ARDMS ABDOMEN DAVIES EXAM,
PRACTICE EXAM, AND STUDY GUIDE EXAM
2024 WITH ACTUAL CORRECT QUESTIONS
AND VERIFIED DETAILED ANSWERS
|FREQUENTLY TESTED QUESTONS AND
SOLUTIONS |ALREADY GRADED A+|BRAND
NEW VERSION!!|LATEST UPDATE
|GUARANTEED PASS
You are scanning a patient with an enlarged caudate lobe and shrunken right lobe. What diffuse liver
process should you suspect?
Cirrhosis
You are scanning an obese patient to rule out fatty liver. What is the common sonographic appearance
this condition?
Increased echogenicity of the liver compared to the normal kidney
You are having difficulty locating the gallbladder in a patient with right upper quadrant pain. What
anatomic landmark will help you identify the gallbladder fossa?
Interlobar hepatic fissure
In what anatomic variant is the fundus of the gallbladder folded over the body?
Phrygian cap
A patient is referred from the emergency room to rule out acute cholecystitis. You think the gallbladder
wall may be thickened. What is the normal diameter of the gallbladder wall?
less than 3 mm
You are scanning the gallbladder and notice some smudgy echoes within it. You suspect the echoes are
due to artifact. What is a common cause of artifactual echoes within the gallbladder?
Reverberation, side lobes, slice thickness artifact
1|Page
,You have a patient scheduled for a gallbladder sonogram. What preparation is required?
The patient should be fasting for 8-12 hours prior to study.
You have been requested to perform a gallbladder ultrasound to rule out cholelithiasis. What is
cholelithiasis?
Gallstones
You are scanning the gallbladder and notice that the wall is abnormally thickened, would this be
associated with malignant ascites?
NO
A referring physician has asked you about the accuracy of gallbladder sonography. The diagnostic
accuracy of gallbladder sonography is:
more than 90%
During gallbladder sonography, you notice echogenic foci within the gallbladder but do not detect distal
acoustic shadowing. What changes below will improve the detectability of stone shadowing?
Increase transducer frequency, increase transducer focusing
You are scanning a patient with a porcelain gallbladder. What does this term mean?
The gallbladder wall contains varying amounts of calcification
Where exactly is the location of the distal common bile duct?
Posterior and slightly lateral to the pancreatic head.
The patient you are scanning has eaten breakfast prior to your study. What is the appearance of the
gallbladder in the postprandial state?
Contraction of the gallbladder with diffuse wall thickening
A patient presents to the ultrasound department for a sonogram to rule out biliary obstruction. Which
lab test would best indicate the presence of bile duct obstruction?
Serum direct bilirubin
What is the most common cause of acute cholecystitis?
Calculus obstruction of the gallbladder neck or cystic duct
Tenderness over the gallbladder with probe pressure is termed:
Murphy's sign
You are performing an abdominal ultrasound study and detect a dilated, nontender gallbladder. What
should you look for?
Mass in the head of the pancreas
2|Page
,What are symptoms associated with acute cholecyctitis?
Nausea, vomiting, epigastric pain, right upper quadrant pain
You are performing an ultrasound examination on a patient with acute cholecyctitis. Complications that
you should look for include, Pancreatitis, pancreatic carcinoma, gallbaladder perforation, gangrenous
cholecytitis, or emphysematous cholecyctitis, EXCEPT?
Pancreatic carcinoma
You have been asked to rule out the presence of choledocholithiasis. What are you looking for?
Stones within the common bile duct
Identification of what anatomic structure would most help a sonographer locate a contracted
gallbladder?
Main lobar fissure
The transverse diameter measurements of the gallbladder in a fasting patient measure 5.3 cm. This
measurement is:
Consistent with a hydropic gallbladder
You are scanning a patient in ICU and notice low-level echoes within the gallbladder consistent with
sludge. The gallbladder wall is not thickened. What could the sludge be due to?
The patient has sludge most likely due to bile stasis
Ultrasound images obtained on a 48-year-old male show a comet-tail or V-shaped reverberation artifact
originating from the anterior wall of the gallbladder. This artifact most likely results from:
Adenomyomatosis
You are performing an ultrasound study to rule out the presence of cholelithiasis. A small echogenic foci
is seen in the posterior aspect of the gallbladder fundus. How can you determine if this foci represents a
poly or a stone?
Shadowing is not present with polyps but is present with stones
What is the sonographic appearance of tumefactive sludge within the gallbladder?
An avascular mass with low-level echoes
You are scanning a 34-year-old multiparous woman with symptoms of severe right upper quadrant pain,
nausea and vomiting. The gallbladder is thick-walled with stones and an adjacent complex fluid
collection is seen. These findings most likely represent:
Acute cholecystitis complicated by gallbladder perforation
You are scanning a 44-year-old man with diabetes. He complains of severe epigastric pain radiating to
the back, vomiting, chills, and fever. Ultrasound findings include a large gallbladder with nondependent
hyperechoic foci associated with ringdown artifacts. These findings are most consistent with:
3|Page
, Emphysematous cholecystitis
Hypervascularity associated with acute cholecystitis is best evaluated with Doppler interrogation of
what artery below?
Cystic artery
Is acalculous cholecystitis associated with cholelithiasis?
NO
You are scanning a gallbladder and notice posterior acoustic shadowing. You are unsure if the
shadowing is due to bowl gas or gallstones. What would be helpful in making this distinction?
Roll the patient into a left lateral decubitus postion
You are imaging the gallbladder in a transverse orientation and notice a long shadow at both edges.
What is the etiology of this shadow?
Refraction artifact
A ultrasound image obtained from the gallbladder shows an irregular mass within the lumen which
demonstrates hypervascularity by color Doppler imaging. Multiple stones are also seen within the
gallbladder lumen. These findings are most consistent with:
Gallbladder caricnoma
What condition is associated with Rokitansky-Aschoff sinues?
Adenomyomatosis
The best way to identify the intrahepatic biliary system is to image which structure?
Intrahepatic portal veins
A patient is referred for a follow-up abdominal sonogram. The previous ultrasound report indicates that
pneumobilia was present. What is pneumobilia ?
Air in the bile ducts
You suspect intrahepatic bile duct dilatation in a patient with right upper quadrant pain and tenderness.
How can you differentiate the dilated bile ducts from intrahepatic veins?
Dilated bile ducts demonstrate irregular, tortuous walls. Bile ducts will not demonstrate flow with color
Doppler
What forms the common bile duct?
Junction of the cystic duct and common hepatic duct
During ultrasound evaluation of the gallbladder system, you notice thickening of the bile duct walls. This
finding may be related to which of the following?
Sclerosing cholangitis. Pancreatitis. Choledocholithiasis. Cholangiocarcinoma.
4|Page
PRACTICE EXAM, AND STUDY GUIDE EXAM
2024 WITH ACTUAL CORRECT QUESTIONS
AND VERIFIED DETAILED ANSWERS
|FREQUENTLY TESTED QUESTONS AND
SOLUTIONS |ALREADY GRADED A+|BRAND
NEW VERSION!!|LATEST UPDATE
|GUARANTEED PASS
You are scanning a patient with an enlarged caudate lobe and shrunken right lobe. What diffuse liver
process should you suspect?
Cirrhosis
You are scanning an obese patient to rule out fatty liver. What is the common sonographic appearance
this condition?
Increased echogenicity of the liver compared to the normal kidney
You are having difficulty locating the gallbladder in a patient with right upper quadrant pain. What
anatomic landmark will help you identify the gallbladder fossa?
Interlobar hepatic fissure
In what anatomic variant is the fundus of the gallbladder folded over the body?
Phrygian cap
A patient is referred from the emergency room to rule out acute cholecystitis. You think the gallbladder
wall may be thickened. What is the normal diameter of the gallbladder wall?
less than 3 mm
You are scanning the gallbladder and notice some smudgy echoes within it. You suspect the echoes are
due to artifact. What is a common cause of artifactual echoes within the gallbladder?
Reverberation, side lobes, slice thickness artifact
1|Page
,You have a patient scheduled for a gallbladder sonogram. What preparation is required?
The patient should be fasting for 8-12 hours prior to study.
You have been requested to perform a gallbladder ultrasound to rule out cholelithiasis. What is
cholelithiasis?
Gallstones
You are scanning the gallbladder and notice that the wall is abnormally thickened, would this be
associated with malignant ascites?
NO
A referring physician has asked you about the accuracy of gallbladder sonography. The diagnostic
accuracy of gallbladder sonography is:
more than 90%
During gallbladder sonography, you notice echogenic foci within the gallbladder but do not detect distal
acoustic shadowing. What changes below will improve the detectability of stone shadowing?
Increase transducer frequency, increase transducer focusing
You are scanning a patient with a porcelain gallbladder. What does this term mean?
The gallbladder wall contains varying amounts of calcification
Where exactly is the location of the distal common bile duct?
Posterior and slightly lateral to the pancreatic head.
The patient you are scanning has eaten breakfast prior to your study. What is the appearance of the
gallbladder in the postprandial state?
Contraction of the gallbladder with diffuse wall thickening
A patient presents to the ultrasound department for a sonogram to rule out biliary obstruction. Which
lab test would best indicate the presence of bile duct obstruction?
Serum direct bilirubin
What is the most common cause of acute cholecystitis?
Calculus obstruction of the gallbladder neck or cystic duct
Tenderness over the gallbladder with probe pressure is termed:
Murphy's sign
You are performing an abdominal ultrasound study and detect a dilated, nontender gallbladder. What
should you look for?
Mass in the head of the pancreas
2|Page
,What are symptoms associated with acute cholecyctitis?
Nausea, vomiting, epigastric pain, right upper quadrant pain
You are performing an ultrasound examination on a patient with acute cholecyctitis. Complications that
you should look for include, Pancreatitis, pancreatic carcinoma, gallbaladder perforation, gangrenous
cholecytitis, or emphysematous cholecyctitis, EXCEPT?
Pancreatic carcinoma
You have been asked to rule out the presence of choledocholithiasis. What are you looking for?
Stones within the common bile duct
Identification of what anatomic structure would most help a sonographer locate a contracted
gallbladder?
Main lobar fissure
The transverse diameter measurements of the gallbladder in a fasting patient measure 5.3 cm. This
measurement is:
Consistent with a hydropic gallbladder
You are scanning a patient in ICU and notice low-level echoes within the gallbladder consistent with
sludge. The gallbladder wall is not thickened. What could the sludge be due to?
The patient has sludge most likely due to bile stasis
Ultrasound images obtained on a 48-year-old male show a comet-tail or V-shaped reverberation artifact
originating from the anterior wall of the gallbladder. This artifact most likely results from:
Adenomyomatosis
You are performing an ultrasound study to rule out the presence of cholelithiasis. A small echogenic foci
is seen in the posterior aspect of the gallbladder fundus. How can you determine if this foci represents a
poly or a stone?
Shadowing is not present with polyps but is present with stones
What is the sonographic appearance of tumefactive sludge within the gallbladder?
An avascular mass with low-level echoes
You are scanning a 34-year-old multiparous woman with symptoms of severe right upper quadrant pain,
nausea and vomiting. The gallbladder is thick-walled with stones and an adjacent complex fluid
collection is seen. These findings most likely represent:
Acute cholecystitis complicated by gallbladder perforation
You are scanning a 44-year-old man with diabetes. He complains of severe epigastric pain radiating to
the back, vomiting, chills, and fever. Ultrasound findings include a large gallbladder with nondependent
hyperechoic foci associated with ringdown artifacts. These findings are most consistent with:
3|Page
, Emphysematous cholecystitis
Hypervascularity associated with acute cholecystitis is best evaluated with Doppler interrogation of
what artery below?
Cystic artery
Is acalculous cholecystitis associated with cholelithiasis?
NO
You are scanning a gallbladder and notice posterior acoustic shadowing. You are unsure if the
shadowing is due to bowl gas or gallstones. What would be helpful in making this distinction?
Roll the patient into a left lateral decubitus postion
You are imaging the gallbladder in a transverse orientation and notice a long shadow at both edges.
What is the etiology of this shadow?
Refraction artifact
A ultrasound image obtained from the gallbladder shows an irregular mass within the lumen which
demonstrates hypervascularity by color Doppler imaging. Multiple stones are also seen within the
gallbladder lumen. These findings are most consistent with:
Gallbladder caricnoma
What condition is associated with Rokitansky-Aschoff sinues?
Adenomyomatosis
The best way to identify the intrahepatic biliary system is to image which structure?
Intrahepatic portal veins
A patient is referred for a follow-up abdominal sonogram. The previous ultrasound report indicates that
pneumobilia was present. What is pneumobilia ?
Air in the bile ducts
You suspect intrahepatic bile duct dilatation in a patient with right upper quadrant pain and tenderness.
How can you differentiate the dilated bile ducts from intrahepatic veins?
Dilated bile ducts demonstrate irregular, tortuous walls. Bile ducts will not demonstrate flow with color
Doppler
What forms the common bile duct?
Junction of the cystic duct and common hepatic duct
During ultrasound evaluation of the gallbladder system, you notice thickening of the bile duct walls. This
finding may be related to which of the following?
Sclerosing cholangitis. Pancreatitis. Choledocholithiasis. Cholangiocarcinoma.
4|Page
