ARDMS ABDOMEN EXAM QUESTIONS WITH VERIFIED ANSWERS LATEST 2023/2024

The wall thickness in a normal fasting gallbladder should not exceed Correct Answer: 3 mm This color Doppler sonogram is most likely demonstrating which of the following abnormalities? Correct Answer: Pseudoaneurysm This color Doppler image demonstrates turbulent swirling blood flow within a fluid collection, classic sonographic findings of a common femoral artery pseudoaneurysm. A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence in the stomach rugae. These findings are most suspicious for which of the following conditions? Correct Answer: Gastritis Prominence of the stomach rugae in a patient with upper abdominal pain is most suspicious for gastritis. Hypervascular, thick gastric walls are sonographic findings associated with gastric ulcers. Which of the following is a complication of acute pancreatitis? Correct Answer: Duodenal obstruction Complications of acute pancreatitis may include abscess formation, duodenal obstruction, hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute pancreatitis. A patient presents with a history of hematuria. The findings in this duplex image are most suspicious for which of the following pathologies? Correct Answer: Carcinoma A vascular echogenic mass is identified protruding from the posterior wall of the urinary bladder. Bladder carcinoma commonly presents with a history of painless hematuria. Based on the clinical history, the sonographic findings are suspicious for a malignant mass. A sagittal sonogram medial to the porta hepatis is demonstrating which of the following abnormalities? Correct Answer: Dilated common bile duct A hypoechoic mass identified by the calipers is obstructing the common bile duct resulting in dilatation. The mass is most likely a malignancy in the head of the pancreas. The pathology in this sonogram is most likely a/an Correct Answer: Pseudocyst A complex fluid collection is identified posterior to the tail of the pancreas. This is most likely a pancreatic pseudocyst. Phlegmons and islet cell tumors appear as hypoechoic masses on ultrasound. A pancreatic hemorrhage is a differential consideration but not the most likely pathology. Which of the following abnormalities is demonstrated in this transverse sonogram? Correct Answer: Stones in the duct of Wirsung Multiple stones are located in main pancreatic duct (duct of Wirsung). Which of the following is a clinical symptom of hypothyroidism? Correct Answer: Muscle cramps Muscles cramping is a symptom of hypothyroidism. Other symptoms may include weight gain, mental and physical lethargy, arthritis, skin dryness, feeling cold, slow metabolic rate, and decreased heart rate. Symptoms commonly associated with hyperthyroidism include weight loss, palpitations, nervousness, exophthalmos, constant hunger, tremors, increased heart rate, and intolerance to heat. A 20-year-old patient presents with a palpable left scrotal mass. The sonographic findings are most suspicious for which of the following pathologies? Correct Answer: Malignant neoplasm A malignant neoplasm is the most likely diagnosis in a young adult demonstrating a hypoechoic intratesticular mass. The patient is afebrile excluding a testicular abscess from the differential considerations. A patient presents with a history of a palpable neck mass. Which of the following terms best describes the sonographic findings? Correct Answer: Heterogeneous thyroid gland The sonographer's technical report should describe the right thyroid lobe as demonstrating an irregular and heterogeneous echo texture. A patient presents with a history of cirrhosis. The arrows are identifying the Correct Answer: coronary ligament A hyperechoic linear structure is identified dividing the right subphrenic space from the subhepatic space. This is consistent with the right coronary ligament. The right coronary ligament serves as a barrier between these two peritoneal spaces. This color Doppler sonogram is most likely demonstrating which of the following abnormalities? Correct Answer: Patent umbilical vein The sonogram is demonstrating a patent paraumbilical vein. Note the liver parenchyma of the left lobe superior to the patent umbilical vein. Gastric varices are generally located to the left of midline. Splenomegaly is a consistent finding in which of the following pathologies? Correct Answer: Portal hypertension Splenomegaly is a consistent finding in cases of portal hypertension. A duplex image of the splenic vein is demonstrating Correct Answer: retrograde flow. That's correct! The splenic vein normally flows toward the transducer, displaying a waveform above the baseline (antegrade). In this case, the blood is flowing away from the transducer back toward the spleen (retrograde). Which of the following structures separates the subphrenic space into two compartments? Correct Answer: Falciform ligament The falciform ligament divides the subphrenic space into right and left compartments. The left coronary ligament suspends the left lobe of the liver from the diaphragm. An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical history, the sonogram most likely demonstrates Correct Answer: fatty infiltration Fatty infiltration is the most likely diagnosis in an asymptomatic patient demonstrating diffusely echogenic liver parenchyma. In addition, the portal veins are still clearly visible, consistent with fatty infiltration. The subhepatic space communicates with the lesser sac through the foramen of Correct Answer: Winslow The foramen of Winslow allows communication between the subhepatic space and lesser sac. Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? Correct Answer: Left renal vein The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal aorta. The celiac axis is located at Correct Answer: superior to the body of the pancreas The celiac axis is located superior to the body of the pancreas, superior mesenteric artery, and splenic vein; posterior to the left gastric vein; inferior to the gastroesophageal junction. A postsurgical patient presents with abdominal tenderness and leukocytosis. A sonogram demonstrates a superficial, ill-defined mass beneath the surgical incision. Based on the clinical history, the sonographic findings are most suspicious for Correct Answer: abscess An ill-defined superficial mass beneath a recent surgical incision in a patient with leukocytosis most likely represents a postsurgical abscess. Secretion of thyroid-stimulating hormone is controlled by the Correct Answer: pituitary gland The anterior pituitary gland controls secretion of thyroid-stimulating hormone. The coronary vein enters the venous system near the Correct Answer: superior border of the portosplenic confluence The coronary vein enters the superior border of the portosplenic confluence and may be a collateral source in cases of portal hypertension. The inferior mesenteric vein enters the inferior border of the portosplenic confluence. A complication generally occurring within days of a renal transplant is Correct Answer: renal vein thrombosis Renal vein thrombosis generally occurs within days of a renal transplant. Renal artery stenosis typically occurs months to years after transplantation. The sonogram is most suspicious for which of the following abnormalities? Correct Answer: Varicocele Multiple anechoic tubular structures are identified posterior to the left testicle, most suspicious for a varicocele. Duplex imaging of these tubular structures should be included in this examination. The solitary echogenic focus most likely represents a(n) Correct Answer: floating gallstone Multiple small stones are present in the dependent portion of the gallbladder. The solitary focus most likely represents a floating gallstone. Clinical findings associated with an ileus may include all of the following EXCEPT Correct Answer: hyperactive bowel sounds Clinical findings in cases of ileus or bowel obstruction may include absent or hypoechoic bowel sounds, fever, constipation, abdominal pain, nausea, and vomiting. A cake kidney is generally located in which of the following regions? Correct Answer: Pelvis A cake kidney is a variant of a horseshoe kidney. The entire medial aspects of the kidneys are fused. A cake kidney is typically located in the pelvis. Focal dilatation of the anterior wall of the abdominal aorta describes a Correct Answer: saccular aneurysm Focal outpouching of one arterial wall is characteristic of a saccular aneurysm. They are often a result of trauma or infection. Which of the following structures is most likely mistaken for the splenic artery? Correct Answer: Pancreatic duct The pancreatic duct and the splenic artery are most likely to be confused with each other. Color Doppler imaging is a quick method of verifying a vascular structure. This transverse sonogram of the right testicle is most likely demonstrating which of the following abnormalities? Correct Answer: Intratesticular calcifications Multiple small hyperechoic foci (microcalcifications) are demonstrated in the right testis. Intratesticular calcifications may be idiopathic or associated with chronic orchitis. The pathology in this sonogram is most consistent with Correct Answer: metastatic lesions The liver demonstrates a heterogenous parenchyma most suspicious for metastatic lesions. A palpable buttock mass identified is most consistent with which of the following? Correct Answer: Lipoma A well circumscribed mass that does not demonstrate posterior acoustic enhancement is most consistent with a lipoma. Extended use of oral contraceptives is a predisposing factor in developing which of the following hepatic neoplasms? Correct Answer: Adenoma Extended use of oral contraceptives is linked to development of liver adenomas. Cavernous hemangiomas and cystadenomas have a female prevalence but are not related to the use of oral contraceptives. Which of the following neoplasms is commonly located in the tail of the pancreas? Correct Answer: Islet cell tumor Islet cell tumors are most commonly located in the body and tail of the pancreas. Adenocarcinoma involving the pancreas commonly develops in the head of the pancreas. Which of the following vascular structures is the arrow identifying? Correct Answer: Internal jugular vein The anechoic structure is located lateral to the thyroid lobe and anterior to the common carotid artery. This is most consistent with the internal jugular vein. The external jugular vein is located in the lateral neck. Bile pigments are produced by the Correct Answer: liver The liver breaks down red blood cells, producing bile pigments. Which of the following anatomic variants involves the fundus of the gallbladder? Correct Answer: Phrygian cap Folding of the gallbladder fundus describes a phrygian cap. Hartmann pouch and junctional fold are anatomic variants in the region of the gallbladder neck. A multiseptated gallbladder is a congenital anomaly and fetal lobulation involves the kidney. Renal dialysis patients have an increased risk of developing a renal Correct Answer: carcinoma Renal dialysis patients have an increased risk of developing a renal carcinoma, cyst, or adenoma. This sonogram of the right kidney is most likely demonstrating Correct Answer: junctional parenchymal defect. A triangular, echogenic cortical defect present in the anterior wall of the right kidney most likely represents a junctional parenchymal defect. An angiomyolipoma is a differential consideration but is not as likely the diagnosis. An endocrine function of the pancreas includes secretion of Correct Answer: glucagon Endocrine functions of the pancreas include secretion of glucagon, insulin, and somatostatin. Exocrine functions include secretion of amylase, lipase, and trypsin. Which of the following demonstrates diffuse enlargement of the abdominal aorta without distal tapering? Correct Answer: Arteriomegaly Arteriomegaly (aortic ectasia) demonstrates as a diffuse enlargement of the abdominal aorta without distal tapering on ultrasound. A patient presents with a history of severe upper abdominal pain increasing in intensity over the last 12 hours. Based on this clinical history, the sonogram is most likely demonstrating Correct Answer: acute pancreatitis.