Which finding is an indication for renal biopsy to assess for renal failure?
Answer(s): A
Significant proteinuria, especially if persistent or in the nephrotic range, may indicate glomerular disease and is a common indication for renal biopsy. Leukocytosis and hypercalcemia are not specific for renal biopsy. Hematuria may warrant biopsy if accompanied by proteinuria.According to KDIGO Clinical Practice Guidelines:"Persistent proteinuria is one of the strongest indications for renal biopsy to evaluate underlying glomerular pathology."
Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Glomerulonephritis, 2021.American Society of Nephrology (ASN) Nephrology Board Review, 2021.
When measuring the abdominal aorta, where should the calipers be placed?
When measuring the abdominal aorta (or any vessel diameter for aneurysm evaluation), calipers should be placed from outer wall to outer wall to ensure inclusion of the full vessel diameter, including any mural thrombus. This is the standard method accepted by professional societies.According to AIUM and SRU Guidelines:"Vessel diameter measurements should be performed from outer wall to outer wall to avoid underestimation of aneurysm size."
AIUM Practice Parameter for the Performance of Abdominal Aortic Ultrasound, 2020.Society of Radiologists in Ultrasound (SRU) Consensus Statement, 2003.
Which sonographic finding is commonly associated with transitional cell cancer of urinary bladder?
Transitional cell carcinoma (TCC) typically presents as a non-mobile, polypoidal, focal intraluminal mass projecting from the bladder wall. Mobility of the lesion helps differentiate TCC from blood clots or debris.According to Rumack's Diagnostic Ultrasound:"Bladder TCC most often appears as a non-mobile, polypoid mass attached to the bladder wall."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for Bladder Ultrasound, 2020.
Which sonographic feature is typical of a thyroid adenoma?
Answer(s): B
Thyroid adenomas typically present as well-defined nodules surrounded by a thin, hypoechoic peripheral halo representing compressed thyroid parenchyma or fibrous capsule. Irregular margins suggest malignancy.According to Rumack's Diagnostic Ultrasound:"A thin hypoechoic halo is characteristic of benign thyroid adenomas."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for Thyroid Ultrasound, 2020.
In which position should a patient be placed when internal echoes are seen within a fluid-filled bladder?
Answer(s): C
Lateral decubitus positioning allows shifting of internal echoes within the bladder, helping differentiate mobile debris (such as blood clots or sediment) from adherent masses like tumors. This technique is helpful in evaluating questionable bladder filling defects.According to Rumack's Diagnostic Ultrasound:"Changing the patient's position, such as turning to the lateral decubitus, can help distinguish mobile debris from attached bladder wall lesions."
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