ABR Diagnostic Radiology Core Exam 2026: Residency-Level
Certification Practice Test — Neuroradiology, Chest, Abdomen,
Musculoskeletal, Breast, Nuclear Medicine, Physics & Imaging
Safety — Multiple-Choice Questions with Answers & Detailed
Rationales
Question 1
A 62-year-old man presents with a 3-week history of progressive right lower extremity
swelling. Doppler ultrasound demonstrates non-compressibility of the right common
femoral vein with absent flow. Which of the following is the most appropriate next step in
management?
A. Initiate therapeutic anticoagulation with low-molecular-weight heparin
B. Obtain CT venography of the abdomen and pelvis
C. Prescribe compression stockings and reassess in 4 weeks
D. Schedule repeat ultrasound in 72 hours
Correct Answer: A
Explanation: Non-compressibility with absent flow confirms acute deep venous thrombosis;
therapeutic anticoagulation prevents propagation and embolization.
Question 2
A 4-week-old infant presents with projectile non-bilious vomiting. Ultrasound demonstrates
a pyloric muscle thickness of 5 mm and channel length of 17 mm. Which of the following is
the most appropriate initial management?
,A. Immediate surgical pyloromyotomy
B. Intravenous fluid resuscitation and electrolyte correction
C. Upper gastrointestinal series to confirm diagnosis
D. Trial of thickened feeds and prone positioning
Correct Answer: B
Explanation: Pyloric stenosis causes hypochloremic hypokalemic metabolic alkalosis; fluid
and electrolyte correction must precede surgery.
Question 3
A 55-year-old woman undergoes screening mammography. The image demonstrates a
cluster of fine pleomorphic microcalcifications in a segmental distribution in the left breast.
What is the BI-RADS assessment category and recommended management?
A. BI-RADS 3; short-interval follow-up in 6 months
B. BI-RADS 4B; stereotactic core biopsy
C. BI-RADS 5; surgical excision without biopsy
D. BI-RADS 2; routine annual screening
Correct Answer: B
Explanation: Segmental pleomorphic microcalcifications are suspicious (BI-RADS 4B);
stereotactic biopsy is required for tissue diagnosis.
Question 4
Certification Practice Test — Neuroradiology, Chest, Abdomen,
Musculoskeletal, Breast, Nuclear Medicine, Physics & Imaging
Safety — Multiple-Choice Questions with Answers & Detailed
Rationales
Question 1
A 62-year-old man presents with a 3-week history of progressive right lower extremity
swelling. Doppler ultrasound demonstrates non-compressibility of the right common
femoral vein with absent flow. Which of the following is the most appropriate next step in
management?
A. Initiate therapeutic anticoagulation with low-molecular-weight heparin
B. Obtain CT venography of the abdomen and pelvis
C. Prescribe compression stockings and reassess in 4 weeks
D. Schedule repeat ultrasound in 72 hours
Correct Answer: A
Explanation: Non-compressibility with absent flow confirms acute deep venous thrombosis;
therapeutic anticoagulation prevents propagation and embolization.
Question 2
A 4-week-old infant presents with projectile non-bilious vomiting. Ultrasound demonstrates
a pyloric muscle thickness of 5 mm and channel length of 17 mm. Which of the following is
the most appropriate initial management?
,A. Immediate surgical pyloromyotomy
B. Intravenous fluid resuscitation and electrolyte correction
C. Upper gastrointestinal series to confirm diagnosis
D. Trial of thickened feeds and prone positioning
Correct Answer: B
Explanation: Pyloric stenosis causes hypochloremic hypokalemic metabolic alkalosis; fluid
and electrolyte correction must precede surgery.
Question 3
A 55-year-old woman undergoes screening mammography. The image demonstrates a
cluster of fine pleomorphic microcalcifications in a segmental distribution in the left breast.
What is the BI-RADS assessment category and recommended management?
A. BI-RADS 3; short-interval follow-up in 6 months
B. BI-RADS 4B; stereotactic core biopsy
C. BI-RADS 5; surgical excision without biopsy
D. BI-RADS 2; routine annual screening
Correct Answer: B
Explanation: Segmental pleomorphic microcalcifications are suspicious (BI-RADS 4B);
stereotactic biopsy is required for tissue diagnosis.
Question 4
