URR ABD Chapter Review Questions

Which of the following is a correct method for assessment of splenomegaly?

a. >13 cm in length

b. upper border of spleen extends across anterior aorta by >2 cm

c. spleen extends past lower pole of LT kidney

d. all the above

d

Which is the most common cause of splenomegaly?

a. AIDS

b. polycythemia vera

c. portal hypertension

d. mononucleosis

c

A hypoechoic enlarged spleen is typically caused by ____, while a hyperechoic enlarged spleen is typically caused by ____.

a. malignancy, infection

b. portal htn, malignancy

c. infection, infarction

d. mononucleosis, AIDS

a

Massive splenomegaly (>20 cm) is caused by all the following except:

a. thalassemia major

b. lymphoma

c. AIDS

d. Gaucher disease

c

The most common splenic infection in an AIDS patient is _____ and the most common malignancy of the spleen in an AIDS patients is ______.

a. mononucleosis, adenocarcinoma

b. pneumocystis carinii, Kaposi sarcoma

c. viral, lymphoma

d. fungal, leukemia

b

Gamna Gandy bodies are most commonly seen with:

a. mononucleosis

b. tuberculosis

c. AIDS

d. portal HTN

d

Which of the following is a common cause of splenic abscess?

a. endocarditis

b. mononucleosis

d. portal HTN

d. Gaucher disease

a

Which splenic abnormality is associated with Kasabach-Merritt syndrome and Klippel-Trenaunay-Weber syndrome?

a. infarction

b. hemangioma

c. hamartoma

d. Gaucher disease

b

What splenic abnormality is associated with tuberous sclerosis or Wiskott-Aldrich syndrome?

a. infarction

b. hemangioma

c. hamartoma

d. Gaucher disease

c

What lab testing values can be used to identify lymphoma?

a. RBC count

b. WBC count

c. lactate dehydrogenase

d. all the above

d

Hodgkin lymphoma typically causes lymphadenopathy in the ___, while Non-Hodgkin lymphoma typically causes lymphadenopathy in the ___.

a. upper body, whole body

b. upper body, abdomen

c. lower body, upper abdomen

d. lower body, abdomen

a

Leukemia causes:

a. low platelet count

b. low RBC count

c. high WBC count

d. all the above

d

Patients with angiosarcoma have an increased risk of:

a. abscess formation

b. lymphoma formation

c. splenic rupture

d. aortic aneurysm

c

Which of the following is the most common primary malignancy to spread to the spleen?

a. lung cancer

b. stomach adenocarcinoma

c. pancreatic adenocarcinoma

d. hepatocellular carcinoma

a

Kidneys develop in the ____ and migrate into the ____.

a. paracolic gutters, Morison pouch

b. pelvic cavity, abdominal cavity

c. chest cavity, abdominal cavity

d. peritoneal cavity, retroperitoneal cavity

b

The ____ muscle lies posterior medial to the kidney, while the _____ muscle lies directly posterior to the kidney.

a. rectus abdominis, psoas

b. quadratus lumborum, psoas

c. psoas, quadratus lumborum

d. quadratus lumborum, rectus abdominis

b

The renal cortex extends from the:

a. capsule to the base of the pyramids

b. renal pelvis to the base of the pyramids

c. minor calyces to the major calyces

d. medulla to renal pelvis

a

What is the most posterior structure at the renal hilum?

a. renal artery

b. renal vein

c. ureter

d. adrenal gland

c

List the structures involved in urine production from blood filtration to the ureter

Glomerulus, Bowman capsule, proximal convoluted tubule, loop of Henle, distal convoluted tubule, collecting duct, pyramid, minor calyces, major calyces, renal pelvis, ureter

The renal arteries are transverse branches of the aorta that originate:

a. 1 cm below the level of the celiac axis origin

b. at the level of the SMA origin

c. 3 cm above the iliac bifurcation

d. 2-3 cm below the origin of the SMA

d

Identifying accessory renal arteries is most important for patients:

a. with malignant htn

b. scheduled for transplant surgery

c. with hydronephrosis

d. diagnosed with adrenal malignancy

b

What position is best for evaluating the length of the left renal artery?

a. supine

b. prone

c. LLD

d. RLD

d

An RI value over 0.7 in the renal parenchymal arteries indicates _____, while an RI value less than 0.5 in the renal parenchymal arteries indicates _____.

a. renal artery stenosis, severe hydronephrosis

b. normal flow, renal artery stenosis

c. parenchymal dysfunction, renal artery stenosis

d. parenchymal dysfunction, normal flow

c

Which renal vessel is normally identified coursing between the AO and the SMA?

a. LRA

b. LRV

c. RRA

d. RRV

b

List the renal arterial circulation path from origin to the renal parenchyma

aorta, main renal artery, segmental artery, interlobar artery, arcuate artery, interlobular artery, afferent arterioles

Which of the following are preferred to directly assess parenchymal resistance in the kidneys?

a. arcuate or interlobular

b. main and segmental

c. interlobar and interlobular

d. segmental and arcuate

a

Which of the following is secreted by the pituitary gland to help regulate fluid levels through changes in water permeability?

a. BUN

b. creatinine

c. aldosterone

d. antidiuretic hormone

d

Aldosterone levels affect:

a. blood volume and pressure

b. urine viscosity

c. urine pH

d. venous outflow

a

Renin is produced by the ____ to aid in autoregulation of the systemic blood pressure.

a. pituitary gland

b. adrenal gland

c. liver

d. kidneys

d

Which of the following serum levels increase with reduced renal function?

a. uric acid

b. creatinine

c. blood urea nitrogen

d. all the above

d

Which of the following serum levels increase with dehydration?

a. BUN

b. aldosterone

c. hematocrit

d. all the above

d

Which of the following Glomerular Filtration rates indicates kidney failure?

a. 100 mL/min

b. 60 mL/min

c. 40 mL/min

d. 10 mL/min

d

Abnormal glucose levels in the urine are related to _______, while abnormal bilirubin levels in the urine are related to ______.

a. diabetes, liver disease

b. pancreatitis, adrenal disease

c. liver disease, pancreatitis

d. renal failure, renal hyperfunction

a

On a transverse view of the kidney, how is the upper and lower pole differentiated from the mid pole?

a. more visible pyramids at the mid pole

b. lack of parenchyma in the hilar area at the mid pole

c. color doppler demonstrates blood flow only at the mid pole

d. all the above

b

Cortical thickness should be measured:

a. in the transverse view of the mid pole

b. from the outer sinus to the capsule

c. from the base of a pyramid to the outer edge of the parenchyma

d. within 2 cm of the hilum

c

Congenital anomalies of what other body system are commonly associated with urinary system anomalies?

a. GI tract

b. reproductive system

c. circulatory system

d. endocrine system

b

If renal agenesis is suspected, the pelvic region of the patient should be evaluated for:

a. possible ectopic kidney

b. possible seminal vesicle agenesis

c. bicornuate uterus

d. all the above

d

Where is the most common location of an ectopic kidney?

a. ipsilateral pelvic area

b. subxiphoid region

c. suprephrenic space

d. Morison pouch

a

Which renal anomaly appears as a duplicated kidney on one side of the body and empty renal fossa on the contralateral side?

a. pancake kidney

b. horseshoe kidney

c. cross fused renal ectopia

d. dromedary hump

c

What is the term for the lower pole tissue connection across the aorta in a horseshoe kidney?

a. hump

b. isthmus

c. bridge

d. tunnel

b

Why is a horseshoe kidney typically found lower in the abdomen than normal kidneys?

a. migration is inhibited by the IMA

b. the liver is usually malpositioned lower too which affects kidney position

c. the spleen is usually malpositioned lower too which affects the kidney position

d. there is usually an associated diaphragmatic hernia preventing migration

a

A dromedary hump is typically identified on the:

a. RT lateral kidney

b. RT medial kidney

c. LT lateral kidney

d. LT medial kidney

c

What renal anomaly is demonstrated as a triangular or wedge-shaped hyperechoic defect in the anterior kidney near the junction of the upper and mid poles of the kidney?

a. dromedary hump

b. pancake kidney

c. fetal lobulation

d. junctional parenchymal defect

d

Which of the following describes a column of Bertin?

a. area is isoechoic and contiguous with the rest of the renal cortex

b. lack of mass effect with this normal variant

c. normal vascularity in the area

d. all the above

d

Which of the following is a sign of a duplicated collecting system?

a. hydronephrosis occuring in the upper or lower pole

b. hydronephrosis occuring in the upper and lower pole

c. a single renal artery that splits inside the kidney

d. dilated renal pelvis with no dilatation inside the kidney

a

What type of imaging exam is preferred to detect a duplicated collecting system?

a. renal ultrasound

b. angiography

c. intravenous pyelogram

d. voiding cystourethrogram

c

All of the following will be dilated with ureteropelvic obstruction, except?

a. renal pelvis

b. minor calyces

c. ureter

d. major calyces

c

A sonographer can discuss the patient exam results with:

a. the patient

b. the patient’s caregiver

c. the patient’s spouse

d. none of these

d

Which of the following patients should be NPO for their exam?

a. thyroid biopsy

b. renal duplex examination

c. scrotal ultrasound

d. breast biopsy

b

What is the proper order for putting on PPE?

a. gown, mask, goggles, gloves

b. gloves, goggles, gown, mask

c. mask, gloves, goggles, gown

d. gown, gloves, mask, goggles

a

What is the proper order for removing PPE?

a. gown, mask, goggles, gloves

b. gloves, goggles, gown, mask

c. mask, gloves, goggles, gown

d. gown, gloves, mask, goggles

b

MRSA requires _____ precautions and tuberculosis requires ____ precautions.

a. contact, airborne

b. droplet, contact

c. airborne, droplet

d. contact, droplet

a

What is the purpose of HIPAA?

a. to aid in reducing the patient exposure to ultrasound

b. to require the protection and confidential handling of protected health information

c. to inspect healthcare facilities for proper disinfection procedures

d. to protect healthcare employees from exposures to diseases

b

An air-filled structure on a CT exam will be represented by what color on the image?

a. black

b. white

c. light gray

d. dark gray

a

A bony structure on a CT exam will be represented by what color on the image?

a. black

b. white

c. light grey

d. dark grey

b

Which of the following must be performed at the start of any procedure or ultrasound exam?

a. enter the patient’s social security number into the imaging equipment

b. ask the patient to sign an informed consent form for complications

c. ask the patient to wash their hands

d. confirm the patient identity

d

A hot nodule on a nuclear medicine exam means:

a. it is malignant

b. it is benign

c. the nodule demonstrated rapid uptake of the radioactive tracer

d. the nodule demonstrated no uptake of the contrast

c

If a stenosis is present on an angiography exam, how will it be displayed on the image?

a. an area of absence of contrast

b. stenosis cannot be detected on angiography, only occlusion

c. an area of increased contrast

d. high velocity motion of the contrast

a

Which of the following is a critical finding on an ultrasound exam?

a. fundal gallstone

b. 3 cm AAA

c. testicular torsion

d. chronic cholecystitis

c

Which of the following exams would be improved by scanning the patient in the standing position?

a. scrotal varicocele

b. possible impacted gallstone

c. inguinal hernia

d. all the above

d

Which of the following patients would benefit from a FAST examination?

a. patient with history of RUQ pain after eating

b. patient with abdominal bruit, weight loss, and post prandial pain

c. patient with history of abdominal pain after a fall from a ladder yesterday

d. patient with suspected prostate cancer

c

What type of simple cyst bulges into the central sinus of the kidney and does not connect to collecting system?

a. peripelvic

b. parapelvic

c. cortical

d. pyelogenic

b

All of the following are characteristics of a simple cyst, except:

a. anechoic

b. through transmission

c. round with smooth borders

d. posterior shadowing

d

All the following are malignant characteristics of a cyst, except:

a. thick and/or irregular septations

b. posterior enhancement

c. calcification within the septations

d. wall nodularity

b

How is a cystic nephroma differentiated from renal cell carcinoma (RCC)?

a. hyperechoic, thick, fibrous capsule surrounding a cystic nephroma is not present with RCC

b. presence of internal vascularity with a cystic nephroma is not present with RCC

c. RCC has numerous punctate calcifications not seen in a cystic nephroma

d. RCC is hypoechoic and a cystic nephroma is hyperechoic

a

How is the echogenic debris in a milk of calcium cyst differentiated from a renal calculus?

a. renal calculi are more echogenic than the debris in a milk of calcium cyst

b. renal calculi will demonstrate mobility with changes in patient position, but the debris in a milk of calcium cyst will not move

c. renal calculi will not demonstrate mobility with changes in patient position, but the debris in a milk of calcium cyst will move

d. renal calculi are less echogenic than the debris in a milk of calcium cyst

c

An autosomal dominant disorder will be present:

a. in every generation

b. in every other generation

c. only when the other parent also has the same gene

d. only in female patients

a

Most patients with autosomal dominant polycystic disease also have:

a. diabetes

b. systemic HTN

c. pulmonary HTN

d. portal HTN

b

An autosomal recessive disorder will be present:

a. in every generation

b. in every other generation

c. only when the other parent also has the same gene

d. only in female patients

c

All the following describe autosomal recessive polycystic disease?

a. bilateral enlargement

b. fatal early in life

c. echogenic kidneys

d. all the above

d

Multicystic dysplastic kidney disease is:

a. most commonly seen in females

b. associated with compensatory enlargement of the unaffected kidney

c. usually bilateral

d. the most common cystic kidney disorder in adults

b

All the following is a sonographic characteristic of multicystic dysplastic kidney disease, except:

a. multiple cysts replace functional tissue

b. prominent renal sinus

c. little or no parenchyma

d. unilateral cyst formation

b

How will the kidneys be demonstrated in a patient with a long history of dialysis?

a. enlarged with numerous cysts

b. calculi formation within the renal pyramids

c. thin cortex with multiple small cysts

d. moderate to severe hydronephrosis

c

What causes medullary sponge kidney?

a. an insult early in pregnancy

b. one parent with a defective gene

c. maternal analgesic abuse

d. two parents with a defective gene

d

Which of the following describes the sonographic appearance of medullary sponge kidney?

a. dilated echogenic pyramids with thinned cortex

b. multiple <1 cm cysts consume the parenchyma

c. multiple <1 cm cysts consume the sinus, thinned cortex

d. large staghorn calculus causes chronic obstruction

a

Which of the following is a clinical finding of nephrocalcinosis?

a. elevated hematocrit

b. elevated serum calcium

c. leukocytosis

d. leukopenia

b

What renal infection frequently occurs as a late complication of pharyngitis?

a. acute pyelonephritis

b. emphysematous pyelonephritis

c. xanthogranulomatous pyelonephritis

d. acute glomerulonephritis

d

Which of the following is a symptom of acute glomerulonephritis?

a. foggy urine

b. hematuria

c. proteinuria

d. all the above

d

Acute glomerulonephritis presents as ____, while chronic glomerulonephritis presents as _____.

a. bilateral renal enlargement, unilateral renal enlargement

b. bilaterally increased renal echogenicity, bilaterally decreased renal echogenicity

c. bilateral renal enlargement, bilateral renal atrophy

d. bilaterally decreased renal echogenicity, bilaterally increased renal echogenicity

c

What causes acute pyelonephritis?

a. ascending bacterial infection

b. throat infection

c. descending bacterial infection

d. renal calculi causing obstruction

a

Which of the following is a sign of acute pyelonephritis?

a. loss of corticomedullary definition

b. diminished sinus echoes in affected kidney

c. calyceal clubbing

d. all the above

d

All the following are characteristics of emphysematous pyelonephritis, except:

a. commonly caused by E. coli

b. abscess formation with intrarenal air

c. areas of ring down and/or dirty posterior shadowing

d. multiple renal calculi within the parenchyma

d

Which of the following renal infections is a critical finding that requires an emergency nephrectomy?

a. HIV nephropathy

b. emphysematous pyelonephritis

c. acute pyelonephritis

d. chronic pyelonephritis

b

_________ are more common in women and diabetics.

a. hydronephrosis and xanthogranulomatous pyelonephritis

b. acute pyelonephritis and chronic pyelonephritis

c. xanthogranulomatous pyelonephritis and emphysematous pyelonephritis

d. acute glomerulonephritis and chronic glomerulonephritis

c

Staghorn calculus and hydronephrosis are commonly seen with:

a. xanthogranulomatous pyelonephritis

b. emphysematous pyelonephritis

c. acute pyelonephritis

d. mycetoma formation

a

Mycetoma formation is associated with:

a. renal calculi formation

b. papillary necrosis

c. candidiasis infection

d. renal cyst formation

c

Mycetoma formation is associated with which of the following?

a. long term use of indwelling urinary catheters

b. those with history of IV drug use

c. long term steroid or antibiotic therapy

d. all the above

d

__________ refers to a renal abscess that forms in the parenchyma caused by hematogenous spread of staphylococcus aureus.

a. carbuncle

b. mycetoma

c. malakoplia

d. HIV nephropathy

a

What acoustic artifact is associated with a renal abscess caused by bacterial infection?

a. mirror image

b. ring down

c. propagation speed

d. posterior enhancement

b

When evaluating a suspected renal hematoma, it is most important to document the location of the hematoma relative to:

a. the liver/spleen

b. diaphragm

c. renal capsule

d. renal hilum

c

How is an intracapsular fluid collection differentiated from an extracapsular fluid collection of the kidney?

a. presence or absence of debris in the fluid

b. presence or absence of septations in the fluid

c. presence or absence of parenchymal distortion

d. all the above

c

What sonographic characteristic indicates a lymphocele is present and not a urinoma?

a. a lymphocele has septations in the fluid

b. a lymphocele has shadowing echogenic foci floating in the fluid

c. a lymphocele is located at the hilum but a urinoma is located in Morison pouch

d. a lymphocele is located in the Morison pouch but a urinoma is located at the hilum

a

Which of the following is a cause of bilateral hydronephrosis?

a. extrinsic compression from mass

b. malformed ureterovesicular junction

c. prostate enlargement

d. ureteropelvic obstruction by staghorn calculus

c

Which of the following is a cause of unilateral hydronephrosis?

a. bladder mass

b. urethral obstruction

c. pregnancy

d. ureteropelvic obstruction by staghorn calculus

d

Which of the following would assist in determining the level of obstruction with hydronephrosis?

a. pre and post void bladder images

b. PW doppler evaluations of the parenchymal arteries

c. PW doppler evaluation of the main renal arteries

d. all the above

a

In cases of significant hydronephrosis, Doppler evaluation of the parenchymal arteries should be performed to obtain what value?

a. peak systolic velocity

b. acceleration time

c. pulsatility index

d. resistive index

d

How is pyonephrosis differentiated from hydronephrosis?

a. presence or absence of debris in the dilated calyces

b. presence or absence of a fever

c. presence or absence of leukocytosis

d. all the above

d

What is the most common cause of acute renal failure?

a. acute tubular necrosis

b. hydronephrosis

c. renal artery stenosis

d. pyelonephritis

a

Which of the following describes acute renal failure?

a. sudden onset of oliguria

b. recent onset of peripheral edema

c. critical finding that is reversible if diagnosed early

d. all the above

d

While the affected kidney may appear normal sonographically with acute renal failure, how is chronic renal failure identified?

a. unilateral or bilateral kidney enlargement

b. increased echogenicity and decreased thickness of the cortex

c. decreased echogenicity and increased thickness of the cortex

d. low RI values from Doppler evaluation

b