SONOGRAPHY CANADA (GENERALIST) – 1 EXAM 290
ACTUAL QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!!
This comprehensive question bank provides 290 multiple-choice questions
designed for the Sonography Canada Generalist exam, with a heavy focus on
abdominal, obstetric, gynecological, vascular, and superficial structure
imaging. Each question is clinically oriented, testing not just factual recall but
also the application of sonographic principles, pathology recognition, and
Doppler interpretation. The detailed rationales explain the correct answers by
linking sonographic findings to underlying pathophysiology, normal variants,
and diagnostic criteria. This resource emphasizes high-yield topics such as
biliary obstruction, renal masses, testicular pathology, first-trimester dating,
and portal hypertension, making it an effective tool for exam preparation and
clinical knowledge reinforcement.
1. A true abdominal aortic aneurysm is defined as dilation of the aorta:
A) Inferior to the renal arteries
B) When compared with a previous study
C) With a diameter measuring three centimeters or greater
D) When compared with a proximal segment
E) When compared with a distal segment
Correct Answer: C
Rationale: A true abdominal aortic aneurysm is defined as a focal dilation of the
aorta with a diameter of 3 cm or greater. This measurement is the standard
diagnostic threshold.
2. Which of the following vascular structures is located directly posterior to the
neck of the pancreas?
A) Inferior vena cava
B) Proper hepatic artery
C) Gastroduodenal artery
D) Superior mesenteric vein
E) Superior mesenteric artery
,Correct Answer: D
Rationale: The superior mesenteric vein courses directly posterior to the neck of
the pancreas, where it joins the splenic vein to form the main portal vein.
3. Which of the following acoustic windows is generally utilized in non-cardiac
imaging of the chest?
A) Subcostal
B) Intercostal
C) Substernal
D) Intracostal
E) Suprasternal
Correct Answer: B
Rationale: The intercostal acoustic window is used to image the chest to evaluate
pleural effusions, lung masses, or the diaphragm, as it allows sound to pass
between the ribs.
4. Which of the following laboratory values increases in Addison's disease?
A) Cortisol
B) Calcitonin
C) Aldosterone
D) Serum sodium
E) Serum potassium
Correct Answer: E
Rationale: Addison's disease results in decreased production of aldosterone,
leading to a reduced ability to excrete potassium, which causes serum potassium
levels to increase.
5. The spleen lies in which of the following anatomical positions relative to the
stomach?
A) Anterior and medial
B) Posterior and lateral
C) Superior and lateral
D) Inferior and medial
E) Anterior and lateral
Correct Answer: B
Rationale: The spleen is located in the left upper quadrant, posterior and lateral to
the stomach.
,6. A post-surgical patient presents with abdominal tenderness and leukocytosis. A
sonogram demonstrates a superficial ill-defined mass beneath the surgical incision.
The sonographic findings are most suspicious for:
A) Seroma
B) Abscess
C) Hematoma
D) Lymphocele
E) Pseudoaneurysm
Correct Answer: B
Rationale: A postoperative abscess typically presents as an ill-defined, hypoechoic
or complex fluid collection with internal debris, and the clinical presentation of
fever, tenderness, and leukocytosis supports this diagnosis.
7. Blood is supplied directly to the epididymis through which of the following
arteries?
A) Capsular
B) Testicular
C) Cremasteric
D) Centripetal
E) Inferior vesical
Correct Answer: C
Rationale: The cremasteric artery, a branch of the inferior epigastric artery, directly
supplies the epididymis.
8. In a patient with clinically suspected deep vein thrombosis, which of the
following venous segments is most commonly involved?
A) Common femoral
B) Popliteal
C) Calf veins
D) External iliac
E) Proximal femoral
Correct Answer: C
Rationale: Calf veins, particularly the soleal and gastrocnemius veins, are the most
common sites for initiation of deep vein thrombosis.
9. During spectral Doppler evaluation of the portal vein, which of the following
patterns is considered normal?
A) Hepatopetal flow with respiratory variation
B) Hepatofugal flow with continuous waveform
C) Monophasic flow with no respiratory variation
, D) Reversed diastolic flow
E) High-velocity turbulent flow
Correct Answer: A
Rationale: Normal portal vein flow is hepatopetal (toward the liver) and shows
phasic variation with respiration, increasing with inspiration and decreasing with
expiration.
10. A patient with right upper quadrant pain and jaundice is examined. The
sonogram reveals a dilated common bile duct with an echogenic focus at the distal
end. The most likely diagnosis is:
A) Choledocholithiasis
B) Sclerosing cholangitis
C) Cholangiocarcinoma
D) Pancreatic pseudocyst
E) Mirizzi syndrome
Correct Answer: A
Rationale: The presence of a dilated bile duct with an echogenic focus (stone) at
the distal end in a jaundiced patient is highly suggestive of choledocholithiasis.
11. In the first trimester, the mean sac diameter is used to estimate gestational age
when:
A) The embryo is not visible
B) The crown-rump length is greater than 10 mm
C) The heart rate is abnormal
D) The yolk sac is absent
E) The beta-hCG level is unknown
Correct Answer: A
Rationale: Mean sac diameter is the preferred method for dating when an embryo
is not yet visible on ultrasound.
12. The normal adult kidney length is approximately:
A) 6 to 8 cm
B) 9 to 12 cm
C) 13 to 15 cm
D) 16 to 18 cm
E) 4 to 6 cm
Correct Answer: B
Rationale: A normal adult kidney typically measures between 9 and 12 cm in
length, with some variation based on patient height and body habitus.
ACTUAL QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!!
This comprehensive question bank provides 290 multiple-choice questions
designed for the Sonography Canada Generalist exam, with a heavy focus on
abdominal, obstetric, gynecological, vascular, and superficial structure
imaging. Each question is clinically oriented, testing not just factual recall but
also the application of sonographic principles, pathology recognition, and
Doppler interpretation. The detailed rationales explain the correct answers by
linking sonographic findings to underlying pathophysiology, normal variants,
and diagnostic criteria. This resource emphasizes high-yield topics such as
biliary obstruction, renal masses, testicular pathology, first-trimester dating,
and portal hypertension, making it an effective tool for exam preparation and
clinical knowledge reinforcement.
1. A true abdominal aortic aneurysm is defined as dilation of the aorta:
A) Inferior to the renal arteries
B) When compared with a previous study
C) With a diameter measuring three centimeters or greater
D) When compared with a proximal segment
E) When compared with a distal segment
Correct Answer: C
Rationale: A true abdominal aortic aneurysm is defined as a focal dilation of the
aorta with a diameter of 3 cm or greater. This measurement is the standard
diagnostic threshold.
2. Which of the following vascular structures is located directly posterior to the
neck of the pancreas?
A) Inferior vena cava
B) Proper hepatic artery
C) Gastroduodenal artery
D) Superior mesenteric vein
E) Superior mesenteric artery
,Correct Answer: D
Rationale: The superior mesenteric vein courses directly posterior to the neck of
the pancreas, where it joins the splenic vein to form the main portal vein.
3. Which of the following acoustic windows is generally utilized in non-cardiac
imaging of the chest?
A) Subcostal
B) Intercostal
C) Substernal
D) Intracostal
E) Suprasternal
Correct Answer: B
Rationale: The intercostal acoustic window is used to image the chest to evaluate
pleural effusions, lung masses, or the diaphragm, as it allows sound to pass
between the ribs.
4. Which of the following laboratory values increases in Addison's disease?
A) Cortisol
B) Calcitonin
C) Aldosterone
D) Serum sodium
E) Serum potassium
Correct Answer: E
Rationale: Addison's disease results in decreased production of aldosterone,
leading to a reduced ability to excrete potassium, which causes serum potassium
levels to increase.
5. The spleen lies in which of the following anatomical positions relative to the
stomach?
A) Anterior and medial
B) Posterior and lateral
C) Superior and lateral
D) Inferior and medial
E) Anterior and lateral
Correct Answer: B
Rationale: The spleen is located in the left upper quadrant, posterior and lateral to
the stomach.
,6. A post-surgical patient presents with abdominal tenderness and leukocytosis. A
sonogram demonstrates a superficial ill-defined mass beneath the surgical incision.
The sonographic findings are most suspicious for:
A) Seroma
B) Abscess
C) Hematoma
D) Lymphocele
E) Pseudoaneurysm
Correct Answer: B
Rationale: A postoperative abscess typically presents as an ill-defined, hypoechoic
or complex fluid collection with internal debris, and the clinical presentation of
fever, tenderness, and leukocytosis supports this diagnosis.
7. Blood is supplied directly to the epididymis through which of the following
arteries?
A) Capsular
B) Testicular
C) Cremasteric
D) Centripetal
E) Inferior vesical
Correct Answer: C
Rationale: The cremasteric artery, a branch of the inferior epigastric artery, directly
supplies the epididymis.
8. In a patient with clinically suspected deep vein thrombosis, which of the
following venous segments is most commonly involved?
A) Common femoral
B) Popliteal
C) Calf veins
D) External iliac
E) Proximal femoral
Correct Answer: C
Rationale: Calf veins, particularly the soleal and gastrocnemius veins, are the most
common sites for initiation of deep vein thrombosis.
9. During spectral Doppler evaluation of the portal vein, which of the following
patterns is considered normal?
A) Hepatopetal flow with respiratory variation
B) Hepatofugal flow with continuous waveform
C) Monophasic flow with no respiratory variation
, D) Reversed diastolic flow
E) High-velocity turbulent flow
Correct Answer: A
Rationale: Normal portal vein flow is hepatopetal (toward the liver) and shows
phasic variation with respiration, increasing with inspiration and decreasing with
expiration.
10. A patient with right upper quadrant pain and jaundice is examined. The
sonogram reveals a dilated common bile duct with an echogenic focus at the distal
end. The most likely diagnosis is:
A) Choledocholithiasis
B) Sclerosing cholangitis
C) Cholangiocarcinoma
D) Pancreatic pseudocyst
E) Mirizzi syndrome
Correct Answer: A
Rationale: The presence of a dilated bile duct with an echogenic focus (stone) at
the distal end in a jaundiced patient is highly suggestive of choledocholithiasis.
11. In the first trimester, the mean sac diameter is used to estimate gestational age
when:
A) The embryo is not visible
B) The crown-rump length is greater than 10 mm
C) The heart rate is abnormal
D) The yolk sac is absent
E) The beta-hCG level is unknown
Correct Answer: A
Rationale: Mean sac diameter is the preferred method for dating when an embryo
is not yet visible on ultrasound.
12. The normal adult kidney length is approximately:
A) 6 to 8 cm
B) 9 to 12 cm
C) 13 to 15 cm
D) 16 to 18 cm
E) 4 to 6 cm
Correct Answer: B
Rationale: A normal adult kidney typically measures between 9 and 12 cm in
length, with some variation based on patient height and body habitus.
