Usrad

Front 1

DDX gb wall thickness

Back 1

hepatitis,
ascites,
cholecystitis,
hypoalbuminemia,
heart failure,
portal venous hypertension,
hypoproteinemia,
adenomyomatosis,
gallbladder tumor,
pericholecystic collections,
varices resulting from portal hypertension
obstructed lymphatics
contracted gallbladder in a non-fasting patient,
hyperplastic cholecystoses,
carcinoma of the gallbladder,
hepatic fluid overload with secondary gallbladder wall edema.

Front 2

differential diagnosis of non-shadowing, non-dependent, echogenic intraluminal masses in the gall bladder

Back 2

tumefactive sludge,
polypoid tumors,
organized hemorrhage in patients with hematobilia.

Front 3

DDX conditions that predispose to echogenic bile or sludge formation include

Back 3

hemolytic anemia,
prolonged fasting, hyperalimentation,
cholestasis with extrahepatic bile duct obstruction, and intrinsic disorders of the gallbladder such as abnormal mucoprotein production.
Cystic fibrosis is associated with gallbladder sludge and splenomegaly in a child

Front 4

differential diagnosis of non-shadowing, non-moving focal echogenic areas within the gallbladder includes

Back 4

small adherent gallstones, adenomyomatosis,
focal inflammatory disease, papillomas, and carcinoma.

Front 5

What is the fatty meal challenge

Back 5

used to separate those patients with large but unobstructed ducts from those patients with a partial or complete obstruction. Fat given orally releases cholecystokinin from the duodenum. Intravenous cholecystokinin could be used instead to elicit the same response.

Front 6

Increased incidence of cholangiocarcinoma in patients with

Back 6

chronic ulcerative colitis, cystic diseases of the liver biliary tract (such as Caroli's disease),
Clonorchis sinensis infestation (Oriental cholangiohepatitis)

Front 7

Sonographic features that have been described as being suggestive of a hilar cholangiocarcinoma include:

Back 7

1. Dilated intrahepatic bile ducts with normal-sized extrahepatic biliary tree and gallbladder.
2. Intraductal mass at the confluence of the left and right hepatic ducts.
3. Porta hepatis mass or enlarged portal lymph nodes.

Front 8

Biliary atresia assoc.

Back 8

Down syndrome,
polysplenia syndrome,
Alagille syndrome arteriohepatic dysplasia (characterized by intrahepatic biliary ductule hypoplasia, pulmonary artery hypoplasia, vertebral anomalies and typical facies), and
Byler's disease (familial intrahepatic cholestasis in the Amish).

Front 9

DDX Pneumobilia

Back 9

surgically created biliary-enteric anastomosis,
post sphincterotomy, incompetent sphincter of Oddi, wall erosion by a gallstone or ulcer into common bile duct.

Front 10

DDX Fatty Pancreas

Back 10

(1) elderly, (2) obese, (3) diabetes mellitus, (4) Cushing's disease, (5) lipomatosis, and (6) after steroid administration.

Front 11

The double systolic peak is referred to as bisferiens or "twice beating" pulse and is seen in three clinical entities:

Back 11

aortic regurgitation,
combined aortic stenosis and regurgitation,
obstructive hypertrophic cardiomyopathy.

Front 12

main clinical indications for performing a duplex ultrasound examination include:

Back 12

the evaluation of patients with confusing or nonhemispheric symptoms; patients with asymptomatic bruits; patients scheduled to undergo major cardiac or vascular surgery; and follow-up of patients postendarterectomy.

Front 13

DDX vaginal bleeding in a postmenopausal woman

Back 13

atrophic endometrium and exogenous estrogen. Other causes include endometrial hyperplasia, polyps, and submucosal fibroids. Endometrial carcinoma is less common.

Front 14

ultrasound findings suggestive of an ectopic

Back 14

adnexal ring,
complex mass
cyst
presence of free fluid

Front 15

DDX Sac like pelvic structures

Back 15

ectopic pregnancy
pyosalpinx
endometrioma
hemorrhagic corpus luteum.

Front 16

differential diagnosis in postmenopausal women with endometrial fluid collection includes

Back 16

carcinoma (endometrial and cervical),
endometrial polyp,
in patients who are status-post pelvic radiation therapy. However, probably the most common cause is exogenous estrogen administration in the presence of cervical stenosis.

Front 17

DDX Medullary nephrocalcinosis

Back 17

hypercalcuria and often with hypercalcemia.
Primary hyperparathyroidism and distal renal tubular acidosis account for over 60% of these cases.
hypercalciuria,
medullary sponge kidney,
milk-alkali syndrome, Cushing's syndrome,
bony metastases, hyperthyroidism, hypothyroidism,
sarcoidosis,
furosemide therapy,
vitamin D and phosphorus therapy in a case of hypophosphatemic rickets.
williams's syndrome

Front 18

DDX Cortical Nephrocalcinosis

Back 18

acute cortical necrosis
chronic glomerulonephritis, Alport's syndrome.
Primarily hyperoxaluria
renal vein thrombosis,
amyloidosis,
leukemic infiltration, and other causes of cortical nephrocalcinosis (chronic glomerulonephritis, Alport's syndrome, acute cortical necrosis). Other clinical manifestations include arthritis, cardiac conduction defects, localized ischemic skin lesions, and peripheral neuropathy.

Front 19

DDX Dilated collecting systems in the absence of obstruction

Back 19

prominent extrarenal pelves,
a distended bladder with delayed caliceal emptying, reflux, diuretic effect, congenital megacalices

Front 20

differential diagnosis of a solitary small solid renal mass on ultrasound should include

Back 20

renal cell carcinoma, oncocytoma, angiomyolipoma, and solitary metastasis.

Front 21

Adrenal lesions that need to be included in the differential diagnosis

Back 21

metastatic disease (especially if the patient has a primary lung or breast carcinoma), adenoma, lymphoma, hemorrhage (usually with obvious history of trauma or coagulopathy), and other less common primary adrenal neoplasms (pheochromocytoma, adrenal cortical carcinoma). Adrenal cysts and pseudocysts.

Front 22

DDX Bladder Diverticula

Back 22

1. Bladder ears, transitory bladder pouches projecting anteriorly into the inguinal rings in males under 6 months of age. Unlike congenital diverticula, they are anterior in position without an obvious neck connecting the pouch to the bladder.
2. Outpouching from the bladder, posterolateral to the ureteral orifices in girls. This area contains an anatomically thin muscle, so that the bladder normally bulges during voiding. Many regard this as a normal anatomical variation, although some feel that it is a true diverticulum.
3. Wide-mouthed lateral bladder pouches with a normal thickness of muscle. These contract when the bladder contracts and are considered a normal anatomical variation.
4. Extravasated urine that has become walled off after surgery or injury. This cavity, lined with granulation tissue, communicates with the bladder. The previous history is necessary to make the diagnosis.

Front 23

DDX Bladder Tumors

Back 23

normal bladder trabeculae, edema, mural folds, surgery scars, endometriosis, blood clot, and chronic cystitis.

Front 24

the most common urachal remnant

Back 24

cyst.

Front 25

DDX Prostate mass

Back 25

prastate ca,
focal prostatitis, prostatic intraepithelial neoplasia,
scarring,
atrophy

Front 26

DDX Fatty infiltration of the liver

Back 26

corticosteroid administration, chemotherapy,
diabetes mellitus,
small bowel bypass surgery, trauma,
obesity,
hyperalimentation.

Front 27

DDX portal vein thrombosis

Back 27

cirrhosis, intrahepatic malignancy, sepsis, pancreatitis, postoperatively or post-traumatically, and in hypercoagulable states, including blood dyscrasias, intra-abdominal malignancy, or even pregnancy

Front 28

DDX hepatic cyst

Back 28

simple cysts; pyogenic, amebic, and hydatid abscesses; polycystic liver disease; Caroli's disease; and traumatic hematomas.

Front 29

DDX Benign primary liver neoplasms

Back 29

capillary and cavernous hemangiomas, liver cell adenomas, focal nodular hyperplasia, and biliary cystadenomas.

Front 30

DDX lg cystic liver mass

Back 30

primary biliary cystadenoma/cystadenocarcinoma,
necrotic metastasis,
hydatid cyst.

Front 31

differential diagnosis of a large solitary hepatic lesion includes

Back 31

metastatic disease,
primary hepatocellular carcinoma, and benign hepatic lesions. In a patient with hepatic cirrhosis, hepatocellular carcinoma is likely.

Front 32

Causes of hepatocellular carcinoma:

Back 32

1. Hepatitis
2. Chronic liver disease
A. Alcoholic and postnecrotic cirrhosis
B. Alpha 1 antitrypsin deficiency
C. Hemochromatosis
D. Hereditary tyrosinosis
3. Mycotoxins (metabolites of Saprophytic fungi)

Front 33

differential diagnosis of liver calcifications

Back 33

primary or secondary malignancy.
primary mucinous carcinoma of the colon with secondary calcified liver metastases. Other common primary malignancies that have calcified metastases to the liver are the breast and ovary.

Front 34

Causes for assymetric form of IUGR

Back 34

\where the abdominal circumference is small in proportion to the head size and femur length. This is usually the result of placental insufficiency in patients with hypertension or diabetes mellitus. Less common causes include severe maternal malnutrition, heavy smoking, substance abuse, collagen vascular disease and anemia.

Front 35

differential diagnosis of an encephalocele includes

Back 35

cystic hygroma, scalp edema, branchial cleft cysts, hemangioma, and teratoma.

Front 36

DDX masses in the sacrococcygeal region

Back 36

chordoma, anterior sacral meningocele, neurenteric cyst, neuroblastoma, lipoma, rhabdomyosarcoma, hemangioma, malignant melanoma, and a meconium pseudocyst. A predominantly or entirely external cystic mass may resemble a myelomeningocele, which must be excluded by demonstrating intact posterior spinal elements

Front 37

differential diagnosis for an entirely intra-abdominal sacrococcygeal teratoma includes

Back 37

ovarian cyst, meconium pseudocyst, enteric duplication cyst, or anterior myelomeningocele

Front 38

differential diagnosis of congenital diaphragmatic hernia includes

Back 38

cystic adenomatoid malformation of the lung, bronchogenic and enteric cysts, mediastinal cystic teratoma, pulmonary sequestration, bronchial atresia, large chest wall or pleural-based masses, and unilateral agenesis of the lung.

Front 39

causes for enlarged hyperechoic kidneys

Back 39

include asphyxiating thoracic dysplasia and chromosomal disorders i.e. trisomy 13, 18, potter's, meckel gruber.

Front 40

DDX fetal ovarian cyst

Back 40

duplication cyst, mesenteric cyst, and urachal cyst.

Front 41

Entities that cloverleaf skull occurs in

Back 41

only in dysplasias that are either thanatophoric dysplasia, camptomelic dysplasia and homozygous achondroplasia

Front 42

differential diagnosis for a hypoechoic subchorionic hemorrhage beyond approximately 16 weeks includes a

Back 42

myoma, area of uterine contraction, a succenturiate placenta, a marginal placental chorioangioma, and an amniotic sheet.

Front 43

The differential diagnosis for solid hypoechoic masses in the pancreas include:

Back 43

carcinoma, focal pancreatitis, lymphoma, metastases, islet cell tumors, thrombosed aneurysm and pancreatic phlegmon.

Front 44

differential diagnosis of a low attenuation intrasplenic mass found on CT or a hypoechoic mass found on ultrasound

Back 44

infarction, hematoma, splenic cyst, or a primary splenic neoplasm such as lymphoma.

Front 45

differential diagnosis for low density areas noted in the spleen of patients with AIDS. These include:

Back 45

disseminated Kaposi's sarcoma, lymphoma as well as other fungal and mycobacterial infections and pcp.

Front 46

The most common site for a gastrointestinal duplication cyst is the

Back 46

ileum.

Front 47

DDX Retroperitoneal Lymphadenopathy

Back 47

: lymphoma; metastases from pelvic malignancies, particularly cervical, uterine, bladder, or prostate carcinoma; other intra-abdominal malignancies such as colon, pancreas, or renal carcinoma; and extraabdominal malignancies such as lung or breast carcinoma. Sarcoidosis or retroperitoneal fibrosis, particularly in its inflammatory stage, may create a retroperitoneal mantle. Benign nodal hyperplasia is rare.

Front 48

Types of Sacrococcygeal Teratomas

Back 48

Type I: Predominantly external.

Type II: Dumbbell-shaped, predominantly external mass with significant intrapelvic component.

Type III: Predominantly intrapelvic lesion with small external mass.

Type IV: Totally intrapelvic presacral mass with no external component.

Front 49

differential diagnosis of a presacral mass in children includes

Back 49

neuroblastoma, chordoma, abscess, rectal duplication, and anterior sacral meningocele

Front 50

mcc of hydrocephalus in a term infant

Back 50

aqueductal stenosis

Front 51

Benign appearing thyroid nodules

Back 51

Benign
Solitary
Cystic
Eggshell or Peripheral Calcifications

Front 52

DDX intra-testicular mass

Back 52

neoplasm
infarction
abscess

Front 53

Tumors of the epididymis in children include

Back 53

rhabdomyosarcoma, hemangioma, lymphangioma, metastasis, and lymphoma (less likely leukemia).

Front 54

Differential diagnosis of an adrenal cyst includes

Back 54

adrenal abscess, hematoma, and cystic neoplasms (adenoma, carcinoma, pheochromocytoma, metastases

Front 55

DDX adrenal tumor

Back 55

adenomas (by far the most common), cysts, hematomas, myelolipomas, and rare lesions such as hemangiomas, lymphomas, nonhyperfunctioning pheochromocytomas, ganglioneuromas, and stromal tumors (fibromas, leiomyomas, etc.)

Front 56

ACC may be seen in children with

Back 56

Beckwith-Wiedemann syndrome or in association with hemihypertrophy

Front 57

differential diagnosis of myelolipoma includes

Back 57

lipoma and liposarcoma of the adrenal gland or retroperitoneum, or teratoma and angiomyolipoma arising from adjacent renal parenchyma. Recently a fat-containing adrenal adenoma was reported

Front 58

Familial pheochromocytomas are most notable

Back 58

in MEN syndrome, but can also occur with neurofibromatosis and von Hippel-Lindau disease

Front 59

What 3 things can cause ring down artifact

Back 59

gas
metal
crystals (cholesterol crystals in gallbladder adenomyomatosis)

Front 60

dirty shadowing is usually caused by

Back 60

gas

Front 61

What is normal placental thickness?

Back 61

2 to 4 cm

Front 62

Risk factors for Placenta Accreta?

Back 62

Risk factors for placenta accreta include:

placenta previa,

prior cesarean section,

prior uterine surgery breaching the endometrium, and

prior history of placenta accreta.

Front 63

What are us and mri findings in placenta accreta?

Back 63

Helpful ultrasound and MRI findings of placenta accreta include placental lacunae on ultrasound, hypervascularity on Doppler ultrasound or abnormal vessels on MRI, intraplacental dark bands on T2-weighted imaging, and focal uterine bulging.

Front 64

What size adnexal cysts need to be followed and how often?

Back 64

Cysts smaller than 3 cm do not need to be described in the imaging report. Cysts 3–5 cm in size should be described in the report but require no follow-up. Cysts 5–7 cm in size are to be followed with yearly US.