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Quiz 2026 Efficient AB-Abdomen: Valid Exam Abdomen Sonography Examination Preparation
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ARDMS AB-Abdomen Exam Syllabus Topics:
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ARDMS Abdomen Sonography Examination Sample Questions (Q130-Q135):
NEW QUESTION # 130
Which vessel is located directly proximal to the origination of the renal arteries?
- A. Left portal vein
- B. Splenic vein
- C. Superior mesenteric artery
- D. Hepatic artery
Answer: C
Explanation:
The renal arteries originate from the abdominal aorta just inferior to the superior mesenteric artery (SMA).
The SMA arises anteriorly from the abdominal aorta at the level of L1, and just below it, the renal arteries branch laterally. The splenic vein, portal vein, and hepatic artery are located more superiorly in relation to the renal arteries.
According to Moore's Clinically Oriented Anatomy:
"The superior mesenteric artery arises from the anterior surface of the abdominal aorta just above the renal arteries." (Moore KL et al., Clinically Oriented Anatomy, 8th ed.) Reference:
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.
Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
NEW QUESTION # 131
Which sonographic appearance of the bile ducts is demonstrated in this image?
- A. Dilated intrahepatic
- B. Dilated common bile
- C. Normal intrahepatic
- D. Dilated common hepatic
Answer: A
Explanation:
The image shows a transverse view of the left lobe of the liver with the portal triads clearly visible. The
"parallel channel" or "double barrel" sign is observed-where dilated intrahepatic bile ducts run alongside the portal veins, creating a characteristic sonographic pattern of paired anechoic (black) tubular structures.
This sonographic feature is diagnostic for dilated intrahepatic bile ducts and is typically seen in obstructive jaundice or biliary obstruction from conditions such as:
* Choledocholithiasis (stone in the common bile duct)
* Stricture or mass compressing the bile ducts
* Cholangiocarcinoma
The intrahepatic bile ducts normally are too small to visualize clearly unless dilated. Their dilation gives the liver a "too many tubes" appearance, where bile ducts become as prominent as the portal veins.
Comparison of answer choices:
* A. Normal intrahepatic ducts are not usually seen this clearly or prominently on ultrasound.
* B. Dilated intrahepatic - Correct. The parallel channel sign supports this diagnosis.
* C. Dilated common bile duct would be visualized extrahepatically, typically anterior to the portal vein near the head of the pancreas.
* D. Dilated common hepatic duct is also extrahepatic and seen in the porta hepatis, not within the liver parenchyma.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.
Taylor KJW, Burns PN, Wells PNT. Clinical Applications of Doppler Ultrasound. Raven Press; 1990.
NEW QUESTION # 132
Based on this image, what is the most likely clinical indication for the examination?
- A. Projectile vomiting
- B. Abnormal prenatal ultrasound
- C. Neonatal hyperbilirubinemia
- D. Red currant jelly stools
Answer: A
Explanation:
The ultrasound image demonstrates findings consistent with hypertrophic pyloric stenosis (HPS). This condition typically affects infants between 2 and 8 weeks of age and presents clinically with non-bilious projectile vomiting, weight loss, and dehydration.
In the ultrasound image, the classic "target" or "donut" sign can be seen in the transverse view of the hypertrophied pyloric muscle. Key sonographic criteria for HPS include:
* Pyloric muscle thickness #3 mm
* Pyloric channel length #15-18 mm
This imaging appearance strongly correlates with the clinical presentation of projectile vomiting (Choice D), which is the hallmark symptom of HPS.
Comparison of answer choices:
* A. Abnormal prenatal ultrasound (Choice A) is not typically associated with HPS, which develops postnatally.
* B. Neonatal hyperbilirubinemia (Choice B) is not an indication for a pyloric ultrasound and affects liver
/biliary imaging.
* C. Red currant jelly stools (Choice C) are indicative of intussusception, not HPS.
* D. Projectile vomiting (Choice D) is the most common clinical indication leading to an ultrasound exam that reveals HPS.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
AIUM Practice Parameter for the Performance of Ultrasound of the Pyloric Region in Infants (2014).
Hernanz-Schulman M. Infantile hypertrophic pyloric stenosis. Radiology. 2003;227(2):319-331.
NEW QUESTION # 133
Which condition is demonstrated in this image?
- A. Intussusception
- B. Hydronephrosis
- C. Gastritis
- D. Pyloric stenosis
Answer: D
Explanation:
The ultrasound image clearly demonstrates a thickened and elongated pyloric muscle with a visible channel, which is characteristic of hypertrophic pyloric stenosis (HPS). This condition is most commonly seen in male infants between 2 and 8 weeks of age who present with non-bilious projectile vomiting, dehydration, and a palpable "olive-like" mass in the right upper quadrant.
Ultrasound is the imaging modality of choice and is highly sensitive and specific for diagnosing pyloric stenosis.
Key sonographic criteria for HPS:
* Muscle thickness >3 mm
* Pyloric channel length >15-17 mm
* "Target sign" or "doughnut sign" on transverse imaging (concentric rings)
* "Cervix" or "railroad track sign" on longitudinal imaging (elongated canal with echogenic center) Differentiation from other options:
* A. Intussusception: Also shows a target sign, but it occurs in the right lower quadrant or periumbilical region, not in the gastric antrum.
* C. Hydronephrosis: Refers to dilation of the renal pelvis and calyces - not gastrointestinal.
* D. Gastritis: May show gastric wall thickening but lacks the distinct elongated, thickened pyloric muscle seen here.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Gastrointestinal Tract, pp. 474-479.
American College of Radiology (ACR) Appropriateness Criteria - Vomiting in Infants Up to 3 Months of Age.
AIUM Practice Parameter for the Performance of a Pediatric Abdominal Ultrasound Examination, 2020.
NEW QUESTION # 134
Which abnormality is depicted in this image of a patient who presents with a fever following a liver biopsy?
- A. Biloma
- B. Hematoma
- C. Cyst
- D. Abscess
Answer: D
Explanation:
The sonographic image shows a complex fluid collection within the liver parenchyma, with internal echoes and possibly septations, consistent with an abscess. In the clinical context of post-procedural fever following a liver biopsy, a liver abscess is the most likely diagnosis.
A liver abscess appears on ultrasound as a hypoechoic or complex fluid collection that may contain internal debris, septations, or gas (which may produce reverberation artifacts). These features distinguish it from other post-procedural complications.
* A cyst (Option A) typically appears as an anechoic, well-defined lesion with posterior acoustic enhancement and no internal debris-this does not match the image or clinical setting.
* A biloma (Option B) is a bile collection that can appear similar to a cyst or fluid collection but typically occurs due to bile leak; however, fever and internal complexity on ultrasound more strongly suggest abscess.
* A hematoma (Option D) may also appear complex but usually presents with pain and not fever unless secondarily infected. Over time, hematomas evolve in appearance but lack septations and gas unless superinfected.
Reference:
Rumack, Carol M., et al. Diagnostic Ultrasound.5th ed., Elsevier, 2018. Chapter: Hepatobiliary System, pp.
107-111.
American Institute of Ultrasound in Medicine (AIUM) Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum.
NEW QUESTION # 135
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