A 26-year-old female presents with abnormal menstrual cycles, hirsutism, obesity and an inability to become pregnant after one-year of unprotected regular sexual activity.  You suspect an endocrine condition called “Polycystic Ovarian Syndrome” (PCOS) and order a pelvic ultrasound.  What finding supports your suspicions?

Given the anatomically identified markings in the pelvic ultrasound, what is the anatomic location of this ectopic pregnancy?  (Hint: L OV= left ovary,  UT= uterus)

What is the finding on a spectral Doppler at the vascular narrowing area due to a plaque formation?

How is venous thrombosis detected on ultrasound? 

A 36-year-old female patient presents complaining of menorrhagia and pelvic pain during her menses for many years.  The main concern is a leiomyoma.  Which of the following modalities could be the preferred imaging study of choice?

In what type of breast tissue is it EASIEST to see a breast cancer in on mammogram?

A 30 year old male with no PMH reports shortness of breath since 1 hour ago.  Patient reports the onset was sudden and started while he was walking to his car from the store.  Patient denies tobacco use, fever, chills, nasal congestion, cough, chest pain, abdominal pain, nausea, vomiting, diarrhea or leg swelling.  On exam, patient appears tall and thin, in mild respiratory distress and tachypneic, but speaking full sentences.  Trachea midline.  Chest expansion is symmetric, anterior:lat diameter is 2:1.  On auscultation, decreased lung sounds on Lt side, the rest of the lungs with no wheezing, rales or rhonchi.  S1 and S2 with no murmurs, rubs or gallops.  No leg edema.  VS: BP: 145/95 sitting Rt arm; HR: 105 bpm; R: 22 breath per minute; T: 98.6F oral; Pulse Ox: 92% on Room Air. Please provide differential diagnosis for this presentation (list at least 5) AND what imaging would be indicated for this case.

A 75 year old male present complaining of cramping abdominal pain, distention and constipation for 2 days.  Patient also reports nausea and vomiting that started few hours ago.  Patient reports he has not been able to pass gas today.  On exam, patient appears pale. Abdomen is distended, absent bowel sounds, hyper-resonant on percussion, diffuse tenderness with no rebound.  VS: BP: 150/100 mmHg Lt arm supine, HR: 100 bpm, T: 98.8F oral, RR: 20 bpm. Please provide differential diagnosis for this presentation (list at least 5) AND what imaging would be indicated for this case.

A 60 y/o patient with PMH of diverticulitis, reports 3 day history of worsening LLQ pain.  Fever and chills started today.  Patient denies nausea or vomiting, but has not had appetite and has not been eating much.  Patient denies diarrhea and does not recall when he had a bowel movement. He is able to pass gas. On exam, patient is pale and diaphoretic.  Abdomen is distended with decreased bowel sounds, diffuse tenderness and guarding on percussion and palpation. VS: BP: 145/95 mmHg Lt arm supine, HR: 110 bpm, T: 102.7F oral, RR: 22 bpm. Please provide a reading for the following image including the following: Type of image Quality Gas pattern Calcifications and bones Soft tissues and other findings 

A 75 year old male reports nausea, vomiting and abdominal distension for 1 day.  Patient reports that vomiting consisted of foul smelling feculent material.  Patient reports he does not see medical providers, does not take any medications and has not had any preventative screenings.  Patient reports history of constipation, weight loss and tiredness in the last few months.  On exam, patient appears pale. Abdomen is mildly distended, hypoactive bowel sounds, tympany on percussion, diffuse tenderness with no rebound.  VS: BP: 145/95 mmHg Lt arm supine, HR: 100 bpm, T: 98.8F oral, RR: 18 bpm. Please provide a reading for the following image: