Abdomen Boards Review Pt 2

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dorkfork
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290836
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Abdomen Boards Review Pt 2
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2014-12-06 21:33:25
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Abdomen Dorkfork sonography
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  1. Doppler flow pattern of a missed torsion
    Increased testicular flow
  2. Doppler flow pattern of an early testicular torsion
    • Decreased blood flow
    • Hypoechoic and enlarged
  3. Sonographic pattern of a late torsion
    Hypoechoic and smaller with no bloodflow
  4. Sonographic pattern of epididymitis
    • Epididymal enlargement with hypoechoic pattern
    • Increased Doppler signal
  5. Epididymoorchitis usually develop secondary to ____.
    Epididymitis
  6. Location of hydrocele
    Abnormal fluid collection between visceral and parietal layers of the Tunica vaginalis
  7. When the sonographer detects a right varicocele what should be looked at next
    Check the IVC for obstruction
  8. Prostate zone where the majority of cancer originates
    The peripheral zone
  9. Prostate zone where BPH generally originates
    Transitional zone
  10. Normal sonographic pattern of malignancy in the prostate
    70% are hypoechoic and initiate in the peripheral zone
  11. Sonographic sign of prostate cancer
    • Asymmetry of peripheral zone
    • Hyper vascular
  12. Characteristics essential for the diagnosis of benign prostate hyperplasia
    • Decreased force and caliber of urinary stream
    • High postvoid residual volume
    • Prosthetic enlargement of the transitional zone
  13. Normal cause of prostatitis
    Usually the result of a bacterial infection (UTI)
  14. Site of origin for most breast pathology
    Terminal ductolobular unit
  15. Milk of calcium cyst of the breast is common with
    Fibrocystic changes
  16. Most common breast mass and women under 35
    • years of age
    • Fibroadenoma
  17. Most frequent cause of nipple discharge
    Intraductal papilloma
  18. Fothergill's sign
    Hematoma does not cross midline and remains palpable with tense rectus muscle
  19. Rectus sheath hematoma is associated with
    A history of trauma
  20. Most common benign finding of the abdominal wall
    Lipoma
  21. Most frequent site of a Baker's cyst
    Posteriomedial aspect of the joint capsule
  22. Most frequent condition associated with a Baker's cyst
    Rheumatoid arthritis
  23. Transudate pleural effusion is associated with
    CHF, cirrhosis with ascites, urinary tract obstruction
  24. Exudate pleural effusion is associated with
    Inflammatory and the a plastic causes
  25. Plural thickening greater than ____ suggests malignancy
    1 cm
  26. Normal size of the adult adrenal gland
    4 x 2 x .5 cm
  27. Most common adrenal neoplasm
    Adenoma
  28. Functional adenoma a.k.a.
    • Cushing's syndrome
    • secretes cortisol
  29. Most common cause for abdominal mass in young children
    Neuroblastoma
  30. Most common medullary tumor of the adrenal gland
    Pheochromocytoma
  31. Sonographic patterns associated with pheochromocytoma
    5 to 6 cm well-defined homogeneous hypoechoic mass
  32. Metastasis to the adrenal gland generally arises from
    Bronchogenic and breast primary cancers
  33. Sonographic patterns of a hemorrhage from fresh to chronic
    • Fresh: echogenic
    • Older: hypoechoic/complex, smaller
    • Chronic: calcifications
  34. Normal measurement of the spleen
    • 12 x 7 x 4 cm
    • Mild splenomegaly measurement
    • Length over 13 cm AP over 6 cm
  35. Ashers sign
    Spleen extends more than 2 cm anterior to the aorta
  36. Relationship of the splenic vein branches to arterial tributaries
    They do not accompany each other throughout splenic parenchyma
  37. Splenic artery arises from
    The celiac trunk
  38. Lateral recess of the lesser sac is located
    Medial to the spleen
  39. Conditions the produce splenomegaly
    • Neoplasms: Lymphoma, leukemia, metastasis
    • Infections: hepatitis, Mono
    • Immunologic: lupus, aids, portal hypertension
    • Cirrhosis
    • Anemias, sickle cell disease
  40. Most frequent primaries associated with splenic metastasis
    Melanoma, lymphoma, leukemia
  41. Histoplasmosis
    • Caused by mold produces granulomas within spleen
    • Splenic abscess
  42. Candidal abscess in the spleen
    • AIDS patients
    • Bull's-eye pattern, hyperechoic foci
  43. What imaging modality is the method of choice for evaluation of splenic trauma
    CT
  44. Sonographic patterns of a hematoma
    • Fresh: echogenic
    • 1 to 2 days old: isoechoic
    • Older: complex to cystic
  45. Areas evaluated on an FAST exam
    Morrison's pouch, posterior cul-de-sac, left and right paracolic gutters
  46. Classic sonographic pattern of an infarction
    • Wedge-shaped area with the base towards organ capsule
    • Recent: Hypoechoic
    • Chronic: hyperechoic
  47. One of the most frequent causes for focal splenic mass
    Infarction
  48. Normal bowel wall thickness should not exceed _____ when distended
    3 mm
  49. Hypertrophic pyloric stenosis
    Pyloric sphincter connects antrum of stomach with duodenum, hypertrophy produces constriction/obstruction of gastric outlet and projectile vomiting
  50. Transverse pyloric muscle should not measure more than ___.
    3mm
  51. Pyloric canal length greater than ___ suggests pyloic stenosis.
    1.2 cm
  52. Inner layer of bowel wall
    Superficial mucosa
  53. Outer layer of bowel wall
    Serosa
  54. Most frequently performed G.I. ultrasound exam
    Acute appendicitis
  55. Maximum outer diameter and wall thickness of the appendix
    • Outer wall diameter 6 mm or less
    • Wall thickness 2 mm or less
  56. Crohn's disease usually affects what parts of the GI tract
    Terminal ileum and colon
  57. Paralytic ileus
    • Destruption in nervous stimulation for peristalsis
    • Common with acute pancreatitis
  58. Intussusception
    Portion of bowel loops telescopes into adjacent bowel
  59. Most frequent primary cancer of the bowel
    Adenocarcinoma
  60. Potential spaces of the greater sac
    • Paracolic gutters
    • Right and left subphrenic spaces
    • Posterior and anterior cul-de-sac
    • Right and left colic spaces
    • Right and left subhepatic spaces
    • Morrison's pouch
  61. Inferior borders of the lesser sac
    • Caudate lobe
    • Phrenicosplenic ligament
    • First portion of duodenum
    • Gastrosplenic ligament
    • Transverse mesocolon
    • Foramen of Winslow
  62. Cause of Chylous ascites
    Lymphatic obstruction
  63. Echogenic ascites is most commonly the result of
    • Mucinous cystadenoma carcinoma
    • Rarely associated with appendicitis
  64. Peritoneal metastasis is the most frequently associated with primaries from
    G.I. tract, kidney, pancreas, breast and pelvic organ primaries
  65. Contents of the retroperitoneal cavity
    Kidneys, adrenal gland, pancreas, aorta, IVC, lymph nodes, major portion of duodenum, asending in transverse colon
  66. Superior and inferior borders of the retroperitoneal cavity
    • Superior: diaphragm
    • Inferior border: pelvic brim
  67. Gerotas fascia
    Posterior border of the anterior pararenal space
  68. Organs contained in the posterior pararenal space
    Contains no organs
  69. Fascia of Zuckerkandl
    Separates pararenal space from posterior pararenal space
  70. As a general rule lymph nodes should never be located ____ in relation to the aorta
    Posterior
  71. Lymph nodes enlarge in the presence of
    • Infection
    • Malignancy
    • Hyperplasia
  72. Most common pathway for metastasis
    Lymphadenopathy
  73. Most common primary is that metastasize to the lymph nodes
    Renal, testicular, cervical, prostate
  74. Normal diameter of the proximal and distal aorta and iliac arteries
    • In general: 1 to 3 mm
    • Proximally order: 2 to 3 cm
    • Distal aorta: 1 to 2 cm
    • Iliac arteries: less than 2 cm
  75. An aneurysm is considered ___ cm, with an increased risk of rupture at __ cm.
    • Aneurysm: 3 to 4 cm diameter
    • Risk of rupture significantly increases greater than 5 cm
  76. Fusiform aneurysm
    Most common type of anyurism entire diameter is dilated
  77. Saccular aneurysm
    Localized portion of wall weakens
  78. Dissecting aneurysm
    Along the plane of the aortic wall, normal intra-lunar diameter and greatly increased outer two outer measurement
  79. Mycotic aneurysm
    Due to infection
  80. Symptoms of leaking or ruptured aneurysm
    Moderate to severe abdominal/groin pain that increases in severity of the patient sits or stands
  81. Pseudoaneurysm
    • Blood collection outside vessel wall that communicates with an artery via a neck
    • Produces swirling flow was in mass "ying yang" pattern with color Doppler on
  82. Doppler flow pattern of an aortic stenosis
    • Increased pulsatility proximal to stenosis
    • Increased PI and RI
    • Increased peak systolic and diastolic velocities at stenosis
    • Post stenotic turbulence
    • Damping of waveform distal to the stenosis
  83. Normal velocity and waveform of the hepatic artery
    Monophasic flow 20 to 30 cm/s
  84. Most common form of portal hypertension
    Intrahepatic (cirrhosis)
  85. Most sensitive Doppler sign of cirrhosis
    Enlarge collaterals
  86. Decreased velocity less than _____ puts a patient at increased risk for thrombosis thronbosis
    10 cm/s
  87. Sonographic characteristics of thrombosis
    • Acute thrombus: anechoic/hypoechoic
    • Chronic thrombosis: hyper cook
    • Complete occlusion: no flow
  88. Most common cause of hepatic congestion
    CHF
  89. Normal resistive index of the hepatic artery
    0.6 to 0.7
  90. Hepatic veins have what type of flow
    Triphasic flow
  91. Tumor invasion of the portal vein is most frequently caused by
  92. Hepatocellular carcinoma- lable the W wave form
    A. S. V. D. A
  93. Causes of Budd-Chiari syndrome
    Trauma, medications, sickle cell anemia, neoplasm
  94. Most common in a stenosis of TIPS
    Between right hepatic vein and right portal vein
  95. A well functioning shunt has what type of flow pattern and speed
    • High velocity flow 70 to 200 cm/s
    • Hepatofugal flow in portal branches: complete diversion of flow into shunt
  96. Doppler criteria signifying shunt stenosis
    Velocity drop by 50 cm/s or more over baseline examination
  97. Most common condition requiring a liver transplant
    Hepatitis C
  98. Most frequent location of hepatic artery stenosis following transplant of the liver
    At anastomotic site
  99. Sonographic criteria of hepatic artery stenosis
    • Peak systolic velocity greater than 2 to 3 cm/s
    • Turbulent distal flow
    • Tardus parvus anywhere in hepatic artery
  100. Criteria for renal artery stenosis
    • Renal/aortic ratio greater than 3.5
    • Peak stock velocity greater than 200 cm/s
  101. Indirect Doppler examination of renal arteries
    Sample segmental arteries in renal hilum
  102. Two most common causes of renal artery disease
    • Atherosclerotic renal artery stenosis
    • Fibromuscular dysplasia
  103. Abnormal resistive index of the renal artery post transplant
    Greater than .9
  104. Velocity threshold for stenosis
    Greater than 200 cm/s

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