ARDMS AB 2026 Study Guide Abdomen
Sonography Specialty Practice Questions
Answer Explanations Ultrasound Anatomy
Pathology Imaging Techniques Exam
Preparation
SECTION 1: LIVER (Questions 1–20)
Question 1. Which liver lobe is separated from the left lobe by the ligamentum
teres?
A. Caudate lobe
B. Right lobe
C. Quadrate lobe
D. Lateral segment
Answer: B. Right lobe
Rationale: The ligamentum teres (round ligament) separates the right and left
lobes of the liver anatomically. The falciform ligament contains the ligamentum
teres and is the external landmark for this division.
Question 2. What is the normal sonographic appearance of liver parenchyma?
A. Homogeneous, medium-level echogenicity
B. Hyperechoic with coarse texture
C. Hypoechoic with prominent vessels
D. Heterogeneous with focal lesions
Answer: A. Homogeneous, medium-level echogenicity
Rationale: Normal liver parenchyma is homogeneous with medium-level
echogenicity, slightly hyperechoic to the renal cortex. Vessels are visible but not
prominent.
,Question 3. Which vessel is used as a landmark to divide the liver into right and
left lobes?
A. Portal vein
B. Hepatic vein
C. Middle hepatic vein
D. Inferior vena cava
Answer: C. Middle hepatic vein
Rationale: The middle hepatic vein divides the liver into right and left lobes
(Cantlie's line). The right hepatic vein separates the right lobe into anterior and
posterior segments.
Question 4. What is the most common benign liver tumor?
A. Hepatocellular carcinoma
B. Hemangioma
C. Focal nodular hyperplasia
D. Hepatic adenoma
Answer: B. Hemangioma
Rationale: Hemangioma is the most common benign liver tumor. Sonographically,
it appears as a well-defined, hyperechoic lesion, often with posterior acoustic
enhancement.
Question 5. Which sonographic feature is characteristic of a hepatic hemangioma?
A. Hypoechoic halo
B. Hyperechoic, well-defined mass
C. Diffuse parenchymal changes
D. Posterior acoustic shadowing
Answer: B. Hyperechoic, well-defined mass
Rationale: Hemangiomas are typically hyperechoic, well-circumscribed masses.
They may show peripheral enhancement on contrast-enhanced ultrasound.
,Question 6. What is the sonographic appearance of hepatic steatosis?
A. Increased echogenicity of liver parenchyma
B. Decreased echogenicity of liver parenchyma
C. Focal hypoechoic lesions
D. Prominent hepatic veins
Answer: A. Increased echogenicity of liver parenchyma
Rationale: Hepatic steatosis (fatty liver) causes increased echogenicity of the liver
parenchyma. The liver appears brighter than the renal cortex, and vascular margins
may be obscured.
Question 7. Which finding suggests cirrhosis on ultrasound?
A. Smooth liver surface
B. Caudate lobe hypertrophy
C. Normal portal vein diameter
D. Homogeneous parenchyma
Answer: B. Caudate lobe hypertrophy
Rationale: Cirrhosis is associated with a nodular liver surface, caudate lobe
hypertrophy, right lobe atrophy, and signs of portal hypertension. The caudate lobe
often enlarges due to compensatory flow.
Question 8. What is the normal diameter of the main portal vein?
A. Less than 5 mm
B. 5–10 mm
C. 13 mm or less
D. Greater than 20 mm
Answer: C. 13 mm or less
Rationale: The normal main portal vein diameter is 13 mm or less. Dilatation may
indicate portal hypertension.
Question 9. Which Doppler finding is characteristic of portal hypertension?
, A. Hepatofugal flow
B. Hepatopetal flow
C. Normal phasic flow
D. High-resistance hepatic artery flow
Answer: A. Hepatofugal flow
Rationale: In portal hypertension, portal venous flow may reverse (hepatofugal)
due to increased resistance. This is an ominous sign.
Question 10. What is the sonographic appearance of a simple hepatic cyst?
A. Anechoic with posterior acoustic enhancement
B. Hyperechoic with shadowing
C. Complex with septations
D. Solid with vascularity
Answer: A. Anechoic with posterior acoustic enhancement
Rationale: Simple hepatic cysts are anechoic, well-defined, and show posterior
acoustic enhancement. They have no internal vascularity.
Question 11. Which liver lesion is associated with oral contraceptive use?
A. Hemangioma
B. Focal nodular hyperplasia
C. Hepatic adenoma
D. Hepatocellular carcinoma
Answer: C. Hepatic adenoma
Rationale: Hepatic adenomas are associated with oral contraceptive use and
anabolic steroids. They have a risk of hemorrhage and malignant transformation.
Question 12. What is the sonographic appearance of focal nodular hyperplasia
(FNH)?
A. Usually hypoechoic with central scar
B. Usually hyperechoic with central scar
Sonography Specialty Practice Questions
Answer Explanations Ultrasound Anatomy
Pathology Imaging Techniques Exam
Preparation
SECTION 1: LIVER (Questions 1–20)
Question 1. Which liver lobe is separated from the left lobe by the ligamentum
teres?
A. Caudate lobe
B. Right lobe
C. Quadrate lobe
D. Lateral segment
Answer: B. Right lobe
Rationale: The ligamentum teres (round ligament) separates the right and left
lobes of the liver anatomically. The falciform ligament contains the ligamentum
teres and is the external landmark for this division.
Question 2. What is the normal sonographic appearance of liver parenchyma?
A. Homogeneous, medium-level echogenicity
B. Hyperechoic with coarse texture
C. Hypoechoic with prominent vessels
D. Heterogeneous with focal lesions
Answer: A. Homogeneous, medium-level echogenicity
Rationale: Normal liver parenchyma is homogeneous with medium-level
echogenicity, slightly hyperechoic to the renal cortex. Vessels are visible but not
prominent.
,Question 3. Which vessel is used as a landmark to divide the liver into right and
left lobes?
A. Portal vein
B. Hepatic vein
C. Middle hepatic vein
D. Inferior vena cava
Answer: C. Middle hepatic vein
Rationale: The middle hepatic vein divides the liver into right and left lobes
(Cantlie's line). The right hepatic vein separates the right lobe into anterior and
posterior segments.
Question 4. What is the most common benign liver tumor?
A. Hepatocellular carcinoma
B. Hemangioma
C. Focal nodular hyperplasia
D. Hepatic adenoma
Answer: B. Hemangioma
Rationale: Hemangioma is the most common benign liver tumor. Sonographically,
it appears as a well-defined, hyperechoic lesion, often with posterior acoustic
enhancement.
Question 5. Which sonographic feature is characteristic of a hepatic hemangioma?
A. Hypoechoic halo
B. Hyperechoic, well-defined mass
C. Diffuse parenchymal changes
D. Posterior acoustic shadowing
Answer: B. Hyperechoic, well-defined mass
Rationale: Hemangiomas are typically hyperechoic, well-circumscribed masses.
They may show peripheral enhancement on contrast-enhanced ultrasound.
,Question 6. What is the sonographic appearance of hepatic steatosis?
A. Increased echogenicity of liver parenchyma
B. Decreased echogenicity of liver parenchyma
C. Focal hypoechoic lesions
D. Prominent hepatic veins
Answer: A. Increased echogenicity of liver parenchyma
Rationale: Hepatic steatosis (fatty liver) causes increased echogenicity of the liver
parenchyma. The liver appears brighter than the renal cortex, and vascular margins
may be obscured.
Question 7. Which finding suggests cirrhosis on ultrasound?
A. Smooth liver surface
B. Caudate lobe hypertrophy
C. Normal portal vein diameter
D. Homogeneous parenchyma
Answer: B. Caudate lobe hypertrophy
Rationale: Cirrhosis is associated with a nodular liver surface, caudate lobe
hypertrophy, right lobe atrophy, and signs of portal hypertension. The caudate lobe
often enlarges due to compensatory flow.
Question 8. What is the normal diameter of the main portal vein?
A. Less than 5 mm
B. 5–10 mm
C. 13 mm or less
D. Greater than 20 mm
Answer: C. 13 mm or less
Rationale: The normal main portal vein diameter is 13 mm or less. Dilatation may
indicate portal hypertension.
Question 9. Which Doppler finding is characteristic of portal hypertension?
, A. Hepatofugal flow
B. Hepatopetal flow
C. Normal phasic flow
D. High-resistance hepatic artery flow
Answer: A. Hepatofugal flow
Rationale: In portal hypertension, portal venous flow may reverse (hepatofugal)
due to increased resistance. This is an ominous sign.
Question 10. What is the sonographic appearance of a simple hepatic cyst?
A. Anechoic with posterior acoustic enhancement
B. Hyperechoic with shadowing
C. Complex with septations
D. Solid with vascularity
Answer: A. Anechoic with posterior acoustic enhancement
Rationale: Simple hepatic cysts are anechoic, well-defined, and show posterior
acoustic enhancement. They have no internal vascularity.
Question 11. Which liver lesion is associated with oral contraceptive use?
A. Hemangioma
B. Focal nodular hyperplasia
C. Hepatic adenoma
D. Hepatocellular carcinoma
Answer: C. Hepatic adenoma
Rationale: Hepatic adenomas are associated with oral contraceptive use and
anabolic steroids. They have a risk of hemorrhage and malignant transformation.
Question 12. What is the sonographic appearance of focal nodular hyperplasia
(FNH)?
A. Usually hypoechoic with central scar
B. Usually hyperechoic with central scar
