Lange Review Ultrasonography Examination, 4th Edition

Questions

GENERAL INSTRUCTIONS: For each question, select the best answer. Select only one answer for each question unless otherwise specified.

1. What is the most common location for a spermatocele?

(A) head of the epididymis

(B) body of the epididymis

(C) tail of the epididymis

(D) tunica vaginalis

(E) mediastinum testis

2. A 15-year-old boy presents with sudden intense right scrotal pain, nausea, and vomiting. A sonogram is performed, and an enlarged hypoechoic right scrotum with decreased arterial flow is documented. The left scrotum is normal. This is most consistent with which of the following?

(A) testicular rupture

(B) varicocele

(C) spermatocele

(D) torsion

(E) hydrocele

3. Which of the following statements is true in patients with uncomplicated acute epididymitis?

(A) There is enlargement of the scrotum with focal or generalized thickening of the epididymis.

(B) The epididymis is uniformly enlarged and more anechoic than usual.

(C) The epididymis is small with areas of calcifications.

(D) There is decreased blood flow to the epididymis.

(E) The epididymis is too tender to be touched and cannot be scanned.

4. On a longitudinal scan of the scrotum, which of the following is the most superior portion?

(A) ductus deferens

(B) rete testis

(C) head of the epididymis

(D) tunica albuginea

(E) spermatic cord

5. Which of the following is true concerning the seminal vesicles?

(A) They produce sperm and are located within the prostate

(B) They produce sperm and are located posterior to the urinary bladder

(C) They are the reservoir for sperm and are located posterior to the urinary bladder

(D) They are the reservoir for sperm and are located between the mediastinum testes and the pampiniform plexus

(E) They are the reservoir for sperm and are located in the peripheral zone of the prostate

6. On a sonographic examination, which of the following describes the appearance of a seminoma of the testicle?

(A) solid, homogeneous mass

(B) large, multilocular cystic mass

(C) small, simple cyst

(D) diffuse enlargement of the testicle

(E) small, complex mass

7. On a sonographic examination, which of the following describes the appearance of thyroiditis?

(A) multiple cysts within the thyroid

(B) a diffuse, enlarged thyroid with decreased echogenicity

(C) a small, echogenic thyroid

(D) multiple complex masses within the thyroid

(E) fluid collection surrounding an enlarged thyroid

8. A pheochromocytoma is a benign hormone-producing tumor of which of the following?

(A) thyroid

(B) kidney

(C) testicle

(D) pancreas

(E) adrenal gland

9. Which of the following is the most likely diagnosis shown in Fig. 5–2?

(A) a testicular tumor

(B) testicular torsion

(C) epididymitis

(D) a cryptorchidism

(E) a normal testicle

Image

Image

FIGURE 5–2. Longitudinal color Doppler sonograms of the right and left hemiscrotum.

10. Which of the following may be the presenting symptom of a testicular malignant tumor?

(A) para-aortic lymphadenopathy

(B) acute scrotal pain

(C) leukemia

(D) retroperitoneal lymphadenopathy

(E) all of the above

11. The left testicular vein drains into which of the following veins?

(A) inferior vena cava

(B) left internal iliac vein

(C) common internal iliac vein

(D) left renal vein

(E) prostatic vein

12. In the subacute phase of testicular torsion, which of the following describes the appearance of the testes?

(A) anechoic areas in testes with decreased blood flow

(B) small and echogenic

(C) enlarged with increased blood flow

(D) at normal size with a decrease in size of the epididymis

13Fig. 5–3 is a transverse sonogram of the right and left hemiscrotum. Which of the following is this image most consistent with?

(A) torsion

(B) orchiectomy

(C) cryptorchidism

(D) epididymitis

(E) normal testicles

Image

FIGURE 5–3. Transverse color Doppler sonogram of the right and left testicles.

14Fig. 5–4 is a Duplex Doppler sonogram obtained in the upper hemiscrotum. What is the abnormality?

(A) a dilated spermatic duct

(B) dilated vessels near the head of the epididymis

(C) an extratesticular vascular tumor

(D) a pampiniform venous plexus

(E) a dilated deferential artery

Image

FIGURE 5–4. Duplex Doppler sonogram obtained in the right upper hemiscrotum.

15. Based on the findings in Fig. 5–4, what is the most likely diagnosis?

(A) varicocele

(B) hydrocele

(C) testicular torsion

(D) spermatocele

(E) testicular infarct

16. A scrotal scan was performed on a 69-year-old man. The findings in Fig. 5–5 are consistent with which one of the following diagnoses?

(A) epididymitis

(B) hydrocele

(C) seminoma

(D) varicocele

(E) spermatocele

Image

FIGURE 5–5. Longitudinal scan through the right testis.

17. A scrotal scan was performed on a 78-year-old man. What is the arrow in Fig. 5–6 pointing to?

(A) a fractured testicle

(B) the normal head of the epididymis

(C) the mediastinum

(D) seminoma

(E) testicular torsion

Image

FIGURE 5–6. Magnified longitudinal scan of the right testis.

18Fig. 5–7 is a longitudinal scan through a male pelvis. What is the arrow pointing to in the image?

(A) prostate

(B) seminal vesicle

(C) prostatic urethra

(D) membranous urethra

(E) urethra

Image

FIGURE 5–7. Longitudinal scan through a normal male pelvis.

19. A young male patient presents with left testicular pain. A scan of his testicles is performed. What is the arrow in Fig. 5–8 pointing to?

(A) a spermatocele

(B) an epididymal cyst

(C) a cryptorchidism

(D) a varicocele

(E) the mediastinum

Image

FIGURE 5–8. Longitudinal scan through the left testis.

20. Which of the following connects the two lobes of the thyroid?

(A) sternothyroid muscle

(B) common carotid artery

(C) trachea

(D) isthmus

(E) lower poles

21. Parathyroid adenomas may be associated with which of the following?

(A) hypercalcemia

(B) hypertension

(C) bloating

(D) acne

(E) headaches

22. What is the most common congenital cause of urinary tract obstruction in males?

(A) ureteropelvic junction obstruction (UPJ)

(B) posterior urethral valve (PUV)

(C) infantile polycystic kidney disease

(D) undescended testis

(E) duplex collecting system