ARDMS Abdomen Davies

ARDMS Abdomen Davies Questions
And
Answers Well
Illustrated.



You are scanning a patient with a known mass in the left medial segment of the liver.
What anatomic landmark can you use to identify the left medial segment separate from
the right anterior segment of the liver? correct answers. Middle Hepatic Vein

Which organ is the largest visceral organ in the body ? correct answers. Liver

Where is the major portion of the liver, the right lobe located? correct answers. in the
right upper quadrant of the abdomen

What organ is covered in large part by the peritoneum , except for a small area posterior
to the dome known as the bare area? correct answers. the Liver

Which organ is covered in a layer of fibrous tissue, glisson's capsule? correct answers.
the Liver

You suspect enlargement of the caudate lobe in a patient with liver disease. What
structure located at the anterior border of the caudate lobe will help you to identify this
lobe of the liver? correct answers. Fissure for the ligamentum venosum

You are asked to rule out the presence of a recannalized paraumbilical. Which anatomic
structure is a useful landmark in location of this structure? correct answers.
Ligamentum
teres

,What is the left portal vein in contact with? correct answers. Ligamentum teres

Where does the paraumbilical vein begins? correct answers. begins at the left portal
vein and exits the liver at the ligamentum
teres

2Which vessel course within the main lobar fissure? correct answers. middle hepatic
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vei
2




n
2


Oxygenated blood is supplied to the liver via the: correct answers. Portal vein and
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hepatic artery
2
2
2


You are performing a sonogram on a slender female and notice a long, thin extension of
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the inferior aspect of the right lobe of the liver. The most likely represents: - correct
2
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answer. Reidel's lobe
2
22 2
2


What forms the caudal border of the left portal vein? correct answers. Ligamentum
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teres
2


2


What ligament divides the left lobe of the liver into medial and lateral segments? -
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correct answer. Ligamentum teres
2
2 22 2
2


You are asked to perform a Doppler study on the hepatic veins in the liver. What differentiat
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es the hepatic veins from the portal veins?
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correct answers. the portal veins are accompanied by branches of the biliary tree and hep
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atic artery
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2


You have detected a mass anterior and to the left of ligamentum venosum. This mass is
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located in what lobe of the liver ? correct answers. Left Lobe
2
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2


The thin capsule surrounding the liver is known as: correct answers. Glisson's capsule
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2


What courses interlobar and intersegmental within the liver? correct answers. Hepatic
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vein
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s
2


You are performing an ultrasound exam of the liver on a small patient with a 5MHz curved li
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near array. Although you have increased the overall gain to its maximum setting, the poste
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rior border of the liver and diaphragm are not visualized. What should you do?
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2correct answers. Rescan the liver with a lower frequency transducer.
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2


Correctly describe the probe placement and imaging plane you would use to demonstrate t
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he three hepatic veins and inferior vena cava in the one view?
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correct answers. Subcostal oblique approach with the probe angled superiorly and to the
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patient's right. 2 2
2


You are performing a follow-up sonogram on a patient in which a 5 -mm cyst was
2
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previously identified at the anterior border of the left lobe liver. Although you are using a
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, 3.5 MHz curved linear array probe, you do not see the cyst. What would be most helpful
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in improving visibility of this cyst?
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2correct answers. Rescan the left lobe with a higher frequency transducer. Visibility of smal
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l cysts is limited by spatial resolution. To improve spatial resolution, the best option is to inc
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rease the imaging frequency. 2 2 2 2
2


What do you need to do to improve spatial resolution to visualize small cysts (which has
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a limited spatial resolution)? correct answers. The best option is to increase the
2
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imaging frequency
2
2
2


You are imaging a patient with a high liver. Subcostal images do not clearly demonstrate th
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e liver tissue. What should you do? correct answers. Scan the patient in deep inspiration
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2


A patient is referred for ultrasound evaluation of a questionable mass in the dome of the
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liver seen on a CAT scan. What would improve visualization in this area of the liver? -
22
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correct answer. Perform a subcostal scan with the probe angled superior and the
2
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patient in deep inspiration
2
2 2 2
2


A patient is referred for a liver ultrasound with the clinical history of a raised serum alpha-
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fetoprotein level. What should you look for? correct answers. Hepatocellular carcinoma
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2


If a non pregnant person with elevated levels of serum alpha-
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fetoprotein AFP , what is associated with this? 2 2 2 2 2 2 2


2correct answers. Hepatocellular carcinoma, germ cell tumor of gonadal, retroperitoneal, o
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r mediastinal origin. Sometimes with cancer of pancreas, stomach, or biliary system.
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2


What may produce modest serum AFP elevations? correct answers. Hepatitis and
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cirrhosi
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s
2


You are reviewing lab work prior to performing an abnormal ultrasound exam. Elevated lab
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values include Gamma- glutamyl transpeptidase -
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GGT and alkaline phosphatase. What would it be?
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correct answers. Concomitant elevation of both GGT and alkaline phosphate indicates th
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e source of the elevated alkaline phosphatase is the liver.
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2


what other reasons would alkaline phosphatase be elevated ? correct answers.
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skeletal disease, hyperparathyroidism, and acute hepatocellular disease
2
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2


What is NOT a lab test use in evaluation of liver function out of the following GGT, AST,
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direct bilirubin, indirect bilirubin, or lipase? correct answers. Lipase - is used to
2
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evaluate acute pancreatitis
2
2 2
2


What does it mean when direct bilirubin is elevated?
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correct answers. usually indicates biliary obstruction, which may be intrahepatic due to he
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patitis, cirrhosis, or extrahepatic due to gallstones, gallbladder or pancreatic cancer.
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2


Why would indirect bilirubin be elevated? correct answers. with hepatocellular
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dysfunction such as hepatitis
2
2 2 2
2