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ARDMS Abdomen Davies 2024/2025 already graded A+
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ARDMS Abdomen DaviesYou 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? - ANSMiddle Hepatic Vein
Which organ is the largest visceral organ in the body ? - ANSLiver
Where is the major portion of the liver, the right lobe located? - ANSin 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? - ANSthe Liver
Which organ is covered in a layer of fibrous tissue, glisson's capsule? - ANSthe 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? - ANSFissure 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? - ANSLigamentum teres
What is the left portal vein in contact with? - ANSLigamentum teres
Where does the paraumbilical vein begins? - ANSbegins at the left portal vein and exits the
liver at the ligamentum teres
Which vessel course within the main lobar fissure? - ANSmiddle hepatic vein
Oxygenated blood is supplied to the liver via the: - ANSPortal vein and hepatic artery
You are performing a sonogram on a slender female and notice a long, thin extension of the
inferior aspect of the right lobe of the liver. The most likely represents: - ANSReidel's lobe
What forms the caudal border of the left portal vein? - ANSLigamentum teres
What ligament divides the left lobe of the liver into medial and lateral segments? -
ANSLigamentum teres
You are asked to perform a Doppler study on the hepatic veins in the liver. What
differentiates the hepatic veins from the portal veins? - ANSthe portal veins are
accompanied by branches of the biliary tree and hepatic artery
,You have detected a mass anterior and to the left of ligamentum venosum. This mass is
located in what lobe of the liver ? - ANSLeft Lobe
The thin capsule surrounding the liver is known as: - ANSGlisson's capsule
What courses interlobar and intersegmental within the liver? - ANSHepatic veins
You are performing an ultrasound exam of the liver on a small patient with a 5MHz curved
linear array. Although you have increased the overall gain to its maximum setting, the
posterior border of the liver and diaphragm are not visualized. What should you do? -
ANSRescan the liver with a lower frequency transducer.
Correctly describe the probe placement and imaging plane you would use to demonstrate
the three hepatic veins and inferior vena cava in the one view? - ANSSubcostal oblique
approach with the probe angled superiorly and to the patient's right.
You are performing a follow-up sonogram on a patient in which a 5 -mm cyst was previously
identified at the anterior border of the left lobe liver. Although you are using a 3.5 MHz
curved linear array probe, you do not see the cyst. What would be most helpful in improving
visibility of this cyst? - ANSRescan the left lobe with a higher frequency transducer. Visibility
of small cysts is limited by spatial resolution. To improve spatial resolution, the best option is
to increase the imaging frequency.
What do you need to do to improve spatial resolution to visualize small cysts (which has a
limited spatial resolution)? - ANSThe best option is to increase the imaging frequency
You are imaging a patient with a high liver. Subcostal images do not clearly demonstrate the
liver tissue. What should you do? - ANSScan the patient in deep inspiration
A patient is referred for ultrasound evaluation of a questionable mass in the dome of the liver
seen on a CAT scan. What would improve visualization in this area of the liver? -
ANSPerform a subcostal scan with the probe angled superior and the patient in deep
inspiration
A patient is referred for a liver ultrasound with the clinical history of a raised serum
alpha-fetoprotein level. What should you look for? - ANSHepatocellular carcinoma
If a non pregnant person with elevated levels of serum alpha-fetoprotein AFP , what is
associated with this? - ANSHepatocellular carcinoma, germ cell tumor of gonadal,
retroperitoneal, or mediastinal origin. Sometimes with cancer of pancreas, stomach, or biliary
system.
What may produce modest serum AFP elevations? - ANSHepatitis and cirrhosis
You are reviewing lab work prior to performing an abnormal ultrasound exam. Elevated lab
values include Gamma- glutamyl transpeptidase -GGT and alkaline phosphatase. What
would it be? - ANSConcomitant elevation of both GGT and alkaline phosphate indicates the
source of the elevated alkaline phosphatase is the liver.
, what other reasons would alkaline phosphatase be elevated ? - ANSskeletal disease,
hyperparathyroidism, and acute hepatocellular disease
What is NOT a lab test use in evaluation of liver function out of the following GGT, AST,
direct bilirubin, indirect bilirubin, or lipase? - ANSLipase - is used to evaluate acute
pancreatitis
What does it mean when direct bilirubin is elevated? - ANSusually indicates biliary
obstruction, which may be intrahepatic due to hepatitis, cirrhosis, or extrahepatic due to
gallstones, gallbladder or pancreatic cancer.
Why would indirect bilirubin be elevated? - ANSwith hepatocellular dysfunction such as
hepatitis
What is Aspartate aminotransferase - AST used in evaluating? - ANSused in evaluation of
acute hepatic disease. May also be elevated with recent myocardial infarction.
What is Gamma- glutamyl transpeptidase - GGT is used with what to suggest the source of
elevated alkaline phosphatase levels? - ANSused with alkaline phosphatase
A patient is referred with right upper quadrant tenderness and a history of oral contraceptive
use. A solid, hypoechoic mass is identified in the right lobe of the liver. Color Doppler reveals
hypervascularity of the mass. What is the scenario likely to be? - ANSHepatic Adenoma - the
incidence of hepatic adenomas has increased in the united states since the 1970s. And are
associated with use of oral contraceptives.
A liver ultrasound on a 49-year-old obese male demonstrates diffuse increased echogenicity
with a focal hypoechoic area anterior to the portal vein. This most likely represents: -
ANSFatty metamorphosis of the liver with focal sparing
What is commonly seen as a hypoechoic mass anterior to the portal vein? - ANSFocal fatty
sparring
A 52-year-old male with known liver cirrhosis presents for an abdominal ultrasound. You will
carefully evaluate the liver to rule out the presence of any focal mass because of what? -
ANSPatients with liver cirrhosis are at increased risk for hepatocellular carcinoma
You are scanning a patient with suspected liver cirrhosis. All of the following, 1. Surface
nodularity, 2. Shrunken caudate lobe, 3. Altered echo texture, 4. Ascites, 5. Regenerative
nodules are sonographic feature of cirrhosis Except: - ANSShrunken caudate lobe
The caudate lobe is most commonly enlarged compared to the right lobe due to sparing in
what disease? - ANSLiver cirrhosis
An ultrasound evaluation of liver cirrhosis should include a search for which associated
complication? - ANSPortal hypertension
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