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128 Cards in this Set
- Front
- Back
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the frequency of the sound wave is determined by
a) its propagation speed b) its source c) the angle of reflection d) the propagation medium e) none of the above |
ITS SOURCE (b)
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which of the following techniques is/are best when trying to prove a posterior structure to be a rib rather than a solid mass?
a) images the structure in 2 planes b) rotate the transducer during real time scanning , demonstratin elongation c) demonstrate shadowin deep to the structure d) a and b e) a,b,c |
a and b
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silicone gel breast implants are typically located in which of the following locations
a) between the pectoralis major and the subscapularis muscles b) between the glandular tissue and the pectoral muscle c) within the subcutaneous layer d) a and b e) a,b,c |
b
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the lowest percentage of malignant breast tumors occur in which breast location?
a) retroareolar b) UIQ c) LIQ d) LOQ e) UOQ |
lower inner quadrant (c)
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which of the following is currently considered appropriate uses of breast US without or prior to a MMG?
a) to diagnose a failed breast implant b) to investigate a lactating patient c) for the guidance of invasive procedure d) a and b e) a, b and c |
e- all
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a breast mass is imaged with color flow Doppler and exhibits flow in the 50 cm/sec range. The mass is therefore
a) unlikely to be benign b) highly likely to be benign c) definitely benign |
a)
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which of the following determines the propagation speed of sound
a) amplitude of sound wave b) medium through which sound travels c) frequency of the sound wave d) degree of attenuation of the sound beam e) all of the above |
b- medium
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which of the following is NOT a characteristic of a simple cyst?
a) echo free b) oval shape c) thin edge shadows d) smooth contours e) isoechoic |
e
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which of the following ranges best describes approx how many lobes are found in the normal, adult, female breast?
a) 5-10 b) 10-15 c) 15-20 d) 20-25 e) 25-30 |
c) 15-20
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using the breast imaging reporting and data system (BIRADS) , a breast lesion has been classified as Category 2. The lesion is therefore:
a) malignant b) mildly suspicious for malignancy c) probably benign d) benign e) none of the above |
d- benign
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in US, the range equation relates
a) echo amplitude to the speed of sound b) reflector distance to the speed of sound c) reflector distance to echo arrival time d) reflector distance to echo amplitude e) echo frequency to echo arrival time |
c
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the hyperechoic, horizontal band positioned immediately anterior to the pectoral muscle is
a) deep fascia of the breast b) deep pectoral muscle c) superficial pectoral fascia d) retromammary layer e) none of the above |
a
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when the system gains are set optimally, which of the following structures appear hyperechoic during US scanning?
a) fatty tissue b) carcinomas c) simple cysts d) fibrous tissue e) lung |
d
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at puberty, which of the following substances are responsible for breast enlargement?
a) maternal estrogen, testosterone and prolactin b) progesterone, colostrum and lactogen c) progesterone, estrogen and growth hormone d) placental lactogen, progesterone, and estrogen e) estrogen, prolactin and testosterone |
c
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in soft tissue, if the pulse round trip is 65 microsec what is the distance from the source to the reflector?
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5 cm
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if a descrete nodule is identified on a mammogram, it is unlikely to be which of the following:
a) cyst b) fat lobule c) fibroadenoma d) invasive ca e) hamartoma |
b- fat lobule
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which of the following breast implant abnormalities can reliably be diagnosed using mammography?
a) extracapsular rupture b) intracapsular rupture c) radial folds d) a and b e) a,b and c |
a
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complete absence of nipple, areola and glandular tissue is called?
a) athelia b) amastia c) aplasia d) hypoplasia e) none of the above |
b- amastia
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which of the following are malignant mass characteristics evident during mammography?
a) hard and gritty b) acoustic shadowing c) disrupts normal tissue architecture d) a and b e) a,b and c |
c
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which of the following are considered limitations of color Doppler flow?
a) dependence on the Doppler angle b) color demonstrated aliasing at relatively low velocities c) low PRF are necessary to provide the color image d) a and b e) a,b and c |
d
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which of the following BEST describes the purpose of TGC?
a) TGC controls time, gain and color b) TGC controls the power applied to the transducer c) it improves both axial and lateral resolution d) it ensures that all returning echoes are displayed with equal signal strength |
d
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the mass most commonly associated with nipple discharge is
a) papilloma b) fibroadenoma c) seroma d) hamartoma e) complex cyst |
a
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the attenuation coefficient ________as the frequency increases
a) remains the same b) increases c) decreases |
b
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which of the following is/are considered pregnancy induced changes to the breast?
a) circulating estrogen promotes duct development b) circulating progesterone induces alveolar development c) high levels of estrogen and progesterone promote milk production d) a and b e) a,b and c |
d
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following lumpectomy, approximately what percentage of breast cancers recur locally within 5 years of the original diagnosis?
a) 0-5% b)5-10% c) 10-15% D) 15-25% |
b
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which of the following is/are considered normal variants when imaging breast implants with US or MRI?
a) radial folds b) native capsular calcification c) implant filling valve d) a and b e) a,b and c |
e
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the phenomenon known as volume averaging may result in ______?
a) 2 separate structures appearing as a single structure b) artifactual echoes within a cyst c) a biopsy needle appearing "broken" within a cyst d) a and b e) a,b and c |
d
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which of the following is/are true statements regarding primary breast lymphoma?
a) breast lymphomas are typically hypoechoic with irregular borders b) primary breast lymphoma is often accompanied by palpable axillary lymph nodes c) primary breast lymphoma is relatively common d) a and b e) a,b, and c |
d
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the majority of breast cancers arise from which of the following structures?
a) cooper's ligaments b) fat lobule c) TDLU d) axillary tail of Spence e) the nipple |
c
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which of the following statements about transducer construction is/are true?
a) thinner transducer elements have higher resonant frequencies b) a transducer's operating frequency is determined in part by the thickness of the transducer element c) transducer crystals are made piezoelectric using a process called depolarization d) a and b e) b and c |
d
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what is/are the most appropriate technique(s) to investigate a non-palpable mass?
a) FNA b) needle directed core biopsy c) open surgical biopsy d) a and b e) a,b and c |
b
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in a non-lactating patient, normal lactiferous ducts should never exceed_____ in size
a) 1mm b) 2mm c) 3mm d) 4mm e) 5mm |
b- 2mm
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which of the following best descibes multifocal breast carcinoma?
a) foci of cancer in the vicinity of each other b) foci of cancer remote from the dominant mass c) multiple tumors within the same breast d) multiple tumors in both breasts e) none of the above |
a
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involution
a) is initiated by oxytocin b) breast lobules shrivel and are replaced by fat c) duct and alveolar development occur during breast involution d) a and b e) b and c |
b
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which is defined as "the maximum distance separating two different echoes along the longitudinal axis of sound travel"?
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axial resolution
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which of the following pathologies is a rare type of invasive ductal cancer formed by mucus producing cancer cells?
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colloid carcinoma (=mucinous ca)
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the snowstorm sign is a result of which of the following phenomena?
a) intracapsular rupture b) folding of the implant capsule within the fibrous capsule of the implant c) presence of silicone within the fibrous capsule of the implant d) all of the above e) none of the above |
e (extracapsular rupture)
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axial resolution _______________ as frequency increases
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improves
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which invasive breast ca is usually soft, mobile and well circumscribed, with smooth, non-infiltrating borders?
a) mucinous ca b) medullary ca c) invasive lobular ca d) intraductal ca e) none of the above |
b
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which of the following is/are true statements regarding pathological lymph nodes?
a) they typically demonstrate a hypoechoic hilum b) they may demonstrate a total absence of echoes c) they are typically wider than deep d) a and b e) a,b and c |
b
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which of the following statements is/are false regarding breast mass characteristics?
a) malignant masses tend to have irregular contours, angular margins and spiculations b) benign masses tend to have smooth contours c) malignant masses are typically wider than they are tall d) all of the above e) none of the above |
c is false
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US prop. speeds (from highest to lowest)
a) bone, water, lung b) blood, bone, air c) fat, muscle, lung d) brass, mercury, bone e) water, lung, bone |
a
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which imaging modality is best for detecting implant failure?
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MRI
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second most common invasive tumor, making up 10-15% of all breast cancers?
a) invasive ductal ca b) infiltrating lobular ca c) medullary ca d) mucinous ca e) none of the above |
b- inv. lobular ca
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high resolution breast images require at least ______ shades of gray to delineate fine differences in tissue architecture
a) 512 b)256 c) 128 d) 64 e) 32 |
b 256
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strictly speaking, the pulse repetition frequency is determined by
a) the line frequency b) mechanical properties of the crystal c) bandwidth of the crystal d) size and shape of the crystal e) number of times the crystal is electronically stimulated |
a
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which statement is false regarding Paget's disease of the nipple?
a) it is a true form of breast cancer b) often confused with eczema c) often originates as LCIS d) a and b e) a,b and c |
c is false
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not a benign characteristic of breast mass?
a) homogenous echotexture b) thin, echogenic capsule c) smooth borders d) one or two lobulations e) spiculated |
e
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which % of intraductal ca's are circular or oval shaped as opposed to stellate or spiculated?
a) 10% b) 25% c) 33% d) 50% e) 75% |
c
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at what rate is sound attenuated by breast tissue?
a) 0.5 dB/cm/MHz b) 0.5 dB/cm c) 5 dB/cm/kHz d) 5 dB/cm e) 1 dB/cm/MHz |
a
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power / beam area is equal to:
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intensity
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which subset of invasive breast lesions makes up 65-80% of all mammary carcinomas?
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invasive ductal
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in general the AIUM statement on bio effects report that "no bio effects reported with unfocused beams at intensities below_____"
a) 100 mW/cm^2 b) 100 mW/cm c) 100 W/cm^2 d) 100 W/cm |
a
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what is often referred to as "lobular neoplasia"
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LCIS
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of the following US characterstics, which may be used as a fairly reliable indicator of a benign vs. malignant lesion?
a) size, shape and orientation of lesion b) effect of lesion on surrounding tissue planes c) absence of microcalcifications d) a and b e) a,b and c |
d
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refractions is
a) reflection of sound at the interface of two different acoustic media b) bending of sound beam at tissue interface c) ratio of reflected to incident sound d) none of the above |
b
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true regarding LCIS
a) pt with LCIS often underwent bilateral mastectomy b) LCIS most common in postmenopausal women c) LCIS has typical mammography appearance d) a and b e) a,b and c |
a
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echo palpation is
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simultaneous palpation of the breast with one hand while scanning the breast with the other
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which statement about dynamic range is false?
a) the dynamic rance of an US system may be 100:1 b) the TGC of the US system allows us to compensate for the dynamic range of returning echoes c) dyn, range is a measure of the range of the weakest to the strongest echo signals that an US system can detect d) dynamic range may be described in units of decibels e) none of the above |
e
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in situ means the lesion is typically
a) noninvasive b) precancerous c) capable of metastasis d) a and b e) a,b and c |
d
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which of the following affect lateral resolution?
a) transducer frequency b) transducer focal length c) PRF d) a and b e) a,b and c |
d
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when imaging breast implants with MRI for evidence of failure, the best results are obtained
a) enhancing the images with contrast b) acquiring the images in the sagittal plane c) using cc and mlo projections d) a and b e) a,b and c |
b
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high quality mammography has affected the detection of which the most?
a) LCIS b) infiltrating ductal ca c) DCIS d) invasive lobular ca e) none of the above |
c
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of the following, the least invasive:
a) LCIS b) invasive lobular ca c) medullary ca d) invasive ductal ca e) Paget's disease of the nipple |
a
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which breast zone(s) contain little or no fat?
a) area beneath nipple and areola b) mammary layer in a 55 y/o pt c) retromammary layer d) a and b e) a,b and c |
a
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US guided biopsy: needle approach parallel because
a) follow needle in real time b) avoid puncture of pleural space c) when lesion is superficial d) a and b e) a,b and c |
d
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a 10 MHz transducer typically has an axial resolution of approximately
a) 0.02 mm b) 0.2 mm c) 2.0 mm d) 2cm |
b
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current high res breast US transducers are focused in the ______range
a) 0.5-1.0cm b) 1.0-3.0cm c) 3.0-5.0cm d) 5.0-7.5cm |
b
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which of the sources of arterial blood to the breast are least important in terms of volume of blood supplied?
a) perforating arteries b) external mammary artery c) intercostal arteries d) internal mammary artery |
a
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propagation speed of US in a vacuum is
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- (can't propagate!)
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underlying medical conditions associated with gynocomastia?
a) testicular tumors b) liver cirrhosis c) substance abuse d) a and b e) a,b and c |
e
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true reagarding ductography:
a) usually performed on pts with single duct discharge and a normal MMG b) 20-40 ml of contrast is used to fill the lactiferous duct c) following injection, the ducts are images using MMG, US or MRI d) a and b e) a, b and c |
a
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which following benign lesions can fill surgical cavity?
a) hematoma b) oil cyst c) seroma d) a and b e) a,b and c |
e
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the strength of echoes returning from Rayleigh scatterers is:
a) proportional to the propagation speed raised to the 4th power b) proportional to the frequency raised to the 4th power c) inversely porportional to the frequency raised to the 4th power d) inversely proportional to the propagation speed raised to the 4th power e) none of the above |
b
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breast within a breast
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hamartoma (fibroadenolipoma)
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presence of free air within breast mass is most indicative of which of the following lesions
a) abscess b) contusion c) gynecomastia d) oil cyst e) none of the above |
a
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in the Doppler equation the audible Doppler signal is the result of:
a) frequency changes in the incident US beam caused by variations in the transmission medium b) frequency changes in the reflected US beam caused by varying acoustical impedances c) frequency changes in the reflected US beam caused by the motion of acoustic reflectors d) frequency changes in the incident US beam caused by a change in transducer frequency e) b and c |
c
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which of the following is the most common breast biopsy method in use today
a) FNA b) open surgical biopsy c) cyst aspiration d) a nad b e) a,b and c |
b
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US and MMG views best used for comparison:
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cc view and transverse US plane
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THI (tissue harmonic imaging) improves images by
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removing the fundamental imaging frequency, leaving only the higher harmonic frequencies to create the image
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which are true regarding chronic mastitis
a) often occurs during lactation b) usually only involves one area of the breast c) may be precipitated by milk stasis d) more commonly in older women e) none |
d
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juvenile papillomas exhibit:
a) they are large tumors with an average size of 4cm b) they have a gross appearance similar to Swiss cheese c) they arise within the glandular tissue of the breast d) a and b e) a,b and c |
d
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which is the least important route for lymphatic drainage
a) from the posterior intercostal nodes to the axillary lymph nodes b) from the subcutaneous nodes along the inferomedial aspect of the breast c) from the internal mammary chain along the inner aspect of the breast d) from the posterior intercostal nodes to the anterior mediastinal glands |
b
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the largest doppler shift occurs when the US beam insonates a vessel at _______ degrees
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45
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which is most commonly formed when the blood supply to fat cells is compromised either following surgery or trauma?
a) seroma b) hematoma c) oil cysts d) hamartoma e) none |
c
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how many lymph nodes are typically removed during sentinel node procedure?
a) 1 b) 1-3 c) 5-10 d) 10-15 e) all visible nodes are removed |
b
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which of the following statements about fibroadenomas are false?
a) make up approx. 50 % of all benign breast pathologies b) are most common in young patients c) approx 33% of fibroadenomas have a complex appearance d) fibroadenomas may reach 10-15 cm in size e) none |
e
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which transducer is most appropriate for high res BUS?
a) 3.5 MHz linear array b) 5.0 MHz curved array c) 7.5 MHz phased array d) 10 MHz linear array e) 10 MHz curved array |
d
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which of the following is responsible for allocation of displayed gray scale?
a) scan converter b) system receiver c) transducer d) display monitor e) none |
a
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which is/are true?
a) witch's milk is also known as colostrum b) witch's milk is a breast secretion found in newborn c) witch's milk is a common result of papilloma or malignant papilloma d) a and b e) a,b and c |
a
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which of the following is the most common primary cancer to spread to the breast?
a) melanoma b) colon c) bone d) lung e) urinary bladder |
a
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branch of anatomy that deals with structures as discernible with a microscope is known as:
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histology
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which is the most correct way to measure a leasion on US?
a) antero-posterior b) sagittal and long axis c) radial d) longitudinal and transverse e) lateral |
a
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most common abnormality in the breast?
a) fibroadenoma b) fibrocystic breast disease c) postpartum acute mastitis d) DCIS e0 none |
b
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which is/are advantages of power Doppler?
a) independence from the Doppler angle b) indicates flow direction in small, deep vessels c) measures extrelemly low flow velocities d) a and b e) a,b and c |
a
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hypo- and hyper- echoic are used in relationship to
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fat
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which statement(s) about power Doppler are true?
a) power Doppler is angle independent allowing detection of flow even when the US beam is perpendicular to flow b) Power Doppler provides freedm from aliasing as well as directional information c) in low flow situations, conventional color Doppler provides superior sensitivity d) a and b are true e) a,b and c |
a
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which of the following are NOT composed totally of stromal alements of the breast?
a) skin, ducts, fat and dense connective tissue b) lobules, lobes, skin and fat c) loose connective tissue, fat, Cooper's ligaments d) a and b e) a,b,c |
d
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which is true?
a) breast cancer is the leading cause in cancer mortality in women b) breast cancer mortality rates are decreasing c) approx. 140, 000 men will be diagnosed with cancer in the year 2000 d) a and b e) a,b and c |
b
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tumor located on CC view in lateral part of breast. Compared to the MLO view, the location of the mass on US exmination will be
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lower in the breast
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acoustic enhancement may occur when
a) a low attenuation structure is situated in front of the reflector b) a blodd vessel lies on top of the area of interest c) the sound beam is totally attenuated by an anterior structure d) a and b e) a,b,c |
d
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which does NOT imply a benign lesion?
a) ellipsoid shape, wider than tall b) microlobulations c) well circumscribed margins, smooth borders d) thin, echogenic capsule e) pure hyperechogenicity |
b
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the formation of fibrous tissue in response to an invasive breast ca may also be called
a) desmoplasia b) reactive fibrosis c) fibroelastic host response d) a and b e) a,b,c |
e
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which of the following does NOT originate in the TDLU?
a) central, solitary papilloma b) lobular ca c) invasive ductal ca d) simple cyst e) fibroadenoma |
a
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which of the following invasive carcinomas is most likely to be overlooked on a routine mammogram?
a) tubular b) ductal c) lobular d) Phyllodes e) medullary |
c
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which of the following types of mastitis is related to lactation?
a) puerperal b) granulomatous c) periductal d) chronic e) traumatic |
a
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the most common breast sarcoma is
a) fibrosarcoma b) lymphoma c) melanoma d) Phyllodes tumor e) liposarcoma |
d-Phyllodes tumor
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which tissue specimen not suitable for histologic analysis
a) vacuum assisted mammotomy b) FNA biopsy c) ABBI d) automated spring loaded core biopsy e) excisional biopsy |
b
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following cyst aspiration, pt returns to physician with tender lump. US reveals descrete cystic mass with uniform, isoechoic wall thickening. Thes findings are consistent with:
a) galactocele b) seroma c) traumatic oil cyst d) infected cyst e) hematoma |
d
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pt with prev hx of high grade, invasive ductal ca demonstrates 3 small, hypoechoic lesions with shadowing in the same breast quadrant. Pattern is described as:
a) bilateral b) contralateral c) multifocal d) multicentric e) desmoplastic |
c
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LCIS is most often diagnosed
a) as a mass during clinical breast exam b) as an incidental finding, within bx material acquired for another reason c) on MRI as enhancing lesion d) on mammography as suspicious calcifications e) on US as ill-defined mass |
b
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which of the following is NOT typical of metastatic lesions to the breast from extramammary sources?
a) fast growing b) discrete mass located in subcutaneous fat c) solitary or multiple d) tumor cells reach breast via blood stream e) highly spiculated margins |
e
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what equipment control allows for uniform amplifications of the echoes received by the transducer from tissues located in breast?
a) overall receiver gain b) time-gain compensation c) dynamic range d) transmit power e) electronic focusing |
a
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most characteristic sonographic features of benign, fibrous stromal tissue
a) uniform, marked hypoechogenicity b) uniform, marked hyperechogenicity c) ellipsoid shape d) taller than wide e) thin, echogenic capsule |
b
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which of the following would not appear as a water density on a mammogram?
a) carcinoma b) fibroadenoma c) fibroglandular d) cyst e) fat lobule |
e
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acoustic shadowing is a common feature in all of the following pathologies, except:
a) invasive ductal ca b) radial scar c) medullary ca d) fibrotic fat necrosis e) post surgical scarring |
c
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young diabetic pt with firm, non-tender mass. US shows highly attenuating region of breast tissue with marked distal acoustic shadowing and irregular borders. What is the most likely cause for the US appearance?
a) invasive ductal b) fibroadenoma c) fibrous mastopathy d) Phyllodes tumor e) fat necrosis |
c) fibrous mastopathy
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which of the following cyst aspirtes has the highest risk for malignancy?
a) yellow b) green c) serous d) bloody e) milky |
d
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from which structure do most breast cnacers originate?
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TDLU
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which phase in the menstrual cycle is most responsible for proliferation and growth of breast lobules?
a) pre-ovulatory (follicular) phase b) post-ovulatory (luteal) phase c) onset of menses d) cessation of menses e) none |
b
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following which event do the acini become fully formed and functional?
a) ovulation b) menstruation c) puberty d) pregnancy and lactation e) menopause |
d
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which of the following muscles is located deep to the lateral third of the breast, forming the medial wall of the axilla?
a) anterior serratus b) pectoralis major c) pectoralis minor d) external oblique e) none |
a
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recommended course of action for BIRADS 3 categoy?
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f/u in 3-6 months
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ability to receive and display weak echoes from structures located deep within the breast is called:
a) lateral resolution b) dynamic range c) sensitivity d) axial resolution e) TGC |
c
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most appropriate pt position for palpable mass?
a) supine b) affected sideup c) affected side down d) erect e) position which best allows palpation of mass |
e
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most of the breast lies anterior to which of the following muscles?
a) pec minor b) pec major c) serratus anterior d) external oblique E) intercostal |
b
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most common primary cancer to metatasize to the male breast?
a) melanoma b) testicular c) prostate d) live e) bone |
c
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most common placement for implants?
a) preglandular- subpectoral b) subpectoral, subcutaneous c) subglandular-prepectoral d) submuscular-subpectoral e) prepectoral-submuscular |
c
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