2014Sp Son-131-2W1

Front 1

Contrast enhancement lasts longest when administering the ultrasound contrast agent by:

Back 1

Slow infusion

Front 2

Currently in the United States, which of the following contrast agents are available and approved by the U.S. Food and Drug Administration (FDA) for use in echocardiography?

Back 2

Definity, Optison, Imagent

Front 3

Depending on the clinical application, vascular UCAs may be administered via:

Back 3

Intravenous infusion

Front 4

Evaluation of a patient with known cirrhosis often demonstrates a(n):

Back 4

Reduced portal venous flow with an increase in hepatic artery flow

Front 5

For a vascular ultrasound contrast agent to be clinically useful, it should:

Back 5

a. Be nontoxic
b. Have microbubbles that are small enough to traverse the pulmonary capillary beds
c. Be stable enough to provide multiple recirculations
d. Have all of the above

For a contrast agent to be clinically useful, it should be nontoxic, have microbubbles that are small enough to traverse the pulmonary capillary beds, and be stable enough to provide multiple recirculations.

The correct answer is: Have all of the above

Front 6

Hepatic cavernous hemangioma demonstrate peripheral enhancement only during the:

Back 6

Arterial phase

Front 7

In harmonic-imaging mode, the echoes from the oscillating microbubbles have a:

Back 7

High signal-to-noise ratio

Front 8

In the early arterial phase, using tissue-specific contrast agents, focal nodular hyperplasia can have a similar appearance to a:

Back 8

Hepatocellular carcinoma (HCC)

Front 9

Induced acoustic-emission effects are independent of:

Back 9

Contrast motion

Front 10

Most of the research and development of ultrasound contrast agents (UCAs) has centered on creating agents that can:

Back 10

Be administered intravenously

Front 11

Several reports have described the contrast-enhanced sonographic appearance of hepatocellular carcinoma as having intense enhancement in the _____________ phase.

Back 11

Early arterial

Front 12

The detection of flow in the hepatic capillaries is identified in the ___________ phase.

Back 12

Late vascular

Front 13

The first ultrasound contrast agent to receive FDA approval was used in:

Back 13

Echocardiography

Front 14

The mechanical index (MI) uses:

Back 14

Low acoustic output power

Front 15

The microbubble of a first-generation UCA contains which one of the following types of substance?

Back 15

Room air

Front 16

The microbubbles of tissue-specific UCAs are:

Back 16

Taken up by or have an affinity for specific tissues

Front 17

The rupture of microbubbles results in random:

Back 17

Doppler shifts

Front 18

Tissue-specific ultrasound contrast agents can be considered to be:

Back 18

Molecular-imaging agents

Front 19

To aid in contrast-enhanced imaging equipment, manufacturers have begun to incorporate into their systems:

Back 19

Intermittent imaging capabilities

Front 20

Ultrasound contrast agents have shown the potential to improve the accuracy of hepatic sonography including:

Back 20

a. Enhanced detection of hepatic masses
b. Enhanced characterization of hepatic masses
c. Improved detection of intrahepatic and extrahepatic blood flow
d. All of the above

Front 21

Vascular ultrasound agents enhance Doppler flow signals by:

Back 21

Adding more and better acoustic scatterers to the bloodstream

Front 22

When insonating microbubble-based UCAs, the energy present within the acoustic field:

Back 22

Can have a detrimental effect on the contrast microbubbles

Front 23

When the microbubble is destroyed:

Back 23

Contrast enhancement is no longer provided

Front 24

When using ultrasound contrast agents, a lesion that gets progressively echogenic over time is most likely:

Back 24

Hemangioma

Front 25

Which of the following vessels are the first to demonstrate contrast enhancement in the liver?

Back 25

Hepatic arteries

Front 26

A higher percentage of positive cells is observed in the _____________ of a thyroid mass?

Back 26

Small calcifications

Front 27

A preprocedural image should document the patient's name and the:

Back 27

Time, date, and needle path

Front 28

A specific complication of a renal biopsy is:

Back 28

Hematuria

Front 29

Advantages of using ultrasound guidance include all of the following except:

Back 29

Fixed angles when using needle guides

Front 30

Biopsies of the spleen carry an increased risk for:

Back 30

Hemorrhage

Front 31

Contraindications for a biopsy include all of the following except:

Back 31

Dehydration

Front 32

In a renal parenchymal biopsy, which part of the kidney is typically biopsied?

Back 32

Lower pole

Front 33

In a renal transplant procedure, which part of the kidney is typically biopsied?

Back 33

Upper pole

Front 34

In which of the following positions is a patient placed for a thoracentesis?

Back 34

Sitting

Front 35

Limitations of ultrasound guidance include all of the following except:

Back 35

Shorter procedure times

Front 36

Postbiopsy complications may include all of the following except:

Back 36

Heart failure

Front 37

Renal parenchymal biopsies are requested for patients with:

Back 37

Proteinuria

Front 38

The best way to recognize the tip of the needle with ultrasound is all of the following except:

Back 38

The needle tip appears as a hypoechoic area

Front 39

The common indication for a biopsy is to:

Back 39

Confirm a malignancy in a mass.

Front 40

The international normalized ratio (INR) was developed because of the variable results of _________ among laboratories.

Back 40

PT

Front 41

The most common organ biopsied is:

Back 41

Liver

Front 42

The national patient safety standards mandate that a "time-out" be performed before beginning any procedure, which means all of the following except the:

Back 42

Patient's name is recited by a team member

Front 43

The primary advantage of an ultrasound-guided procedure is:

Back 43

Provides for continuous real-time visualization of the biopsy needle.

Front 44

The role of the cytopathology team is to:

Back 44

a. . Ensure enough diagnostic tissue is obtained
b. Increase the percentage of successful biopsies
c. Minimize the number of core samples
d. Provide all of the above.

Front 45

The test used to evaluate the effects of heparin, aspirin, and antihistamines on the blood-clotting process is:

Back 45

PTT

Front 46

The wait time after discontinuing the use of aspirin is:

Back 46

5 to 7 days

Front 47

The _______________ patient position is most commonly used in a prostate biopsy.

Back 47

Left lateral decubitus

Front 48

What needle gauge is typically used in a fine-needle aspiration?

Back 48

20 to 25

Front 49

Which one of the following laboratory tests could indicate a liver lesion?

Back 49

Alpha-fetoprotein (AFP)

Front 50

Which one of the following types of biopsy uses an automatic spring-loaded device to provide tissue for analysis?

Back 50

Core biopsy

Front 51

A hernia in the bowel that cannot be reduced is a(n) ______________ hernia.

Back 51

Incarcerated

Front 52

A hernia with vascular compromise is ________________.

Back 52

Strangulated

Front 53

A pseudodissection demonstrates which one of the following?

Back 53

Turbulent blood flow pattern

Front 54

Approximately 70% of aortic dissections occur in the:

Back 54

Ascending aorta

Front 55

For years, which one of the following techniques has been used as a surgical tool for the diagnosis of hemoperitoneum?

Back 55

Peritoneal lavage

Front 56

In reproductive-age women, free fluid isolated to the posterior cul-de-sac is likely which one of the following?

Back 56

Physiologic

Front 57

In the early stages of testicular torsion, the echogenicity of the testis appears _____________.

Back 57

Normal

Front 58

In the trauma setting, the most common finding of free fluid in the abdomen or pelvis is:

Back 58

Hemoperitoneum

Front 59

Midepigastric pain radiating to the back is characteristic of:

Back 59

Acute pancreatitis

Front 60

One of the most common conditions that necessitate emergent surgery is:

Back 60

Acute appendicitis

Front 61

Paraumbilical hernia occurs more often in which one of the following?

Back 61

Female adults

Front 62

People go to the emergency department for all of the following frequent reasons except:

Back 62

Ear pain

Front 63

Posttrauma, the most common location for fluid to accumulate is in the ___________.

Back 63

Morison's pouch

Front 64

Sonographic findings in acute pancreatitis may include which one of the following?

Back 64

Normal-appearing parenchyma

Front 65

Sonographic findings of acute cholecystitis include all of the following except:

Back 65

Small gallbladder

Front 66

Stones as small as _____ millimeters (mm) may be visualized with ultrasound.

Back 66

0.5

Front 67

The complications of peritoneal lavage include all of the following except:

Back 67

Pneumothorax

Front 68

The initial survey of a FAST scan is directed to the:

Back 68

Pericardium

Front 69

The most common cause of acute cholecystitis is:

Back 69

Obstruction of the cystic duct

Front 70

The most common sonographic finding of a hernia is:

Back 70

Peristalsis of the bowel during a Valsalva maneuver

Front 71

The sonographic finding in aortic dissection includes all of the following except:

Back 71

Laminar blood flow pattern

Front 72

The traditional modality of choice for evaluating urolithiasis is:

Back 72

Intravenous urography

Front 73

Three types of abdominal hernias include all of the following except:

Back 73

Carcerated hernia

Front 74

Torsion of the spermatic cord occurs as a result of which one of the following?

Back 74

Abnormal mobility of the testis

Front 75

Which one of the following is nearly always associated with aortic dissection?

Back 75

Hypertension

Front 76

A cystic formation lateral to the thyroid gland is typically which one of the following?

Back 76

Brachial cleft cyst

Front 77

A solitary thyroid nodule in the presence of ipsilateral lymphadenopathy suggests which one of the following?

Back 77

Malignancy

Front 78

A ___________ is a palpable midline mass between the hyoid bone and the isthmus of the thyroid gland.

Back 78

Thyroglossal duct cyst

Front 79

All of the following structures form neighboring structures for the thyroid gland except the:

Back 79

Parotid muscle

Front 80

An abnormal lymph node demonstrates which one of the following?

Back 80

Round contour

Front 81

Approximately 20% of solitary thyroid nodules are ___________.

Back 81

a. Cystic
x

Front 82

Common disorders associated with hyperthyroidism include all of the following except:

Back 82

Acute thyroiditis

Front 83

Hyperfunction of all parathyroid glands with no apparent cause occurs with which one of the following?

Back 83

Primary hyperplasia of the parathyroid glands

Front 84

Increased vascularity with color Doppler, termed the thyroid inferno, is observed in ___________________.

Back 84

Graves' disease

Front 85

Sonographically, the normal thyroid gland may be described as having all of the following characteristics except:

Back 85

Diffusely homogenous

Front 86

The approximate dimensions of the thyroid gland are:

Back 86

5 cm length, 2 cm width, 2 cm depth

Front 87

The lobes of the thyroid gland are connected by:

Back 87

The isthmus

Front 88

The most common cause of primary hyperparathyroidism is which one of the following?

Back 88

Parathyroid adenoma

Front 89

The most common cause of thyroid disorders worldwide is which one of the following?

Back 89

Iodine deficiency

Front 90

The most common cause of thyroid malignancy is _____________ carcinoma.

Back 90

Papillary

Front 91

The normal parathyroid glands measure less than _______ millimeters (mm).

Back 91

4

Front 92

The parathyroid glands lie between the ____________ borders of the ____________ lobes of the thyroid gland.

Back 92

Posterior; medial

Front 93

The parathyroid glands produce a hormone that affects the:

Back 93

Kidneys, bones, and gastrointestinal tract

Front 94

The pyramid lobe of the thyroid gland extends from the __________________.

Back 94

Superior isthmus

Front 95

The thyroid gland consists of ________ lobes:

Back 95

Two

Front 96

The thyroid is an endocrine gland that regulates metabolic function through the production of all of the following hormones except:

Back 96

Thyroliberin

Front 97

Usually _____ parathyroid glands exist.

Back 97

Four

Front 98

Which one of the following sonographic features of a thyroid adenoma is the most common?

Back 98

Hypoechoic peripheral halo

Front 99

Which one of the following structures lies medial to the left thyroid lobe?

Back 99

Larynx

Front 100

Which one of the following structures lies posterolateral to the thyroid gland?

Back 100

Longus colli muscle

Front 101

Neck muscles located anterolateral to the thyroid gland include all of the following except the

Back 101

longus colli muscle (LCM)

Front 102

The average weight of the thyroid gland is approximately

Back 102

25 g.

Front 103

The high resolution sonography recommended for evaluation of parathyroid adenomas is

Back 103

7.5 to 15 MHz.

Front 104

The mathematical method for calculating thyroid volume is based on the ellipsoid formula with a correction factor, which is:

Back 104

Length ´ Width ´ Thickness ´ 0.52 for each lobe

Front 105

The secretion of triiodothyronine (T3), thyroxine (T4), and calcitonin is regulated by the

Back 105

hypothalamus and pituitary gland

Front 106

The sonographic appearance of the normal parathyroid glands generally is

Back 106

hypoechoic compared with the thyroid gland

Front 107

The sonographic appearance of the normal thyroid gland is uniformly

Back 107

echogenic with medium level echoes, similar to the testes and liver

Front 108

The superior and inferior parathyroid glands are supplied by the

Back 108

separate small branches of the superior and inferior thyroid arteries and by branches from the longitudinal anastomoses between these vessels

Front 109

The superior thyroid artery is a branch of the :

Back 109

external carotid artery.

Front 110

The thyroid gland is composed of follicles filled with a substance called

Back 110

colloid

Front 111

The thyroid is an endocrine gland that secretes three hormones, which are

Back 111

thyroxine (T4), triiodothyronine (T3), and calcitonin.

Front 112

When ultrasound fails to identify abnormal parathyroid glands preoperatively, and in patients considered for repeat surgery, which test(s) is/are commonly used?

Back 112

Scintigraphy, SPECT, and MRI

Front 113

Which neck muscle(s) is/are located posterior to the thyroid gland?

Back 113

Longus colli muscle

The longus colli muscle lies posterior to the thyroid gland.

Front 114

Which statement is NOT true about imaging of the parathyroid glands?

a. High resolution (7.5 to 15 MHz) linear transducers are routinely used to image abnormal parathyroid glands.

b. In a patient with a thick neck, a lower frequency (e.g., a 4 to 8 MHz convex transducer) may be required to enhance acoustic visualization.

c. In examinations for inferior parathyroid adenomas, the swallow maneuver briefly elevates the thyroid gland, permitting acoustic access to the most inferior aspect of the gland.

d. Sonography routinely is performed on patients with normal calcium levels.

Back 114

d. Sonography routinely is performed on patients with normal calcium levels

The most common clinical indication for parathyroid imaging is hypercalcemia.

Front 115

Which statement is NOT true about parathyroid gland physiology?

a. When serum calcium levels are low, PTH raises serum calcium by releasing calcium from the bone and decreasing calcium absorption in the liver.


b. The parathyroid glands maintain homeostasis of blood calcium by promoting calcium absorption into the blood and preventing hypocalcemia.

c. The parathyroid glands secrete parathyroid hormone, also called PTH or parathormone.

d. Hypercalcemia (calcium levels greater than 10.2 mg/dl in adults and 10.7 mg/dl in children) is an indication for localizing abnormal parathyroid glands.

Back 115

a. When serum calcium levels are low, PTH raises serum calcium by releasing calcium from the bone and decreasing calcium absorption in the liver.

When serum calcium levels are low, parathyroid hormone (PTH) raises serum calcium by releasing calcium from the bone, increasing calcium absorption in the gut, and decreasing renal calcium by decreasing renal phosphate excretion.

Front 116

Which statement is NOT true about the adult thyroid gland?

a. It plays a major role in growth and development and regulates basal metabolism through the synthesis, storage, and secretion of thyroid hormones.
b. In cross-section, it is outlined posterolaterally by the CCA and the IJV.
c. The isthmus measures approximately 2 to 6 mm in AP diameter.
d. The thyroid parenchyma is composed of connective tissue and masses of chief cells.

Back 116

d. The thyroid parenchyma is composed of connective tissue and masses of chief cells.

The thyroid parenchyma is composed of follicles, connective tissue, stroma, blood vessels, nerves, and lymphatics.

Front 117

Which statement is NOT true about the parathyroid glands and parathyroid adenomas?

a. Approximately 35% of parathyroid glands are ectopic
b. Ectopic locations for parathyroid glands include the carotid bulb, as well as retroesophageal space, the thymus and perithymic tissues, and within the thyroid gland.
c. Current state-of-the-art color flow imaging of parathyroid adenomas demonstrates intraparenchymal hypervascularization in approximately 90% of cases.
d. Normal cervical structures, such as the longus colli muscle, esophagus, and small extrathyroidal arteries and veins, can mimic parathyroid adenomas.

Back 117

a. Approximately 35% of parathyroid glands are ectopic.

Approximately 15% of parathyroid glands are ectopic. They frequently are found within the thymus or perithymic tissues (10%). Other aberrant locations include the carotid bulb and sheath (1%), the retroesophageal space (1% to 3%), and within the thyroid (1%).

Front 118

Which statement is NOT true about the parathyroid glands?

a. Most people (about 80%) have four parathyroid glands located in a symmetric position contiguous with the thyroid gland.
b. The parathyroid glands generally are situated anterior to the thyroid gland.
c. The parathyroid glands may be intrathyroidal.
d. Approximately 15% of parathyroid glands are ectopic.

Back 118

b. The parathyroid glands generally are situated anterior to the thyroid gland

The parathyroid glands typically are located posterior to the thyroid gland and anterior to the longus colli muscle.

Front 119

Which statement is NOT true about the parathyroid glands?
a. They generally have a multilobulated shape.
b. Ectopic locations include the carotid bulb and retroesophageal, thymus, and intrathyroidal locations.
c. Normal parathyroid glands measure approximately 5 to 7 mm in length, 3 to 4 mm in width, and 1 to 2 mm in thickness.
d. Approximately 15% to 20% of parathyroid glands are ectopic.

Back 119

a. They generally have a multilobulated shape.

The shape of the parathyroid glands varies. They generally are oval, bean shaped, or spherical (83%), or elongated (11%), bilobulated (5%), or multilobulated (1%).

Front 120

Which statement is NOT true about the parathyroid glands?
a. Normal adult parathyroid glands generally are not seen with sonography.
b. The parathyroid glands are situated posterior to the thyroid gland and anterior to the longus colli muscle.
c. Normal parathyroid glands almost always can be seen, especially in young patients.
d. A prominent longus colli muscle may be mistaken for a parathyroid adenoma.

Back 120

c. Normal parathyroid glands almost always can be seen, especially in young patients.

Normal thyroid glands generally are not visualized in adults. They can be seen occasionally in young patients, by using newer high-frequency transducers.

Front 121

Which statement is NOT true about the parathyroid glands?
a. The typical sonographic appearance of a parathyroid adenoma is an oval, hyperechoic, structure without through transmission.
b. Primary hyperparathyroidism is caused by a solitary parathyroid adenoma in 80% to 90% of cases.
c. Most people have four parathyroid glands located posterior to the thyroid lobe and anterior to the longus colli muscle.
d. The most common indication for parathyroid imaging is hypercalcemia.

Back 121

a. The typical sonographic appearance of a parathyroid adenoma is an oval, hyperechoic, structure without through transmission.

A parathyroid adenoma generally appears on ultrasound as a hypoechoic to anechoic, oval or bean-shaped, homogeneous mass that does not demonstrate through transmission.

Front 122

Which statement is NOT true about the size and shape of the thyroid gland?
a. The right lobe often is slightly larger than the left lobe.
b. Shorter, obese patients tend to have oval lateral lobes measuring less than 3.5 cm.
c. Tall, thin patients have elongated lateral lobes that can measure up to 7 to 8 cm in the longitudinal plane.
d. Thyroid gland measurements have a wide range of variability.

Back 122

b. Shorter, obese patients tend to have oval lateral lobes measuring less than 3.5 cm.

Shorter, obese patients tend to have oval lateral lobes measuring less than 5 cm.

Front 123

Which statement is NOT true about the sonographic appearance of the neck muscles and the esophagus?
a. The esophagus appears hypoechoic with an echogenic center representing mucosa.
b. The infrahyoid muscles, or strap muscles, are hypoechoic relative to the thyroid gland.
c. The sternocleidomastoid muscle is hypoechoic compared with the thyroid gland.
d. The longus colli muscle is hyperechoic compared with the thyroid gland.

Back 123

d. The longus colli muscle is hyperechoic compared with the thyroid gland.

The neck muscles (infrahyoid, sternocleidomastoid, and longus colli) are hypoechoic relative to the thyroid gland.

Front 124

Which statement is NOT true about the sonographic appearance of the normal thyroid gland?
a. It is more echogenic than contiguous muscles and vascular structures.
b. It is uniformly echogenic with medium level echoes, similar to the liver and testes.
c. Anechoic, 1- to 2-mm tubular structures represent the thyroid arteries and veins.
d. It is more uniformly hypoechoic than contiguous muscles and vascular structures.

Back 124

d. It is more uniformly hypoechoic than contiguous muscles and vascular structures

The normal thyroid gland appears more echogenic than surrounding muscles and vascular structures. It is uniformly echogenic with medium level echoes, similar to the liver and testes. Anechoic, 1- to 2-mm tubular structures with bright, thin walls represent the thyroid arteries and veins.

Front 125

Which statement is NOT true about the thyroid gland?
a. It lies anterior to the trachea.
b. It is composed of right and left lobes only.
c. A pyramidal lobe is present in approximately 15% to 30% of the population.
d. It is composed of right and left lobes connected across the midline by the isthmus.

Back 125

b. It is composed of right and left lobes only.

The thyroid gland is composed of right and left lobes connected across the midline by the isthmus. It lies anterior to the trachea, and a pyramidal lobe is present in approximately 15% to 30% of the population.

Front 126

Which statement is NOT true about the thyroid gland?
a. It measures approximately 4 to 6 cm in length, 2 to 3 cm in anteroposterior (AP) diameter, and 1.5 to 2 cm in width.
b. In cross-section, it is outlined anteriorly by the longus colli muscle and the internal jugular vein.
c. The isthmus measures approximately 2 to 6 mm in AP diameter.
d. It plays a major role in growth and development and regulates basal metabolism through the synthesis, storage, and secretion of thyroid hormones.

Back 126

b. In cross-section, it is outlined anteriorly by the longus colli muscle and the internal jugular vein

The longus colli muscle lies posterior and the internal jugular vein lies lateral to the thyroid lobes.

Front 127

Which statement is NOT true about the thyroid gland?
a. Thyroid volumes increase with age and body weight, as well as in patients with acute hepatitis and those living in regions deficient in iodine.
b. It is an endocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and calcitonin.
c. It is an exocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and iron.
d. The normal mean thyroid volume is 18.6 ± 4.5 ml (± SD), which converts to a 18.6-g gland.

Back 127

c. It is an exocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and iron.

The thyroid is an endocrine gland that secretes T3, T4, and calcitonin. The normal mean thyroid volume is 18.6 g. A number of factors can increase thyroid volume, including age, body weight, acute hepatitis, and iodine deficiency.

Front 128

Which statement is NOT true about the thyroid gland?
a. It is connected across the midline by the isthmus.
b. It is composed of right and left lobes.
c. It lies anterior to the trachea.
d. In cross-section, it is outlined posterolaterally by the common carotid artery (CCA) and internal jugular vein (IJV), and anteriorly by the longus colli muscle.

Back 128

d. In cross-section, it is outlined posterolaterally by the common carotid artery (CCA) and internal jugular vein (IJV), and anteriorly by the longus colli muscle.

In cross-section, the thyroid gland is outlined posterolaterally by the CCA and the IJV and posteriorly by the LCM.

Front 129

Most parathyroid adenomas appear in the area of an anatomic "triangle" formed by the thyroid gland, longus colli muscle, common carotid artery, and internal jugular vein. ____ T or F

Back 129

True

Front 130

Patients with secondary hyperparathyroidism develop hypercalcemia. ____ T or F

Back 130

True

Front 131

The major neurovascular bundle is located posterolateral to the thyroid gland and consists of the common carotid artery, internal jugular vein, and vagus nerve. ____ T or F

Back 131

True

Front 132

The presence of an extrathyroidal artery leading to an abnormal parathyroid gland aids the detection of an otherwise inconspicuous parathyroid adenoma ____ T or F

Back 132

True

Front 133

About 60% of semen is composed of

Back 133

alkaline fluid rich in fructose, produced by the seminal vesicles.

Front 134

Convoluted seminiferous tubules connect to straight tubules, which empty into the

Back 134

rete testis.

Front 135

In an adult, testicular volume is _____, and testicular weight is _____.

Back 135

25 ml; 10 to 15 g

Front 136

Spermatozoa exit the testis through the

Back 136

efferent ducts

Front 137

Testicular parenchyma on ultrasound is

Back 137

homogeneous

Front 138

The epididymis empties into the

Back 138

ductus deferens.

Front 139

The epididymis is connected to which portion of the testis?

Back 139

Superior

Front 140

The main arterial blood supply of the penis includes the

Back 140

deep artery of the penis, bulbourethral artery, and dorsal artery.

Front 141

The median raphe divides the

Back 141

scrotum into two testicles

Front 142

The penis is composed of

Back 142

two corpora cavernosa dorsolaterally and one corpus spongiosum midventrally

Front 143

The scrotum consists of the

Back 143

testicles, epididymis, and proximal vas deferens

Front 144

The testes are classified as

Back 144

exocrine and endocrine glands

Front 145

What is the echogenicity of the cavernosal arterial walls?

Back 145

High echogenicity

Front 146

What is the echogenicity of the corpora cavernosa?

Back 146

Medium level echoes

Front 147

What is the echogenicity of the corpus spongiosum?

Back 147

Medium level echoes

Front 148

What is the echogenicity of the epididymis?

Back 148

Medium level echoes

Front 149

What is the echogenicity of the mediastinum testis?

Back 149

High echogenicity

Front 150

What is the echogenicity of the septum penis?

Back 150

High echogenicity

Front 151

What is the echogenicity of the spermatic cord?

Back 151

Low level echoes

Front 152

What is the echogenicity of the tunica albuginea?

Back 152

High echogenicity

Front 153

A clinical history of a vasectomy is associated with:

Back 153

Sperm granulomas

Front 154

A common cause of acute scrotal pain in adults is:

Back 154

Epididymo-orchitis Correct

Front 155

A hydrocele develops between the:

Back 155

Parietal and visceral layers of the tunica vaginalis

Front 156

A linear stripe of variable thickness and echogenicity running through the testis in a craniocaudal direction represents the:

Back 156

Mediastinum testis

Front 157

A seminoma of the testicle generally appears on ultrasound as a(n) _____________ mass.

Back 157

Hypoechoic

Front 158

A spermatocele is always located in which portion of the epididymis?

Back 158

Head

Front 159

Attached at the superior pole of the testis between the epididymis and the testis is which one of the following?

Back 159

Appendix testis

Front 160

Common causes of a hydrocele include all of the following except:

Back 160

Microlithiasis

Front 161

Compared with the testis, the epididymis typically appears:

Back 161

Hypoechoic

Front 162

Epididymo-orchitis most commonly results from a:

Back 162

Bladder infection

Front 163

Follow-up examination of patients with microlithiasis is recommended:

Back 163

Annually

Front 164

Intratesticular cysts have an association with:

Back 164

Spermatoceles

Front 165

Microlithiasis of the testis is associated with a(n):

Back 165

Malignant neoplasm

Front 166

Sonographic characteristics of the normal testis include a(n):

Back 166

Homogeneous pattern with medium-level echoes

Front 167

The diameter of a varicocele measures more than _____ millimeters (mm).

Back 167

2

Front 168

The epididymis is located ________________ to the testis.

Back 168

Posterior and superior

Front 169

The most common cause of acute scrotal pain in the adolescent is:

Back 169

Testicular torsion

Front 170

The primary source of blood flow to the testicles is via the _____________ arteries.

Back 170

Testicular

Front 171

The rete testis is located:

Back 171

At the hilum of the testis

Front 172

The testes are covered by a fibrous capsule formed by the:

Back 172

Tunica albuginea

Front 173

The testes measure:

Back 173

4 cm long, 3 cm in diameter (AP), 3 cm wide

Front 174

Tubular ectasia of the rete testis is associated with a(n):

Back 174

Epididymal cyst

Front 175

Which one of the following almost always transpires secondary to epididymitis?

Back 175

Orchitis

Front 176

Which one of the following facts about an undescended testis is false?

Back 176

All undescended testes are found in the inguinal canal

Front 177

Which one of the following statements about varicoceles is false?

Back 177

Varicoceles are more common on the right side of the scrotum

Front 178

The central fissure separates the

Back 178

parietal and frontal lobes

Front 179

The diencephalon rests superior to the brain stem. It consists of

Back 179

the thalamus, hypothalamus, and epithalamus

Front 180

The fourth ventricle is connected to the third ventricle by the

Back 180

aqueduct of Sylvius

Front 181

The lateral fissure, or sylvian fissure, separates the

Back 181

temporal lobes from the frontal lobes

Front 182

The lateral ventricles communicate with the third ventricle through the

Back 182

interventricular foramina of Monro

Front 183

The structures of the brain stem are

Back 183

the pons, midbrain, and medulla oblongata.

Front 184

The transverse fissure separates the

Back 184

cerebrum from the cerebellum

Front 185

What is the echogenicity of the bones of the cranial vault?

Back 185

Echogenic

Front 186

What is the echogenicity of the caudate nucleus?

Back 186

Moderately echogenic

Front 187

What is the echogenicity of the caudothalamic groove?

Back 187

Echogenic

Front 188

What is the echogenicity of the cavum septum pellucidum?

Back 188

Anechoic

Front 189

What is the echogenicity of the cerebral parenchyma?

Back 189

Low level echoes

Front 190

What is the echogenicity of the choroid plexus?

Back 190

Echogenic

Front 191

What is the echogenicity of the corpus callosum?

Back 191

Hypoechoic

Front 192

What is the echogenicity of the fourth and third ventricles?

Back 192

Anechoic

Front 193

What is the echogenicity of the lateral ventricle?

Back 193

Anechoic

Front 194

What is the echogenicity of the posterior periventricular white matter?

Back 194

Echogenic

Front 195

What is the echogenicity of the quadrigeminal plate cistern?

Back 195

Hypoechoic

Front 196

What is the echogenicity of the sulci and fissures?

Back 196

Echogenic

Front 197

What is the echogenicity of the sylvian fissure?

Back 197

Echogenic

Front 198

A mass of special cells located in the atrium of the lateral ventricles is which one of the following?

Back 198

Choroid plexus

Front 199

A thin, triangular space filled with CSF that lies between the anterior horn of the lateral ventricles is:

Back 199

Cavum septi pellucidi

Front 200

Acute neonatal brain hemorrhage appears ____________________.

Back 200

Echogenic

Front 201

Approximately 40% of CSF is produced by which one of the following?

Back 201

Choroid plexus

Front 202

Bilateral occlusion of the carotid arteries may result in __________________.

Back 202

Hydranencephaly

Front 203

Convolutions on the surface of the brain are called which one of the following?

Back 203

Gyri

Front 204

Cyclopia is associated with which one of the following?

Back 204

Holoprosencephaly

Front 205

Dysgenesis of the fourth ventricle results in which one of the following malformations?

Back 205

Dandy-Walker

Front 206

Periventricular leukomalacia is defined as which one of the following?

Back 206

White matter necrosis

Front 207

Sonography of the neonatal brain is evaluated through which one of the following?

Back 207

Anterior fontanelle

Front 208

The area in which the falx cerebri sits that separates the two cerebral hemispheres is which one of the following?

Back 208

Interhemispheric fissure

Front 209

The brain coverings are known as which one of the following?

Back 209

Meninges

Front 210

The junction of the anterior, occipital, and temporal horns is called the ________________.

Back 210

Atrium (trigone)

Front 211

The largest subarachnoid space demonstrated sonographically is ________________.

Back 211

Cistern magnum

Front 212

The most common cause of congenital hydrocephalus is which one of the following?

Back 212

Aqueductal stenosis

Front 213

The most important cause of abnormal neurodevelopment sequelae in premature infants is which one of the following?

Back 213

White matter necrosis

Front 214

The part of the brain that connects the forebrain and the spinal cord is which one of the following?

Back 214

Brainstem

Front 215

The periventricular tissue, which may bleed easily before 32 weeks' gestation, is the ____________________.

Back 215

Germinal matrix

Front 216

The portion of the brain that forms the lateral borders of the frontal horns of the lateral ventricles and lies anterior to the lateral ventricles and thalamus is which one of the following?

Back 216

Caudate nucleus

Front 217

The portion of the brain that lies posterior to the cranial fossa under the tentorium is called which one of the following?

Back 217

Cerebellum

Front 218

The primary brain vesicle, rhombencephalon, is located in which one of the following?

Back 218

Hindbrain

Front 219

The two ovoid brain structures located on either side of the third ventricle superior to the brainstem make up the ________________.

Back 219

Thalami

Front 220

What is the name of the structure that forms between the corpus callosum and the anterior horn or lateral ventricle?

Back 220

Septum pellucidum

Front 221

Which one of the following is most likely the result of a germinal matrix hemorrhage?

Back 221

Subependymal cyst

Front 222

Which three mechanisms account for the development of hydrocephalus?

Back 222

Outflow obstruction, decreased absorption, and overproduction

Front 223

A pitfall in diagnosing appendicitis may be which one of the following?

Back 223

Enlarged lymph nodes

Front 224

An abdominal ultrasound may be ordered in the neonate when jaundice persists beyond ______________.

Back 224

2 weeks

Front 225

An overdistended stomach ____________ displaces the pylorus.

Back 225

Posteriorly

Front 226

Children with intussusception may exhibit the following clinical presentations except:

Back 226

Tenderness over McBurney's point

Front 227

Hepatoblastoma has been associated with which one of the following?

Back 227

Precocious puberty

Front 228

Hypertrophic pyloric stenosis occurs in all of the following patient populations except:

Back 228

Most commonly found in female patients

Front 229

In older children, the common bile duct should not exceed _____ mm.

Back 229

4

Front 230

In patients with appendicitis, the outer diameter should measure at least _____ mm.

Back 230

6

Front 231

Other causes of vomiting in the infant include all of the following except:

Back 231

Appendicolith

Front 232

Other findings that may indicate appendicitis include all of the following except:

Back 232

Meckel diverticulum

Front 233

Preparation for a biliary sonographic examination of a 2-year-old child is nothing by mouth (nil per os; NPO) for ____ hours.

Back 233

4

Front 234

Sonographic characteristics associated with the bowel include all of the following signs except:

Back 234

Pseudokidney

Front 235

The length of the pediatric gallbladder should not exceed which one of the following?

Back 235

Length of the kidney

Front 236

The mean portal vein measurement in children younger than 10 years of age is ______ millimeters (mm).

Back 236

8.5

Front 237

The most common acute abdominal disorder in early childhood is which one of the following?

Back 237

Intussusception

Front 238

The most common causes of prolonged neonatal jaundice include all of the following except:

Back 238

Hepatoblastoma

Front 239

The most common type of choledochal cyst is:

Back 239

Fusiform dilation of the CBD

Front 240

The pylorus muscle connects the ______________ with the duodenum.

Back 240

Antrum of the stomach

Front 241

Unconjugated bilirubin is elevated in which one of the following percentages of normal-term infants?

Back 241

60

Front 242

What percentage of liver tumors in children are benign?

Back 242

40%

Front 243

When bowel prolapses into the distal bowel and is propelled in an antegrade fashion, this condition is known as which one of the following?

Back 243

Intussusception

Front 244

Which one of the following is considered to be the infantile form of hepatocellular carcinoma?

Back 244

Hepatoblastoma

Front 245

Which one of the following is the most likely condition to lead to cirrhosis?

Back 245

Biliary atresia

Front 246

Which one of the following statements about appendicitis is false?

Back 246

The appendix is anterior and lateral to the psoas muscle

Front 247

Which one of these statements accurately completes the following: Biliary atresia ______________________________.

Back 247

Is more common in female patients

Front 248

A pelvocaliceal dilation without ureteral dilation is seen with which one of the following conditions?

Back 248

Ureteropelvic junction obstruction

Front 249

Between which one of the following ranges of age does the incidence of Wilms tumor peak?

Back 249

2 to 5 years

Front 250

Bilateral renal enlargement is seen with which one of the following conditions?

Back 250

Autosomal recessive polycystic kidney disease

Front 251

Clinical signs of renal vein thrombosis in the neonate include all of the following except:

Back 251

High platelet count

Front 252

Conditions in the newborn associated with renal abnormalities include all of the following except:

Back 252

Vomiting

Front 253

Conditions that may lead to adrenal hemorrhage include all of the following except:

Back 253

Hydronephrosis

Front 254

Differential considerations for hydronephrosis include all of the following except:

Back 254

Renal vein thrombosis

Front 255

If the ipsilateral renal is absent or ectopic in location, then the adrenal gland:

Back 255

Remains in the renal fossa

Front 256

Neuroblastoma is typically a malignant tumor of the _____________________.

Back 256

Adrenal gland

Front 257

Renal vein thrombosis is more prevalent in infants of _________ mothers.

Back 257

Diabetic

Front 258

Sonographic findings in adrenal hemorrhage in the neonate include all of the following conditions except:

Back 258

Irregular-shaped small gland

Front 259

The adrenal medulla in the neonate appears as a(n):

Back 259

Echogenic stripe

Front 260

The best way to demonstrate the dilated ureter at the ureteropelvic junction is with a ___________ scan.

Back 260

Coronal

Front 261

The left adrenal gland:

Back 261

Extends medial to the kidney

Front 262

The most common cause of bladder outlet obstruction in the male neonate is which one of the following?

Back 262

Posterior urethral valve obstruction

Front 263

The normal renal length in the pediatric patient varies with ___________.

Back 263

Age

Front 264

When empty, the bladder wall thickness should not exceed _____ millimeter (mm).

Back 264

5

Front 265

Which one of the following conditions is the most common cause of renal cystic disease in the neonate?

Back 265

Multicystic dysplastic kidney (MDK) disease

Front 266

Which one of the following conditions occurs when the fetus is stressed during a difficult delivery or during a hypoxia insult?

Back 266

Adrenal hemorrhage

Front 267

Which one of the following genitourinary problems is commonly associated with the prune-belly syndrome?

Back 267

Ureteral reflux

Front 268

Which one of the following malignant tumors is most frequent in the neonate and infant?

Back 268

Wilms tumor

Front 269

Which one of the following statements regarding ectopic ureteroceles is incorrect?

Back 269

Are more commonly found in male patients

Front 270

Which one of the following structures is thin in the neonate with echogenicity similar to or slightly greater than the normal liver parenchyma?

Back 270

Cortex

Front 271

Which one of the following structures lies at the bases of the medullary pyramids and appears as echogenic structures?

Back 271

Arcuate arteries

Front 272

Which one of the following structures should not be mistaken for dilated calyces or cysts?

Back 272

Medullary pyramids