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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5775_Библиотеки_им_академика_М_И_Перельмана
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23.ColorandduplexDopplersonographyofatransjugularintrahepaticportosystemicshunt(TIPS)was
performedforroutinefollow-up.Whatisthemostlikelydiagnosis?
A.NormalTIPS
B.Hepaticveinstenosis
C.TIPSstenosis,portalend
D.TIPSstenosis,hepaticend
E.TIPSocclusion
24. High-resolution ultrasound images from rightforearm ofa 55-year-old womanwith erythema and
edemaintherightforearmareshown.Whatisthemostlikelydiagnosis?
A.Superficialthrombophlebitis
B.Cellulitis
C.Acutedeepvenousthrombosis(DVT)
D.Anteriorinterosseousnervesyndrome(Kiloh-Nevinsyndrome)
25.Rightupperquadrantultrasoundshowingtransverseandlong-axisimagesofinferiorvenacavaina
56-year-oldwomanwithabdominalpainareprovided.Whatisthemostlikelydiagnosis?
A.Severetricuspidregurgitation(becauseofdilatedIVCandhepaticveins)
B.Cranialextensionofblandpelvicorlowerlimbdeepvenousthrombosis
C.MigrationofaninfrarenalIVCfilterintoretrohepaticportionofinferiorvenacava
D.Leiomyosarcomaofinferiorvenacava
26.ShownhereareduplexDopplerultrasoundimagesofa40-year-oldwomanundergoingpreoperative
evaluation fora pancreaticheadneuroendocrinetumor. The images showspectralwaveformsofceliac
axisduringexpirationandinspiration.Whatisthenextbeststepinmanagementofthispatient?
A. The increased peak systolic velocity of celiac axis in expiration suggests collateral flow
through celiac axis to compensate for severe stenosis or occlusion of superior mesenteric
artery.PatientneedsstentingofSMA.
B.Theincreasedpeaksystolicvelocityintheceliacaxisconfirmsmalignantinfiltrationofceliac
axisbythe pancreatictumor contraindicatingWhipple procedure.Patientisonlyeligiblefor
medicalmanagement.
C.Theincreaseddiastolicflowintheceliacaxisonexpirationissuggestiveofproximalaortic
stenosis.Patientneedstoundergoplacementofanaorticendovascularstentgraft.
D. The findingsarecharacteristicofmedianarcuate ligament compressionofceliac axis. This
patientcanbenefitfromsurgicalreleaseofmedianarcuateligament.
27.A30-year-oldfemalepresentswithgraduallyworseningleftlowerextremitypainandburning.Her
symptomsfirstbeganin2011,andshedecidedtoseekmedicalattentionin2014whenshestartedhaving
greatdifficultywalking.Thepatientunderwentultrasound,whichpromptedsubsequentMRI.Imagesfrom
bothstudiesareshown.Whatisthemostlikelyetiologyofhersymptoms?
A.Giantcellarteritis
B.Takayasuarteritis
C.Polyarteritisnodosa(PAN)
D.Granulomatosiswithpolyangiitis(GPA)
28. Alower extremity venous Doppler studywas performed. Theleft commonfemoral vein spectral
Dopplerwaveformisnotedtobemonophasic,whereastherightcommonfemoralveinspectralDoppler
waveformisphasic.Whatisthesignificanceofthisfinding?
A.Deepveinthrombosisissuspectedupstreamtotheleftcommonfemoralvein.
B.Deepveinthrombosisissuspectedwithinintheleftcommonorexternaliliacvein.
C.Deepveinthrombosisissuspectedwithinintherightcommonorexternaliliacvein.
D.Thisisanexpectednormalfindingonlowerextremityultrasoundexaminations.
29. Ultrasoundimagingofthe leftcalfshowedan expanded, noncompressibleleft gastrocnemiusvein.
Howshouldthisfindingbereported?
A.Positivefordeepveinthrombosis.
B.Negativefordeepveinthrombosis.
C.Positiveforsuperficialthrombophlebitis.
D.Negativeforsuperficialthrombophlebitis.
E.Indeterminatefordeepveinthrombosis.FurtherimagingwithMRVisadvised.
30. A 50-year-oldpatientwith a carotid bruitwasreferredforaneck ultrasoundafteranabnormality
was detectedonthecarotidarteryDoppler.Images froma neckultrasound,aT1-weightedgadoliniumenhancedaxialMRIatthelevelofthelesion,andadigitalsubtractionangiogramafterinjectionintothe
commoncarotidarteryareprovided.Whatisthemostlikelycauseofthebruit?
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