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Family Physician
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Experience:  Tutor in many fields since college. Physician with MBA
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1. In a fasting patient, what is a common cause for sonographic

Resolved Question:

1. In a fasting patient, what is a common cause for sonographic non-visualization of the gallbladder
a. contraction of the gallbladder due to chronic cholecystitis
b. Biliary sludge
c. mobile stone
d. the ingestion of oral contrast medium used in x-rays of the gallbladder prior to sonographic examination
2. The upper limit of the normal intraluminal diameter of the common duct should not exceed
a. 4 mm
b. 7cm
c. 7mm
d. 10mm
3. The division into anatomic left and right lobes of the liver is along the line of attachment of
a. major hepatic fissure and middle hepatic vein
b. ligamentum venosum
c. falciform ligament
d. middle hepatic vein
4. The liver is covered by a thick membrane of collagenous fibers intermixed with elastic elements.
a. Glisson’s capsule
b. Gerota’s fascia
c. Bowman’s capsule
5. A fluid filled mass anterior to the pancreas may be all of the following except
a. pseudocyst
b. loculated ascites
c. aortic aneurysm
d. fluid-filled stomach
6. The portion of the pancreas that lies posterior to the superior mesenteric artery and vein is the
a. head
b. uncinate process
c. tail
7. High levels of serum amylase may result of all of the following except
a. liver disease
b. acute pancreatitis
c. blockage of the pancreatitic duct by a stone within the common bile duct
8. The pancreas produces all of the following except
a. insulin
b. glucagon
c. bile
d. lipase
9. One of the most frequent complications of pancreatitis is pseudocyst formation. Uncomplicated pseudocysts are usually
a. echogenic with irregular walls and good ultrasound transmission distally
b. echogenic with smooth wall and poor ultrasound transmission distally
c. anechoic with smooth walls and good ultrasound transmission distally
10. The pancreas is both an exocrine and endocrine gland. The endocrine function is to produce
a. insulin
b. lipase
c. amylase
d. carboxypeptide
e. trypsin
f. chymotrypsin
11. The exocrine products of the pancreas are carried within the
a. blood stream
b. acinar cells
c. pancreatic duct
12. The right and left hepatic ducts unite to form the common hepatic duct most commonly
a. in the porta hepatis
b. within the hepatic parenchyma
c. at the level of the pancreas
13. The main pancreatic duct is
a. Santorini’s duct
b. Wirsung’s duct
c. Hirschspring’s duct
14. Cystic lesions within the liver include
a. congenital cysts
b. polycystic liver disease
c. Carroli’s disease
d. all of the above
15. The causes of a large gallbladder include all of the following except
a. adenomyomatosis
b. cystic duct obstruction
c. pancreatic carcinoma
d. diabetes mellitus
e. a fasting patient
16. Compare the echogenicities of the following structures and place them in decreasing echogenic order
a. pancreas > renal sinus > liver > spleen > renal parenchyma
b. renal sinus >pancreas > liver > spleen > renal parenchyma
c. renal sinus > renal parenchyma >pancreas > liver > spleen
d. pancreas > renal sinus > renal parenchyma > liver > spleen
17. The common bile duct is joined by the pancreatic duct as they enter the
a. transverse portion of the duodenum
b. first portion of the duodenum
c. third portion of the duodenum
d. second portion of the duodenum
18. If the sonogram suggest a mass in the head of the pancreas, the sonographer should
a. examine the Biliary radicles, common bile duct, and gallbladder to determine whether they are dilated
b. outline the hepatic artery and splenic arteries to determine whether they are dilated
c. scan the pancreas using the left kidney as a window then end the examination
d. examine both kidney carefully to exclude a mass
19. Budd-Chiari syndrome is
a. relative enlargement of the caudate lobe due to hepatic vein thrombosis
b. relative shrinking of the caudate lobe due to hepatic vein thrombosis
c. relative shirking of all the lobes of the liver due to hepatic vein thrombosis
d. metastatic disease of the liver from the gastrointestinal tract
20. Riedel’s lobe is a normal liver variant defined as a
a. elongated left lobe of the liver
b. tonguelike extension of the caudate lobe
c. tonguelike extension of the right lobe of the liver
d. extra lobe of the liver visualized in some of the population
21. All of the following laboratory test can be used for liver evaluation except
a. bilirubin
b. serum protein
c. prothrombin time
d. fetal antigen
e. amylase
22. Given the clinical findings of a fever, right upper quadrant pain, and elevated white blood cell count, what should one expect to find in the patient’s liver
a. abscess
b. hepatoma’
c. hemangioma
d. hematoma
e. metastasis
23. A 35 year old alcoholic male presented with epigastric pain. Sonography demonstrated a moderately enlarged gallbladder with a round fluffy non-shadowing mobile echo. This finding suggests
a. a gallstone
b. carcinoma of the gallbladder
c. choledochal cysts
d. a sludge ball
Submitted: 1 year ago.
Category: Homework
Expert:  Family Physician replied 1 year ago.
I will be happy to check your answers to these questions if you post your answers.
Customer: replied 1 year ago.

1-a


2-d


3-c


4-b


5-d


6-c


7-a


8-c


9-c


10-c


11-c


12-a


13-c


14-d


15-c


16-c


17-b


18-a


19-c


20-b


21-d


22-e


23-d


 

Expert:  Family Physician replied 1 year ago.
Great.... Give me a few minutes so that I can check all of your answers and provide you information/reference for any incorrect answers.
Expert:  Family Physician replied 1 year ago.
I'm working my way through your answer. Here are the first 5:

1-a

2-d

This answer is likely the answer they are looking for, however as this reference points out, it is somewhat age dependent and not entirely 100% agreed upon.

http://radiology.rsna.org/content/225/3/921.full

3-c

4-b

Incorrect – this is the fascia surrounding the kidney

http://www.urology-textbook.com/kidney-anatomy.html

5-d

Since the stomach is anterior to the pancreas this is not the correct answer.

http://www.jefferson.edu/jurei/ultrasound_conf10/files/Requisites/Baltarowich/Baltarowich_ABD_pt2_Panc_Spleen.pdf

Expert:  Family Physician replied 1 year ago.

6-c

7-a

8-c

9-c

10-c

Endocrine glands do not secrete into ducts – Insulin is the correct answer. The other hormones mentioned are secreted into the pancreatic duct

http://faculty.clintoncc.suny.edu/faculty/Michael.Gregory/files/Bio%20102/Bio%20102%20lectures/Endocrine%20System/endocrin.htm

Expert:  Family Physician replied 1 year ago.

11-c

12-a

13-c

Incorrect

http://www.anatomyatlases.org/AnatomicVariants/OrganSystem/Images/21.shtml

14-d

15-c

Pancreatic cancer can indeed cause gallbladder enlargement – sometimes to the degree that it can be felt on physical examination

http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-diagnosis


Expert:  Family Physician replied 1 year ago.
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Category: Homework
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Experience: Tutor in many fields since college. Physician with MBA
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