1
← Back to quizzesFree quiz
Ultrasound Diagnostic Findings
Ultrasound is a bedside, radiation‑free tool that can rapidly answer critical clinical questions. This course reviews the most common ultrasound patterns encountered in emergency and general…
0 / 25
Score: 0%
2
During a focused cardiac exam, the pulmonary acceleration time is measured at 55 ms and PASP is 58 mmHg. What does this pattern suggest?
3
A 45‑year‑old woman with suspected DVT undergoes lower‑extremity ultrasound. Which finding best confirms an acute thrombus?
4
In a trauma patient, lung ultrasound shows absent sliding at the right anterior chest. What is the most likely diagnosis?
5
A pregnant patient’s transvaginal ultrasound shows a gestational sac without a yolk sac. Which statement is correct?
6
During a bedside cardiac exam, the TAPSE measurement is 15 mm. What does this imply about right ventricular function?
7
A 70‑year‑old man’s abdominal aorta measures 3.2 cm on ultrasound. What is the appropriate interpretation?
8
In a pediatric patient with suspected intussusception, which ultrasound sign on transverse view is classic?
9
A patient with suspected pulmonary embolism has a 60/60 sign on ultrasound. Which two measurements define this sign?
10
During a renal ultrasound, the resistive index is measured at 0.75. How should this be interpreted?
11
A bedside ultrasound of the gallbladder shows a wall‑echo‑shadow (WES) sign. What does this indicate?
12
In a patient with suspected aortic dissection, which sonographic finding is pathognomonic?
13
A 30‑year‑old male presents with acute scrotal pain. Which Doppler finding most strongly supports testicular torsion?
14
During a focused cardiac exam, the EPSS measured is 8 mm. What does this suggest about left ventricular function?
15
A 55‑year‑old woman’s common bile duct measures 7 mm on ultrasound. How should this be interpreted given her age?
16
Which ultrasound artifact is most characteristic of gas within soft tissue?
17
A patient’s optic nerve sheath diameter is measured at 6 mm. What does this suggest in an adult?
18
During a focused abdominal exam, a 2.5 cm fluid collection is seen posterior to the lung near the descending aorta. What is the most likely diagnosis?
19
A bedside ultrasound of the lower extremity shows a vein that is partially compressible and echogenic. Which type of DVT does this pattern favor?
20
In a trauma patient, ultrasound reveals a target sign in the small bowel. What does this indicate?
21
A patient with suspected pulmonary embolism has a pulmonary acceleration time of 70 ms and PASP of 55 mmHg. Which of the following is true?
22
During a focused cardiac exam, the mitral inflow respiratory variation is measured at 30%. What does this finding support?
23
A 28‑year‑old woman presents with right lower quadrant pain. Ultrasound shows a non‑compressible blind‑ending tubular structure measuring 7 mm. What does this suggest?
24
A patient with suspected testicular torsion has a whirlpool sign on ultrasound. Which structure is visualized in this sign?
25
During a bedside cardiac exam, the right atrial systolic collapse is observed. How does its timing compare to other chamber collapses in tamponade?
Ultrasound Diagnostic Findings in General Medicine
Ultrasound is a bedside, radiation‑free tool that can rapidly answer critical clinical questions. This course reviews the most common ultrasound patterns encountered in emergency and general medicine, explains why they matter, and provides practical tips for interpretation.
1. Cardiac Tamponade: Recognizing the Most Specific Ultrasound Sign
Patients with shortness of breath and peripheral edema often have a cardiac cause. While many findings suggest elevated right‑sided pressures, the right ventricular diastolic collapse is the most specific sign of tamponade.
- Right ventricular diastolic collapse: The RV wall bows inward during diastole because intrapericardial pressure exceeds intracavitary pressure.
- Other findings (plethoric IVC, mitral inflow variation) are supportive but not as specific.
Key tip: In the subcostal four‑chamber view, look for a “floppy” RV that collapses with each inspiration. Combine this with clinical signs (pulsus paradoxus) for a confident diagnosis.
2. Pulmonary Acceleration Time (PAT) and Pulmonary Artery Systolic Pressure (PASP)
During a focused cardiac exam, a PAT of 55 ms together with a PASP of 58 mmHg points toward an acute pulmonary embolism (PE).
- A PAT < 70 ms indicates markedly elevated pulmonary pressures.
- Acute PE causes a sudden rise in right‑ventricular afterload, shortening the acceleration time.
- Chronic RV strain usually shows a longer PAT and lower PASP.
Mnemonic: “PE = Pressure‑Eruption” – a rapid pressure surge shortens the PAT.
3. Deep Vein Thrombosis (DVT) Ultrasound: Identifying an Acute Thrombus
When evaluating a suspected DVT, the hallmark of an acute thrombus is a vein that is enlarged and hypoechoic.
- Acute thrombi appear dark (hypoechoic) because they contain fresh blood.
- They often cause the vein to expand, making it larger than the contralateral side.
- Chronic thrombi become echogenic and the vein may be smaller.
Compressibility is still present in early stages, so partial compressibility does not rule out an acute clot.
4. Lung Ultrasound in Trauma: Detecting Pneumothorax
Absent lung sliding on the right anterior chest is most consistent with a pneumothorax.
- Normal lung sliding represents visceral pleura moving against parietal pleura.
- When air separates the pleural layers, sliding disappears.
- Other findings such as B‑lines or consolidation suggest alternative diagnoses.
Clinical pearl: Look for the “lung point” sign – the exact location where sliding reappears – to confirm the pneumothorax size.
5. Early Pregnancy Ultrasound: Interpreting a Gestational Sac Without a Yolk Sac
In a transvaginal scan, a gestational sac lacking a yolk sac does not prove an intrauterine pregnancy. The presence of a yolk sac is required to confirm viability.
- Absence may indicate a very early pregnancy (
- Do not assume miscarriage or rule out ectopic pregnancy based solely on this finding.
- Follow‑up imaging in 7–10 days is recommended.
Bottom line: A yolk sac is a critical marker for a confirmed intrauterine pregnancy.
6. Tricuspid Annular Plane Systolic Excursion (TAPSE) and Right Ventricular Function
A TAPSE measurement of 15 mm indicates right ventricular systolic dysfunction.
- Normal TAPSE is ≥ 17 mm.
- Reduced TAPSE correlates with poorer RV contractility and can be seen in pulmonary hypertension, RV infarction, or chronic lung disease.
- It is a quick, reproducible bedside metric that complements visual assessment.
Tip: Combine TAPSE with RV size and septal motion for a comprehensive RV evaluation.
7. Abdominal Aortic Ultrasound: Recognizing Aneurysmal Dilation
An abdominal aortic diameter of 3.2 cm in a 70‑year‑old man meets criteria for an aneurysm.
- Normal aortic diameter is < 2.5 cm.
- Aneurysmal dilation is defined as > 3 cm or > 50 % above normal for the patient’s size.
- Surveillance intervals depend on size; > 5.5 cm typically warrants surgical repair.
Early detection allows for monitoring and timely intervention, reducing rupture risk.
8. Pediatric Intussusception: The Classic “Target” Sign
On transverse ultrasound, intussusception appears as a target (or donut) sign.
- The concentric rings represent the telescoped bowel segments.
- It is highly sensitive (> 95 %) and specific when performed by experienced operators.
- Prompt diagnosis enables non‑operative reduction with air or contrast enemas.
Remember: In children with intermittent abdominal pain and vomiting, a quick bedside ultrasound can confirm intussusception and expedite care.
9. Integrating Ultrasound Findings into Clinical Decision‑Making
Understanding the nuances of each ultrasound pattern empowers clinicians to:
- Prioritize life‑threatening diagnoses (e.g., tamponade, pneumothorax, PE).
- Tailor management plans—whether it’s emergent pericardiocentesis, anticoagulation, or surgical referral.
- Communicate findings clearly to the care team using standardized terminology.
Regular practice and correlation with clinical presentation are essential for mastery.
