Ultrasounds Of The Block
Welcome to SIU's EM Residency "Ultrasounds of the Block" curriculum (formerly known as "Ultrasound of the Month"). First instituted as a friendly competition to spark increased volume of bedside studies, it has now become a melee of ultrasound fun. As part of an asynchronous curriculum in emergency ultrasound, all ultrasounds performed at our clinical sites are reviewed for quality assurance by ultrasound director. Each block a few images/clips are selected because of an interesting finding, a high quality image showing great anatomy, or because they carry an important teaching point. These “Ultrasounds of the Block” are then displayed online with clinical vignettes and questions to test residents and their knowledge. The competition aspect of the curriculum is that residents gain points by performing any selected "Ultrasounds of the Block" and for answering monthly questions correctly. Each year a winner is announced based on overall points and surprised with trophy gifts to cherish and gloat about for the many years to come.
Past "Ultrasounds of the Block" can be viewed by clicking here. This blocks "Ultrasounds of the Block" can be viewed below.
Ultrasounds Of The Block (B9)
Question 1:
The following ultrasound exam is performed on a patient in respiratory distress. They have a history of COPD and heart failure and present tachycardic and hypertensive. The presence of what artifact on this exam suggests heart failure as the etiology of this patients difficulty in breathing. (10pts)
a) Acoustic shadowing
b) Acoustic enhancement
c) Beam width
d) Reverberation
Courtesy of AR & JT
a) Acoustic shadowing
b) Acoustic enhancement
c) Beam width
d) Reverberation
Courtesy of AR & JT
Question 2
A 40 y/o obese female presents with abdominal pain. The following ultrasound is performed. What findings obtained during this exam would be highly specific for acute cholecystitis? (10pts)
a) Maximal pain ellicited with direct pressure of the ultrasound probe over the vizualized liver
b) Maximal pain ellicited with direct pressure of the ultrasound probe over the vizualized gallbladder
c) Maximal pain ellicited with direct pressure of the ultrasound probe during deep inspiration
d) Maximal pain ellicited with direct pressure of the ultrasound probe during deep expiration
Courtesy of AR & JT
a) Maximal pain ellicited with direct pressure of the ultrasound probe over the vizualized liver
b) Maximal pain ellicited with direct pressure of the ultrasound probe over the vizualized gallbladder
c) Maximal pain ellicited with direct pressure of the ultrasound probe during deep inspiration
d) Maximal pain ellicited with direct pressure of the ultrasound probe during deep expiration
Courtesy of AR & JT
Question 3:
A 50 y/o male presents with crushing substernal chest pressure? His EKG shows a LBBB and the following ultrasound was performed at the bedside as a part of his evaluation. What with regards to this patient's history would suggest this patient should be sent to the cathlab for immediate PCI? (10pts)
a) A recently performed EKG showing normal sinus rhythm
b) A recently performed EKG showing a LBBB
c) A recently performed echo showing no wall motion abnormalities
d) A recently performed echo showing septal wall motion abnormalities
Courtesy of AR & JT
a) A recently performed EKG showing normal sinus rhythm
b) A recently performed EKG showing a LBBB
c) A recently performed echo showing no wall motion abnormalities
d) A recently performed echo showing septal wall motion abnormalities
Courtesy of AR & JT
Question 4:
A 55 y/o male presents with pain and swelling to their right foot. They are afebrile and state they recently went to a picnic where she had her favorite dish liver and "sweetbread." What labeled ultrasound finding helps to make the diagnosis of what is causing this patients pain and swelling? (10pts)
a)
b)
c)
d)
Courtesy of SI
a)
b)
c)
d)
Courtesy of SI