malignancy of the thyroid, solid mass with microcalcifications - Answer: papillary carcinoma more aggressive than papillary carcinoma, spreads through bloodstream - Answer: follicular carcinoma 5% of thyroid cancers associated with multiple endocrine neoplasia, increased calcitonin - Answer: medullary carcinoma the appendix must be greater than ____ mm in diameter and the wall must be greater than _____ mm, increased vascularity, noncompressible, pericecal fluid in order for appendicitis to be considered - Answer: 6, 2 in cases of HPS, the transverse muscle greater than ____ mm and a pyloric length greater than ____ mm must be seen - Answer: 4, 18

encloses most of the abdominal organs - Answer: greater sac small sac bordered anteriorly by the stomach, posteriorly by the pancreas and a portion of the transverse colon - Answer: lesser sac passageway between greater and lesser sac just inferior to the liver - Answer: epiploic of winslow double peritoneum extends from liver to lesser curvature of stomach and beginning of duodenum - Answer: lesser omentum large fold peritoneum that extends from stomach, passes anteriorly to the colon and small intestine - Answer: greater omentum nomal size of the thyroid, length, AP, and width - Answer: 4-6 cm in length, 2-3 cm in AP, 1.5 - 2 cm in width testicular artery branching in order: recurrent rami, capsular artery, centripetal artery, testicular artery - Answer: testicular artery > capsular artery > centripetal artery > recurrent rami