Elevation of alpha-fetoprotein levels is a characteristic finding in which tumor?
Answer(s): A
Alpha-fetoprotein (AFP) is commonly elevated in patients with hepatocellular carcinoma (hepatoma), particularly in those with underlying cirrhosis or chronic hepatitis B/C. AFP is not typically elevated in adenomas, cholangiocarcinoma, or FNH.According to Rumack's Diagnostic Ultrasound:"Serum AFP levels are elevated in 5070% of patients with hepatocellular carcinoma."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AASLD Guidelines for HCC Surveillance, 2018.
Which condition is associated with multiple pancreatic cysts?
Answer(s): B
Von Hippel-Lindau (VHL) syndrome is a genetic disorder associated with multiple pancreatic cysts, pancreatic neuroendocrine tumors, and other systemic neoplasms. While cystic fibrosis can produce thickened pancreatic secretions, it rarely causes true pancreatic cysts.According to Rumack's Diagnostic Ultrasound:"Multiple pancreatic cysts are strongly associated with Von Hippel Lindau syndrome."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.WHO Classification of Digestive System Tumors, 5th ed., IARC, 2019.
Which scanning technique would best reduce reverberation artifact when assessing the gallbladder?
Answer(s): D
Tissue harmonic imaging significantly reduces reverberation and side-lobe artifacts by utilizing nonlinear propagation of ultrasound waves. This produces clearer images of fluid-filled structures like the gallbladder, improving visualization of wall thickness and intraluminal contents.According to Zwiebel's Introduction to Vascular Ultrasound:"Harmonic imaging effectively reduces reverberation artifact, improving image quality in gallbladder and cystic structure evaluation."
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.AIUM Practice Parameter for Abdominal Ultrasound, 2020.
Which structures converge to form the inferior vena cava?
Answer(s): C
The inferior vena cava (IVC) is formed by the confluence of the right and left common iliac veins at the level of approximately L5. The hepatic veins drain into the IVC superiorly but do not form it. The superior mesenteric and splenic veins join to form the portal vein, not the IVC.According to Moore's Clinically Oriented Anatomy:"The IVC begins at the level of L5 by the union of the right and left common iliac veins."
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
Which renal finding is often present in patients with tuberous sclerosis?
Angiomyolipomas are benign renal tumors composed of fat, smooth muscle, and blood vessels. They are strongly associated with tuberous sclerosis and may be multiple and bilateral in these patients. While RCC may occur, angiomyolipomas are much more characteristic.According to Rumack's Diagnostic Ultrasound:"Angiomyolipomas are frequently multiple and bilateral in patients with tuberous sclerosis."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.AIUM Practice Parameter for Renal Ultrasound, 2020.
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