with Answers & Rationales (2023 Edition)
Test Bank Questions on Vascular Structures
Reference: Systematic Approach to Performing and Interpreting
Abdominal Ultrasound Examinations, 3rd Edition (2016), Thieme
Chapter 4: The Aorta and Its Branches
Question 1:
Title: Normal Aortic Diameter
What is the upper limit of normal for the anteroposterior diameter of the
abdominal aorta in adults?
A. 2.0 cm
B. 2.5 cm
C. 3.0 cm
D. 3.5 cm
Answer: C. 3.0 cm
Rationale: A diameter exceeding 3.0 cm is diagnostic of an abdominal
aortic aneurysm (AAA). Measurements are taken in a transverse plane to
ensure accuracy (Chapter 4, p. 89).
Question 2:
Title: Branch Identification
Which branch of the abdominal aorta is the first major anterior branch
and typically arises at the T12 vertebral level?
A. Superior mesenteric artery (SMA)
B. Celiac artery
,C. Renal arteries
D. Inferior mesenteric artery (IMA)
Answer: B. Celiac artery
Rationale: The celiac artery is the first major anterior branch, supplying
the foregut. The SMA arises inferior to the celiac artery at the L1 level
(Chapter 4, p. 94).
Question 3:
Title: Doppler Findings in Aortic Dissection
What ultrasound finding is pathognomonic for an aortic dissection?
A. Thrombus in the aortic lumen
B. Intimal flap with dual lumens
C. Pulsatile abdominal mass
D. Atherosclerotic plaque
Answer: B. Intimal flap with dual lumens
Rationale: A dissection is identified by a hyperechoic intimal flap
separating true and false lumens. Color Doppler may show flow in both
lumens (Chapter 4, p. 102).
Chapter 5: The Vena Cava and Its Tributaries
Question 1:
Title: Normal IVC Diameter
During inspiration, the inferior vena cava (IVC) diameter typically:
A. **Collapses to <2.5 cm**
B. Remains unchanged
C. Dilates to >3.0 cm
D. Measures 4.0 cm
Answer: A. Collapses to <2.5 cm
**Rationale:** Normal IVC collapsibility with inspiration indicates
, normal central venous pressure. A dilated IVC (>2.5 cm) that does not
collapse suggests right heart failure or fluid overload (Chapter 5, p. 127).
Question 2:
Title: Thrombosis in Renal Cell Carcinoma
Which vessel is most commonly invaded by tumor thrombus in patients
with renal cell carcinoma?
A. Hepatic veins
B. Left renal vein
C. Portal vein
D. Splenic vein
Answer: B. Left renal vein
Rationale: Renal cell carcinoma frequently extends into the renal vein,
and tumor thrombus may propagate into the IVC. The left renal vein is
often affected due to anatomical proximity (Chapter 5, p. 138).
Question 3:
Title: Portal Hypertension
What Doppler ultrasound finding is indicative of portal hypertension?
A. Hepatopetal flow in the portal vein
B. Hepatofugal flow in the portal vein
C. Pulsatile flow in the hepatic veins
D. Absence of flow in the IVC
Answer: B. Hepatofugal flow in the portal vein
Rationale: Reversed (hepatofugal) flow in the portal vein occurs when
portal pressures exceed hepatic venous pressures, a hallmark of portal
hypertension (Chapter 5, p. 145).
Chapter 4: The Aorta and Its Branches