Cornell
HM-POCUS

Hospital Medicine Point of Care Ultrasonography

Question 1: Which of these statements is FALSE?

The kidneys are oriented in an oblique plane.
The right kidney is smaller than the left kidney and its superior pole is near the 11th rib.
The left kidney has anatomical relationships with the the splenic flexure of the large intestine, gastric body, and pancreas.
The major muscles associated with the kidneys include the quadratus lumborum, psoas muscle, and the posterior aspect of the diaphragm.

Question 2: Which of the following is TRUE:

The renal capsule separates the renal parenchyma and sinus.
The renal sinus is filled with fibrous-fatty tissue and is hypoechoic on ultrasound.
The pyramids as well as major and minor calyces are found in the renal sinus.
The pyramids are hypoechoic to anechoic on ultrasound; it’s appearance can vary by hydration status.

Question 3: Which of the following is TRUE:

A high frequency probe is used to image the kidney.
To obtain the true long axis of the kidney, the probe is rotated 90 degrees posteriorly.
In the short axis view, tilting the probe allows you to visualize the superior and inferior poles.
To transition from the long axis to short axis view, the probe is swept posteriorly.

Question 4: With the probe marker pointing to the patient’s head, which probe motion will take you from the mid-axillary line to the posterior axillary line?

Rocking
Sliding
Sweeping
Tilting

Question 5: The probe marker is pointing to the patient’s head at the mid-axillary line. In what body plane is your sonographic cut?

Coronal (Frontal)
Median
Sagittal
Transverse (Axial)

Question 6: In which view is the right kidney most superficial?

Midclavicular line
Anterior axillary line
Mid-axillary line
Posterior axillary line

Question 7: Which statement most closely represents how to image the right kidney in the long axis view?

Place the probe on the mid-axillary line with the probe marker cephalad —> rotate the probe posteriorly by 15-30 degrees —> slide the probe superiorly and inferiorly.
Place the probe on the mid-axillary line with the probe marker cephalad —> rotate the probe anteriorly by 15-30 degrees —> sweep the probe anteriorly and posteriorly.
Place the probe on the posterior axillary line with the probe marker cephalad —> rotate the probe marker 15-30 degrees anteriorly —> rock the probe superiorly and inferiorly
Place the probe on the posterior axillary line with the probe marker cephalad —> rotate the probe marker 15-30 degrees posteriorly —> tilt the probe anteriorly and posteriorly

Question 8: Which statement of regarding scanning the left kidney is TRUE?

Scanning from the anterior axillary line is preferred.
The spleen can be used as an acoustic window.
When rotating to the short axis view, the probe marker is posterior.
The IVC and aorta may be seen in the long axis view.

Question 9: What differentiates mild hydronephrosis from moderate hydronephrosis?

The pyramids are blunted in appearance.
The renal sinus is dilated with an anechoic appearance.
The renal medulla is unaffected.
The image can resemble a “bear claw”.

Question 10: What differentiates moderate hydronephrosis from severe hydronephrosis?

The cortex is thinned.
The renal pelvis is not dilated.
There is dilatation of the minor and major calyces.
The pyramids are present but are blunted.

Question 11: Which statement about simple renal cysts is FALSE?

They mimic hydronephrosis.
The walls may be irregular.
Internal septations are not present
They can be associated with imaging artifacts.