E-Book, Englisch, 176 Seiten, ePub
Dawkins Ultrasound Q&A Review for the Boards
1. Auflage 2020
ISBN: 978-1-63853-456-3
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 176 Seiten, ePub
ISBN: 978-1-63853-456-3
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
by esteemed radiologist and educator Adrian Dawkins and an impressive array of authors, delivers a robust test prep. Employing a self-evaluation approach, the book presents fundamental and practice-oriented concepts in ultrasound.
The overall layout mirrors the ABR board exams, with ultrasound images presented in a clinical framework followed by board-format multiple-choice questions. Chapters are generally organized by organ systems and encompass all major areas. The text starts with two chapters covering the first and second trimesters of pregnancy. Subsequent chapters encompass pediatric, renal, hepatobiliary, musculoskeletal, breast, neck, and scrotal ultrasound. The final two chapters on miscellaneous topics and physics ensure a more comprehensive review.
Key Features
- Easy-to-follow cases reinforce common ultrasound concepts, aiding in retention
- Practical questions and answers inspired by everyday practice include explanations for both the correct and incorrect answers, enhancing comprehension and knowledge
- References at the end of each chapter provide readers with resources for further exploration
This book provides an essential review for radiology trainees prepping for initial board certification and sonographers preparing for the boards.
This book includes complimentary access to a digital copy on https://medone.thieme.com.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
1. Gynecology and First Trimester Obstetrics
2. Second Trimester Obstetrics
3. Pediatrics
4. Renal
5. Hepatobiliary
6. Musculoskeletal
7. Breast
8. Neck
9. Scrotum
10. Miscellaneous
11. Physics
Chapter 1 | Gynecology and First Trimester Obstetrics |
1 Questions and Answers
Question 1.1: The Society of Radiologists in Ultrasound (SRU) Consensus Conference statement, published in in September 2010, addresses adnexal cysts in which group of women?
A. Symptomatic pregnant women.
B. Asymptomatic nonpregnant women.
C. Symptomatic premenopausal women.
D. Asymptomatic postmenopausal women.
Answer:
B. Correct. The SRU Consensus statement addressed lesions in asymptomatic nonpregnant women, both pre- and postmenopausal. While the recommendations may be useful in symptomatic women, the overall clinical picture should help steer management in these patients.
A, C, D—Incorrect. Asymptomatic nonpregnant women are addressed.
Question 1.2: What precise cyst measurement should be used to guide management of adnexal cysts according to the SRU Consensus statement ( 2010)?
A. Maximum diameter in the sagittal plane.
B. Maximum diameter in the transverse plane.
C. Mean diameter.
D. Maximum diameter in any plane.
Answer:
D. Correct. The maximum diameter in any plane was chosen, since measurements in all three planes may be altered by pressure created by the endocavitary vaginal transducer.
A, B, C—Incorrect. The maximum diameter in any plane is used.
Question 1.3: These images were obtained in a 28-year-old female with abdominal pain. What is the likely cause for this appearance?
A. Endometriosis.
B. Ovarian hyperstimulation.
C. Molar pregnancy.
D. Ectopic pregnancy.
Answer:
A. Correct. The images demonstrate bilateral tubular fluid-filled structures within the adnexa. Also, tiny projections (), due to longitudinal folds, can be seen protruding into the lumen. This has been described as the “cogwheel sign” and is typical of hydrosalpinx. Of the choices, endometriosis best explains the presence of bilateral hydrosalpinges.
B. Incorrect. Enlarged ovaries are seen in ovarian hyperstimulation.
C. Incorrect. Enlarged ovaries containing theca lutein cyst may be present in cases of molar pregnancy.
D. Incorrect. An ectopic pregnancy would not typically result in this appearance.
Question 1.4: A 54-year-old postmenopausal female undergoes a pelvic ultrasound due to an incidental left ovarian finding on computed tomography (CT). Which statement regarding management of this finding is correct?
A. No follow-up is required.
B. Follow-up in 1 year is recommended.
C. Pelvic magnetic resonance imaging (MRI) is recommended for better characterization.
D. None of the above.
Answer:
A. Correct. Recently published updated guidelines by the Society of Radiologists in Ultrasound (SRU) suggest that simple cysts in asymptomatic postmenopausal females require no follow-up if less than or equal to 3cm in size.
B. Incorrect. No follow-up is recommended.
C. Incorrect. Pelvic MRI may be of value for larger cysts if deemed to be not well-evaluated with ultrasound.
D. Incorrect. No follow-up is recommended.
Question 1.5: A 25-year-old woman presents with irregular menstrual bleeding and undergoes a pelvic ultrasound. A lesion is found within her right ovary. Which statement is correct?
A. The appearance is consistent with an endometrioma.
B. The appearance is consistent with a hemorrhagic cyst.
C. The appearance is consistent with a peritoneal inclusion cyst.
D. The appearance is consistent with a dermoid.
Answer:
D. Correct. The image demonstrates a complex cyst with an echogenic focus within the inferior aspect, toward the left of the image, consistent with fat. Short horizontal dash-like echogenic foci are also noted as well as tiny echogenic dots throughout the lesion. This had been described as the “dot-dash sign.” The findings are classic for an ovarian dermoid cyst.
A. Incorrect. An endometrioma is characterized by homogenous low-level echoes.
B. Incorrect. The typical hemorrhagic cyst demonstrates a mesh-like pattern.
C. Incorrect. A peritoneal inclusion cyst is fairly simple in morphology but conforms to the surrounding pelvic structures.
Question 1.6: Which statement best represents the appropriate management of the lesion seen in (Question 1.5)?
A. This lesion should be aspirated and sent for cytologic analysis.
B. A trial of danazol should be initiated.
C. No follow-up is required.
D. Repeat ultrasound in 6 months to 1 year.
Answer:
D. Correct. A dermoid should initially be re-evaluated with follow-up ultrasound in 6 months to 1 year to document stability. There is a very small risk (1%) of malignant transformation albeit in larger dermoids.
A. Incorrect. Aspiration of cystic ovarian lesions is generally avoided since the yield of useful diagnostic material is very low. There is also the risk of peritoneal seeding.
B. Incorrect. Danazol is a synthetic steroid, used to treat endometriosis.
C. Incorrect. A dermoid should initially be re-evaluated with follow-up ultrasound in 6 months to 1 year to document stability.
Question 1.7: Regarding early pregnancy, which statement is correct?
A. A nonviable pregnancy can be confirmed transabdominally if the crown–rump length measures at least 10 mm and no cardiac activity is detected.
B. A positive serum pregnancy test is defined as a beta human chorionic gonadotropin (HCG) value of 3 mIU/mL and above.
C. A pregnancy of unknown location is defined as one in which there is a positive serum or urine pregnancy test, with no discernible intrauterine gestational sac or sonographic evidence of an ectopic on a transvaginal scan.
D. A nonviable pregnancy is defined as one which has not yet reached 26 weeks gestation.
Answer:
C. Correct. A pregnancy of unknown location is defined as one in which there is a positive serum or urine pregnancy test, with no discernible intrauterine gestational sac or sonographic evidence of an ectopic on a transvaginal scan.
A. Incorrect. A nonviable pregnancy can be confirmed transabdominally if the crown–rump length measures at least 15 mm and no cardiac activity is detected.
B. Incorrect. A positive serum pregnancy test is defined as a beta HCG value of 5 mIU/mL and above.
D. Incorrect. A nonviable pregnancy is defined as one which has no chance of resulting in a liveborn child, for example, an ectopic pregnancy.
Question 1.8: A 32-year-old patient presents with sharp left-sided pelvic pain and a positive urine beta HCG. A pelvic ultrasound is performed. Given the sonographic findings and patient symptoms, what is the likelihood of an ectopic pregnancy?
A. 1 in 30,000.
B. 1 in 3,000.
C. 1 in 300.
D. 1 in 30.
Answer:
A. Correct. The image demonstrates the normal appearance of an early intrauterine pregnancy (IUP). The presence of an ectopic pregnancy in conjunction with an IUP, that is a heterotopic pregnancy, is very unlikely occurring in 1 in 30,000 pregnancies.
B, C, D—Incorrect. A heterotopic pregnancy occurs in 1 in 30,000 pregnancies.
Question 1.9: If the image in (Question 1.8) represents a normal early pregnancy, which structure should develop next?
A. Yolk sac.
B. Amnion.
C. Fetal pole.
D. Gestational sac.
Answer:
A. Correct. The yolk sac is the first structure to...
