Deck 10: Gallbladder and the Biliary System

Question 1

In cases of choledocholithiasis, stones tend to lodge in the:

A) pancreatic duct.
B) common bile duct.
C) ampulla of Vater.
D) common hepatic duct.

Answer 1

C

Question 2

Which one of the following is a function of the gallbladder?

A) Storage for extra cholesterol
B) Storage for enzymes
C) Reservoir for bile
D) Reservoir for biliary salts

Answer 2

C

Question 3

Inflammation of the gallbladder is known as:

A) cholecystitis.
B) choledocholithiasis.
C) cholesterosis.
D) adenomyomatosis.

Answer 3

A

Question 4

Thickening of the gallbladder wall may be caused by all of the following except:

A) hepatitis.
B) pancreatitis.
C) adenomyomatosis.
D) cholecystitis.

Question 5

The cystic duct connects the _________ of the gallbladder with the common hepatic duct to form the ___________.

A) fundus; common hepatic duct (CHD)
B) fundus; common bile duct (CBD)
C) neck; CBD
D) body; CHD

Question 6

A gallbladder with a small outpuch at the neck is called a:

A) Murphy pouch.
B) Phyrgian cap.
C) Hartmann pouch.
D) Murphy sign.

Question 7

The normal diameter of the common hepatic duct is approximately ________ millimeters (mm).

A) 2
B) 3
C) 4
D) 5

Question 8

In a 50-year-old adult, the normal common bile duct should not measure more than _____ mm.

A) 5
B) 6
C) 8
D) 10

Question 9

The right and left hepatic ducts emerge from the right lobe of the liver in the porta hepatis and unite to form the:

A) common hepatic duct.
B) cystic duct.
C) common bile duct.
D) common pancreatic duct.

Question 10

The common bile duct is joined by the main pancreatic duct. Together they open through the _____________________ into the duodenal wall.

A) ampulla of Oddi
B) ampulla of Water
C) ampulla of Vater
D) ampulla of Santorini

Question 11

A Phrygian cap of the gallbladder is:

A) partial septation.
B) calcification of the gallbladder wall.
C) septations within the organ.
D) folding of the gallblabber fundus.

Question 12

The distal duct lies ___________ with the anterior wall of the inferior vena cava (IVC).

A) parallel
B) perpendicular
C) lateral
D) horizontal

Question 13

Gas-forming bacteria in the gallbladder appear on ultrasound as a:

A) dilated round shape.
B) nonshadowing echogenic mass.
C) localized dilation.
D) bright echo with a ring down or comet-tail artifact.

Question 14

The hepatic duct is joined by the ______________ to form the ________________.

A) pancreatic duct; cystic duct
B) cystic duct; common bile duct
C) common bile duct; cystic duct
D) right hepatic duct; common bile duct

Question 15

A condition causing RUQ pain in which small polypoid masses arise from the gallbladder wall demonstrating "comet tail" artifact is:

A) choledocholithiasis.
B) cholesterosis.
C) adenomyomatosis.
D) pruritus.

Question 16

A positive Murphy sign is a clinical finding associated with:

A) cholelithiasis.
B) cholecystitis.
C) porcelain gallbladder.
D) adenomyomatosis.

Question 17

Which one of the following describes the most common sonographic appearance of gallbladder carcinoma?

A) "Comet tail" shadowing posterior to a hypoechoic focus
B) Irregular echogenic mass projecting from the gallbladder wall
C) Shadowing posterior to mobile echogenic mass
D) Comet tail shadowing posterior to a hyperechoic focus

Question 18

The bright linear echo within the liver connecting the neck of the gallbladder and the right or main portal vein is called the:

A) right lobar fissure.
B) main lobar fissure.
C) ligamentum teres.
D) left lobar fissure.

Question 19

A fusiform dilation of the common bile duct is known as:

A) a choledochal cyst.
B) adenomyomatosis.
C) cholangitis.
D) a Phrygian cap.

Question 20

Classic symptoms of gallbladder disease include all of the following except:

A) hematuria.
B) right upper quadrant pain.
C) right shoulder pain.
D) nausea and vomiting.

Question 21

A thick calcified gallbladder wall describes which one of the following conditions?

A) Wall-echo-shadow (WES) sign
B) Gangrenous gallbladder
C) Porcelain gallbladder
D) Emphysematous gallbladder

Question 22

The physiologic effect of a fatty meal includes all of the following except:

A) stimulation of cholecystokinin (CCK).
B) contraction of the gallbladder.
C) decreased bile flow to the liver.
D) relaxation of the sphincter of Oddi.

Question 23

Which one of the following best describes nonshadowing, low-amplitude echoes in a dependent gallbladder?

A) Cholelithiasis
B) Porcelain gallbladder
C) Cholecystitis
D) Sludge

Question 24

The most common cause of biliary ductal obstruction is the presence of a ductal:

A) cyst.
B) tumor.
C) stone.
D) stricture.

Question 25

All of the following sonographic appearances are found in cases of gallbladder carcinoma except:

A) pericholecystic fluid.
B) wall thickening.
C) cholelithiasis.
D) intraluminal wall mass.

Question 26

The most common tumor sites that can spread carcinoma to the biliary tree include all of the following except:

A) colon.
B) breast.
C) melanoma.
D) kidney.

Question 27

Air within the biliary tree, secondary to common bile duct stents, is called:

A) pneumobilia.
B) hemobilia.
C) pneumothorax.
D) cholangitis.

Question 28

The sonographic appearance of cholelithiasis is best described as:

A) nonshadowing, mobile, hyperechoic focus.
B) mobile, hyperechoic focus demonstrating posterior shadowing.
C) immobile, echogenic focus demonstrating a comet-tail artifact.
D) mobile, hypoechoic focus demonstrating posterior shadowing.

Question 29

Patients positive for AIDS are at risk for developing:

A) hepatitis.
B) cholangitis.
C) pancreatitis.
D) nephritis.

Question 30

The valves of Heister are tiny valves found within the:

A) cystic duct.
B) common bile duct.
C) pancreatic duct.
D) common hepatic duct.