Abdomen and Small Parts Exam 2

The anterolateral border of the head of the pancreas is marked by the:

GDA

The celiac axis arises ________ to the pancreatic body.

Superior

The MOST common cause of pancreatic pseudocyst formation is:

Acute pancreatitis

The neck of the pancreas is directly anterior to the:

SMV

The normal head of the pancreas should measure no more than ______ in the anterior posterior dimension.

3.5 cm

TRUE or FALSE: the pancreas becomes more echogenic with age due to the increase in thickness of its capsule.

False

TRUE or FALSE: The pancreas is an intraperitoneal organ that functions as both an exocrine and endocrine organ

False

The uncinate process lies _____ to the superior mesenteric vein.

Posterior

What is the name of the main pancreatic duct?

Duct of Wirsung

When examine the pancreatic duct on the ultrasound, at what measurement would you comment on the possibility of ductal dilation?

3 mm

Which of the following are risk factors associated with the development of adenocarcinoma of the pancreas

All the above

Which of the following structures marks the posterolateral border of the head of the pancreas?

CBD

Which of the following ultrasound appearances has the LEAST association with chronic pancreatitis?

A swollen edematous pancreas

Which of the following vessels are major branches of the celiac trunk?

left gastric artery, common hepatic artery, and splenic artery

Which portion of the pancreas is usually most difficult to visualize using ultrasound?

Tail

Zollinger Ellison syndrome is associated with:

Gastrin-producing tumors of the pancreas

A patient presents for an ultrasound examination of the abdomen. The patient complains of sudden acute epigastric pain. Lab values indicate a drop in hematocrit and an increase in serum amylase. On ultrasound the pancreas is diffusely enlarged. This most probably represents:

Necrotizing hemorrhagic pancreatitis

A patient presents for ultrasound complaining of sudden repeated attacks of epigastric pain, weight loss, steatorrhea, and has diabetes. On ultrasound the pancreas is irregular in contour, atrophied, and increased in echogenicity. What is the most probable cause?

Chronic pancreatitis

All of the following are patient CLINICAL signs that may be related to pancreatic carcinoma EXCEPT

Courvoisier gallbladder

All of the following are secreted by the exocrine portion of the pancreas EXCEPT

Insulin

An enlarged pancreatic head is MOST likely to cause:

Biliary obstruction

Failure of the pancreas to produce sufficient amounts of insulin leads to:

Diabetes mellitus

In the United States, the most common cause of acute pancreatitis in the adult is:

ETOH abuse

Which location is a pancreatic pseudocyst most likely to be found?

Lesser sac

TRUE OR FALSE: A kidney, which has a complete separation of the renal sinuses and two ureters emerging from the hilum, is said to have a double collecting system.

True

A lateral bulge of the left kidney, which may sometimes mimic a mass is termed:

Dromedary hump

A pelvic kidney has a.....

Normal appearance — abnormal location

A transplanted kidney is placed in:

Iliac fossa of the pelvis

Directly posterior to the renals is/are:

Psoas muscles and quadratus lumborum muscles

The kidneys, the perinephric fat, and the adrenal glands are all covered by:

Gerota's fascia

The size of the normal kidney in the adult should be:

10–12 cm in SAG

When the patient takes a deep inspiration, the kidneys move:

Inferiorly

Which of the following tests is most likely to be abnormal in renal dysfunction?

Serum Creatinine

Adult Polycystic Kidney Disease may be characterized by all of the following statements EXCEPT

The kidneys become enlarged and highly echogenic

Causes or disease processes associated with nephrolithiasis include

All of the above

Kidneys in end stage renal failure are?

Small with increased echogenicity

Patient signs and symptoms of renal disease include all of the following EXCEPT

Positive Murphy’s sign

When the renal pelvis is dilated with fluid due to obstruction anywhere from the ureter to the urethra, this is termed:

Hydronephrosis

Which of the following cystic diseases of the kidney is autosomal recessive?

Infantile polycystic kidney disease

Which of the following is considered an obstructive uropathy?

All of the above

What is hydronephrosis?

A collection of backed-up urine within the kidney

Which type of renal structure may potentially be confused with hydronephrosis?

Any cystic structure

A renal angiomyolipoma typically appears:

Highly hyperechoic

Renal angiomyolipomas are usually:

Solitary and unilateral

Renal angiomyolipoma is associated with:

Tuberous sclerosis

A renal angiomyolipoma is usually located within the:

Renal cortex

Which ultrasound finding is associated with end-stage renal failure?

Loss of distinction between the cortex and sinus

The renal cortex in end-stage renal failure is typically:

Hyperechoic

Adult polycystic kidney disease is:

Autosomal dominant

Adult polycystic kidney disease is commonly latent until:

The 30s or 40s

Infantile polycystic kidney disease may be detected in utero with:

Oligohydramnios

Infantile polycystic kidney disease is associated with:

All of the above

Multicystic dysplastic kidney disease is usually:

Unilateral

Multicystic dysplastic kidney disease is caused by:

Ureteral obstruction before the first 8–10 weeks of development

The cysts associated with multicystic dysplastic kidney disease:

Do not communicate

A staghorn calculus is a type of:

Infective stone

A staghorn calculus may fill:

The entire renal pelvis and collecting system to the proximal ureter

Uric acid stones are associated with:

All of the above

The typical ultrasound appearance of nephrolithiasis is:

Echogenic foci with clean posterior shadowing

A transplanted kidney is connected to the

Common iliac or external iliac vessels

A transplanted kidney is typically placed

In an inverted position

Chronic pancreatitis is best described as

Progressive irreversible destruction of the pancreas due to repeated episodes of acute pancreatitis

The most common cause of chronic pancreatitis is

ETOH abuse

Which is a characteristic ultrasound appearance of chronic pancreatitis?

Normal or decreased size, lobulated contour and increased echogenicity

Chronic pancreatitis may demonstrate

All of the above

Besides chronic pancreatitis, which conditions may increase pancreatic echogenicity?

Advanced age and cystic fibrosis

A pancreatic pseudocyst is usually

Single, although it may be multiple

A pancreatic pseudocyst typically has

Sharp, smooth, well-defined walls

A pancreatic pseudocyst may contain

Anechoic fluid or low-level echoes

A pancreatic pseudocyst typically demonstrates

Posterior enhancement

Zollinger Ellison syndrome is caused by

A non-beta islet cell gastrin-secreting tumor

A Zollinger Ellison tumor may appear as

A hypoechoic nodule in the pancreatic head

The most common type of pancreatic carcinoma is

Adenocarcinoma

Pancreatic adenocarcinoma involves the

Exocrine portion

Pancreatic adenocarcinoma is most commonly located in the

Head

Pancreatic adenocarcinoma typically appears as

A poorly defined hypoechoic mass

Associated findings of pancreatic carcinoma include

All of the above

The total normal length of the pancreas is approximately

12–18 cm

The normal pancreatic neck measures approximately

1.5–2.5 cm

The normal pancreatic body measures approximately

2–3 cm

The normal pancreatic tail measures approximately

1–2 cm

The normal pancreas

Does not have a capsule

With deep inspiration, the kidneys move inferiorly approximately

2.5 cm

The normal transverse measurement of an adult kidney is approximately

5–7 cm

The normal AP measurement of an adult kidney is approximately

2–3 cm

Which kidney normally lies slightly more inferior?

Right kidney

The right kidney is posteroinferior to the

Liver and gallbladder

Splenic trauma is commonly caused by

All of the above

A splenic hematoma may appear

Any of the above depending on its age

The BEST imaging modality for suspected splenic rupture is

CT

The normal spleen measures approximately

10–12 cm

The normal echogenicity of the spleen is most similar to

Liver

Which is a function of the spleen?

All of the above

Which is considered a normal splenic variant?

All of the above

The spleen is located

All of the above

A splenic abscess is usually caused by

Bacterial infection

A patient with a splenic abscess may present with

All of the above

A splenic hamartoma is

A rare benign neoplasm

A splenic hamartoma typically appears

Echogenic and well defined

A cavernous lymphangioma is

A benign lymphatic malformation