CPSS EXAM #1 (POCUS PICS) 53 Questions with Verified Answers
Small Bowel Obstruction (SBO)
Interpretation: Anechoic (Black) lesions with thickened
... [Show More] bowel walls and posterior enhancement; suggestive of SBO - CORRECT ANSWER An US of the abdomen reveals the finding in the picture, what is the likely diagnosis?
Benign Cyst
Interpretation: Anechoic (black) lesion with posterior enhancement artifact (White patch after lesion) suggests that this cavity is fluid filled; suggestive of a cyst. - CORRECT ANSWER An US of the breast reveals the finding in the picture, what is the likely diagnosis?
Posterior Enhancement Artifact (Acoustic Enhancement)
NORMAL finding - CORRECT ANSWER What artifact is seen in the US?
Posterior Shadowing Artifact (Acoustic Shadowing)
NORMAL finding - CORRECT ANSWER What artifact is seen in the US?
Edge Artifact
NORMAL finding - CORRECT ANSWER What artifact is seen in the US?
A-Lines (Reverberation artifact)
NORMAL finding
lungs - CORRECT ANSWER What artifact is seen in the US?
Mirror Image Artifact (Reverberation artifact)
NORMAL finding
Liver - CORRECT ANSWER What artifact is seen in the US?
Ringdown artifact (B-Lines)
Note: These are the vertical hyperechoic lines noted in the US; indicates pulmonary edema - CORRECT ANSWER What artifact is seen in this US of the lungs?
Normal US of kidney
Renal capsule: Hyperechoic
Renal pyramids: Anechoic/hypoechoic
Collecting system (Pelvis): Hyperechoic - CORRECT ANSWER What is shown on this US of the kidneys?
Mild to moderate hydronephrosis
Renal sinus is not hyperechoic, but shows dilated anechoic regions. - CORRECT ANSWER What is shown on this US of the kidneys?
Normal US of the bladder
Bladder lining: Hyperechoic
Internal bladder: Anechoic - CORRECT ANSWER What is shown on this US of the Bladder?
Normal US of the uterus
Note endometrial strip - CORRECT ANSWER What is shown on this longitudinal view of the uterus?
Normal US of the uterus
Note hyperechoic horizontal line that is representive of the endometrial strop - CORRECT ANSWER What is shown on this transverse view of the uterus?
Intrauterine pregnancy!
Fetal pole in a yolk sac; presence of this excludes ectopic pregnancy unless on IVF - CORRECT ANSWER What is shown on this longitudinal view of the uterus?
Subxiphoid view
Great to analyze for pericardial effusion or standstill - CORRECT ANSWER What view of the heart is shown in this US?
Pericardial effusion - CORRECT ANSWER What is shown on this US - subxiphoid view of the heart?
Parasternal Short Axis (PSAX) "doughnut view"
Note: Abdominal marker should be at either 10 or 4 o'clock position - CORRECT ANSWER What view of the heart is shown in this US?
Parasternal Long Axis (PSLAX)
Note: Abdominal marker should be at either 10 or 4 o'clock position - CORRECT ANSWER What view of the heart is shown in this US?
Apical 4 chamber view (A4C)
Note: Place in left lateral decubitus position with marker at 3 or 9 oclock position; right side of heart is on left side of screen - CORRECT ANSWER What view of the heart is shown in this US?
Normal variant longitudinal view of the gallbladder
Phrygian Cap: Single fold at the fundus (Right of image)
Hatmann's Pouch: Single fold at the neck (Left of image) - CORRECT ANSWER What 2 structures are shown in this US?
Normal variation of gallbladder anatomy
Hyper-echoic invaginations are gallbladder folds and are more susceptible to lodge gallstones - CORRECT ANSWER What is shown in this US?
Gallstones
Hyperechoic dependent masses with posterior shadowing; stones should move when rolling the pt - CORRECT ANSWER What is shown in this US?
"Wall echo sign" suggesting gallbladders are completely full of gallstones - CORRECT ANSWER What is shown on these US?
Gallbladder polyp
Small isoechoic mass within the gallbladder lumen. May present with a visible stock. Immobile and without posterior shadowing. - CORRECT ANSWER What is shown on this transverse image of the gallbladder?
Gallbladder wall thickness without gallstones (>3mm)
Wall is less hyper-echoic with mixed echogenicity indicating wall edema - CORRECT ANSWER What is shown on this US?
Gallbladder sludge
Hypo-echoic mass that collects on the dependent aspect of the gallbladder lumen and moves slowly with position change - CORRECT ANSWER What is shown on this US?
B-Lines (Ringdown artifacts)
Indicative of pulmonary edema
Note: Need 3-5 lines for pathological diagnosis - CORRECT ANSWER What is shown on this US of the lungs?
Barcode sign
All the hyper-echoic lines are static lung tissue, indicating a pneumothorax or Lack of lung sliding - CORRECT ANSWER What is shown on this US of the lungs?
Note: The probe is in "M-mode"
Lung point
The point where the normal "Seashore sign"(Left of image) of the lung meets the "Barcode sign"(Right of image), identifying the exact location of the pneumothorax.
Remember barcode sign = pneumothorax
seashore sign = normal lung - CORRECT ANSWER What is shown on this US of the lungs?
Note: The probe is in "M-mode"
"Seashore sign" indicated NORMAL tissue - CORRECT ANSWER What is shown on this US of the lungs?
Note: The probe is in "M-mode"
Aortic dissection - CORRECT ANSWER What is shown on this US of the Aorta?
Cellulitis
"Cobblestone appearance" - CORRECT ANSWER What is shown on this US of the skin?
Normal anatomy
Largest anechoic circle on the right = basilic vein
Two mixed echoic ("Honecombing") areas to the left of the basilic vein = median and ulnar nerve
middle anechoic circle = Brachial artery
Two anechoic circles surrounding breachial artery = Brachial veins - CORRECT ANSWER What is shown on this US of the skin?
Necrotizing fasciitis
-Mainly on patient presentation - Pain out of proportion to the area
-Edematous anechoic areas found with hyperechoic collections which are air pockets from the bacteria
Surgical emergency! - CORRECT ANSWER What is shown on this US of the skin?
Abscess
-Borders are not clear or round, so unlikely to be cyst
-Internal hyperechoic regions that correlate with pus formation
-Mixed echogenecity throughout entire region - CORRECT ANSWER What is shown on this US of the skin?
Solid mass - likely a swanoma
-Heterogenous echogenecity throughout region, all 1 density - CORRECT ANSWER What is shown on this US of the skin?
Normal lymph node - CORRECT ANSWER What is shown on this US of the skin?
Glass!
looking underneath the foreign body, there is a reverberation artifact. so technically it could also be anything else that causes reverberation artifacts. - CORRECT ANSWER What could the foreign body be made of in this US?
1. Cornea
2. Anterior chamber
3. Cilary bodies
4. Lens
5. Vitreous chamber
6. Posterior wall (Retina, Choroid, Sclera)
7. Optic nerve
8. Periorbital fat
9. Optic disc - CORRECT ANSWER What are the anatomical structures associated with each number on this US of the eye?
Periorbital abscess
Located in the left upper corned of the image. - CORRECT ANSWER What is shown on this US of the eye?
Periorbital cellulitis and Posterior abscess
-Cobble-stoning in the upper portion of the image.
-Abscess behind the orbit, distorting normal anatomy of the eye - CORRECT ANSWER What is shown on this US of the eye?
Retinal detachment
The retina is the white strand in the middle of the image... it shouldn't be there
Note: can see this move in real time if you ask the patient to look in different directions - CORRECT ANSWER What is shown on this US of the eye?
Retina detachment = "V" shaped form, following the optic nerve and anchored a the optic nerve sheath
Choroid detachment = Not shape or form, does NOT follow optic nerve - CORRECT ANSWER How can we tell this image is a detached retina, as opposed to a choroid detachment?
Parasternal short axis view (PSAX)
Note: The mitral valve is visible here - CORRECT ANSWER What view is this of the heart?
Apical 4 chamber view - CORRECT ANSWER What view is this of the heart?
Subxiphoid view - CORRECT ANSWER What view is this of the heart?
Parasternal Long axis view (PSLAX) - CORRECT ANSWER What view is this of the heart?
B lines
Indicates pulmonary edema - CORRECT ANSWER What is shown on this US of the lungs?
Gallstones
Posterior shadowing noted after hyperechoic areas - CORRECT ANSWER What is shown on this US of the gallbladder?
"Wall echo sign"
Indicates a gallbladder completely full with stones - CORRECT ANSWER What is shown on this US of the gallbladder?
Actue cholecystitis
-Thickened wall (>3mm)
-Sludge present with gallstones
-Pericholecystic fluid noted - CORRECT ANSWER What is shown on this US of the gallbladder?
Enlarged prostate
Note: left image is transverse, right is long - CORRECT ANSWER What is shown on this US of the bladder?
Enlarged prostate
Note: left image is transverse, right is long - CORRECT ANSWER What is shown on this US of the bladder? [Show Less]