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ARDMS Abdomen Sonography Examination Sample Questions (Q89-Q94):

NEW QUESTION # 89
Which disease process causes exudative ascites?

A. Infection
B. Hypoproteinemia
C. Liver failure
D. Renal failure

Answer: A

Explanation:
Exudative ascites is characterized by high protein content and cellular debris, typically resulting from infections (e.g., peritonitis, tuberculosis), malignancy, or inflammatory conditions. Transudative ascites is more commonly seen in conditions such as liver failure, renal failure, and hypoproteinemia due to changes in hydrostatic or oncotic pressure.
According to Light's Criteria:
"Infection and malignancy are common causes of exudative ascites, distinguished by high protein content and elevated LDH." Reference:
Light RW. Pleural Diseases. 6th ed. Lippincott Williams & Wilkins, 2013.
AASLD Guidelines for the Evaluation of Ascites, 2021.
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NEW QUESTION # 90
Which disease process may cause numerous shadowing calcifications to form within the spleen?

A. Thalassemia
B. Histoplasmosis
C. Non-Hodgkin lymphoma
D. Sickle cell anemia

Answer: B

Explanation:
Histoplasmosis is a fungal infection that can lead to granulomatous disease. Chronic granulomatous infections may result in multiple splenic calcifications that appear as small echogenic foci with shadowing on ultrasound. Other infectious granulomas (e.g., tuberculosis) may present similarly.
According to Rumack's Diagnostic Ultrasound:
"Granulomatous infections such as histoplasmosis and tuberculosis may produce multiple splenic calcifications, often with shadowing." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of Abdominal Ultrasound Examinations, 2020.
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NEW QUESTION # 91
Which vessel is typically seen with an echogenic ring of fat when imaging the upper abdominal mesenteric circulation?

A. Splenic artery
B. Superior mesenteric artery
C. Gastroduodenal artery
D. Common hepatic artery

Answer: B

Explanation:
The superior mesenteric artery (SMA) is typically visualized surrounded by an echogenic fat pad in the mesentery, producing a characteristic "echogenic ring" appearance on ultrasound. This is a helpful landmark for identifying the SMA in the transverse abdominal aortic plane.
According to Rumack's Diagnostic Ultrasound:
"The superior mesenteric artery is often seen as a round anechoic structure surrounded by echogenic fat at its origin from the anterior aorta." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
Moore KL, Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.

NEW QUESTION # 92
Which portion of the renal arterial vasculature is indicated by the arrow in this image?

A. Arcuate
B. Interlobar
C. Segmental
D. Interlobular

Answer: A

Explanation:
The arrow in this Doppler ultrasound image of the kidney is pointing to vessels located at the corticomedullary junction, arching over the bases of the medullary pyramids. This vascular pattern is characteristic of the arcuate arteries.
Renal arterial anatomy follows a specific branching hierarchy:
* Segmental arteries branch off the main renal artery.
* Interlobar arteries travel between renal pyramids.
* Arcuate arteries arch over the base of the pyramids at the corticomedullary junction.
* Interlobular arteries extend into the cortex from the arcuate arteries.
Key characteristics of arcuate arteries on ultrasound:
* Located at the corticomedullary junction (between the medullary pyramids and renal cortex).
* Run perpendicular to the long axis of the kidney, often forming an arching or curving pattern.
* Commonly targeted in Doppler studies to assess resistive index (RI) in renal perfusion studies.
Comparison of answer choices:
* A. Interlobular arteries are smaller vessels that extend perpendicularly from the arcuate arteries into the cortex-not visible at this level.
* B. Arcuate - Correct. The arrow is indicating these vessels arching over the medullary pyramids.
* C. Segmental arteries are larger and deeper, branching off the renal artery near the hilum.
* D. Interlobar arteries course between the pyramids but do not arch along their base.
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.
AIUM Practice Parameter for the Performance of a Renal Artery Duplex Sonogram (2020).

NEW QUESTION # 93
Which scanning technique would best reduce reverberation artifact when assessing the gallbladder?

A. Turn on harmonics
B. Turn on penetration
C. Decrease the sector width
D. Decrease the overall gain

Answer: A

Explanation:
Tissue harmonic imaging significantly reduces reverberation and side-lobe artifacts by utilizing nonlinear propagation of ultrasound waves. This produces clearer images of fluid-filled structures like the gallbladder, improving visualization of wall thickness and intraluminal contents.
According to Zwiebel's Introduction to Vascular Ultrasound:
"Harmonic imaging effectively reduces reverberation artifact, improving image quality in gallbladder and cystic structure evaluation." Reference:
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.
AIUM Practice Parameter for Abdominal Ultrasound, 2020.

NEW QUESTION # 94
......

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