Sono Abdom: KLiver Diff and Artifacts

Septations are thin, bright, membranous inclusions within a lesion

Selected Answer:

True

Answers:

True

False

Question 2

  • 3 out of 3 points

The primary ultrasound characteristics which are indicative of portal hypertension include:

Selected Answer:

E.

A, B &C

Answers:

A.

Hepatofugal flow in the portal vein

B.

Dilated portal vein

C.

Visualization of dilated collateral channels

D.

Hepatopetal flow in the portal vein

E.

A, B &C

F.

B and D

Question 3

  • 3 out of 3 points

A patient with biopsy-proven cirrhosis is referred for sonographic evaluation of the liver. Which lobe of the liver should the sonographer expect to demonstrate hypertrophy?

Selected Answer:

caudate lobe

Answers:

quadrate lobe

right lobe

caudate lobe

left lobe

Question 4

  • 3 out of 3 points

A disease that is inherited and characterized by abnormal storage and accumulation of glycogen in the tissues, especially the liver and kidneys, is known as:

Selected Answer:

D.

Von Gierke disease

Answers:

A.

Granulomatous disease

B.

Passive hepatic congestion

C.

Hemachromatosis disease

D.

Von Gierke disease

Question 5

  • 3 out of 3 points

Which sonographic feature best describes diffused disease?

Selected Answer:

parenchymal changes throughout an organ

Answers:

well outlined disease of an organ

an organ containing a solid lesion

parenchymal changes throughout an organ

change in parenchyma within at least a half of an organ

Question 6

  • 3 out of 3 points

Liver inflammation resulting from infectious agents.

Selected Answer:

D.

Hepatitis

Answers:

A.

Cirrhosis

B.

Hepatic lipoma

C.

Fatty liver

D.

Hepatitis

Question 7

  • 3 out of 3 points

The left hepatic vein can be used to separate the:

Selected Answer:

C.

Medial segment of the left lobe from the lateral segment of the left lobe

Answers:

A.

Anterior segment of the right lobe from the lateral segment of the right lobe

B.

Anterior segment of the right lobe from the medial segment of the left lobe

C.

Medial segment of the left lobe from the lateral segment of the left lobe

D.

Posterior segment of the right lobe from the anterior segment of the right lobe

Question 8

  • 3 out of 3 points

Elevation of alkaline phosphatase is associated with::

Selected Answer:

A.

Biliary obstruction

Answers:

A.

Biliary obstruction

B.

Fatty infiltration

C.

Fatty sparring

D.

Hemochromatosis

Question 9

  • 3 out of 3 points

Focal regions of normal liver parenchyma within a fatty infiltrated liver are seen in the image below, what is the term used to describe this phenomenon?


Selected Answer:

C.

Focal fatty sparing

Answers:

A.

Cavernous transformation

B.

Acute Cirrhosis

C.

Focal fatty sparing

D.

Chronic cirrhosis

Question 10

  • 3 out of 3 points

All of the following increase with hepatocellular disease except:

Selected Answer:

B.

PSA

Answers:

A.

AST

B.

PSA

C.

Bilirubin

D.

ALT

E.

ASP

Question 11

  • 3 out of 3 points

The most common glycogen storage disease is _________________________________.

Selected Answer:

D.

A & C

Answers:

A.

Von Gierke's

B.

Type II

C.

Type I

D.

A & C

Question 12

  • 3 out of 3 points

In the given transverse view of the liver, use your mouse to place your cursor on the left medial lobe (Quadrate lobe)

Selected Answer:

371, 191

Correct Answer:

Top Left Coordinates

(309, 116)

Bottom Right Coordinates

(433, 235)

Instructor selection and Learner response

Question 13

  • 3 out of 3 points

Which of the following statements is not true concerning portal hypertension?

Selected Answer:

C.

The hepatic artery decreases its blood supply to the liver secondary to obstruction

Answers:

A.

Flow within the portal vein will be hepatofugal

B.

The portal vein diameter will exceed 13 mm in the anteroposterior dimension

C.

The hepatic artery decreases its blood supply to the liver secondary to obstruction

D.

Pressure in the portal veins will increase

Question 14

  • 4 out of 4 points

Match the letters to the appropriate liver segment.

Question

Correct Match

Selected Match

Letter A indicates segment______________.

B.

Segment 1

B.

Segment 1

Letter B indicates segment______________.

F.

Segment 4b

F.

Segment 4b

Letter C indicates segment______________.

E.

Segment 4a

E.

Segment 4a

Letter D indicates segment______________.

D.

Segment 2

D.

Segment 2

Letter E indicates segment______________.

G.

Segment 3

G.

Segment 3

Letter F indicates segment______________.

C.

Segment 8

C.

Segment 8

Letter G indicates segment______________.

A.

Segment 5

A.

Segment 5

Letter H indicates segment______________.

H.

Segment 6

H.

Segment 6

Letter I indicates segment______________.

I.

Segment 7

I.

Segment 7

All Answer Choices

A.

Segment 5

B.

Segment 1

C.

Segment 8

D.

Segment 2

E.

Segment 4a

F.

Segment 4b

G.

Segment 3

H.

Segment 6

I.

Segment 7

Question 15

  • 3 out of 3 points

Cirrhotic changes to the liver include _____________

Selected Answer:

A.

Small echogenic liver

Answers:

A.

Small echogenic liver

B.

Enlarge hypoechoic liver

C.

Normal liver

D. None of the above

Question 16

  • 3 out of 3 points

The largest lobe of the liver is the left lobe:

Selected Answer:

False

Answers:

True

False

Question 17

  • 3 out of 3 points

A patient with cirrhosis and portal hypertension is referred for sonographic evaluation. A hypoechoic, tubular structure in the region of the ligament of teres is noted. Within this structure, pulsed-wave and color Doppler demonstrates blood flow exiting the liver. This finding most likely represents:

Selected Answer:

Recanalization of the umbilical vein

Answers:

A failed TIPS

Esophageal varices

Recanalization of the umbilical vein

A regenerating nodule

Question 18

  • 0 out of 3 points

Which of the following occurs as a consequence of bilirubin accumulation within the tissues of the body?

Selected Answer:

B.

Cholangiocarcinoma

Answers:

A.

Jaundice

B.

Cholangiocarcinoma

C.

Pancreatic carcinoma

D.

Hyperalimentation

Question 19

  • 3 out of 3 points

Budd Chiari syndrome is characterized by thrombosis in the _______________

Selected Answer:

E.

A&B

Answers:

A.

Hepatics

B.

IVC

C.

Portal

D.

Aorta

E. A&B

Question 20

  • 3 out of 3 points

Which of the following could lead to a false positive diagnosis of hepatomegaly?

Selected Answer:

D.

Reidel’s lobe

Answers:

A.

Agenesis of the left lobe

B.

Situs Inversus

C.

Papillary hepatic process

D.

Reidel’s lobe

Question 21

  • 3 out of 3 points

On ultrasound, the patient with acute hepatitis may demonstrate a liver with portal vein borders that may be more echogenic than usual, this is know as the _____________________.

Selected Answer:

B.

Starry sky sign

Answers:

A.

Murphy sign

B.

Starry sky sign

C.

Mcburney's sign

D.

Sandwich sign

Question 22

  • 3 out of 3 points

A patient presents with moderately elevated AST and markedly elevated ALT. The patient has a history of drug abuse and needle-sharing. A liver sonogram reveals an overall hypoechoic appearance. The smaller portal veins appear more echogenic than normal. The liver is enlarged, measuring 19 cm from the superior to the inferior border. What is the most likely explanation for these findings?

Selected Answer:

acute hepatitis

Answers:

fat sparing

fatty liver disease

acute hepatitis

cirrhosis

Question 23

  • 3 out of 3 points

Transjugular intrahepatic portosystemic shunting is used to treat:

Selected Answer:

A.

Portal hypertension

Answers:

A.

Portal hypertension

B.

Hepatitis

C.

Budd-Chiari syndrome

D.

Nuremberg syndrome

Question 24

  • 3 out of 3 points

Using your mouse, place the cursor on the anterior wall of the Gallbladder.

Selected Answer:

272, 141

Correct Answer:

Top Left Coordinates

(237, 136)

Bottom Right Coordinates

(299, 154)

Instructor selection and Learner response

Question 25

  • 3 out of 3 points

The caudate lobe is located on the:

Selected Answer:

B.

posterosuperior suface of the liver

Answers:

A.

anteroinferior surface of the liver.

B.

posterosuperior suface of the liver

C.

right lateral surface of the liver.

D.

anterosuperior surface of the liver

Question 26

  • 3 out of 3 points

Which laboratory value is the most sensitive indicator of hepatocellular disease?

Selected Answer:

C.

alanine aminotransferase (ALT)

Answers:

A.

lactic dehydrogenase

B.

unconjugated bilirubin

C.

alanine aminotransferase (ALT)

D.

hematocrit

Question 27

  • 3 out of 3 points

A moderately obese patient with slightly elevated AST, ALT, and direct bilirubin is referred for liver sonography. The patient has no previous significant medical history. The liver sonogram demonstrates an overall hyperechoic appearance. The hepatic vasculature was difficult to visualize. What is the most likely explanation for these findings?

Selected Answer:

E.

A and D

Answers:

A.

Fatty liver disease

B.

Acute hepatitis

C.

Portal hypertension

D.

Steatosis

E.

A and D

Question 28

  • 3 out of 3 points

This image is of the right upper quadrant in a patient complaining of elevated liver function test and abdominal distention. Which of the following is the most likely diagnosis?



Selected Answer:

B.

Cirrhosis

Answers:

A.

Budd-Chiari syndrome

B.

Cirrhosis

C.

Metastatic liver disease

D.

Hepatitis

Question 29

  • 3 out of 3 points

Distended collateral veins visualized on the abdominal wall have been referred to as the:

Selected Answer:

D.

Caput Medusal Sign

Answers:

A.

Seagull sign

B.

Doughnut sign

C.

Tip of the iceberg sign

D.

Caput Medusal Sign

Question 30

  • 3 out of 3 points

Which ultrasound characteristics are seen with advancing cirrhosis

Selected Answer:

D.

All of the above

Answers:

A.

Sound bean attenuation

B.

Coarse echogenicity

C.

Decreased size of the liver

D. All of the above

Question 31

  • 3 out of 3 points

The ligamentum teres:

Selected Answer:

E.

all of the above

Answers:

A.

is a remnant of the umbilical vein

B.

resides in the left intersegmental fissure.

C.

reopens in severe cirrhosis with portal hypertension

D.

is an echogenic spot on the transverse left liver image

E.

all of the above

F.

A and B

Question 32

  • 3 out of 3 points

Which sonographic findings will describe the complex lesion?

Selected Answer:

mass containing cystic and solid components

Answers:

homogeneous appearing mass

mass containing tissue and perfused with blood supply

fluid-filled mass

mass containing cystic and solid components

Question 33

  • 3 out of 3 points

Which of the following is defined as hepatocyte death, fibrosis and necrosis of the liver, and subsequent development of regenerating nodules?

Selected Answer:

A.

Cirrhosis

Answers:

A.

Cirrhosis

B.

Hepatocellular carcinoma

C.

Portal hypertension

D.

Hepatitis

Which sonographic findings best describe focal diffused disease?

Selected Answer:

isolated area of parenchymal changes

Answers:

isolated area of parenchymal changes

well-circumscribed solid lesion

encapsulated lesion with solid and cystic components

heterogeneous changes throughout the parenchyma

Question 2

  • 2.5 out of 2.5 points

During an abdominal sonogram, recanalization of the umbilical vein is identified. This may be associated with

Selected Answer:

portal hypertension

Answers:

ascites

abscess

portal hypertension

hepatitis

Question 3

  • 2.5 out of 2.5 points

Which protein, produced by the liver, transports indirect bilirubin from the spleen to the liver?

Selected Answer:

ALBUMIN

Answers:

ALT

ASP

ALBUMIN

AST

Question 4

  • 2.5 out of 2.5 points

A complex mass contains both solid and cystic components.

Selected Answer:

True

Answers:

True

False

Question 5

  • 2.5 out of 2.5 points

Why is the liver considered a crucial organ for metabolism?

Selected Answer:

All of the above

Answers:

It produces enzymes required for all metabolic reactions in the body

It stores excess glucose as glycogen for later use

It detoxifies harmful substances and helps eliminate them from the body

All of the above

Question 6

  • 2.5 out of 2.5 points

Which enzyme is considered a specific marker for biliary obstructive disease?

Selected Answer:

ALP

Answers:

ALP

AST

ALT

BILIRUBIN

Question 7

  • 2.5 out of 2.5 points

The spectral Doppler finding in the picture below represents



Selected Answer:

normal hepatopetal flow

Answers:

normal flow away from liver

normal hepatopetal flow

abnormal flow toward the liver

normal hepatofugal flow

Question 8

  • 2.5 out of 2.5 points

Which artifact is more sensitive for detecting small renal stones or gallstones?

Selected Answer:

Twinkling artifact

Answers:

Twinkling artifact

Enhancement artifact

Mirror artifact

Ringdown artifact

Question 9

  • 2.5 out of 2.5 points

Which enzyme is mainly found in the liver and becomes elevated when the liver is damaged?

Selected Answer:

ALT

Answers:

AST

ALT

ASP

BILIRUBIN

Question 10

  • 2.5 out of 2.5 points

What is the function of prothrombin, a protein produced by the liver?

Selected Answer:

It is responsible for blood clotting mechanism.

Answers:

It transports indirect bilirubin from the spleen to the liver.

It breaks down proteins.

It is responsible for blood clotting mechanism.

It removes bilirubin from blood.

Question 11

  • 2.5 out of 2.5 points

A recanalized umbilical vein is usually associated with presence of portal hypertension, whose main cause is cirrhosis

Selected Answer:

True

Answers:

True

False

Question 12

  • 2.5 out of 2.5 points

What is the minimum number of scanning planes required to survey pathology?

Selected Answer:

TWO

Answers:

FIVE

TWO

SEVEN

FOUR

Question 13

  • 2.5 out of 2.5 points

When investigating a pathology, required images should include but not be limited to longitudinal and transverse pictures; images with and without measurements; followed by the color Doppler investigation of the pathology

Selected Answer:

True

Answers:

True

False

Question 14

  • 2.5 out of 2.5 points

A solid mass is described as a tissue with evident blood perfusion by color Doppler.

Selected Answer:

True

Answers:

True

False

Question 15

  • 2.5 out of 2.5 points

Obstructive jaundice may be diagnosed sonographically by demonstrating

Selected Answer:

a mass of the head of the pancreas with a dilated common bile duct

Answers:

a mass of the head of the pancreas with a dilated common bile duct

renal stones

fatty liver

liver focal sparing

Question 16

  • 2.5 out of 2.5 points

What happens to the indirect/unconjugated bilirubin in the liver?

Selected Answer:

It is converted into direct/conjugated bilirubin

Answers:

It is excreted through urine

It is converted into direct/conjugated bilirubin

It is stored in the gallbladder

It is released into the bloodstream

Question 17

  • 2.5 out of 2.5 points

A major branch of the common hepatic artery is the

Selected Answer:

gastroduodenal artery

Answers:

duodenal artery

gastroduodenal artery

left gastric artery

coronary artery

Question 18

  • 2.5 out of 2.5 points

Which enzyme(s) show mild to severe elevation in both hepatocellular and biliary obstructive diseases?

Selected Answer:

AST and ALT

Answers:

ALT and ASP

AST and ASP

AST and ALT

Albumin and Bilirubin

Question 19

  • 2.5 out of 2.5 points

Which statement best characterizes a cavernous transformation of portal vein?

Selected Answer:

multiple tourtous channels in peri-portal area

Answers:

communication between the portal vein and venous cava

non-visualization of common bile duct

compressed portal vein

multiple tourtous channels in peri-portal area

Question 20

  • 2.5 out of 2.5 points

The pathology imaged in the picture of Porta Hepatis below, most likely represents





Selected Answer:

cavernous portal transformation

Answers:

normal portal vein flow

color Doppler artifact

cavernous portal transformation

normal hepatic artery flow

Question 21

  • 2.5 out of 2.5 points

Point with your cursor liver fatty infiltration

Selected Answer:

126, 97

Correct Answer:

Top Left Coordinates

(99, 21)

Bottom Right Coordinates

(206, 179)

Instructor selection and Learner response

Question 22

  • 2.5 out of 2.5 points

In the picture below, lesion imaged may be described as a



Selected Answer:

E.

B and C

Answers:

A.

cystic

B.

complex

C.

septated

D.

solid

E.

B and C

Question 23

  • 2.5 out of 2.5 points

Which location is the most common area for focal liver sparing?

Selected Answer:

gallbladder fossa and peri-portal area

Answers:

along IVC

adjacent to common bile duct

dome of the liver

gallbladder fossa and peri-portal area

Question 24

  • 2.5 out of 2.5 points

Which type of bilirubin can be found in bile?

Selected Answer:

Direct/Conjugated bilirubin

Answers:

Direct/Conjugated bilirubin

Indirect/Unconjugated bilirubin

Both types of bilirubin

None of the above

Question 25

  • 2.5 out of 2.5 points

A cystic mass is characterized by being filled with fluid.

Selected Answer:

True

Answers:

True

False

Question 26

  • 2.5 out of 2.5 points

Which artifact is typically bright and extends from gas bubbles through to the bottom of the display?

Selected Answer:

Ringdown effect

Answers:

Comet tale artifact

Ringdown effect

Twinkling artifact

Mirror artifact

Question 27

  • 2.5 out of 2.5 points

Which of the following best defines artifacts in ultrasound imaging?

Selected Answer:

False images or parts of images that do not represent true anatomic structures

Answers:

True images or parts of images that represent false anatomic structures

True images that represent false anatomic structures

False images or parts of images that do not represent true anatomic structures

False images that represent true anatomic structures

Question 28

  • 2.5 out of 2.5 points

The appearance of alternating colors on the Doppler signal behind a reflective object is known as:

Selected Answer:

Twinkling artifact

Answers:

Comet tail artifact

Mirror artifact

Twinkling artifact

Ringdown artifact

Question 29

  • 2.5 out of 2.5 points

What causes a localized reverberation known as a comet tail artifact?

Selected Answer:

a.

Cholesterol stones, air bubbles, and lung-pleural interface

Answers:

a.

Cholesterol stones, air bubbles, and lung-pleural interface

b.

Acoustic shadowing from small stones

c.

Metal objects, surgical staples, needles, and bullets

d.

a and c

Question 30

  • 2.5 out of 2.5 points

Which type of bilirubin is produced due to breaking down old, damaged, and excessive red blood cells?

Selected Answer:

Direct/Conjugated bilirubin

Answers:

Direct/Conjugated bilirubin

Indirect/Unconjugated bilirubin

Both types of bilirubin

None of the above

Question 31

  • 2.5 out of 2.5 points

What level of CBD should be measured for intraluminal diameter estimation?

Selected Answer:

extrahepatic, at Porta hepatis

Answers:

extrahepatic, at Porta hepatis

once you found it, anywhere

inside of the liver by GB neck

intrahepatic, at Porta hepatis

Question 32

  • 2.5 out of 2.5 points

The maximum normal intraluminal diameter of the portal vein is

Selected Answer:

less than 13 mm

Answers:

less than 8 mm

less than 13 mm

less than 17 mm

less than 3 mm

Question 33

  • 2.5 out of 2.5 points

Chronic active hepatitis is a progressive destructive liver disease that eventually leads to

Selected Answer:

hepatocellular carcinoma

Answers:

liver enlargement

liver cysts

pancreatitis

hepatocellular carcinoma

Question 34

  • 2.5 out of 2.5 points

The process by which the ultrasound beam "bounces" repeatedly between two or more interfaces is known as:

Selected Answer:

Reverberation artifact

Answers:

Reverberation artifact

Mirror artifact

Moving artifact

Twinkling artifact

Question 35

  • 2.5 out of 2.5 points

A patent umbilical vein may be found in the

Selected Answer:

ligamentum teres

Answers:

falciform ligament

ligamentum venosum

ligamentum teres

gallbladder fossa

Question 36

  • 2.5 out of 2.5 points

Jaundice in a pediatric patient is less likely caused by

Selected Answer:

cirrhosis

Answers:

anemia

cirrhosis

biliary atresia

hepatitis

Question 37

  • 2.5 out of 2.5 points

The color Doppler finding in the picture below represents



Selected Answer:

abnormal hepatofugal flow

Answers:

hepatofugal flow in hepatic artery

abnormal hepatofugal flow

hepatopetal flow in portal vein

normal portal vein flow

Question 38

  • 2.5 out of 2.5 points

Hepatofugal blood flow in main portal vein is best described as

Selected Answer:

reversal flow

Answers:

intermittent flow

reversal flow

normal flow

turbulent flow

Question 39

  • 2.5 out of 2.5 points

Which image represents Porta Hepatis better?

Selected Answer:

273, 187

Correct Answer:

Top Left Coordinates

(8, 6)

Bottom Right Coordinates

(462, 345)

Instructor selection and Learner response

Question 40

  • 2.5 out of 2.5 points

Why is a single-plane representation of an abnormality, not enough confirmation?

Selected Answer:

All of the above.

Answers:

It does not provide accurate dimensions.

It only captures one view of the abnormality.

It does not show the composition of pathology fully.

All of the above.