ARDMS Abdomen Davies Exam
ARDMS Abdomen Davies Exam Study Guide
Questions and Answers 2024-2025
You are scanning a patient with a known mass in the left medial segment of the liver.
What anatomic landmark can you use to identify the left medial segment separate from
the right anterior segment of the liver? -Correct Answer ✔Middle Hepatic Vein
Which organ is the largest visceral organ in the body ? -Correct Answer ✔Liver
Where is the major portion of the liver, the right lobe located? -Correct Answer ✔in the
right upper quadrant of the abdomen
What organ is covered in large part by the peritoneum , except for a small area posterior
to the dome known as the bare area? -Correct Answer ✔the Liver
Which organ is covered in a layer of fibrous tissue, glisson's capsule? -Correct Answer
✔the Liver
You suspect enlargement of the caudate lobe in a patient with liver disease. What
structure located at the anterior border of the caudate lobe will help you to identify this
lobe of the liver? -Correct Answer ✔Fissure for the ligamentum venosum
You are asked to rule out the presence of a recannalized paraumbilical. Which anatomic
structure is a useful landmark in location of this structure? -Correct Answer
✔Ligamentum teres
What is the left portal vein in contact with? -Correct Answer ✔Ligamentum teres
Where does the paraumbilical vein begins? -Correct Answer ✔begins at the left portal
vein and exits the liver at the ligamentum teres
Which vessel course within the main lobar fissure? -Correct Answer ✔middle hepatic
vein
Oxygenated blood is supplied to the liver via the: -Correct Answer ✔Portal vein and
hepatic artery
You are performing a sonogram on a slender female and notice a long, thin extension of
the inferior aspect of the right lobe of the liver. The most likely represents: -Correct
Answer ✔Reidel's lobe
What forms the caudal border of the left portal vein? -Correct Answer ✔Ligamentum
teres
ARDMS Abdomen Davies Exam
,ARDMS Abdomen Davies Exam
What ligament divides the left lobe of the liver into medial and lateral segments? -
Correct Answer ✔Ligamentum teres
You are asked to perform a Doppler study on the hepatic veins in the liver. What
differentiates the hepatic veins from the portal veins? -Correct Answer ✔the portal veins
are accompanied by branches of the biliary tree and hepatic artery
You have detected a mass anterior and to the left of ligamentum venosum. This mass is
located in what lobe of the liver ? -Correct Answer ✔Left Lobe
The thin capsule surrounding the liver is known as: -Correct Answer ✔Glisson's capsule
What courses interlobar and intersegmental within the liver? -Correct Answer ✔Hepatic
veins
You are performing an ultrasound exam of the liver on a small patient with a 5MHz
curved linear array. Although you have increased the overall gain to its maximum
setting, the posterior border of the liver and diaphragm are not visualized. What should
you do? -Correct Answer ✔Rescan the liver with a lower frequency transducer.
Correctly describe the probe placement and imaging plane you would use to
demonstrate the three hepatic veins and inferior vena cava in the one view? -Correct
Answer ✔Subcostal oblique approach with the probe angled superiorly and to the
patient's right.
You are performing a follow-up sonogram on a patient in which a 5 -mm cyst was
previously identified at the anterior border of the left lobe liver. Although you are using a
3.5 MHz curved linear array probe, you do not see the cyst. What would be most helpful
in improving visibility of this cyst? -Correct Answer ✔Rescan the left lobe with a higher
frequency transducer. Visibility of small cysts is limited by spatial resolution. To improve
spatial resolution, the best option is to increase the imaging frequency.
What do you need to do to improve spatial resolution to visualize small cysts (which has
a limited spatial resolution)? -Correct Answer ✔The best option is to increase the
imaging frequency
You are imaging a patient with a high liver. Subcostal images do not clearly
demonstrate the liver tissue. What should you do? -Correct Answer ✔Scan the patient
in deep inspiration
A patient is referred for ultrasound evaluation of a questionable mass in the dome of the
liver seen on a CAT scan. What would improve visualization in this area of the liver? -
Correct Answer ✔Perform a subcostal scan with the probe angled superior and the
patient in deep inspiration
ARDMS Abdomen Davies Exam
, ARDMS Abdomen Davies Exam
A patient is referred for a liver ultrasound with the clinical history of a raised serum
alpha-fetoprotein level. What should you look for? -Correct Answer ✔Hepatocellular
carcinoma
If a non pregnant person with elevated levels of serum alpha-fetoprotein AFP , what is
associated with this? -Correct Answer ✔Hepatocellular carcinoma, germ cell tumor of
gonadal, retroperitoneal, or mediastinal origin. Sometimes with cancer of pancreas,
stomach, or biliary system.
What may produce modest serum AFP elevations? -Correct Answer ✔Hepatitis and
cirrhosis
You are reviewing lab work prior to performing an abnormal ultrasound exam. Elevated
lab values include Gamma- glutamyl transpeptidase -GGT and alkaline phosphatase.
What would it be? -Correct Answer ✔Concomitant elevation of both GGT and alkaline
phosphate indicates the source of the elevated alkaline phosphatase is the liver.
what other reasons would alkaline phosphatase be elevated ? -Correct Answer
✔skeletal disease, hyperparathyroidism, and acute hepatocellular disease
What is NOT a lab test use in evaluation of liver function out of the following GGT, AST,
direct bilirubin, indirect bilirubin, or lipase? -Correct Answer ✔Lipase - is used to
evaluate acute pancreatitis
What does it mean when direct bilirubin is elevated? -Correct Answer ✔usually indicates
biliary obstruction, which may be intrahepatic due to hepatitis, cirrhosis, or extrahepatic
due to gallstones, gallbladder or pancreatic cancer.
Why would indirect bilirubin be elevated? -Correct Answer ✔with hepatocellular
dysfunction such as hepatitis
What is Aspartate aminotransferase - AST used in evaluating? -Correct Answer ✔used
in evaluation of acute hepatic disease. May also be elevated with recent myocardial
infarction.
What is Gamma- glutamyl transpeptidase - GGT is used with what to suggest the
source of elevated alkaline phosphatase levels? -Correct Answer ✔used with alkaline
phosphatase
A patient is referred with right upper quadrant tenderness and a history of oral
contraceptive use. A solid, hypoechoic mass is identified in the right lobe of the liver.
Color Doppler reveals hypervascularity of the mass. What is the scenario likely to be? -
Correct Answer ✔Hepatic Adenoma - the incidence of hepatic adenomas has increased
in the united states since the 1970s. And are associated with use of oral contraceptives.
ARDMS Abdomen Davies Exam
ARDMS Abdomen Davies Exam Study Guide
Questions and Answers 2024-2025
You are scanning a patient with a known mass in the left medial segment of the liver.
What anatomic landmark can you use to identify the left medial segment separate from
the right anterior segment of the liver? -Correct Answer ✔Middle Hepatic Vein
Which organ is the largest visceral organ in the body ? -Correct Answer ✔Liver
Where is the major portion of the liver, the right lobe located? -Correct Answer ✔in the
right upper quadrant of the abdomen
What organ is covered in large part by the peritoneum , except for a small area posterior
to the dome known as the bare area? -Correct Answer ✔the Liver
Which organ is covered in a layer of fibrous tissue, glisson's capsule? -Correct Answer
✔the Liver
You suspect enlargement of the caudate lobe in a patient with liver disease. What
structure located at the anterior border of the caudate lobe will help you to identify this
lobe of the liver? -Correct Answer ✔Fissure for the ligamentum venosum
You are asked to rule out the presence of a recannalized paraumbilical. Which anatomic
structure is a useful landmark in location of this structure? -Correct Answer
✔Ligamentum teres
What is the left portal vein in contact with? -Correct Answer ✔Ligamentum teres
Where does the paraumbilical vein begins? -Correct Answer ✔begins at the left portal
vein and exits the liver at the ligamentum teres
Which vessel course within the main lobar fissure? -Correct Answer ✔middle hepatic
vein
Oxygenated blood is supplied to the liver via the: -Correct Answer ✔Portal vein and
hepatic artery
You are performing a sonogram on a slender female and notice a long, thin extension of
the inferior aspect of the right lobe of the liver. The most likely represents: -Correct
Answer ✔Reidel's lobe
What forms the caudal border of the left portal vein? -Correct Answer ✔Ligamentum
teres
ARDMS Abdomen Davies Exam
,ARDMS Abdomen Davies Exam
What ligament divides the left lobe of the liver into medial and lateral segments? -
Correct Answer ✔Ligamentum teres
You are asked to perform a Doppler study on the hepatic veins in the liver. What
differentiates the hepatic veins from the portal veins? -Correct Answer ✔the portal veins
are accompanied by branches of the biliary tree and hepatic artery
You have detected a mass anterior and to the left of ligamentum venosum. This mass is
located in what lobe of the liver ? -Correct Answer ✔Left Lobe
The thin capsule surrounding the liver is known as: -Correct Answer ✔Glisson's capsule
What courses interlobar and intersegmental within the liver? -Correct Answer ✔Hepatic
veins
You are performing an ultrasound exam of the liver on a small patient with a 5MHz
curved linear array. Although you have increased the overall gain to its maximum
setting, the posterior border of the liver and diaphragm are not visualized. What should
you do? -Correct Answer ✔Rescan the liver with a lower frequency transducer.
Correctly describe the probe placement and imaging plane you would use to
demonstrate the three hepatic veins and inferior vena cava in the one view? -Correct
Answer ✔Subcostal oblique approach with the probe angled superiorly and to the
patient's right.
You are performing a follow-up sonogram on a patient in which a 5 -mm cyst was
previously identified at the anterior border of the left lobe liver. Although you are using a
3.5 MHz curved linear array probe, you do not see the cyst. What would be most helpful
in improving visibility of this cyst? -Correct Answer ✔Rescan the left lobe with a higher
frequency transducer. Visibility of small cysts is limited by spatial resolution. To improve
spatial resolution, the best option is to increase the imaging frequency.
What do you need to do to improve spatial resolution to visualize small cysts (which has
a limited spatial resolution)? -Correct Answer ✔The best option is to increase the
imaging frequency
You are imaging a patient with a high liver. Subcostal images do not clearly
demonstrate the liver tissue. What should you do? -Correct Answer ✔Scan the patient
in deep inspiration
A patient is referred for ultrasound evaluation of a questionable mass in the dome of the
liver seen on a CAT scan. What would improve visualization in this area of the liver? -
Correct Answer ✔Perform a subcostal scan with the probe angled superior and the
patient in deep inspiration
ARDMS Abdomen Davies Exam
, ARDMS Abdomen Davies Exam
A patient is referred for a liver ultrasound with the clinical history of a raised serum
alpha-fetoprotein level. What should you look for? -Correct Answer ✔Hepatocellular
carcinoma
If a non pregnant person with elevated levels of serum alpha-fetoprotein AFP , what is
associated with this? -Correct Answer ✔Hepatocellular carcinoma, germ cell tumor of
gonadal, retroperitoneal, or mediastinal origin. Sometimes with cancer of pancreas,
stomach, or biliary system.
What may produce modest serum AFP elevations? -Correct Answer ✔Hepatitis and
cirrhosis
You are reviewing lab work prior to performing an abnormal ultrasound exam. Elevated
lab values include Gamma- glutamyl transpeptidase -GGT and alkaline phosphatase.
What would it be? -Correct Answer ✔Concomitant elevation of both GGT and alkaline
phosphate indicates the source of the elevated alkaline phosphatase is the liver.
what other reasons would alkaline phosphatase be elevated ? -Correct Answer
✔skeletal disease, hyperparathyroidism, and acute hepatocellular disease
What is NOT a lab test use in evaluation of liver function out of the following GGT, AST,
direct bilirubin, indirect bilirubin, or lipase? -Correct Answer ✔Lipase - is used to
evaluate acute pancreatitis
What does it mean when direct bilirubin is elevated? -Correct Answer ✔usually indicates
biliary obstruction, which may be intrahepatic due to hepatitis, cirrhosis, or extrahepatic
due to gallstones, gallbladder or pancreatic cancer.
Why would indirect bilirubin be elevated? -Correct Answer ✔with hepatocellular
dysfunction such as hepatitis
What is Aspartate aminotransferase - AST used in evaluating? -Correct Answer ✔used
in evaluation of acute hepatic disease. May also be elevated with recent myocardial
infarction.
What is Gamma- glutamyl transpeptidase - GGT is used with what to suggest the
source of elevated alkaline phosphatase levels? -Correct Answer ✔used with alkaline
phosphatase
A patient is referred with right upper quadrant tenderness and a history of oral
contraceptive use. A solid, hypoechoic mass is identified in the right lobe of the liver.
Color Doppler reveals hypervascularity of the mass. What is the scenario likely to be? -
Correct Answer ✔Hepatic Adenoma - the incidence of hepatic adenomas has increased
in the united states since the 1970s. And are associated with use of oral contraceptives.
ARDMS Abdomen Davies Exam
