Difference between a replaced and an accessory artery?
"Replaced: Artery arises from an anomalous source (1 anomalous artery). Accessory: one of atleast two arteries arises from an anomalous source (2 arteries present, 1 artery anomalous)."
Which gallstones can float?
Cholesterol stones can float in high specific gravity bile.
What patient's benefit from an carotid endarterectomy?
Symptomatic patients with stenosis >70%.
Best study to identify a splenule?
Sulfur colloid scan or heat-damaged tagged RBC scan.
Reversed flow in the internal mammary veins indicates?
Blunt tendon tip (longitudinal view). Mass (transverse view). Refractive shadowing. Nonvisualization. Loss of fibrillar architecture. Fluid collection.
Sonographic signs of full-thickness rotator cuff tear?
Anechoic or hypoechoic defect. Focal superficial contour abnormality. Compressibility. Nonvisualization.
Characteristics of pseudoaneurysms on ultrasound?
Complex fluid collection. Single of multiple loculations. Visible pulsations on gray-scale imaging. Internal luminal flow on color Doppler. To and fro flow in the neck.
Characteristics of iatrogenic arteriovenous fistulas at ultrasound?
Usually located below femoral artery bifurcation. Perivascular tissue vibration. Low-resistance flow in supplying artery near fistula. High-velocity flow at site of communication. Turbulent and/or arterialized flow in draining vein near fistula.
Extremity artery waveform?
"High-resistance flow. Typically triphasic waveform: Antegrade systole, retrograde early diastole, antegrade in mid diastole, absent flow in end diastole."
Extremity venous waveform?
Respiratory phasicity. Variable cardiac related pulsatility.
Factors that decrease chance of scrotal malignancy?
Extratesticular. Nonpalpable. Simple cystic appearance. No detectable vascularity.
Factors that increase chance of scrotal malignancy?
Intratesticular. Palpable. Solid or complex cyst. Detectable internal vascularity.
Beta-hCG level in an ectopic pregnancy patients increases slower or faster than an IUP?
Slower.
Where can an ectopic pregnancy occur within the uterus?
Cornua. Cervix.
Define an heterotopic pregnancy?
Concomitant intrauterine and extrauterine pregnancy.
What is a pseudogestational sac?
Collection of fluid or decidual cast within endometrial canal or thickened endometrium in an ectopic pregnancy.
"With a positive pregnancy test, give 5 findings that have positive predictive value for ectopic pregnancy?"
Gestation sac in ectopic position Adnexal mass with yolk sac or embryo. Tubal ring appearing as an empty gestation sac. Complex or solid adnexal mass. Moderate amount of intraperitoneal fluid.
95% infrarenal. Majority are fusiform. Mural thrombus common with large aneurysm. Surgery considered when >5 cm. AP diameter measured on sagittal images. Transverse diameter measured on coronal images.
Hypoplastic right heart. Ebstein's anomaly with pulmonary hypoplasia.
Fetal hydrops generalities
"Immune and nonimmune causes. Excessive fetal body water. Fluid in serous cavities, skin thickening, placental enlargement, polyhydramnios."
Fetal pericardial effusions are normal if isolated and measure less than ____?
2 mm in thickness.
Fetal cystic thoracic masses
Bochdalek congenital diaphragmatic hernias. Type I and II cystic adenomatoid malformations. Bronchogenic cysts. Duplication cysts. Pulmonary sequestration.
Fetal solid thoracic masses
Morgagni and some Bochdalek congenital diaphragmatic hernias. type III CAMs. Bronchopulmonary sequestration.
"Most common fetal intrathoracic, extracardiac abnormality"
"Enlarged hyperechoic fetal lungs, a finding for this rare entity"
Laryngeal atresia.
Most common cause of enlarged fetal liver?
Hydrops and infections.
Most common cause of small fetal liver?
Growth restriction
Fetal pseudoascites?
Hypoechoic band in upper abdomen
Umbilical vein varix implications?
Normal outcome or fetal hydrops. Structural abnormalities. Aneuploidy. Intrauterine demise.
Fetal meconium ileus?
Impaction of thick meconium within terminal ileum. Proximal bowel dilation may not occur until 3rd trimester. Causes: Mechanical intestinal obstruction. Cystic fibrosis.
If equal to or greater than bone brightness it may be abnormal. Associations: Cystic fibrosis. Chromosomal abnormalities. Growth restriction. Swallowed blood. Perinatal death.
"Defects of mid abdomen. Covered by thin amnioperitoneal membrane. Large type contains liver, usually stomach and bowel. Small type contains only bowel located at the base of umbilical cord. Associations: Structural abnormalities and chromosomal abnormalities."
Fetal gastroschisis
"Paraumbilical, usually right lower quadrant. No covering membrane. Protruding bowel floats freely in amniotic fluid. No associated anomalies or abnormal karyotype."
Femur length falls below 10th percentile before 28 weeks' gestation.
Osteogenesis imperfecta fetal US findings?
Skeletal deformities (fractures and abnormal bowing) or demineralization.
Achondrogenesis fetal US major finding?
Severe shortening of limbs (micromelic pattern). Varying degrees of demineralization and chest narrowing.
Thanatophoric dysplasia fetal US findings?
Normal bone brightness. Severe limb shortening and chest narrowing. Pronounced polyhydramnios.
Amniotic band syndrome at fetal US?
Skeletal deformities are asymmetric and atypical in appearance compared to skeletal dysplasias.
"Subchorionic versus retroplacental hemorrhages, prognosis?"
"Uncomplicated subchorionic hemorrhages are usually benign. Retroplacental hemorrhages can cause considerable fetal and, infrequently, maternal problems."
Presence of fetal (not placental) blood vessels that cross the internal cervical os (marginal or velamentous cord insertions or with succenturiate lobes).
Cervical incompetence US findings?
"Shortening of endocervical length to less than 2.5 cm, with or without cervical funneling."
Complete (classic) hydatidiform mole features?
Noninvasive (85%). Locally invasive (13%). Metastatic (choriocarcinoma 2%). Enlarged uterus filled with hyperechoic tissue (multiple cysts). No fetus present.