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Although in most cases the sonographic appearance of the testes remains unchanged after vasectomy, what changes can occur in approximately 40% of postvasectomy patients?
Enlargement of the epididymis
Compared to the normal testicular parenchyma, what is the predominant sonographic appearance of malignant testicular tumors?
Most undescended testis occurs in which region?
What anatomy is included in the spermatic cord?
Testicular artery and vein
What dilatation of the seminiferous tubules is usually seen bilaterally and is associated with epididymal cysts and spermatoceles?
Tubular ectasia of the rete testis
What divides the scrotal pouch into two main compartments?
What is the globus major?
What is the most common location for epididymal cysts?
Throughout the epididymis
What is the most common primary tumor to metastasize to the testis?
What is the most common scrotal fluid collection?
What pathologic alteration is usually secondary to the spread of tuberculosis from the kidneys, prostate, or seminal vesicles?
Where does spermatogenesis occur?
Where is the dartos muscle located?
Which sonographic technique is used to document a varicocele?
Which testicular carcinoma is the most aggressive and presents as a focal or diffuse hypoechoic mass with distinct or indistinct boundaries?
What is a limitation of a FAST exam?
Difficulty examining obese patients
What acoustic window is the most commonly used to visualize the cardiac structures?
What laboratory test is used to evaluate for blood clotting abnormalities?
When used for thyroid biopsy, what is an advantage of fine-needle capillary technique?
What term describes air located outside of the lung but within the pleural cavity?
What is the likely diagnosis of an anechoic or hypoechoic fluid collection localized to the costophrenic angle after blunt or penetrating chest injury superior to an intact diaphragm?
Which type of needle will have a larger reflectivity surface?
What is the concept behind the FAST exam or eFAST exam?
What is a contraindication to a needle biopsy?
What procedure is used to remove ascites?
What is the range of needle gauges used for a fine-needle aspiration?
What is a major benefit of FAST or eFAST?
What is the relationship between the needles bore size and its gauge?
What procedure is used to remove pleural fluid?
What patient position increases the sensitivity of the FAST exam, especially in the detection of free fluid in the hepatorenal and perisplenic spaces?
Using one of the eFAST methods, what is indicated if there is an absence of the sliding sign?
What is a sign of cardiac tamponade?
When evaluating for a deep vein thrombosis, what observation suggests a clot?
Why is a fine-needle aspiration of a thyroid nodule less than 10 mm discouraged?
What is the advantage of using color flow Doppler imaging when performing sonography-guided biopsy procedures?
What is the most common benign breast tumor?
From which embryonic layer does the breast develop?
What is one advantage of applying transducer compression during a breast sonography?
What is the most common source of metastases to the breast from a primary cancer?
What anatomy can be seen as a moderate hyperechoic area posterior to the retromammary fat?
What is the most common area for a woman to get breast cancer?
Which of the following is a sonographic characteristic of a phyllodes tumor?
What benign, fluid-filled mass is caused by obstruction of a lactiferous duct in the pregnant or lactating woman?
What is the most common cause for an abnormal cystic-appearing dilated breast ducts?
In addition to providing an adjunct to mammography for palpable and nonpalpable indeterminate masses, which characteristic principally apply to breast sonography imaging?
What is the most common congenital breast anomaly?
What characteristic distinguishes a benign fibroadenoma in comparison to malignant appearing masses?
What is the most common imaging modality used to evaluate the breast and remains the only widely used screening tool proven effective at reducing breast mortality?
What should sonography rule out on a 28-year-old woman who presents with a tender, swollen left breast on the sixth postpartum day?
What is the ratio of American women who develop breast cancer during a lifetime?
What may be demonstrated in the spleen, liver, kidneys, and adrenal glands in patients with extrapulmonary pneumocystis carinii secondary to AIDS?
What is the name of the accessory pancreatic duct?
How does a sonographer describe the transducer's orientation to the anatomic plane, to the specific organ, or to a structure?
What is the most common primary liver malignancy in an adult?
What is the most common cause of a pancreatic pseudocyst in an adult patient?
What plane is perpendicular to both the sagittal and transverse planes?
Which of the following imaging modalities is considered noninvasive?
The porta hepatis (portal triad) contains the portal vein, hepatic artery, and what other structure?
In a longitudinal section, what portion of the pancreas is located between the aorta and the superior mesenteric artery?
What is the normal gallbladder wall thickness measured parallel to the sound beam adjacent to the liver?
In normal arterial flow, where is the most turbulent arterial flow pattern demonstrated?
What process contributes to an acquired aplasia and hypoplasia?
In which vessels does the right branch bifurcate into an anterior branch and a posterior branch?
A marked increase of AST variance, greater than 1,000 U/mL, is clinically indicative of what pathology?
The anteroposterior (AP) measurements of the aorta are made from which scanning plane?
What mechanism describes a decrease in insulin secretion when blood glucose levels are decreased?
What circular vascular structure is identified coursing posterior to the inferior vena cava?
Acute cholecystitis is most likely to occur secondary to which entity?
What splenic function removes iron and other substances from erythrocytes?
On transverse scans, what is the course of the left renal vein?
In the patient is in the standard anatomic position, what is the course of the portal vein?
In which vessel does an increase in blood flow occur after eating?
Which vessel supplies the liver with oxygen-rich blood?
What vessel courses to the patient's right and is located posterior to the pancreas?
Severe sound attenuation is associated with which pathology?
Which vessels are used to delineate the right and left lobes; the right posterior and right anterior segments; and the left medial and left lateral segments?
Neoplasm of which origin comprise the largest group of pancreatic tumors?
Locating the inferior vena cava, superior mesenteric vein, and gastroduodenal artery helps identify what portion of the pancreas?
What is the principle site of filtration within the spleen?
Which term means toward the midline of the body or toward the median plane?
What is the likely explanation for a septated cystic mass in the head of the pancreas in a 43-year-old, chronic alcoholic who presents with a normal serum lipase, elevated serum amylase, and an enlarging mass in the epigastrium?
On a longitudinal section, where is the extension of the superior splenic component located compared to the inferior component?
What is the classification of an annular pancreas?
When is the spleen considered to be enlarged?
What is ruled out when the sonographer demonstrates the spleen?
What vascular tumor is composed of blood vessel cells with a nonspecific sonographic appearance?
What term means on the opposite side of the body?
When would the sonographer NOT be able to image a thickened gallbladder wall?
What echogenic intraluminal projection does not change location with a change in the patient's position and does not cast an acoustic shadow?
What reference plane divides the body into right and left halves?
On a longitudinal image, which of the following major vessels is located to the right of midline with the cephalic portion curving ventrally?
Which vessel lies posterior to the bile duct and anterior to the portal vein?
What anatomy is located on the anterior border of the spleen?
What is the location of a mass detected anterior and to the left of the ligamentum venosum?
What Doppler signal would be expected in the portal vein of a patient with portal hypertension?
What should be included in a possible list of imaging differential diagnosis when acoustic shadows are presented behind the aorta and the sonographer is having difficulty visualizing both the anterior and posterior wall?
What symptom describes tenderness over the gallbladder with probe pressure?
As a blood reservoir, the liver has the capacity to enlarge and store how much blood?
What is a diagnostic explanation for a 40-year-old woman with right upper quadrant pain, mild jaundice, and elevated alkaline phosphatase?
In what direction does the term caudal refer?
What is a common finding associated with vascular stenosis?
What is the likely diagnosis for a 5-year-old who presents with recurrent fever, right upper quadrant pain, jaundice, and a sonogram demonstrating a 2-cm cyst that is medial and separate from the gallbladder and is communicating with the common bile duct? What is the likely diagnosis for a 5-year-old who presents with recurrent fever, right upper quadrant pain, jaundice and a sonogram demonstrating a 2-cm cyst located medial and separate from the gallbladder and is communicating with the common bile duct?
Normally, the echogenicity of the pancreas is equal to or greater than that of which organ?
Which 8-cm duct is located in the lesser omentum's right free edge, passes posterior to the first duodenal part, and is distally situated in a groove on the posterior surface of the pancreatic head?
What condition describes acute or chronic inflammation of the gallbladder?
What type of gland secretes its products into blood or cellular tissue?
In the spleen, what structure is made up of lymph tissues arranged around splenic arteriole?
The superior mesenteric vein empties into which vein?
Which term defines the inner wall layer of an artery and vein?
What anatomic structure is located lateral and to the left of the common bile duct?
Where is the uncinate process located relative to the head of the pancreas?
What straddles the midline, is superior to the head of the pancreas, and is anterior to the inferior vena cava?
What is a choledochal cyst?
Approximately what percentage of the liver's blood is supplied by the hepatic artery?
What are the clinical implications for a 52-year-old man with a liver sonography examination suggesting long standing liver disease and the presence of alpha-fetoprotein?
Where is the acoustic pattern evaluated to determine the attenuation properties of a mass?
What is the normal sonographic appearance of splenic parenchyma?
What term best describes the pancreatic hormone insulin?
What is the most likely explanation when a 43-year-old woman is clinically jaundiced and has a marked elevated serum conjugated (direct reading) bilirubin level?
Which structure does the common bile duct join prior to terminating at the major duodenal papilla?
With a normally functioning gallbladder, what is stimulated by ingesting a fatty meal?
What vessel supplies the gallbladder with blood?
Relative to the surrounding tissue, what echo amplitude is displayed distal to a high attenuating structure?
Which variant presents with a kinked or folded back fundus?
What two ducts unite to form the common bile duct before it enters the duodenum?
What is the most common location of aneurysms associated with the continuation of an abdominal aortic aneurysm?
What is the spleen's function in the embryological stage of development?
Leukopenia may result from what condition?
Which of the following is an autosomal dominant disease is characterized by the presence of multiple small cysts in the kidney, liver, and pancreas?
If the patient has a known history of a porcelain gallbladder, what will the sonographer observe?
Which scanning plane should the sonographer initially select to best visualize the lower liver segment?
If a malignant neoplasm appears as an anechoic mass, what is a likely explanation for this echo characteristic?
What happens to the normal aorta as it progresses inferiorly?
What is the upper normal limit for the anteroposterior (AP) diameter measurement of the pancreatic duct in the adult patient?
What is the likely cause for echoes originating from within the gallbladder with acoustic shadows?
What is the patient position if the patient is lying on his or her back?
In addition to a central portal vein branch and hepatic artery, what other structure is contained in each of the eight segments described by Couinard?
What projects from the splenic capsule and divides the spleen into several compartments?
Which patient position is best for scanning the normal adult spleen?
The functional or true right and left intrahepatic lobar divisions are between what structures?
What enzyme digests carbohydrates?
When other approaches fail, what pancreatic portion may be scanned through the left kidney on a patient in the prone position?
To visualize the normal or abnormal anatomical areas of the subdiaphragmatic, subhepatic, and hepatorenal spaces, the sonographer would select what anatomic scanning location?
What is the best explanation if the sonogram reveals a focal area of high echogenicity with acoustic attenuation (shadowing)?
What small normal tubular structure does NOT demonstrate a Doppler signal?
Which of the following is an enzyme secreted by the pancreas that is essential to the digestion and absorption of essential nutrients?
What term describes the echogenicity of the normal splenic parenchyma when compared to the liver?
What could account for decreased pulsations of the abdominal aortic walls and hyperechoic aortic wall echoes?
What pancreatic function occurs in the islets of Langerhans?
Which ligament attaches the spleen to the greater curvature of the stomach?
In the presence of a horseshoe kidney, what anomaly may be simulated?
What entity is associated with sinus lipomatosis?
Enlargement of the sinus area
What is the most significant clinical implication of an elevated serum creatinine?
50% plus nephron destruction
What is the elevated variance in the urinalysis that indicates an injury to the glomerular membrane as a result of disease?
What condition is associated with urinary stasis?
What structures transport urine from the renal pelvis to the urinary bladder?
The renal sinus contains all of the following except:
A contracture of the bladder neck will cause what secondary condition?
Large capacity bladder
Which scanning technique can be utilized to help localize a dilated ureter?
The pelvis is surveyed with a full bladder and the area posterior to the bladder is evaluated.
What is the normal sonographic appearance of the nutcracker phenomenon?
Narrowing of the left renal vein between the aorta and the superior mesenteric artery
What pathology is best demonstrated by use of Doppler for evaluating ureteral jets?
Ureteral obstruction with unilateral calculi
What serves as a barrier against trauma and the spread of infection to the kidney?
What is the sonographic appearance of bladder diverticula?
What is the name for the one afferent arteriole that divides into a capillary network in the glomerular capsule?
What tumor accounts for approximately 80% to 90% of all renal malignancies in adults?
Renal cell carcinoma
What urinary bladder changes are seen in a patient with a constant Foley catheter drainage?
What is the primary function of the urinary system?
Maintain homeostasis by controlling the composition and volume of blood
Which statement about tubular reabsorption and secretion is correct?
Tubular reabsorption adds materials to the filtrate from the blood; tubular secretion removes substances from the filtrate into the blood.
Which blood vessel courses between the superior mesenteric artery and the aorta?
Left renal vein
From lowest to highest echo amplitude, what is the correct order for the normal renal structures?
Medulla, cortex, sinus
What is the most common malignant tumor of the urinary bladder?
Transitional cell carcinoma
A 56-year-old woman's clinical signs include chills, fever, back pain, malaise, dysuria, and frequent, urgent urination. Her laboratory values include leukocytosis, hematuria, pyuria, and bacteriuria. Sonographically, a small kidney is seen with parenchymal loss and multifocal echoes in the cortical and medullary regions probably from focal fibrosis. Which of the following is the most likely diagnosis?
Chronic atrophic pyelonephritis
What sonographic appearance describes how to identify hydronephrosis?
Fluid-filled pelvocaliceal collecting system
Which statement is the best description for the sonographic appearance of a bladder rupture?
It is usually difficult to visualize
What anomaly refers to renal fusion that usually occurs at the lower pole level?
Which imaging modality would you select to quantitate renal dysfunction even in the presence of an elevated BUN?
What definition describes a posterior urethral valve?
Dilated and elongated prostatic urethra
Which of the following renal masses is the most acoustically reflective hyperechoic lesion that is denser than renal parenchyma?
Which urinary bladder anomaly is sometimes described as a cyst within a cyst?
Which statement is the best description of the sonographic appearance of a bladder tumor?
Echogenic structures protruding into anechoic bladder lumen
What is the measurement range for the normal bladder wall thickness that accounts for the variability caused by bladder distention?
3 to 6 mm
What anomalous condition occurs if the allantoic canal remains open and results in a communication channel between the bladder and the umbilicus?
Patent or persistent urachus
Urine formation requires the occurrence of which events?
Glomerular filtration, tubular reabsorption, and tubular secretion
Which tissue is one of the three layers of smooth muscle fibers covering the transitional epithelium lining of the urinary bladder wall?
Detrusor middle muscle layer
What protects the kidney from trauma and holds it in place in the abdominal cavity?
What is the most common micturition abnormality?
What is the best description of a juxtamedullary nephron?
The glomerulus is located close to the corticomedullary junction with longer loops of Henle extending farther into the medulla.
Discrete, high-level, comma-like, specular echoes arching over the tops of the pyramids described the normal sonographic appearance for what renal structure?
What is the most common composition of renal calculi?
From inner layer to outer layer, what are the three layers of supportive tissues surrounding each kidney?
Fibrous renal capsule, perirenal fat, renal fascia
What is the most common cause of acute posttransplant renal failure?
Renal tubule damage
What is suspected if there is a drop in the timed urine amylase output?
Pancreatic allograft rejection
What is an advantage of using color or power Doppler for evaluating the renal transplant?
Assesses global renal artery perfusion
What is the second leading cause of malpractice lawsuits against emergency medicine physicians?
Missed foreign bodies
What term is used when describing on a radiograph an object that attenuates or blocks radiation?
What can be a complication if immunosuppressive medication dosage is too low?
What term refers to a biological process that occurs within a living organism or natural setting?
What is a disadvantage of using tissue harmonics imaging or transmit beam-steering?
Shadow artifacts are reduced
What is an early sonographic appearance of renal transplant rejection?
What does it mean to triangulate location?
Acquire images in two perpendicular projections
What is the expected echogenic pattern of a foreign body in the acute phase?
Hyperechoic object with shadowing
What condition results when the patient is unable to synthesize erythropoietin?
What is the normal flow pattern for a pancreatic allograft?
Monophasic venous flow
What condition results when the patient is unable to clear nitrogen-containing wastes from the body?
With a retained foreign body, what acoustic property can be identified distal to the echogenic object?
Distal ring down artifacts
During what age of the foreign body does the hypoechoic ring around an object appear most pronounced?
If a foreign body is composed of organic material, what does it refer to?
Biological plant material and animal products
What term describes the reduction in echo amplitude caused by the attenuating properties of an object?
What term describes a left kidney transplanted in the right iliac fossa?
External iliac vein
In rupture of the Achilles tendon, what may be seen injecting posterior into the area of disrupted fibers?
Kager's fat pad
In transverse sections through the shoulder, what is the superficial muscle on the lateral side of the humerus?
What is a common finding in rotator cuff pathology?
Pain in the lateral deltoid area
What is the echogenicity on a long axis plane of large muscle fibers?
What is the most common injury of the ankle?
What is the most superficial muscle visualized when scanning the posterior knee?
What statement best describes a bursa?
Highly specialized synovial lined pouches
What statement best describes a ligament?
Attaches bone to bone
What term describes a change in the properties of a structure when measured or evaluated in different directions such as changing the insonating angle?
What term is used to describe common flexor osteotendinopathy?
Which ligament tear generally occurs from the joint space superiorly?
Medial collateral ligament
Why do females have a great potential for carpal tunnel syndrome?
The carpal tunnel is smaller in females
What is characteristic about the apex that explains why most prostate cancers involve the apex?
Has the greatest portion of peripheral glandular tissue
What is one common entity involving the prostate gland?
What is one of the most common causes of endogenous calculi?
What is the largest accessory gland of the male reproductive system?
What pathology is most likely demonstrated on a 64-year-old man with a slightly elevated prostate-specific antigen level and the endorectal sonogram documenting an 8.9 mm hypoechoic mass in the right peripheral zone?
What pathology is most likely demonstrated on a patient with a painfully swollen prostate gland, an elevated prostate-specific antigen level, and the endorectal sonogram documenting several irregular, hypoechoic areas in the periurethral area?
Where is the near field located on the sonographic image that was obtained using an endorectal technique?
Where is the prostate gland located?
Between the bladder and the pelvic floor
Which area is primarily affected as benign prostatic hypertrophy progresses?
Which of the following is the best indicating marker for diagnosing prostate cancer?
Which prostate zone is most often the primary site of carcinoma?
While scanning the prostate gland, what is the most likely explanation for visualizing while scanning an irregular echo pattern of the internal and external zones?
Capsular invasion has occured because of the carcinoma
Crohn's disease primarily affects young adults and affects what anatomic region?
Gastric carcinoma arises from what layer of the stomach?
In cases of gastritis, thinning of the mucosa is considered a precursor of what pathology?
In what region does inflammation usually start with ulcerative colitis that is an inflammatory disease confined to the colonic mucosa and submucosa?
What carcinoma affects more men and elderly with about equal frequency in the middle and lower third of the esophagus?
Squamous cell carcinoma
What is the deepest, innermost, mucosal esophageal surface that can be visualized on both endoscopic and transabdominal imaging?
What is the most common primary neoplastic lesion of the small bowel?
Smooth muscle tumors
What portion of the GI tract have walls that are thicker and can nearly always be visualized sonographically in the normal patient using a transabdominal scanning approach?
What portion of the duodenum bends and courses inferiorly to the right of the pancreatic head?
What portion of the duodenum includes the duodenal bulb?
Where is the body and antrum of the stomach located relative to the gallbladder and porta hepatis?
Where is the body and antrum of the stomach located relative to the left hepatic lobe?
Posterior and Inferior
Hashimoto's thyroiditis is characterized by all of the following except:
A. Glandular enlargement
B. Course echotexture
All of the following are features of malignant nodules except:
A. Thick incomplete halo
B. Irregular margin
D. All of the following are features of malignant nodules
Graves Disease is associated with all of the following except:
B. Audible bruit
D. Cardiovascular smptoms
The red arrow is pointing to what structure?
On the image in question number 4 what is the purple arrow pointing to?
On the image on question number 4 what is the turquoise arrow pointing to?
This is an image of an adenoma. What is the most significant sonographic feature on this image that distinguishes the likelihood of this being an adenoma?
prominent hypoechoic ring surrounding the mass
A 25-year-old patient with an otherwise normal neck ultrasound has multiple bilateral masses adjacent to the carotid arteries and jugular veins. The masses are flattened and oblong, with their greatest dimension in the long axis. The most likely diagnosis for these masses is:
benign lymph nodes
A ovid solid homogeneous mass is located adjacent to the posterior aspect of the midportion of the thyroid. The sonographic features and location of this mass make it suspicious for:
The most common benign tumor of the thyroid is:
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