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ARDMS Abdomen Sonography Examination Sample Questions (Q144-Q149):

NEW QUESTION # 144
Which congenital anomaly is characterized by the failure of the dorsal and ventral pancreatic buds to fuse?

A. Annular pancreas
B. Pancreatic agenesis
C. Ectopic pancreas
D. Pancreas divisum

Answer: D

Explanation:
Pancreas divisum occurs when the dorsal and ventral pancreatic ducts fail to fuse during embryologic development. This results in most pancreatic secretions draining through the minor papilla via the dorsal duct (duct of Santorini).
According to Rumack's Diagnostic Ultrasound:
"In pancreas divisum, the dorsal and ventral pancreatic ducts fail to fuse, resulting in separate drainage systems." 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.
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NEW QUESTION # 145
Which technique would best assist the sonographer to verify the finding in this image obtained from the right upper quadrant?

A. Assess for sonographic Murphy sign
B. Change the patient's position
C. Ask patient to perform Valsalva
D. Use compound imaging

Answer: A

Explanation:
The image demonstrates a gallbladder with a possible echogenic focus (likely a gallstone) and posterior acoustic shadowing. This is suggestive of cholelithiasis. To differentiate uncomplicated gallstones from acute cholecystitis, the most effective technique is to assess for a positive sonographic Murphy sign.
A positive sonographic Murphy sign refers to the presence of focal tenderness over the gallbladder when it is directly palpated with the ultrasound transducer. It is a strong indicator of acute cholecystitis when combined with other features such as gallbladder wall thickening, pericholecystic fluid, and gallstones.
Sonographic Murphy sign - key points:
* Assessed during real-time scanning
* Localized tenderness when pressure is applied over the gallbladder
* Highly sensitive for acute cholecystitis (especially in the presence of stones) Differentiation from other options:
* A. Use compound imaging: Improves image quality by reducing artifacts but does not verify tenderness or confirm acute inflammation.
* B. Change the patient's position: Helpful to confirm mobility of gallstones, but not diagnostic of inflammation.
* C. Ask patient to perform Valsalva: Used primarily in vascular studies (e.g., assessing for varicocele or venous reflux), not relevant here.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Gallbladder and Biliary System, pp. 148-152.
AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum, 2020.
Radiopaedia.org. Sonographic Murphy sign:https://radiopaedia.org/articles/sonographic-murphy-sign

NEW QUESTION # 146
Which is the most likely etiology of a spherical mass near the splenic hilum that is isoechoic to the normal spleen in a 55-year-old female?

A. Lymph node
B. Kidney mass
C. Pancreatic mass
D. Accessory spleen

Answer: D

Explanation:
An accessory spleen (splenule) is a congenital variant, commonly located near the splenic hilum, and has identical echogenicity to the native spleen. This finding is benign and often incidental.
According to Rumack's Diagnostic Ultrasound:
"Accessory spleens are typically found near the splenic hilum and are isoechoic to the normal splenic parenchyma." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Abdominal Ultrasound, 2020.
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NEW QUESTION # 147
Which condition is most likely to develop after splenic trauma?

A. Hamartoma
B. Splenosis
C. Target lesion
D. Splenule

Answer: B

Explanation:
Splenosis refers to autotransplantation of splenic tissue following splenic trauma or splenectomy. After rupture, splenic fragments may implant throughout the peritoneal cavity and vascularize, forming multiple nodules of functional splenic tissue. Splenosis is typically asymptomatic and discovered incidentally on imaging.
Splenule (A) is a congenital accessory spleen, not related to trauma.
Hamartoma (C) is a benign primary splenic lesion.
Target lesion (D) generally refers to sonographic appearance seen in metastases or infections, not post-trauma.
Reference Extracts:
Mortele KJ, et al. "Multimodality imaging of splenic lesions and the spleen." Radiographics. 2004;24(4):1137-
1163.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
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NEW QUESTION # 148
Which malignancy most commonly metastasizes to the testes?

A. Prostate cancer
B. Bladder cancer
C. Hodgkin lymphoma
D. Non-Hodgkin lymphoma

Answer: A

Explanation:
Testicular metastases are rare and usually identified in older patients. The most frequent primary site of malignancies metastasizing to the testes is theprostate. Studies (Ulbright and Young, 2008; Mosharafa et al.,
2003) indicate that prostatic adenocarcinoma accounts for the highest number of testicular metastases, with lung and gastrointestinal tract malignancies also contributing less frequently. These metastases can be unilateral or bilateral and are often discovered incidentally during surgical intervention for prostate cancer.
The metastatic route involves retrograde venous extension, arterial embolism, or lymphatic dissemination.
Histologically, prostatic adenocarcinoma in the testis can be confirmed viaimmunohistochemical markers like prostate-specific antigen (PSA), supporting its prostatic origin.
References:
Ulbright TM, Young RH. Tumors of the Testis, Adnexa, Spermatic Cord, and Scrotum. AFIP Atlas of Tumor Pathology, 4th Series, Fascicle 18. Armed Forces Institute of Pathology, 2008.
Mosharafa AA, Foster RS, Bihrle R, et al. Clinical and pathologic features of testicular metastases from solid tumors: a 40-year review. Urology. 2003;61(5): 1064-1068.

NEW QUESTION # 149
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AB-ABDOMEN EXAM DURATION | AB-ABDOMEN RELATED CONTENT

AB-Abdomen Exam Duration | AB-Abdomen Related Content