Question 1

Which vessel is responsible for supplying approximately 70% of the blood flow to the liver, and what is its normal diameter as seen on ultrasound?

Accepted Answer

Portal vein; normal diameter ≤ 13 mm

Question 2

A patient presents with jaundice, elevated direct (conjugated) bilirubin, and a dilated common bile duct (CBD) on ultrasound. Which of the following is the most likely cause?

Accepted Answer

Obstructive choledocholithiasis

Question 3

Which anatomical structure separates the right anterior and right posterior segments of the liver according to the Couinaud classification?

Accepted Answer

Right hepatic vein

Question 4

A 45-year-old male with a history of alcoholism presents with a small, nodular liver, ascites, and splenomegaly. Which of the following best describes the pathophysiology of his condition?

Accepted Answer

Cirrhosis leading to portal hypertension and varices

Question 5

Which of the following is the most common benign liver tumor, and how does it typically appear on ultrasound?

Accepted Answer

Cavernous hemangioma; echogenic solid mass

Question 6

A patient with a history of chronic hepatitis C is being evaluated for liver transplantation. Which vascular complication is most commonly seen post-operatively and should be closely monitored with Doppler ultrasound?

Accepted Answer

Hepatic artery thrombosis

Question 7

Which of the following best describes the flow of bile from the liver to the duodenum?

Accepted Answer

Liver → Right/Left hepatic ducts → Common hepatic duct → Cystic duct → Gallbladder → Cystic duct → Common bile duct → Ampulla of Vater → Duodenum

Question 8

A 60-year-old woman presents with painless jaundice and an enlarged, palpable gallbladder. Ultrasound reveals a mass in the pancreatic head. What is the name of this clinical sign and what is the most likely diagnosis?

Accepted Answer

Courvoisier sign; pancreatic carcinoma

Question 9

Which of the following is the correct order of arterial blood flow through the kidney, from the renal artery to the nephron?

Accepted Answer

Renal artery → Segmental artery → Interlobar artery → Arcuate artery → Interlobular artery → Nephron

Question 10

A 35-year-old male presents with hypertension and an ultrasound reveals a tardus parvus waveform in the segmental renal artery. What is the most likely underlying pathology?

Accepted Answer

Renal artery stenosis

Question 11

Which of the following is the most common cause of acute pancreatitis, and what laboratory finding is most specific for this diagnosis?

Accepted Answer

Choledocholithiasis; elevated lipase

Question 12

A pediatric patient presents with a palpable abdominal mass and ultrasound reveals a large, heterogeneous mass in the adrenal gland with liver metastases. What is the most likely diagnosis?

Accepted Answer

Neuroblastoma

Question 13

Which of the following best describes the sonographic appearance and clinical significance of a 'WES' (wall-echo-shadow) sign in the gallbladder?

Accepted Answer

Echogenic anterior wall, echo, and shadow with no posterior wall seen; gallbladder packed with stones

Question 14

A 28-year-old woman presents with fever, right upper quadrant pain, and leukocytosis. Ultrasound shows a thickened gallbladder wall, pericholecystic fluid, and a stone in the cystic duct. What is the most likely diagnosis?

Accepted Answer

Acute cholecystitis

Question 15

Which of the following is the most common cause of splenomegaly in adults, and what is a key sonographic finding?

Accepted Answer

Portal hypertension; spleen length \u003e13 cm

Question 16

A 55-year-old male with a history of hypertension presents with severe abdominal pain. Ultrasound reveals an aortic diameter of 6.5 cm with an intimal flap. What is the most urgent diagnosis?

Accepted Answer

Aortic dissection

Question 17

Which of the following best describes the anatomical relationship of the left renal vein as seen in cross-sectional imaging?

Accepted Answer

Anterior to the aorta and posterior to the SMA

Question 18

A 40-year-old male presents with hypertension, obesity, and purple striae on his abdomen. Ultrasound reveals a solid, hypoechoic adrenal mass. Which syndrome is most likely present?

Accepted Answer

Cushing syndrome

Question 19

Which of the following is the most common cause of a non-obstructive, asymptomatic, echogenic renal mass in an adult, and what is its clinical significance?

Accepted Answer

Angiomyolipoma; benign but may be associated with tuberous sclerosis if bilateral

Abdominal Anatomy & Physiology: Ultrasound Study Guide

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