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3) Hemachromatosis4) Fatty liver disease??
1) Gastroesophageal shunt (clinically sig/marked)
2) Rectal sigmoid shunt3) Umbilicus shunt
1)Fluid to alleviate blood loss
2) Shunts placed to help w/blood flow in/out liver.3) Liver transplant
1) Large extended belly.
4) Spider veins extending from umbilical area outward(maybe jaundice??)
1) Cirrhosis2) Chronic Hep B or C
1) Hepatocellular adenoma2) Hepatobiliary cystadenoma
1) Aflatoxin exposure
2) Alcoholic liver disease
4) Chronic Hep B or C5)?
2) single3) diffuse
a) Hepatocellular adenoma
b) Focal nodular hyperplasiaFibrolamellar carcinoma
b) Hepatic cystsc) Hepatobiliary cystadenoma?
b) older – 40+
c) obese/obesityd) female sex hormones
1) Cholesterol; obesityMixed, weight loss
b. Sudden onset severe RUQ painc.Elevated WBC
a)empyema – pus filled GB
b)gangrene (tissue death of GB)
c) fistula formation – w/adjacent loops of bowl
d) choledocholithiasis – leads to pancreatitis or cholangitise) gallstone ileus
b) jaundicec) biliary colic/Murphy’s sign also
A) Beading appearance of bile ductsDecreased branching
1)ulcerative colitis2) cholangiocarcinoma
1. Hepatic duct
5. Pancreatic duct
6. Ampulla of Vater
7. Common Hepatic duct
1) Sodium bicarb; neutralize stomach acid/ balance pH
2) Amylase; breaks down starches into smaller molecules3) Lipase; breaks down fat
1) Insulin; tells cells in organs to uptake glucose; lowers blood sugar2) Glucagon; tells liver to release stores of glycogen so blood levels will go up; raises blood sugar
M/C disease of pancreas:
M/C cause of acute pancreatitis:
2) GB stones
Current diagnostic test for dx of acute pancreatitis?
M/C complications of acute pancreatitis:
1) pancreatic abscess
General principle & main forms of tx for acute pancreatitis?
a) IV fluids
b) pain relief
c) NPO – nothing by mouth
d) Nasogastric suction
1) Constant, moderate, gnawing epigastric pain
3) steatorrhea4) weight loss
1)air fluid level = cystic2) small, well defined
M/C pancreatic malignancy:
M/C location for adenocarcinoma:
Classical clinical presentation of m/c type of pancreatic malignancy?
Where does adenocarcinoma of pancreas usually spread?
Name curative surgery for pancreatic malignancy:
Gastrinoma; one common pancreatic endocrine tumor, special type of pancreatic neoplasm makes bio active product:
a) What product does it make?
b) What is presentation of gastrinoma?Where is it most likely found?
b) wt gain, ulcerc) tail
Risk factors for developing pancreatic carcinoma?
c) family hx
72 y.o. man, loss appetite & fatigue. On work up, multiple liver lesions. This is most likely?
27 y.o. complains abd pain, nausea & vomiting. She has gallstones & 8 cm solid central liver mass. Most likely diagnosis?
51 y.o. man w/cirrhosis has new dom 5 cm liver mass. Most likely dx?
Rare & spectacular exam finding of RUQ of non tender enlarged GB, usually worrisome for possibility of underlying malignanacy in biliary tree:
Most common overall liver disease?
Most common causes of hepatitis? Which is most common in US?
Most common liver neoplasm?
Most common malignant?
Most common primary malignant tumor?
Most common disease of gallbladder?
Most common GB neoplasm?
Most common autoimmune?
Primary sclerosing cholangitis M>F
Complications: Cirrhosis of liver and cholangiocarcinoma
Most common disease of pancreas?
Most common causes of pancreatitis?
Most common cause of chronic pancreatitis?
Continuous alcohol abuse.
Most common type of exocrine based cancer?
Most common hormone secreting islet cell tumor?
Differentials for 3 yr old with acute pancreatitis?
Trauma, Cystic Fibrosis, Drugs
Differentials for 3 year old with chronic pancreatitis?
What is the physiologic status of prepuberty?
Which one of the following arteries sheds blood during menses?
Which one of the following muscle groups may be seen in the false pelvis along the lateral sidewall of the pelvis?
Which one of the following ligaments contains the uterine blood vessels and nerves?
Which one of the following ligaments occupies the space between the layers of another ligament and occurs in front and below the fallopian tubes?
Bending forward of the fundus and body of the uterus toward the cervix is called which one of the following positions?
The normal size of the menarchal uterus should measure ______ centimeters (cm) long and _____ cm wide.
The superficial layer of glands and stroma of the endometrium is called which one of the following?
Which one of the following structures lies above the utero-ovarian ligament, round ligament, and tubo-ovarian vessels?
The ovary produces two hormones. Estrogen is secreted by __________, whereas progesterone is secreted by the ___________.
Follicles; corpus luteum
The release of an egg from the ruptured follicle is termed which one of the following?
The vagina has two sources of blood supply; they are the:
uterine artery and vaginal artery
The ovary receives its primary blood supply from which one of the following arteries?
Which one of the following portions of the fallopian tube is the most coiled?
postmenopausal patients who are not on hormone replacement therapy, an endometrial thickness less than ______ millimeters (mm) is considered benign.
Which one of the following statements is false?
The ovaries are almond shaped.
The ovaries are suspended from the anterior aspect of the broad ligaments.
The ovaries lie in the ovarian fossa.
The ovaries receive blood from the ovarian and uterine arteries.
The left ovarian vein drains into which one of the following veins?
The ovaries are laterally supported by which one of the following ligaments?
A mature follicle is known as a __________ follicle.
mature follicle typically measures _____ cm right before ovulation.
The endometrium demonstrates the “three-line” sign in which one of the following phases?
The retrouterine space is also known as which one of the following?
The pelvic recess between the anterior bladder wall and the pubic symphysis is which one of the following?
Space of Retzius
Abnormally heavy or long menses is termed:
Which one of the following ligaments provides support to the cervix?
Depending on the menstrual cycle, the inner lining of the uterine cavity that appears echogenic to hypoechoic on ultrasound is which one of the following structures?
Menarche may be defined as which one of the following?
The state after reaching puberty during which menses occur every 21 to 28 days
Which one of the following are small vessels found along the periphery of the uterus?
Which one of the following refers to a horizontal plane through the longitudinal axis of the body to image structures from anterior to posterior?
The endometrium is at its greatest thickness and echogenicity with posterior enhancement in which one of the following phases?
To image the fundus of the uterus with transvaginal sonography, the transducer should be angled so that the handle is positioned as described in which one of the following?
With endovaginal sonography, the cervix of an anteverted uterus is seen in the _________ of the screen, whereas the fundus of the anteverted uterus is found in the __________ of the screen.
The thickness of the endometrium should be measured in which one of the following planes?
The middle layer of the uterus is which one of the following?
The thin outer layer of the uterus is separated from the immediate layer by which one of the following?
Flexion refers to the axis of the uterine body relative to the ___________.
Nabothian cysts are found near which one of the following anatomic structures?
Arcuate artery calcifications are observed in patients who are _______________.
Which one of the following techniques is the best way to measure the cervical-fundal dimension of the uterus?
Limitations of translabial scanning may be overcome by which one of the following?
Elevating the patient’s hips
On transabdominal imaging of the female pelvis, the distended urinary bladder:
Is an acoustic window to view the pelvic anatomy.
Serves as a “cystic” reference.
Displaces the bowel into the false pelvis.
Is all of the above.
Which statement most accurately describes the anatomic relationships of the ovary, the ureter, and the internal iliac vessels?
The ureter and internal iliac vessels both lie posterior to the ovary.
Which of the following is used to divide the pelvic cavity into the pelvis major (false pelvis) and the pelvis minor (true pelvis)?
Which muscles do NOT lie within the true pelvis?
Which of the following produces the hormones estrogen and progesterone in females?
The fibrous tissue mass that remains in the ovarian cortex after ovulation and regression of the corpus luteum is called the
The arteries in the uterus that penetrate the myometrium are the
The region of the uterus where the fallopian tube passes through the uterine wall and communicates with the uterine cavity is called the
Which of the following is the outermost layer of the ovary?
Which support structure anchors the ovary loosely to the uterine cornua?
Which support structure extends from the uterine cornua, passes over the pelvic brim, through the inguinal canal, and is secured at the labia majora?
The most echogenic layer of the vagina is the
A bicornuate uterus is a congenital malformation caused by incomplete fusion of which structures during embryogenesis?
On ultrasound, the skeletal muscles of the abdomen and pelvis appear _____ compared to their surrounding structures.
The space between the pubic symphysis and the anterior wall of the urinary bladder is called the
space of Retzius.
Name the gonadotropin responsible for maintaining the corpus luteum.
Luteinizing hormone (LH)
When the uterine body and fundus are tilted posteriorly, uterine position is described as
When the uterine body and fundus are situated posteriorly adjacent to the cervix, the uterine position is described as
When the urinary bladder is empty, the uterine position is described as
When the corpus and fundus are bent anteriorly until the fundus is resting on the cervix, the uterine position is described as
The portions of the large intestine contained within the true pelvis are the
The vagina can be identified in the _____ portion of the pelvis between the _____ (anteriorly) and the _____ (posteriorly).
inferior; urinary bladder; rectum
“A thin, reflective, midline stripe in the uterus” describes the sonographic appearance of the
Anechoic areas seen between the outer and intermediate layers of the myometrium represent
The _____ phase is the best time to observe blood flow within the ovary.
The muscles of the pelvic diaphragm and any fluid in the posterior cul de sac are visualized
The three descriptive regions of the pelvis are the ________, ________, and _______ regions.
right iliac; hypogastric; left iliac
The two descriptive compartments of the pelvis are the ________ and ________.
The congenital malformation recognized sonographically by the presence of two endometrial canals is known as a ________________.
The uterine tubes are oriented ________ in the body.
The peritoneal cavity space posterior to the broad ligaments is the ________.
The _______ ligaments are not true ligaments and provide minimal support.
narrow and relatively straight; located within the uterine cornua
medial portion closest to uterus
longest portion; normal site of fertilization
outer trumpet shaped end
The anterior pituitary gland secretes _________ and ________.
When FSH levels are at their peak ____________________ stimulates dominant follicle.
What hormone stimulates the corpus luteum?