Liver Sonography by Duplex and Color Doppler

E. renal vein thrombosis

11. An important and specific sonographic finding in patients with portal hypertension is the presence of

A. coronary vein thrombosis

B. hepatofugal flow in the hepatic artery

C. portosystemic collaterals

D. hepatopetal flow in the splenic vein

E. portal vein thrombosis

12. In patients with portal hypertension, normally existing collaterals include all of the following veins EXCEPT

A. coronary

B. paraumbilical

C. inferior mesenteric

D. short gastric

E. superior mesenteric

13. Because of improvements in technology, the coronary vein can be seen in some normal patients, however, its diameter should be

A.  6 mm and flow should be hepatofugal

B.  6 mm and flow should be hepatopetal

C.  6 mm and flow should be bi-directional

D. > 6 mm and flow should be hepatofugal

E. > 6 mm and flow should be hepatopetal

14. In patients with portal hypertension, high velocities in the left renal vein would be an indirect sign of which of the following shunts

A. porto-portal

B. spleno-retroperitoneal

C. paraumbilical

D. spleno-renal

E. hepato-adrenal

15. An example of an inflammatory cause of portal vein thrombosis would be

A. anti-phospholipid antibody syndrome

B. antithrombin II deficiency

C. hepatocellular carcinoma

D. polycythemia vera

E. pancreatitis

16. If a thrombus is identified within the portal vein, the presence of ________ within the thrombus is very specific for a malignant thrombus.

A. a monophasic waveform

B. a bi-directional flow

C. an absence of flow

D. low amplitude “D” and “S” waves

E. a hepatofugal arterial signal

17. Patients with portal vein thrombosis and cavernous transformation not only develop portosystemic collaterals, but also develop ________ collaterals.

A. porto-portal

B. hepato-adrenal

C. paracholedochal

D. spleno-renal

E. paraumbilical

18. The type of Budd-Chiari syndrome that is more common in underdeveloped countries such as Nepal, China, South Africa, India, and Japan is

A. inferior vena cava thrombosis

B. compression of the hepatic veins from a neoplasm

C. mechanical obstruction of the hepatic veins

D. compression of the hepatic veins from an abscess

E. hepatic vein thrombosis

19. All of the following are examples of secondary causes of Budd-Chiari Syndrome EXCEPT

A. compression of the hepatic veins by hepatocellular carcinoma

B. mechanical obstruction of the hepatic veins by an abscess

C. hepatic vein thrombosis caused by protein S deficiency

D. compression of the hepatic veins by renal cell carcinoma

E. mechanical obstruction of the hepatic veins from a hydatid cyst.

20. When scanning a patient in the setting of chronic Budd-Chiari syndrome, it is also important to examine the ________ of the liver, which frequently has enlarged veins that drain directly to the inferior vena cava.

A. portal vein portion

B. left lobe

C. right lobe

D. caudate lobe

E. hepatic artery portion