At what level do the renal arteries arise from the abdominal aorta?

Approx. 1 cm below the level of the SMA

The spleen in a patient with leukemia

will most likely be

a. Enlarged

b. Atrophied

c. Absent

d. Micro-nodular

e. Normal

a. Enlarged

Gastroduodenal artery (GDA) and common bile duct (CBD)            The GDA is more anterior than the CBD

True or False.

False

The donor kidney is usually taken from the left side because..

a.       easier for the doctor

b.      the left renal vein is longer than the right renal vein

c.       the doctor doesn’t have to worry about the liver

d.      all but A

True or False.  

 Primary splenic disease is common

dietary insufficiency of iodine

Non-toxic goiter is a simple enlargement of the thyroid gland without any increased secretion of thyroid hormone. It can be endemic or sporadic. Endemic goiter is mainly seen in areas like mountainous regions, flood planes which lacks iodine in the soil. Though the etiology of sporadic goiter is not clearly known, possible reasons could be pregnancy, physiological stress, enzyme deficiencies, some drugs, and goitrogens like cabbage

An autoimmune disease of intrahepatic bile ducts is:   

A:  Hepatocellular Carcinoma  

B:  Budd Chiari  

C:  Primary biliary cirrhosis  

D:  Wilson’s Disease

Which of the following is not a function of the kidneys?  

A:  Regulating blood pressure 

B:  Regulating sugar levels 

C:  Hormone secretion 

D:  Regulating electrolyte concentrations

True or False. 

The pancreas is an Exocrine and Edocrine organ?

True

It is both exocrine (secreting pancreatic juice containing digestive enzymes) and endocrine (producing several important hormones, including insulin, glucagon, and somatostatin.

True or False. 

Primary carcinoma is linked to chronic cholecystitis and cholelithiasis.

A 54 yr old male presents to the doctor with a hx. of cirrhosis, increased serum bilirubin, and hepatic encephalopathy. After his ultrasound you saw that the liver is coarse and echogenic, there is reversal of the normal portal venous blood flow, the spleen is enlarged measuring 15 cm, there are multiple varices in the splenic hilum, and very prominent vasculature is seen in the left renal hilum. 

 What is the most likely Diagnosis? 

A:  Hepatocellular Carcinoma secondary to cirrhosis

B:  Metastatic Disease

C:  Splenorenal shunt secondary to cirrhosis and portal venous hypertension

D:  Intrahepatic Biliary cirrhosis accompanied by portal hypertension

Which of the following organs not located within the retroperitoneum? 

A:  Kidneys

B:  Bladder

C:  Uterus

D:  Stomach

True or False 

The main function of the prostate is to store and secrete a clear, slightly Acidic fluid that constitutes 10-30% of the volume of the seminal fluid.

False 

The main function of the prostate is to store and secrete a clear, slightly Alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that, along with spermatozoa, constitutes semen.

The primary function of the thyroid is production of the following hormones except for: 

A:  Thyglocon (T2)

B:  Thyroxine (T4)

C:  Triiodothyronine (T3)

D:  Calcitonin.

What is the direction of flow for the normal portal vein?

Hepatopetal flow.   Hepatopetal flow is towards the liver while hepatofugal flow is away from the liver.

Which ligement should be evaluated for recanalization in a patient with portal hypertension?

Ligament Teres, a hyperechoic triangular structure which divides the medial and lateral segments of the left lobe of the liver.

True or False:  Ultrasound is an appropriate modality to evaluate renal function?

False- Ultrasound can not determine the function of the kidneys.

 Renal pyramids are located in the:

A. cortex

B. medulla

C. Sinus

D. Egypt

Which vessel runs along the posterior border of the tail of the pancreas?

A. Splenic artery

B. Splenic vein

C. Superior mesenteric vein

D. Left gastic artery

B. Splenic vein

. What another name for exaggeration of Rokitansky-Ashoff sinuses?

Adenomyomatosis

Which is not a cause of splenomegaly?

A. portal hypertension

B. lupus erythematosus

C. HIV

D. cholelithiasis

D. cholelithiasis is not a cause for splenomegaly.

Triphasic.

The term for undescended testicle is?

cryptorchidism

What muscle is seen posteriolateral to the thyroid gland?

longus coli muscle

True or False

The portal system supplies what percentage of total blood flow to the liver? 

a. 30 % 

b.50 % 

c.75 % 

d. 90 %

The nephrons are involved in urine formation. Which of the following is not of the nephron?  

a. loops of Henle 

b. calyces 

c.convoluted tubules  

d. renal corpuscles

True or False

True or False: 

The gallbladder is perfused by the left gastic artery?

True or Flase 

Spiral valves of Heister prevent the cystic duct from over distending or collapsing?

True or False:

Intraperitoneal structures are connected to the cavity by the?   a. omentum  

b. grater sac  

c. lesser sac

d. mesentary

 Which of the following is not a remnant of the fetal circulation?
a ligamentum teres
b ligamentum venosum
c falciform ligament
d coronary ligament

All of the following are associated with cirrhosis except
a ascites
b splenomegaly
c jaundice
d hepatomegaly
e collateral vessel development

Absence of an ureteral jet is consistent with
a pyleonephrosis
b parapelvic renal cyst
c obstructive hydronephrosis
d posterior urethral values
e renal cell carcinoma

A pelvic kidney has
a an abnormal appearance in a normal location
b a normal appearance in an abnormal location
c a normal appearance in a normal location
d an irregular shape
e twice the renal volume

True or False 

When closed, the sphincter of Oddi allows bile to flow into the duodenum

True or False 

The gallbladder's venous drainage is by means of the cystic veins draining through tributaries of the hepatic/portal vein system

High-resistance Doppler spectral waveforms recorded throughout the renal medulla and cortex would suggest
a proximal renal artery stenosis
b flow-limiting disease in the distal renal artery
c intrinsic medial renal disease
d the presence of accessory renal arteries

The cells within the spleen that perform the primary lymphocytic functions of the spleen are the
a red pulp
b white pulp
c malpighian corpuscles
d splenic sinuses

Which of the following is not obtained within the spermatic cord?
a ductus deferens
b pampiniform plexus
c ejaculatory duct
d cremaster muscle

A 35-year-old woman presents with a tender neck, and on physical exam an enlarged thyroid is found. An enlarged inhomogeneous thyroid with irregular borders is seen on the sonogram.  This is most characteristic of
a a malignant lesion
b Grave's disease
c cyst
d adenomatous hyperplasia
e Hashimoto's thyroiditis

True or False. 

Indirect bilirubin is increased with obstructive disease.

What tumor comprises approximately 80% of all primary malignant renal tumors?           

A.        Transitional cell carcinoma           

B.        Renal Cell carcinoma           

C.        Nephroblastoma           

D.        Adenoma

 True or False. 

Which of the following laboratory tests is most sensitive for pancreatic disease?

A.           Amylase

B.           Lipase

C.           Trypsin

D.           Alkaline phosphatase

Tunica  intima – inner lining

Tunica media – middle lining

Tunica adventitia – outer lining

All of the following are true regarding the spleen EXCEPT

A.    It is part of the reticuloendothelial system

B.    It is a retroperitoneal organ

C.    Most splenic pathologies are blood related

D.    It plays a major role in fetal hemopoiesis

 What are calcifications that develop as a result of chronic inflammation and hydroceles called?

A. Granulomas

B. Testicular stones

C. Microlithiasis

D. Scrotal pearls

True or False.  

Hydrops of the gallbladder may be secondary to all of the following except … 

A)   sludge

B)   surgery

C)   obstruction of the distal common bile duct

D)   stones in Hartman’s pouch

E)   mass in the head of the pancreas

True or False:

Splenomegaly is diagnosed when the spleen is greater than

The resistive index (RI) in the renal arteries should not exceed

True or False:

The seminal vesicles join the vas deferens to form the ejaculatory duct.

True or False:

Hashimoto’s disease is a type of chronic 

A)   orchitis

B)   laryngitis

C)   hepatitis

D)   thyroiditis

E)   prostatitis

True or False:

A 35 yr. Old male with a history of steroid use presents for a RUQ ultrasound to evaluate a palpable mass.  Lab work shows normal LFTs.  During your scan you find a hyperechoic mass in the Right lobe.  Your differential diagnosis should include all of the following, EXCEPT  

a)      cavernous hemangioma

b)            focal nodular hyperplasia

c)             hepatic adenoma

d)            hepatoblastoma

e)             all are to be included in the differential

In the Western hemisphere, hepatic abscesses are most often associated with

a)      post-surgical complications

b)            Amebic

c)             Cholangitis

d)            Trauma

e)             Sepsis

Maternal pyelocaliectasis is

a)             commonly seen in pregnancy

b)            seen more in the right kidney

c)             seen more in the left kidney

d)            A & B

e)             A & C

d)            A & B

The functions of the kidney include all, EXCEPT

a)             maintain salt and water balance

b)            regulate fluid volume

c)             maintain acid and base balance

d)            phagocytosis

e)             all are functions of the kidney

All of the following are signs and symptoms associated with carcinoma of the biliary tree, EXCEPT           

a)      anorexia

b)            anemia

c)             Right Upper Quadrant pain

d)            weight loss

e)             jaundice

True or False

True or False 

The most common primary malignant tumor of the spleen is

a)             Angiosarcoma

b)            Harmatoma

c)             Lymphoma

d)            Cavernous Hemangioma

e)             Harmatoma

True or False 

True or False 

Over 90% of ascites accumulation is due to what?

a) neoplasm

b) cirrhosis

c) tuberculosis

d) all the above

a.True

B.cholangitis

d.adenoma

d.all of the above

d. all of the above

b.second

d. TSH--thyroid stimulating hormone

True or False

Coronary ligament is NOT a remnant of the fetal circulation.

True

coronary ligaments define the bare area of the liver.

Chronic active hepatitis is a progressive destructive liver disease that eventually leads to:

A).liver cysts

B). hepatoma

C). cirrhosis

D). pancreatitis

E). liver metastases

C). cirrhosis. 

Transplanted kidneys are usually placed

A). within the renal fossa

B). in the pelvis along the iliopsoas margin

C). in the pelvis anterior to the bladder

D). within the abdominal rectus sheath

E). in Morrison’s pouch

Chronic renal disease is associated with:

A). an enlarged kidney with a small contralateral kidney

B). unilateral hydronephrosis

C). small echogenic kidneys

D). large echogenic kidneys

E). an ectopic kidney

Jaundice in a pediatric patient is most likely caused by

A). hepatitis

B). fatty infiltration

C). biliary atresia

D). cirrhosis

E). portal hypertension

Splenomegaly may be caused by all of the following, except:

A). an inflammatory process

B). portal vein thrombus

C). a left subphrenic abscess

D). polycythimia vera

E). chronic leukemia and lymphoma

True or False

The portal veins can be differentiated from the hepatic veins by all of the following except:

A). portal veins become larger as they approach the diaphragm

B). portal veins have echogenic borders

C). portal veins bifurcate into the right and left branches

D). the main portal vein is part of the portal triad

Which vessels course between lobes (interlobar) and between segments (intersegmental)? 

a)  portal veins

b) hepatic arteries

c) hepatic veins

d) none of the above

True or False: 

The psoas muscle covers which portion of the kidney?

a) anterior

b) posterior

c) lateral

d) medial

e) the kidney does not come in contact with the psoas muscle

True or False: 

True-

Where are the spiral valves of Heister located?

a) fundus of the GB

b) neck of the GB

c) cystic duct

d) CBD

Hydrops of the gallbladder is most often due to the prolonged and total obstruction of what?

a) cystic duct

b) proximal CBD

c) distal CBD

d) CHD

True or False: 

True-

True or False: 

False-

True or False: 

True-

True or False:

The embryonic kidneys are drained by the wolffian ducts.

True

wolffian is another name for mesonephric ducts

The most common primary liver malignancies is

a. metastasis disease                       

b. choricarcinoma                             

c. hepatocellular carcinoma                 

d. lymphoma                                   

The elevation of serum bilirubin result in:

a. hepatocellular disease                   

b. ascites                                        

c. jaundice                                      

d. hemolysis                                    

A benign, non-shadowing tumor attached to the inner lumen of the GB is known as:

a. cholesterol polyp                     

b. junctional fold                        

c. sludge ball                             

d. cholelithiasis                         

Ascites is the accumulation of serous fluid in potential spaces.                                  

  T or F                 

Large GB stones are more dangerous than small GB stones.                                                   

Tor F                          

Which of the following arteries is a branch of the celiac trunk?                                                 

a. left hepatic             

b. pancreatic               

c. splenic                    

d. gastroguodenal        

The spleen is a retroperitoneal organ?

Tor F      

Which of the following is not benign renal tumor?

a. adenoma                 

b. renal cell carcinoma    

c. angiomyolipoma        

d. oncocytoma              

The most common tumor in children is

a. renal cell carcinoma      

b. simple cyst                 

c. Wilm's tumor              

d. angiomyolipoma          

What is the most common cause of acute scrotal pain and swelling?        

a. tortion                   

b. epididymitis         

c. hydrocele           

d. seminoma            

Functions of the liver include:

A. Hemopoiesis throughout life

B. Phagocytosis

C. Destruction of fats and conversion to phospholipids

D. B & C

E. All of the Above

A decrease in BUN can be caused from:

A. Acute Renal Disease

B. Dehydration

C. Liver Failure

D. Urinary Obstruction

Intrarenal causes of renal failure include all of the following except:

A. Parenchymal disease

B. Renal vascular thrombosis

C. Glomerulonephritis

D. Renal ischemia

The gallbladder contains 4 layers.

T or F

The sonographic appearance of Mirizzi Syndrome would include all except:

A. Impacted stone in cystic duct or neck

B. Presence of two parallel tubular structures

C. Dilated intrahepatic ducts

D. Contracted, or non-visualized GB

Abdominal Aorta aneurysms:

A. Most are asymptomatic

B. Project anteriorly and to the left of midline

C. Most are arteriosclerotic in origin and fusiform D. All of the above

A wandering spleen is caused by failure of fusion of the dorsal mesentery with the posterior peritoneum.

T or F?

Spermatic cord torsion is associated with all of the following except:

A. Enlarged testicle and epididymal head with decreased echogenicity first 24 hrs

B. No arterial flow or decreased flow

C. Bell Clapper Deformity

D. Cryptorchism

What structure lies adjacent to the trachea and is posterior to thyroid & CCA?

 A. Sternohyoid muscle

 B. Esophagus

 C. Jugular Vein

 D. Longus Colli Muscle

 The portal supplies 20-30% of oxygenated blood to the liver?

False. 

The portal vein supplies 70-80% of the blood, while the hepatic artery supplies 20-30% of oxygenated blood.

Lab values will be normal in the presence of a liver cyst without an underlying biliary disease.

True.  The lab values of a liver cyst without any other liver or biliary disease will remain normal.

Benign epithelial liver tumors that are seen in women. They are often surgically removed due to their know progression to hepatocellular carcinoma.

a.       Hepatoblastoma

b.      Cirrhosis

c.       Adenomas

d.      Hydatid cysts

C. Adenomas.  Adenomas are linked to the use of contraceptives.  Adenomas are a mass that can occasionally progress to become hepatocellular carcinoma.

If Multicystic Dysplastic Kidney Disease is bilateral, it is compatible with life.

False.  Multiple renal cysts are formed of varying sizes.  The disease is usually unilateral.  If it is bilateral, it is not compatible with life.

A benign kidney tumor composed of fat, blood vessel, and smooth muscle.  S/A is more echogenic than the renal sinus and can be quite large.  Patient presents with hematuria, severe flank pain, and hypertension or asymptomatic.  ___________.

Angiomyolipoma.  It is more commonly found in women 40-60 years old. 

The pancreas is an endocrine and exocrine organ.

True.  Exocrine – enzymes are secreted by the acinar cells.  Endocrine – islet cells of Langerhans secrete hormones directly into the blood stream.

Patient presents with impacted stone in the cystic duct, jaundice, and dilatation of the common hepatic duct above the level of the gallstone impacted.  The duct presents normal below the stone.  All of these symptoms point to which?

a.                Mirrizzi Syndrome

b.               Porcelain Gallbladder

c.                Caroli’s Disease

A.      Mirrizzi Syndrome. The impacted stone in the cystic duct causes dilatation of the common hepatic duct above the level of the stone, along with jaundice.

A rare malignancy that occurs in the spleen.  Most patients present with anemia.  S/A is similar to a cavernous hemangioma.  Frequently metastasizes to the liver. 

a.                   Hamartoma

b.                  Cavernous Lymphangioma

c.                   Epidermoid cyst

d.                  Hemangiosarcoma

D. Hemangiosarcoma.  This rare malignancy occurs in the spleen and often metastasizes to the liver.

Multiple small calcifications that are scattered throughout the testicles. 

a.                   Cryptorchism

b.                  Microlithiasis

c.                   Choriocarcinoma

d.                  Seminoma

B  Microlithiasis.  Microlithiasis has no clinical significance.  It is known to be a precursor to a malignancy.

Synovial fluid collections in the calf related to a break in the synovial membrane around the joint.  Local tenderness may mimic and call for a DVT scan.

a.                   Bursae

b.                  Baker’s Cyst

c.                   Cellulitis

B   Baker’s Cyst.  It is a collection of synovial fluid that develops behind the knee joint and in the calf. 

  A “starry night” appearance is a sonographic finding with what pathology?

a)     Budd- Chari Syndrome

b)    Cirrhosis

c)     Acute Hepatitis

d)    Hepatoma

C- A starry night appearance is a finding correlated with acute hepatitis. An apparent increase in portal vein echogencity caused by a decrease in liver echogencity is a finding consistent with a “starry night appearance”

All the following are differential diagnosis for a pyogenic abscess except?

a)     echinococcal infection

b)    hemorrhagic cyst

c)     hematoma

d)    necrotic cystic neoplasm

e)     none of the above

E- All the above are differential diagnosis for an abscess. Ultrasound guided biopsy for lab culture and or drainage is needed.

A ________ is a hyperechoic, wedge shape area on the anterior aspect of the kidney, relating to the fusion of 2embryological components of the kidney.

-         Junctional Parenchymal defect is a normal genitourinary variant   of the kidney. Relating to the fusion of 2 embryological component of the kidney.

True or False    

Grawitz’ tumor is the most common malignant renal mass in adults

True, grawitz tumor is another name for renal cell carcinoma and hypernephroma

Dilation of the intrahepatic bile ducts maybe seen with all the following except

                A) Intrahepatic mass in area of the portal hepatis

                 B) Polyp in the fundus of the gallbladder

                 C) Obstructive stone in the cystic duct

                 D) Lymphadenopathy in the portal hepatis

B- Polyp attached to the fundus of the gallbladder has nothing to do with the biliary ducts. It’s an incidental finding usually.

True or false  

A pseudocyst is the most common complication of pancreatitis

True- Pseudocysts are the most common complication of pancreatitis. Commonly a consequence of alcohol abuse

Choppy triphasic flows are seen in

a)     hepatic veins

b)    portal veins

c)     hepatic artery

d)    Superior mesentery Artery

e)     Iliac veins

           Hepatic veins are triphasic waveform.

Majority of extra testicular masses are

A)  Benign

B)   Malignant

C)   Echogenic

D)  Solid

E)   Complex

A- Benign

Extratesticular masses include: Hydrocele, varicocle, epididymal cyst, spermatocele, and they are mostly cystic

True of False. 

Parathyroid glands may be located in the thyroid gland.

True, May be posterior in the thyroid gland

All the following are storage diseases that can cause splenomegally except

A)  Gauchers

B)   Amyloidosis

C)   Neimann- pick

D)  Hemochromatosis

E)   Polycthemia vera

D hemochromatosis is a rare disease of iron metabolism characterized by excess iron deposits throughout the body. Can lead to cirrhosis. It is not a storage disease.

Which of the following is not a ligament that connects the liver to its surround tissue?

A.      Coronary

B.      Falciform

C.      Broad

D.      Left triangular

C -The broad ligament connects the uterus to the pelvic walls and floor. 

True or False:

Budd-Chari Syndrome can cause hepatomegaly and splenomegaly.

Answer: True

Due to thrombus in the hepatic veins not allowing blood to properly drain into the IVC, blood can back-up causing an enlargement of the liver and spleen. Dilataion of the hepatic vein proximal to the stenosis can also been seen by ultrasound.

Which of the following is anomaly that is found midline of the neck and can occur at any age?

A.                  A goiter

B.                  Brachial Cleft Cyst

C.                  Cystic hygroma

D.                  Thyroglossal duct cyst

D

This is a congenital anomaly which can communicate with the base of the tongue or have a sinus drainage communicating with the skin. Thyroglossal duct cysts rarely undergo malignant changes.

What is the most common cause of acute scrotal pain and swelling?

A.                  Torsion

B.                  Epididymitis

C.                  Hydrocele

D.                  Seminoma

Answer: B

Epididymitis is an inflammation of the epididymis. It is usually caused by a lower urinary tract infection which could also cause infertility. If the infection spreads to the testicle also, it is called epididimorchitis.

Which of the following pathology is common to be identified in the spleen?

A.                  True cysts

B.                  Splenic abscess

C.                  Hemangiosarcoma

D.                  Cavernous hemangioma

Answer: D

Cavernous hemangiomas are the most common benign lesion of the spleen. They usually are asymptomatic and small in size. Sonographically they appear hyperechoic to complex.

  A porcelain gallbladder is:

A.                  An over-distended gallbladder

B.                  A contracted gallbladder

C.                  A gallbladder with calcified walls

D.                  A gallbladder filled with stones

Answer: C

A porcelain gallbladder will sonographically have echogenic walls with posterior shadowing. It can mimic a gallbladder filled with stones.

True or false:

The exocrine function of the pancreas is to produce insulin, glucagon, and somatostatin.

Answer: False

Insulin, glucagon and somatostatin are all hormones produced by the endocrine function of the pancreas. These hormones are secreted directly into the bloodstream. The digestive juices formed by the pancreas are secreted through ducts via the exocrine function of the pancreas.

 Name the three vessel layers of the aorta.

Answer: Tunica intima, tunica media, and tunica adventitia.

The tunica intima is the inner most layer that comes into direct contact to the blood. The tunica media is the middle layer that is composed of smooth muscle cells. The outer most layer of the aorta is called the tunica adventitia.

 True or False:

The most common cancer to affect the bladder is renal cell carcinoma which metastasizes to the bladder via the ureters.

Answer: False

The most common cancer to affect the bladder is transitional cell carcinoma. Renal cell carcinoma usually spreads via the IVC to the contralateral kidney.

This type of renal anomaly occurs when the entire length of the kidneys is fused together on their medial sides and the kidneys are found in the pelvis instead of their normal location.

A.                  Cake kidney

B.                  Horseshoe kidney

C.                  Sigmoid kidney

D.                  Dromedary kidney

Answer: A

A cake kidney is also known as a lump kidney occurs when the medial surfaces of the kidneys before fused together. The kidneys do not normally ascend from the pelvis. A cake kidney is a variation of a horseshoe kidney.

T or F  

 A symptom of bladder outlet obstruction is nocturia.

True, this is due to the incomplete emptying and rapid refilling of the urinary bladder.

T or F 

 Parathyroid adenomas are generally small with echogenicity greater than that of normal thyroid tissue.

False- parathyroid adenomas are small and oblong but the echogenicity is usualy less than thyroid tissue and internal cystic changes and calcifications are possible

A malignant tumor of the retroperitoneum that arises from connective tissue:

     A. Liposarcoma

     B. Leiomyosarcoma

     C. Rhabdomyosarcoma

     D. Fibrosarcoma

D. Fibrosarcoma is malignant connective tissue tumor that can invade the surrounding tissue.

Which type of aneurysm primarily affects the cerebral vessels.

     A. Fusiform

     B. Saccular

     C. Berry

     D. Dissecting

C. rupture of these aneurysms can produce death by hemorrhagic stroke.

If sludge totally fills the gallbladder the gallbladder may be _____________to the liver.

     A. echogenic

     B. hypoechoic

     C. hyperechoic

     D. isoechoic

D. sludge contains low to medium level echoes and is non shadowing.

All of the following are complications of acute pancreatitis except:

     A. Phlegmon

     B. Hemorrhage

     C. Diabetes

     D. Abscess

Fusion of the entire length of the kidney is called:

     A. Horseshoe kidney

     B. Cake kidney

     C. Sigmoid kidney

     D. Crossed fused kidney

B. cake kidney is a varient of horseshe kidney where medial surface is fused with anterior malrotation of the renal pelvis.

The candle sign is often seen with:

     A. ureterocele

     B. fistula

     C. bladder calculi

     D. neurogenic bladder

In Couinauds anatomy of the liver, the ______________divide the liver longitudinally into four sections.

ans: hepatic veins, each segment has at leat one branch of the portal veins and in the center bounded by a  hepatic vein.

T or F 

Serum protein decreases with hepatocellular disease

ans: True- serum protein decreases especially albumin.  ALP, LDH, PT, AST, and ALT all increase with hepatocellular disease.

T or F

Posteriorly on the right, the IVC separates the right lobe and the caudate lobe.

  True.  The IVC separates the right lobe and the caudate lobe and the ligamentum venosum divides the caudate lobe from the left lobe.

1.             A patient comes into the ER experiencing flu-like symptoms.  An ultrasound was performed and the liver parenchyma appeared more echogenic and slightly enlarged.  The gallbladder wall was thickened.  The most likely diagnosis is:

a)             Biliary Obstruction

b)            Acute Hepatitis

c)            Chronic Hepatitis

d)            Diffuse Hepatocellular disease

A laboratory test that measures how much dissolved material is present in the urine.

a)             Specific Gravity

b)            Creatine

c)             Blood Urea Nitrogen (BUN)

d)            Urinalysis

A = Specific Gravity is a laboratory test that measures how much dissolved material is present in the urine.

A 52 yr. old female presents with fever and chills.  She is complaining of flank pain.  She recently passed stones but is still experiencing pain.  She has blood in her urine.  On the ultrasound exam, low-level echoes with fluid-debris were seen in the kidneys.  The most likely diagnosis is:

a)             Acute Tubular Necrosis

b)            Lupus Nephritis

c)             Emphysematous Pyelonephritis

d)            Pyonephrosis

D = Low-level echoes with fluid-debris represents pus in the kidneys.  Patients may present with fevers, flank pain, and hematuria.  Pyonephrosis usually occurs after an obstruction in the renal system such as calculus of the kidneys.  

T or F

 Within the gallbladder, large stones are more dangerous than small stones.

False.  Tiny stones are more dangerous because they can enter the bile ducts and obstruct the outflow of bile.

Name the three cells that are located within the Islets of Langerhans of the Pancreas?

1. Alpha cells.  They produce the hormone glucagon. 

2. Beta cells.      They produce the hormone insulin. 

3. Delta cells. They produce the hormone somatostatin.

T or F

In the Aorta the blood flow varies at different levels.

True.  The proximal aorta has high systolic/low diastolic flow and there is triphasic flow in the distal portion of the aorta.

All of these disorders affect the red blood cells in the spleen except:

a)             Hemolytic anemia

b)            Phagocytosis

c)             Leukopenia

d)            Polycythemia

C = Leukopenia is an abnormal decrease of white blood corpuscles; may be drug induced.

The testis is covered by a dense, white fibrous tissue called

a)             Tunica dartos

b)            Tunica albuginea

c)             Tunica vaginalis

d)            Tunica adventicia

B = Tunica albuginea. 

Name the strap muscles that are located anterior to the thyroid gland.

1. Sternohoid muscle

2. Omohyoid muscle

3. Sternocleidomastoid muscle