ARDMS Abdomen Davies Questions and Answers 100%
Pass Quarantee.
A patient is referred for ultrasound evaluation of a questionable mass in the dome
of the liver seen on a CAT scan. What would improve visualization in this area of
the liver? - ANS -Perform a subcostal scan with the probe angled superior and the
patient in deep inspiration
A patient is referred for a liver ultrasound with the clinical history of a raised
serum alpha-fetoprotein level. What should you look for? - ANS -Hepatocellular
carcinoma
If a non pregnant person with elevated levels of serum alpha-fetoprotein AFP ,
what is associated with this? - ANS -Hepatocellular carcinoma, germ cell tumor of
gonadal, retroperitoneal, or mediastinal origin. Sometimes with cancer of
pancreas, stomach, or biliary system.
What may produce modest serum AFP elevations? - ANS -Hepatitis and cirrhosis
You are reviewing lab work prior to performing an abnormal ultrasound exam.
Elevated lab values include Gamma- glutamyl transpeptidase -GGT and alkaline
phosphatase. What would it be? - ANS -Concomitant elevation of both GGT and
alkaline phosphate indicates the source of the elevated alkaline phosphatase is
the liver.
what other reasons would alkaline phosphatase be elevated ? - ANS -skeletal
disease, hyperparathyroidism, and acute hepatocellular disease
What is NOT a lab test use in evaluation of liver function out of the following GGT,
AST, direct bilirubin, indirect bilirubin, or lipase? - ANS -Lipase - is used to evaluate
acute pancreatitis
What does it mean when direct bilirubin is elevated? - ANS -usually indicates
biliary obstruction, which may be intrahepatic due to hepatitis, cirrhosis, or
extrahepatic due to gallstones, gallbladder or pancreatic cancer.
Why would indirect bilirubin be elevated? - ANS -with hepatocellular dysfunction
such as hepatitis
,What is Aspartate aminotransferase - AST used in evaluating? - ANS -used in
evaluation of acute hepatic disease. May also be elevated with recent myocardial
infarction.
What is Gamma- glutamyl transpeptidase - GGT is used with what to suggest the
source of elevated alkaline phosphatase levels?
- ANS -used with alkaline phosphatase
A patient is referred with right upper quadrant tenderness and a history of oral
contraceptive use. A solid, hypoechoic mass is identified in the right lobe of the
liver. Color Doppler reveals hypervascularity of the mass. What is the scenario
likely to be? - ANS -Hepatic Adenoma - the incidence of hepatic adenomas has
increased in the united states since the 1970s. And are associated with use of oral
contraceptives.
A liver ultrasound on a 49-year-old obese male demonstrates diffuse increased
echogenicity with a focal hypoechoic area anterior to the portal vein. This most
likely represents: - ANS -Fatty metamorphosis of the liver with focal sparing
What is commonly seen as a hypoechoic mass anterior to the portal vein?
- ANS -Focal fatty sparring
A 52-year-old male with known liver cirrhosis presents for an abdominal
ultrasound. You will carefully evaluate the liver to rule out the presence of any
focal mass because of what? - ANS -Patients with liver cirrhosis are at increased
risk for hepatocellular carcinoma
You are scanning a patient with suspected liver cirrhosis. All of the following, 1.
Surface nodularity, 2. Shrunken caudate lobe, 3. Altered echo texture, 4. Ascites,
5. Regenerative nodules are sonographic feature of cirrhosis Except:
- ANS -Shrunken caudate lobe
The caudate lobe is most commonly enlarged compared to the right lobe due to
sparing in what disease? - ANS -Liver cirrhosis
, An ultrasound evaluation of liver cirrhosis should include a search for which
associated complication? - ANS -Portal hypertension
What is the most common cause of intrahepatic portal hypertension in the United
States? - ANS -Cirrhosis
Ultrasound findings of an abdominal study on a 51-year-old female include
enlargement of the hepatic veins and inferior vena cava in an otherwise normal
appearing liver. These findings are most consistent with what? - ANS -Right-sided
heart failure
Focal fatty liver is most commonly found in which location? - ANS -Anterior to the
portal vein at the porta hepatis
You have performed an ultrasound study on a patient with an enlarged caudate
lobe, shrunken right lobe and splenomegaly. The hepatic veins could not be
identified. No other abnormalities were discovered. What should you do?
- ANS -Evaluate the hepatic veins and IVC with color Doppler to confirm patency
The thin-walled hepatic veins may become compressed and difficult to identify by
B-mode imaging with what disease? - ANS -Liver cirrhosis
A patient is referred to rule out hepatomegaly. What is a not useful indicators of
hepatomegaly ? - ANS -NOT USEFUL: Increased diameter of the main portal vein
greater than 1cm
What is useful indicator to rule out hepatomegaly ? - ANS -Rounding of inferior
border of the liver, longitudinal measurement of the right lobe exceeding 15.5cm,
extension of the right lobe inferior to the lower pole of the right kidney, and
increased anteroposterior measurement of the right lobe.
You have identified a single homogeneous hyperechoic lesion measuring 2.4cm in
the posterior aspect of the right lobe of the liver. What is the most common
etiology of a mass fitting this description? - ANS -Cavernous hemangioma
A patient is referred for a sonogram of the liver to rule out metastatic disease.
What describes the sonographic appearance of liver metastasis? - ANS -Single
Pass Quarantee.
A patient is referred for ultrasound evaluation of a questionable mass in the dome
of the liver seen on a CAT scan. What would improve visualization in this area of
the liver? - ANS -Perform a subcostal scan with the probe angled superior and the
patient in deep inspiration
A patient is referred for a liver ultrasound with the clinical history of a raised
serum alpha-fetoprotein level. What should you look for? - ANS -Hepatocellular
carcinoma
If a non pregnant person with elevated levels of serum alpha-fetoprotein AFP ,
what is associated with this? - ANS -Hepatocellular carcinoma, germ cell tumor of
gonadal, retroperitoneal, or mediastinal origin. Sometimes with cancer of
pancreas, stomach, or biliary system.
What may produce modest serum AFP elevations? - ANS -Hepatitis and cirrhosis
You are reviewing lab work prior to performing an abnormal ultrasound exam.
Elevated lab values include Gamma- glutamyl transpeptidase -GGT and alkaline
phosphatase. What would it be? - ANS -Concomitant elevation of both GGT and
alkaline phosphate indicates the source of the elevated alkaline phosphatase is
the liver.
what other reasons would alkaline phosphatase be elevated ? - ANS -skeletal
disease, hyperparathyroidism, and acute hepatocellular disease
What is NOT a lab test use in evaluation of liver function out of the following GGT,
AST, direct bilirubin, indirect bilirubin, or lipase? - ANS -Lipase - is used to evaluate
acute pancreatitis
What does it mean when direct bilirubin is elevated? - ANS -usually indicates
biliary obstruction, which may be intrahepatic due to hepatitis, cirrhosis, or
extrahepatic due to gallstones, gallbladder or pancreatic cancer.
Why would indirect bilirubin be elevated? - ANS -with hepatocellular dysfunction
such as hepatitis
,What is Aspartate aminotransferase - AST used in evaluating? - ANS -used in
evaluation of acute hepatic disease. May also be elevated with recent myocardial
infarction.
What is Gamma- glutamyl transpeptidase - GGT is used with what to suggest the
source of elevated alkaline phosphatase levels?
- ANS -used with alkaline phosphatase
A patient is referred with right upper quadrant tenderness and a history of oral
contraceptive use. A solid, hypoechoic mass is identified in the right lobe of the
liver. Color Doppler reveals hypervascularity of the mass. What is the scenario
likely to be? - ANS -Hepatic Adenoma - the incidence of hepatic adenomas has
increased in the united states since the 1970s. And are associated with use of oral
contraceptives.
A liver ultrasound on a 49-year-old obese male demonstrates diffuse increased
echogenicity with a focal hypoechoic area anterior to the portal vein. This most
likely represents: - ANS -Fatty metamorphosis of the liver with focal sparing
What is commonly seen as a hypoechoic mass anterior to the portal vein?
- ANS -Focal fatty sparring
A 52-year-old male with known liver cirrhosis presents for an abdominal
ultrasound. You will carefully evaluate the liver to rule out the presence of any
focal mass because of what? - ANS -Patients with liver cirrhosis are at increased
risk for hepatocellular carcinoma
You are scanning a patient with suspected liver cirrhosis. All of the following, 1.
Surface nodularity, 2. Shrunken caudate lobe, 3. Altered echo texture, 4. Ascites,
5. Regenerative nodules are sonographic feature of cirrhosis Except:
- ANS -Shrunken caudate lobe
The caudate lobe is most commonly enlarged compared to the right lobe due to
sparing in what disease? - ANS -Liver cirrhosis
, An ultrasound evaluation of liver cirrhosis should include a search for which
associated complication? - ANS -Portal hypertension
What is the most common cause of intrahepatic portal hypertension in the United
States? - ANS -Cirrhosis
Ultrasound findings of an abdominal study on a 51-year-old female include
enlargement of the hepatic veins and inferior vena cava in an otherwise normal
appearing liver. These findings are most consistent with what? - ANS -Right-sided
heart failure
Focal fatty liver is most commonly found in which location? - ANS -Anterior to the
portal vein at the porta hepatis
You have performed an ultrasound study on a patient with an enlarged caudate
lobe, shrunken right lobe and splenomegaly. The hepatic veins could not be
identified. No other abnormalities were discovered. What should you do?
- ANS -Evaluate the hepatic veins and IVC with color Doppler to confirm patency
The thin-walled hepatic veins may become compressed and difficult to identify by
B-mode imaging with what disease? - ANS -Liver cirrhosis
A patient is referred to rule out hepatomegaly. What is a not useful indicators of
hepatomegaly ? - ANS -NOT USEFUL: Increased diameter of the main portal vein
greater than 1cm
What is useful indicator to rule out hepatomegaly ? - ANS -Rounding of inferior
border of the liver, longitudinal measurement of the right lobe exceeding 15.5cm,
extension of the right lobe inferior to the lower pole of the right kidney, and
increased anteroposterior measurement of the right lobe.
You have identified a single homogeneous hyperechoic lesion measuring 2.4cm in
the posterior aspect of the right lobe of the liver. What is the most common
etiology of a mass fitting this description? - ANS -Cavernous hemangioma
A patient is referred for a sonogram of the liver to rule out metastatic disease.
What describes the sonographic appearance of liver metastasis? - ANS -Single
