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POCUSFest 2019

Total questions: 20

Worksheet time: 20mins

Name
Class
Date
1.

A 67 yr male pt with a history of smoking had concerns about AAA. A AAA screening exam was performed. Here is one of the required transverse view through the abdominal aorta. At what level was this view obtained through the abdominal aorta?

a)

Upper abdominal aorta

b)

Middle abdominal aorta

c)

Lower abdominal aorta

d)

Abdominal aorta bifurcation

2.

A 67-year-old asymptomatic male patient presents to the outpatient clinic for a routine physical exam. He has a history of 30 pack years of smoking. The primary care physician performs a AAA screen on the patient. The following view was obtained at the level of the lower abdominal aorta. Which of the following is the correct diagnosis?

a)

Simple cyst

b)

Saccular aneurysm of the abdominal aorta

c)

Fusiform aneurysm of the abdominal aorta

d)

renal artery seen

3.

A family medicine resident performed a AAA screening as part of POCUS training in the OPD. He was not sure about where to place the calipers for measuring the abdominal aorta diameter. So, he performed three measurements of the abdominal aorta diameter as shown in the picture below. Which is the most accurate measurement?

a)

1.19 cm

b)

2.14 cm

c)

1.82 cm

d)

All are acceptable

4.

A 30yr male patient was involved in a high speed vehicle collision. On physical exam in the ER, he has multiple bruises on the chest and abdomen, is conscious, but is in distress. An eFAST exam was performed. This view was obtained in the left upper quadrant. Which of the following labels represents free fluid in the peritoneal cavity?

a)

A

b)

B

c)

C

d)

D

5.

A 35-year-old female patient presented to the Emergency Department with a chief complaint of dyspnea and mild chest pain. There is no history of fever or night sweats. The ultrasound fellow performed a quick PLAX view of the heart. The following view was obtained. What is the most likely diagnosis?

a)

Pericardial effusion

b)

Ascites

c)

Pleural effusion

d)

Pericardial effusion and pleural effusion

6.

A 52yr male patient underwent a POCUS exam to rule out gallstones. The gallbladder showed normal distension and the wall was not thickened. No pericholecystic fluid was seen. No evidence of gallstone or sludge was seen within the lumen of the gallbladder. An anechoic well defined circular cystic lesion was seen within the liver parenchyma. What is the most likely diagnosis?

a)

Liver hemangioma

b)

Anechoic free fluid in the Morison’s pouch

c)

Dilated hepatic vein

d)

Simple cyst of the liver

7.

A 67yr male pt came to the ED with a loss of vision in one eye. The pt did not complain of any pain and there is no history of trauma or injury. There is a history of Myopia and he is hypertensive, but takes an antihypertensive regularly. An ultrasound exam was performed using the ophthalmology preset. What is the diagnosis?

a)

Foreign body in the eye

b)

Vitreous hemorrhage

c)

Displaced intraocular lens

d)

Retinal detachment

8.

A construction worker was brought to the ED by his coworkers after falling from a roof. The patient is in distress and has multiple bruises all over his body. He complains of tenderness on his right anterior upper chest region. A POCUS e-FAST exam was performed. What are the sonographic findings consistent with?

a)

Free fluid in the abdominal cavity

b)

Anechoic pericardial effusion

c)

Free fluid in the pleural cavity on the right side with a positive spine sign

d)

Free fluid in the pleural cavity with a negative spine sign

9.

A 55yr male pt presented to the OPD with a history of wheezing for the past 24 hrs. He smokes one pack of cigarettes/day. He has no history of trauma, fever, or chest pain. A lung ultrasound was performed. The following was one of the views obtained in the right anterior upper chest using M-mode. What is this sign known as?

a)

Seashore sign

b)

Jellyfish sign

c)

Shred sign

d)

Stratosphere sign or the barcode sign

10.

A 45 yr female presents to the OPD with history of right upper quadrant pain for the past 6 months. No history of trauma or surgery. She also complains that she cannot tolerate fatty food. The image is one of the images obtained during the ultrasound exam. What is the most likely diagnosis?

a)

Gallstones without acoustic shadow artifact

b)

Chronic cholecystitis

c)

Multiple gallstones with acoustic shadow artifact

d)

Acute cholecystitis

11.

A 65-year-old female patient was diagnosed to have multiple gallstones. The resident performed a follow up scan and activated color Doppler and positioned the color Doppler box in the region of the gallstones. The gallstones showed some color Doppler signal. This is known as...?

a)

Twinkle artifact

b)

Color Doppler bleeding artifact

c)

Aliasing

d)

Color Doppler color enhancement

12.

A POCUS exam was performed to examine the kidneys, ureters and bladder in a 45-year-old male patient who presented with recurrent urinary tract infection. Bladder and right kidney were normal sonographically. Below is the picture obtained while scanning the left kidney in the transverse section. What is the most likely diagnosis?

a)

Acute pyelonephritis

b)

Simple renal cysts

c)

Renal tumor

d)

Polycystic kidney disease

13.

A 45yr male patient with history of trauma to the left chest and there is bruising seen. A POCUS exam was performed to look for evidence of pneumothorax and or left sided hemothorax/free fluid in the chest cavity. The following image shows anechoic free fluid in the left chest cavity. Which letter corresponds to the free fluid in the chest?

a)

A

b)

B

c)

C

d)

D

14.

An 85yr male patient with a history of abdominal discomfort and distension over the past 2 days. He is a known case of liver cirrhosis but was being managed conservatively. He does not give any history of fall or trauma to the chest or abdomen. The following image was obtained in the right flank region. What is the most likely diagnosis?

a)

Intestinal obstruction

b)

Anechoic free fluid in the Morison’s pouch

c)

Ascites

d)

Hyperechoic/echogenic free fluid seen

15.

A 25yr female patient was brought to the ED after a road traffic accident. A quick eFAST POCUS exam was performed. The following image was obtained while performing one of the views of the eFAST exam. The view obtained is a transabdominal view of the pelvic region in the mid-sagittal plane. The image shows:

a)

Hydrosalpinx

b)

Anechoic free fluid present in the Pouch of Douglas and extending superior to the fundus of the uterus into the pelvic cavity

c)

Ovarian cyst

d)

Normal physiological free fluid in the pelvic region

16.

A 55yr male patient presented to the ED with sudden onset of dyspnea for the past 4 hours. A known smoker with a 40yr history. No history of trauma and is not a known asthmatic. The following image was obtained with the patient supine in the right upper anterior region (Zone 1). Which of the following is most accurate?

a)

Pneumothorax is the most likely diagnosis unless ruled out

b)

Lung point seen

c)

Normal seashore sign is seen

d)

Pleural effusion is present

17.

A 65-year-old male patient presents to the emergency department with a history of recurrent UTI and lower abdomen discomfort for the past 3 years. The ultrasound fellow performed a POCUS bladder scan to rule out bladder pathology. The following image was obtained in the transverse plane. What is the most likely diagnosis?

a)

Free fluid in the pelvic cavity

b)

Cysts

c)

Bladder diverticulum/ diverticula

d)

Bladder stones

18.

A 45yr male patient presented with a history of back pain for the past 3 yrs. No history of trauma or surgery. A scan of his kidneys was completed to rule out renal pathology. The following image is obtained on ultrasound of his right kidney in the longitudinal plane of his kidney. What is the most likely diagnosis?

a)

Renal cysts

b)

Multiple large renal calculi possible Staghorn calculus

c)

Hydronephrosis

d)

Bowel gas

19.

A 25-year-old male athlete presents to the clinic for a routine physical exam. There is no significant medical history. The physician performed a quick basic echo of his heart. The following PLAX view was obtained. What is the most likely diagnosis?

a)

Normal PLAX view

b)

Dilated left atrium

c)

Dilated right ventricle

d)

Concentric LVH

20.

A 45-year-old obese female patient was brought to the emergency department with a history of right upper quadrant pain. A quick POCUS exam was performed to rule out pathology in the right upper quadrant. Ultrasound Murphy’s sign was negative. The following view was obtained. What is the most accurate diagnosis?

a)

Acute acalculous cholecystitis

b)

Gangrenous calculous cholecystitis

c)

Normal gallbladder with artifacts

d)

Chronic acalculous cholecystitis