Michigan Ultrasound Specialty Exam
Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. Which of the following is the most common cause of liver cirrhosis
detectable on ultrasound?
A. Hemochromatosis
B. Wilson’s disease
C. Chronic hepatitis C
D. Alpha-1 antitrypsin deficiency
Chronic hepatitis C is the leading cause of liver cirrhosis worldwide, and
ultrasound can detect features such as a nodular liver surface, coarse
echotexture, and signs of portal hypertension.
2. The most sensitive ultrasound finding for acute cholecystitis is:
A. Gallbladder wall thickening
B. Presence of pericholecystic fluid
C. Gallstones
D. Positive Murphy’s sign on palpation
Pericholecystic fluid is highly specific for acute inflammation of the
gallbladder, especially when combined with gallstones and sonographic
Murphy’s sign.
, 3. Which Doppler finding is typical in a patient with portal
hypertension?
A. Increased hepatic artery resistance
B. Hepatofugal portal flow
C. Decreased splenic vein diameter
D. Normal flow in the portal vein
Hepatofugal flow (blood flowing away from the liver) indicates portal
hypertension, often secondary to cirrhosis.
4. On ultrasound, a simple renal cyst is characterized by:
A. Internal echoes and septations
B. Anechoic appearance with posterior acoustic enhancement
C. Irregular wall thickening
D. Increased Doppler flow
Simple renal cysts appear anechoic, have thin walls, and demonstrate
posterior acoustic enhancement due to fluid content.
5. Which is a classic sonographic feature of fatty liver disease?
A. Increased echogenicity of the liver compared to the renal
cortex
B. Nodular liver surface
C. Ascites
D. All of the above
The primary feature is increased echogenicity relative to the renal
cortex. Nodularity and ascites are more typical of advanced cirrhosis,
not simple fatty infiltration.
(Correction: Only A is correct; D is misleading. So correct answer: A)
6. The first-line imaging for suspected deep vein thrombosis (DVT) is:
A. CT venography
B. MRI venography
, C. Compression ultrasound
D. Plain radiography
Compression ultrasound is non-invasive, highly sensitive, and the
preferred first-line diagnostic tool for DVT.
7. Which of the following structures is best evaluated with
transvaginal ultrasound?
A. Pancreas
B. Spleen
C. Ovaries
D. Liver
Transvaginal ultrasound provides high-resolution images of the uterus
and ovaries, which are difficult to visualize transabdominally in some
patients.
8. On Doppler ultrasound, a normal umbilical artery waveform in a
third-trimester fetus shows:
A. High-resistance flow
B. Low-resistance flow
C. Reversed end-diastolic flow
D. Absent end-diastolic flow
Low-resistance flow in the umbilical artery ensures adequate perfusion
to the fetus. Reversed or absent flow indicates significant pathology.
9. Which of the following is a common sonographic sign of
appendicitis?
A. Non-compressible tubular structure >6 mm in diameter
B. Anechoic cystic structure
C. Hyperechoic kidney
D. Free fluid in Morrison’s pouch
Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. Which of the following is the most common cause of liver cirrhosis
detectable on ultrasound?
A. Hemochromatosis
B. Wilson’s disease
C. Chronic hepatitis C
D. Alpha-1 antitrypsin deficiency
Chronic hepatitis C is the leading cause of liver cirrhosis worldwide, and
ultrasound can detect features such as a nodular liver surface, coarse
echotexture, and signs of portal hypertension.
2. The most sensitive ultrasound finding for acute cholecystitis is:
A. Gallbladder wall thickening
B. Presence of pericholecystic fluid
C. Gallstones
D. Positive Murphy’s sign on palpation
Pericholecystic fluid is highly specific for acute inflammation of the
gallbladder, especially when combined with gallstones and sonographic
Murphy’s sign.
, 3. Which Doppler finding is typical in a patient with portal
hypertension?
A. Increased hepatic artery resistance
B. Hepatofugal portal flow
C. Decreased splenic vein diameter
D. Normal flow in the portal vein
Hepatofugal flow (blood flowing away from the liver) indicates portal
hypertension, often secondary to cirrhosis.
4. On ultrasound, a simple renal cyst is characterized by:
A. Internal echoes and septations
B. Anechoic appearance with posterior acoustic enhancement
C. Irregular wall thickening
D. Increased Doppler flow
Simple renal cysts appear anechoic, have thin walls, and demonstrate
posterior acoustic enhancement due to fluid content.
5. Which is a classic sonographic feature of fatty liver disease?
A. Increased echogenicity of the liver compared to the renal
cortex
B. Nodular liver surface
C. Ascites
D. All of the above
The primary feature is increased echogenicity relative to the renal
cortex. Nodularity and ascites are more typical of advanced cirrhosis,
not simple fatty infiltration.
(Correction: Only A is correct; D is misleading. So correct answer: A)
6. The first-line imaging for suspected deep vein thrombosis (DVT) is:
A. CT venography
B. MRI venography
, C. Compression ultrasound
D. Plain radiography
Compression ultrasound is non-invasive, highly sensitive, and the
preferred first-line diagnostic tool for DVT.
7. Which of the following structures is best evaluated with
transvaginal ultrasound?
A. Pancreas
B. Spleen
C. Ovaries
D. Liver
Transvaginal ultrasound provides high-resolution images of the uterus
and ovaries, which are difficult to visualize transabdominally in some
patients.
8. On Doppler ultrasound, a normal umbilical artery waveform in a
third-trimester fetus shows:
A. High-resistance flow
B. Low-resistance flow
C. Reversed end-diastolic flow
D. Absent end-diastolic flow
Low-resistance flow in the umbilical artery ensures adequate perfusion
to the fetus. Reversed or absent flow indicates significant pathology.
9. Which of the following is a common sonographic sign of
appendicitis?
A. Non-compressible tubular structure >6 mm in diameter
B. Anechoic cystic structure
C. Hyperechoic kidney
D. Free fluid in Morrison’s pouch
