DMS 207 Midterm Musgrove

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Jeopardy questions
Mandi B
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1 1/2 times larger than the normal proximal segment Aneurysm
T/F tortuosity of the abdominal aorta means that it could be crooked or possibly kinked true
T/F hepatopedal flow is a term used to describe normal flow in the portal vein true
T/F a uterine fibroid may be mistakenly diagnosed as an abdominal aneurysm true
T/F a ruptured aneurysm would cause hypotension & a decreased hematocrit true
T/F less than 50% of aneurysms are located inferior to the renal arteries false {95% are infrarenal}
T/F approximately 75% of the patients w/ an abdominal aortic aneurysm are asymptomatic false {30-60% are asymptomatic}
T/F sonographers should measure the abd aorta from outer wall to inner wall false {outer-to-outer}
What is the easiest & quickest way to determine if a cystic structure is truly cystic & not a vascular structure? a. look for ascites b. use grayscale imaging c. turn on colorflow d. take a BP c. turn on colorflow
All of the following arteries produce a low resistance waveform EXCEPT: a. CCA b. renal artery c. hepatic artery in a fasting patient d. femoral artery d. femoral artery (high resistance = extremities, things you can live w/o)
A percentage of patients w/ abd aneurysms are also at risk for developing aneursyms in an artery of the lower extremity. What is the artery that may be involved? a. femoral b. profunda femoral c. posterior tibial d. popliteal d. popliteal
The #1 risk factor/cause for developing an abd aneurysms is: atherosclerosis
The clinical signs of leg edema, low back pain, pelvic pain, gastrointestinal complaints, renal & liver problems may represent: a. abd rupture b. retroperitoneal tumor c. IVC thrombosis d. superior mesenteric thrombus c. IVC thrombosis
In patients w/ lower trunk & leg edema and dilated IVC, a(n) ___ should be suspected. a. retroperitoneal tumor b. arteriovenous fistula c. rupture d. infection b. arteriovenous fistula
Compression technique can be used to treat which kind of aneurysm? pseudoaneurysm
Ultrasound is __ accurate in detecting aneurysms. 98.9%
The normal diameter of the aorta is less than 3cm
Clinical symptoms for dissection include all of the following EXCEPT: a. back pain b. shock c. hematuria d. chest pain c. hematuria
The most common cause of portal hypertension is: intrinsic liver disease, such as cirrohosis
Berry-shaped aneurysms primarily affect which of the following arteries? a. abd aorta b. cerebral c. hepatic d. splenic b. cerebral
Most surgeons recomment surgery to repair aneurysms between _-_cm if that patient has risk factors for rupture such as hypertension, smoking, and COPD. 5-6cm
The most common type of aneurysm is: fusiform
Of the following, in which group of people are aneurysms more commonly found. a. women b. men c. children d. 30-40 yr olds b. men
The umbilical vein changes into the _ postnatally. Ligamentum Teres
_ is a condition in which the aorta is uniformly but not focally enlarged. Ectasia
Dissection of the abdominal aorta is linked to all of the following EXCEPT: a. renal cell carcinoma b. dissection of the thoracic aorta c. trauma d. Marfan's syndrome a. renal cell carcinoma
When a patient develops Portal Hypertension, what is the most common collateral pathway that the body develops to compensate for increased pressure in the liver? coronary & gastroesophogeal veins
The most common tumor to fill the IVC is: renal cell carcinoma usually from the right kidney
Which of the following abd arteries is crucial to evaluate in heart transplant patients? a. SMA b. renal c. phrenic d. hepatic d. hepatic
The sonographic evidence of dissection is: a. increased velocity b. swirling bloodflow on colorflow c. reversal of flow d. intimal flap & 2 channels of bloodflow d. intimal flap & 2 channels of bloodflow
What is the most common imaging modality used to examine a thoracic aortic aneurysm? CT
Most commonly results from intrinsic liver disease; however, it also arises from obstruction of the portal vein, hepatic veins, IVC or prolonged congestive heart failure. portal venous hypertension
Pulsatile hematoma that results from leakage of blood into soft tissues abutting the punctured artery with fibrous encapsulation & failure of the vessel wall to heal. pseudoaneurysm
A disease of arterial vessels marked by thickening, hardening, & loss of elasticity in the arterial walls ateriosclerosis
Hereditary disorder of connective tissues, bones, muscles, ligaments, and skeletal structures Marfan's syndrome
A communication between two blood vessels w/o any intervening capillary network anastomosis
Periportal collateral channels in patients w/ choronic portal vein obstruction cavernous transformation of the the portal
Circumferential enlargement of a vessel with tapering at both ends fusiform aneurysm
thrombosis of the hepatic veins Budd-Chiari syndrome
Image above represents what kind of flow: high resistance or low resistance high resistance
What is a tear in the intima or media of the aortic wall demonstratiing a linear echo within the lumen of the aorta called? dissection
What is the surgical procedure used to relieve portal hypertension? TIPS
Surgical & angiographic placement of a _ into the IVC has been used to prevent recurrent embolization in patients who cannot tolerate anticoagulants. IVC filter
After birth the umbilical vein constricts and changes into the _. ligamentum teres
Class symptoms of gallbladder disease include all of the following except: a. hematuria b. right upper quad pain c. right shoulder pain d. nausea and vomiting a. hematuria
A patient presents with a history of weight loss & pancreatic cancer. Multi target-shaped lesions are demonstrated within the liver & also a polypoid mass is demonstrated within the gb. Given the histroy, the echogenic foci within the gb are most suspicious for: metastatic gallbladder disease
Sonographic findings in metastatic disease of the gallbladder include all of the following except: a. poypoid or irregular intraluminal mass b. indistinct walls c. focal thickening of the gallbladder wall d. intraluminal soft tissue mass on thin stalk d. intraluminal soft tissue mass on thin stalk
inflammation of the gallbladder is: cholecystitis
the most frequent cause of metastic disease to the gallbladder is: melanoma
In the case of a porcelain gallbladder, all of the following facts are true except: a. 90% associated w/ stones b. higher incidence in females than males c. dense wall w/o shadowing d. associated incidence of gb carcinoma c. dense wall w/o shadowing
A condition in which cholesterol stones/ crystals become lodged between diverticula (Rokitansky-Aschoff sinuses) causing comet tail artifacts is called: adenomyomatosis
Causes of non-inflammatory gallbladder wall thickening include all of the following except: a. AIDS b. cirrhosis c. ascites d. cholecystitis d. cholecystitis
The term used to define inflammation of the gb in absence of the cholelithiasis is: acalculous cholecystitis
The following term defines a soft tissue mass pedunculating from the gallbladder wall protruding into the lumen, It does not shadow and does not move with patient position. adenoma (polyp)
Gallstone appearance on ultrasound examination is: dependent, mobile, echogenic
A hyperplastic change in the gallbladder wall that is sometimes referred to as a "strawberry gallbladder" is called: cholesterolosis
A patient presents w/ a postitive Murphy's sign and an elevated bilirubin level. Based on this clinical history, the sonogram is most suspicious for: Wall-echo-shadow (WES)
An impacted stone in the cystic duct, cystic duct remnant or gb describes which condition? Mirizzi's syndrome
Gallbladder perforation may appear in patients with any of the following diseases except: a. gangrenous cholecystitis b. acute cholecystitis c. negative Murphy's sign d. gallbladder carcinoma c. negative Murphy's sign
Thickening of the gallbladder wall may be caused by all of the following except: a. ascites b. nephritis c. AIDS d. congestive heart failure b. nephritis
Nonshadowing, low-amp echoes that sometimes layer out in a dependent gallbladder & move with patient position is most characteristic of: sludge
A 30 yr old asymptomatic patient presents with a history of Hep B. A sonogram is ordered to rule out pathology. The gallbladder demonstrates multi echogenic foci demonstrating comet-tail artifacts. The sono findings are most consistent with: adenomyomatosis
small, well defined soft tissue projection from the gallbladder wall polyp
excessive bilirubin accumulation causes yellow pigmentation of the skin; first seen in the whites of the eyes jaundice
variant of adenmyomatosis; cholesterol polyps cholesterolosis
gallstones in the gallbladder cholelithiasis
small polypoid projections from the gallbladder wall adenomyomatosis
sono pattern found when the gb is packed w/ stones Wall echo shadow (WES)
calcification of the gallbladder wall porcelain gallbladder
hormone secreted into the blood by the mucosa of the upper small intestine; stimulates contraction of the gallbladder & pancreatic secretion of enzymes. cholecystokinin
inflammation of the gb; may be acute or choronic cholecystitis
low-level echoes found along the posterior margin of the gallbladder; move w/ change in position sludge
An enlarged gallbladder w/ a diameter >5cm is called? hydrops
What two lab values will be elevated in cases of biliary obstruction? alkaline phosphatase & bilirubin
cystic dilation within the biliary tract that are congenital anomalies. choledochal cysts
congential segmental saccular cystic dilation of major intrahepatic bile ducts (beaded appearance) found in young adult or pediatric population; may be associated w/ renal disease or congenital hepatic fibrosis Caroli's Disease
inflammation of the bile ducts cholangitis
sono appearance of dilated biliary system shotgun sign, parallel channel sign
stones within the biliary system choledocholithiasis
Acute cholecystitis is associated with what clinical sign? Positive Murphy's sign
Most common cause of acute pancreatitis cholelithiasis
Pancreas lab value that increase 1st (within 1st 24 hrs) Serum Amylase
2nd most common cause of acute pancreatitis alcohol abuse
most common location for a pseudocyst to occur. lesser sac
sonographic appearance of chronic pancreatits hyperechoic w/ possible calcifications
fluid collection in the pancreas caused by inflammatory process necrosis or hemorrhage due to excretion of enzymes outside the duct. pseudocyst
most common primary neoplasm of the pancreas adenocarcinoma
hydrops of the gb caused by mass in the head of the pancreas compressing CBD Courvoisier's sign
Most common functioning islet cell tumor insulinoma
Where do islet cell tumors occur within the pancreas? Islets of Langerhans
One of the most common clinical signs of adenocarcinoma of the pancreas is _. painless jaundice
What is the disease that is congenital and indicates an iron overload in the liver? hemochromatosis
Results from thrombus within the hepatic veins. Budd-Chairi
Most common type of glycogen storage disease Type 1 or von Gierke disease
Lab value elevated with hepatocellular carcinoma. Alpha fetoprotein
Lab values elevated with cirrhosis AST & ALT Bilirubin Alkaline Phosphatase
Most common cause of intrahepatic portal hypertension cirrhosis
Most common cause of transmission of hepatitis in healthcare workers is hepatitis _. B
Condition in which the hepatocytes have accumulated an increase of lipids, tryglycerides are elevated, can be reversed w/ diet and meds Fatty Infiltration
Which two liver masses appear very similar on sonography & may require a biopsy to confirm the diagnosis? Focal nodular hyperplasia/Adenoma
A liver mass seen in sheepherding countries call echinococcal cyst or hydatid cyst is associated w/ which sonographic sign? waterlily
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