Abdominal Sonography Review
Davies Questions with 100% Correct
Answers
You are performing an abdominal ultrasound and are having difficulty
identifying the spleen. Which of the following structures is in contact with the
spleen?
A. Left hemidiaphragm
B. Stomach
C. Pancreas
D. Splenic flexure of the colon
E. All of the above Correct Answer: E. All of the above
You are examining the spleen during routine sonography. What view provides
the best long-axis image of the spleen?
A. Sagittal view from anterior position with patient supine
B. Intercostal coronal view with patient supine
C. Coronal view with patient in left lateral decubitus position
D. Anterior sagittal view with patient in left lateral decubitus position
,E. Posterior sagittal view with patient in a prone position Correct Answer: B.
Intercostal coronal view with patient supine
You are scanning a patient with moderate splenomegaly. Which of the
following is a cause of mild to moderate splenomegaly?
A. Portal hypertension
B. Infection
C. AIDS
D. Lymphoma
E. A, B, and C only Correct Answer: E. A, B, and C only
Explanation: Causes of mild to moderate splenomegaly include portal
hypertension, infection, and AIDS. Leukemia, lymphoma, and myelofibrosis result
in marked splenomegaly.
During routine sonographic evaluation of the spleen, you detect a small,
rounded mass at the splenic hilum that is homogeneous and iscoechoic with
the spleen. You have most likely detected:
A. Exophytic splenic cyst
B. Accessory spleen
,C. Enlarged lymph node
D. Splenic metastasis
E. Splenic hemangioma Correct Answer: B. Accessory spleen
You are imaging the spleen of a 27-year-old male with AIDS. What is the most
common finding in the spleen in patients with AIDS?
A. Abscess
B. Metastasis
C. Accessory spleen
D. Moderate splenomegaly
E. Lymphoma Correct Answer: D. Moderate splenomegaly
Explanation: The most common finding in the spleen in AIDS patients is
moderate splenomegaly. The spleen may also be involved with focal lesions
caused by opportunistic infections such as Candida, pneumocystis, or
mycobacterium. The spleen may also be involved in Kaposi's sarcoma or
lymphoma.
You are performing an abdominal ultrasound scan and detect a hypoechoic,
wedge-shaped lesion within the spleen. This is the typical appearance of which
of the following entities?
, A. Splenic hemangioma
B. Splenic infarction
C. Splenic metastasis
D. Granulomatous disease of the spleen
E. Splenic abscess Correct Answer: B. Splenic infarction
Explanation: Splenic infarction classically appears as a hypoechoic, wedge-
shaped lesion. With time, the infarction may become hyperechoic. Some
infarcts may have a more nodular shape.
Which of the following would be most helpful in improving diagnostic
confidence in the case described in the previous question?
A. Have the patient perform a Valsalva maneuver
B. Evaluate the lesion in both inspiration and expiration
C. Evaluate the lesion with color Doppler
D. Have the patient drink 48 oz. of water and rescan
E. Rescan the patient in an upright position Correct Answer: C. Evaluate the
lesion with color Doppler.
Davies Questions with 100% Correct
Answers
You are performing an abdominal ultrasound and are having difficulty
identifying the spleen. Which of the following structures is in contact with the
spleen?
A. Left hemidiaphragm
B. Stomach
C. Pancreas
D. Splenic flexure of the colon
E. All of the above Correct Answer: E. All of the above
You are examining the spleen during routine sonography. What view provides
the best long-axis image of the spleen?
A. Sagittal view from anterior position with patient supine
B. Intercostal coronal view with patient supine
C. Coronal view with patient in left lateral decubitus position
D. Anterior sagittal view with patient in left lateral decubitus position
,E. Posterior sagittal view with patient in a prone position Correct Answer: B.
Intercostal coronal view with patient supine
You are scanning a patient with moderate splenomegaly. Which of the
following is a cause of mild to moderate splenomegaly?
A. Portal hypertension
B. Infection
C. AIDS
D. Lymphoma
E. A, B, and C only Correct Answer: E. A, B, and C only
Explanation: Causes of mild to moderate splenomegaly include portal
hypertension, infection, and AIDS. Leukemia, lymphoma, and myelofibrosis result
in marked splenomegaly.
During routine sonographic evaluation of the spleen, you detect a small,
rounded mass at the splenic hilum that is homogeneous and iscoechoic with
the spleen. You have most likely detected:
A. Exophytic splenic cyst
B. Accessory spleen
,C. Enlarged lymph node
D. Splenic metastasis
E. Splenic hemangioma Correct Answer: B. Accessory spleen
You are imaging the spleen of a 27-year-old male with AIDS. What is the most
common finding in the spleen in patients with AIDS?
A. Abscess
B. Metastasis
C. Accessory spleen
D. Moderate splenomegaly
E. Lymphoma Correct Answer: D. Moderate splenomegaly
Explanation: The most common finding in the spleen in AIDS patients is
moderate splenomegaly. The spleen may also be involved with focal lesions
caused by opportunistic infections such as Candida, pneumocystis, or
mycobacterium. The spleen may also be involved in Kaposi's sarcoma or
lymphoma.
You are performing an abdominal ultrasound scan and detect a hypoechoic,
wedge-shaped lesion within the spleen. This is the typical appearance of which
of the following entities?
, A. Splenic hemangioma
B. Splenic infarction
C. Splenic metastasis
D. Granulomatous disease of the spleen
E. Splenic abscess Correct Answer: B. Splenic infarction
Explanation: Splenic infarction classically appears as a hypoechoic, wedge-
shaped lesion. With time, the infarction may become hyperechoic. Some
infarcts may have a more nodular shape.
Which of the following would be most helpful in improving diagnostic
confidence in the case described in the previous question?
A. Have the patient perform a Valsalva maneuver
B. Evaluate the lesion in both inspiration and expiration
C. Evaluate the lesion with color Doppler
D. Have the patient drink 48 oz. of water and rescan
E. Rescan the patient in an upright position Correct Answer: C. Evaluate the
lesion with color Doppler.
