What is the ultrasound appearance of retained products of conception?
Echogenic mass within uterine cavity
Blood flow from the myometrium
What is the definition of varicocele?
Tubular veins that are greater than 2-3 mm
Increase with Valsalva
What type of thyroid tumor is associated with microcalcifications?
What are spermatoceles?
Cystic lesions closely associated with epididymis
Where does the fluid in the hydrocele reside?
Fluid goes around the tunica vaginalis
What is the most common neural tube defect?
Anencephaly - absence of brain above orbits
What are classic findings of chronic pancreatitis?
Pancreatic duct dilatation
What is the most common post partum cause of fever?
How does the clinical presentation in patients with retained products of conception differ from patients with endometritis?
Retained products of conception > heavy bleeding
Endometritis > fever and purulent discharge
What is the most common cancer to metastasize to the gallbladder?
What are imaging findings of a malignant thyroid nodule?
Taller than wide shape
What is the urachus?
Connection between bladder and umbilicus
What is the blood supply to the ovary?
What are ultrasound findings of ovarian torsion?
Peripheral cysts (due to central edema)
What is the best measure of gestational age in a FIRST trimester pregnancy?
Crown rump length
How does the venous drainage of the caudate lobe of the liver differ from the rest of the liver?
Caudate lobe drains directly into the IVC
What is a potential hematologic complication of rapidly growing hemangiomas?
Large hemangioma sequestering and destroying platelets
What is the most common ovarian neoplasm in women of reproductive age?
What is the most common ovarian mass (not neoplasm) seen in pregnancy?
Corpus luteum cyst
What is Mirizzi syndrome?
Obstruction of the common hepatic duct by an impacted cystic duct stone
What is the most important parameter to assess renal artery stenosis on ultrasound?
Peak systolic velocity of main renal artery
>200 considered elevated
What is the most common cause of an enlarged UNILATERAL kidney?
Acute renal vein thrombosis
What is the most sensitive and specific finding of ectopic pregnancy on ultrasound?
Nonovarian complex adnexal mass
What are hepatobiliary signs of congestive heart failure?
Gallbladder wall thickening
Pulsatile portal flow
What vessels are normally present in the umbilical cord?
What is the pathophysiology of lymphoproliferative disorder?
Antigenic stimulation of lymphoid tissue leading to lymphoproliferative response
In patients with autoimmune or immunosuppressed conditions
What is the definition of placenta accreta?
Abnormal proliferation of placental tissue beyond endometrial lining of uterus
What is the definition of placenta previa?
Placenta implants in lower uterine segment
What are characteristic findings of polycystic ovarian syndrome on ultrasound?
Increased central stroma (echogenic)
What is vasa previa?
Fetal vessels near cervical os
What is a succenturiate lobe?
Accessory placental lobe
What are virtually diagnostic findings to rule out endometrial cancer in post menopausal women with bleeding?
Endometrial stripe less than 4 mm virtually excludes endometrial cancer
What happens to flow in the renal artery when the renal vein is thrombosed?
Outflow (renal vein) is blocked so flow becomes reversed during diastole
What are signs of portal venous gas on ultrasound?
Small echogenic foci in portal vein
Bi-directional spike like waveform
What are the most common risk factors for hepatic adenoma?
Glycogen storage disease
What types of cells in the ovary account for most ovarian neoplasms?
Epithelial cells (~80%)
Germ cells (~20%)
What are the major types of ovarian epithelial cell neoplasms?
What is the natural history of a hemorrhagic cyst?
Regresses within 14-16 weeks typically spontaneously
Hormone therapy can cause regression by 6 weeks
What syndrome includes benign ovarian tumors combined with excess pleural and peritoneal cavity?
- Meigs syndrome
- 1)Benign tumor (fibroma)
- 2) Pleural effusion
- 3) Ascites
Homogeneous, low level echoes
What genetic abnormality is associated with: choroid plexus cysts, clenched hands, club feet, hyperechogenic kidneys and brachycephaly (strawberry shaped head/early fusion of coronal suture)?
What is the most common cause of fetal abdominal cysts in a female?
What is the most common benign liver neoplasm?
How large can a dominant follicle grow at ovulation?
What is the size of cyst at which mural nodules can be obscured?
(Hence above 7 cm, cysts need MR for further evaluation)
What are imaging findings of hydrosalpinx?
Dilated adnexal tubular structure separate from and leading to ovary
What are features of an indeterminate ovarian cyst?
Multiple thin septations
Solid nodule without detectable flow
What is the appropriate workup for an indeterminate ovarian cyst?
Follow up US in 6-12 weeks
Lesion resolves > hemorrhagic cyst
Unchanged > surgical evaluation if lesion is not endometrioma or dermoid
Pelvic inflammatory disease
Fluid distended fallopian tube
Fishnet/lacelike pattern - comes from retraction/hemolysis of clot
What is the most common cause of delayed graft function in a transplant kidney?
Acute tubular necrosis
What are features that can help to distinguish follicular adenoma versus an adenomatoid nodule?
- Follicular adenoma -
- Hypoechoic halo
- Well defined
What are the most common types of thyroid cancer?
What is the difference between the spread of papillary versus follicular thyroid carcinoma?
Papillary spreads via lymph nodes
Follicular has a hematogenous spread
Homogeneous echotexture replaced by heterogeneous echotexture
What clinical history may be helpful in evaluating an ill defined hypoechoic lesion in the thyroid?
Preceding viral infection
Is the thyroid painful?
What are the most common salivary gland neoplasms?
What are the most common sites for an ectopic parathyroid adenoma?
Behind trachea, medial to carotid
What syndrome is medullary thyroid cancer associated with?
20% seen in patients with MEN-IIa and IIb
What are signs of TIPS malfunction in the main portal vein and in the shunt?
Main portal vein velocity < 35 cm/sec
Shunt velocity < 90 cm/sec
Where do most TIPS occlusions occur?
Hepatic venous side
At what Beta-HCG level should you see a gestational sac?
At a Beta-HCG level of 10,000 what structure should you see?
If you have a beta HCG level greater than 100,000, what should you suspect?
What are the top three causes of polyhydramnios?
Fetal anomalies - structural anomalies that inhibit swallowing or intestinal absorption
What are the effects of tamoxifen on the breast versus the uterus?
Breast - acts as antagonist
Uterus - acts as agonist
What is the demarcation point for central versus lateral neck?
What is the differential for large, hyperechoic kidneys (bilateral) found on obstetric ultrasound and how can one differentiate these causes?
- Autosomal recessive polycystic kidney disease
- Trisomy 13 (multiple additional anomalies)
- Meckel-Gruber syndrome (polydactyly, encephalocele)
What are doppler findings of fetal anemia?
Elevated peak systolic velocity of the middle cerebral artery
How can one distinguish serous cystadenoma of the pancreas from mucinous cystadenoma?
Serous - microcysts, pancreatic head
Mucinous - larger cysts, pancreatic tail
What is the ultrasound appearance of acute hepatitis?
Diffusely decreased echogenicity > more prominent portal triads
What are characteristic velocities suggestive of carotid artery stenosis on duplex ultrasound?
125 cm/sec - suggests greater than 50% stenosis
230 cm/sec - suggests greater than 70% stenosis.
What is the definition of resistive index?
(Peak systolic velocity - Diastolic velocity)/ (Peak systolic velocity)
What can elevated resistive indices signify in a transplant kidney?
Acute tubular necrosis
Mass with lamellated wall in testicle - Epidermoid cyst
What are the findings of hepatic arterial thrombosis after transplant?
Biliary leaks/complications (hepatic artery is only blood supply for biliary system after transplant)
Parvus tardus waveform
What genetic syndrome is associated with holoprosencephaly (~50%), cleft lip/palate, echogenic intracardiac focus, polydactyly, rocker bottom feet?
What genetic syndrome is associated with echogenic intracardiac focus, nuchal thickening, echogenic bowel, cardiac defects and the double bubble sign?