ARDMS ABDOMEN MOCK EXAM QUESTIONS
AND ANSWERS (2022/2023)
1. Progressionofwhichofthefollowingabnormalitiesflattenstheportalveins?
(Answer)Biliary obstruction
2. Thewallthicknessinanormalfastinggallbladdershouldnotexceed(Answer)
3mm
3. ThiscolorDopplersonogramismostlikelydemonstratingwhichofthefollowi
ngabnormalities?(Answer)Pseudoaneurysm
ThiscolorDopplerimagedemonstratesturbulentswirlingbloodflowwithinafluidcollec
tion, classic sonographic findings of a common femoral artery pseudoa-neurysm.
4. Apatientpresentswithsuddenonsetofupperabdominalpain.Ultrasounddemo
nstrates prominence in the stomach rugae. These findings are
mostsuspiciousfor whichof thefollowingconditions?(Answer)Gastritis
Prominence of the stomach rugae in a patient with upper abdominal pain is
mostsuspiciousforgastritis.Hypervascular,thickgastricwallsaresonographicfindingsa
ssociatedwith gastric ulcers.
5. Whichofthefollowingisacomplicationofacutepancreatitis?
(Answer)Duodenalobstruction
Complications of acute pancreatitis may include abscess formation,
duodenalobstruction,hemorrhage,phlegmon,andpseudocystformation.Cholecystitisi
sapossibleetiology of acute pancreatitis.
6. Apatientpresentswithahistoryofhematuria.Thefindingsinthisdupleximagea
remostsuspiciousforwhichofthefollowingpathologies?(Answer)Carcino-ma
A vascular echogenic mass is identified protruding from the posterior wall of
theurinarybladder.Bladdercarcinomacommonlypresentswithahistoryofpainlesshem
aturia. Based on the clinical history, the sonographic findings are suspiciousfora
malignant mass.
7. A sagittal sonogram medial to the portahepatis is demonstrating
whichofthe following abnormalities?(Answer)Dilated common
bileduct
,Ahypoechoicmassidentifiedbythecalipersisobstructingthecommonbileductresulting
in dilatation. The mass is most likely a malignancy in the head of thepancreas.
,8. Thepathology inthis sonogramis mostlikely a/an(Answer)Pseudocyst
A complex fluid collection is identified posterior to the tail of the pancreas. Thisis
most likely a pancreatic pseudocyst. Phlegmons and islet cell tumors
appearashypoechoicmassesonultrasound.Apancreatichemorrhageisadifferentialc
onsiderationbutnotthemostlikelypathology.
9. Whichofthefollowingabnormalitiesisdemonstratedinthistransversesonog
ram?(Answer)Stones in the duct ofWirsung
Multiple stones are located in main pancreatic duct (duct ofWirsung).
10. Whichofthefollowingisaclinicalsymptomofhypothyroidism?
(Answer)Musclecramps
Musclescrampingisasymptomofhypothyroidism.Othersymptomsmayincludeweightg
ain,mentalandphysicallethargy,arthritis,skindryness,feelingcold,slowmetabolic rate,
and decreased heart rate. Symptoms commonly associated withhyperthyroidism
include weight loss, palpitations, nervousness,
exophthalmos,constanthunger,tremors,increasedheartrate,andintolerancetoheat.
11. A 20-year-old patient presents with a palpable left scrotal mass.
Thesonographicfindingsaremostsuspiciousforwhichofthefollowingpatholo-
gies?(Answer)Malignant neoplasm
Amalignantneoplasmisthemostlikelydiagnosisinayoungadultdemonstratinga
hypoechoicintratesticular mass. The patient is afebrile excluding a
testicularabscessfrom the differentialconsiderations.
12. Apatientpresentswithahistory of a palpableneck
mass.Which ofthefollowing terms best describes the
sonographic findings? (Answer)Heterogeneousthyroidgland
The sonographer's technical report should describe the right thyroid lobe
asdemonstratinganirregular andheterogeneousecho texture.
13. Apatientpresentswithahistory ofcirrhosis.The
arrowsare identifyingthe(Answer)coronary ligament
Ahyperechoiclinearstructureisidentifieddividingtherightsubphrenicspacefromthesu
bhepaticspace.Thisisconsistentwiththerightcoronaryligament.Therightcoronary
ligament serves asa barrier between thesetwo peritoneal spaces.
, 14. ThiscolorDopplersonogramismostlikelydemonstratingwhichofthefollowi
ngabnormalities?(Answer)Patent umbilicalvein
The sonogram is demonstrating a patent paraumbilical vein. Note the
liverparenchymaoftheleftlobesuperiortothepatentumbilicalvein.Gastricvaricesarege
nerally located to the left of midline.
15. Splenomegalyisaconsistentfindinginwhichofthefollowingpatholo-gies?
(Answer)Portal hypertension
Splenomegalyisaconsistentfindingincasesofportalhypertension.
16. Adupleximageofthesplenicveinisdemonstrating(Answer)retrogradeflow.
That'scorrect!
Thesplenicveinnormallyflowstowardthetransducer,displayingawaveform above the
baseline (antegrade). In this case, the blood is flowing awayfromthetransducer
backtowardthe spleen(retrograde).
17. Whichofthefollowingstructuresseparatesthesubphrenicspaceintotwoco
mpartments?(Answer)Falciform ligament
The falciformligament divides the subphrenic space into right and left compart-
ments. The left coronary ligament suspends the left lobe of the liver from
thediaphragm.
18. Anasymptomaticpatientpresentswithahistoryofelevatedliverfunctiontests.
Basedonthisclinicalhistory,thesonogrammostlikelydemonstrates-
(Answer)fattyinfiltration
Fatty infiltration is the most likely diagnosis in an asymptomatic patient demon-
stratingdiffuselyechogenicliverparenchyma.Inaddition,theportalveinsarestillclearly
visible, consistentwith fatty infiltration.
19. Thesubhepaticspacecommunicateswiththelessersacthroughtheforame
nof(Answer)Winslow
TheforamenofWinslowallowscommunicationbetweenthesubhepaticspaceandlesser
sac.
20. Whichvascularstructurecoursesposteriortothesuperiormesentericartery
and anterior to the abdominalaorta?(Answer)Left renal vein
AND ANSWERS (2022/2023)
1. Progressionofwhichofthefollowingabnormalitiesflattenstheportalveins?
(Answer)Biliary obstruction
2. Thewallthicknessinanormalfastinggallbladdershouldnotexceed(Answer)
3mm
3. ThiscolorDopplersonogramismostlikelydemonstratingwhichofthefollowi
ngabnormalities?(Answer)Pseudoaneurysm
ThiscolorDopplerimagedemonstratesturbulentswirlingbloodflowwithinafluidcollec
tion, classic sonographic findings of a common femoral artery pseudoa-neurysm.
4. Apatientpresentswithsuddenonsetofupperabdominalpain.Ultrasounddemo
nstrates prominence in the stomach rugae. These findings are
mostsuspiciousfor whichof thefollowingconditions?(Answer)Gastritis
Prominence of the stomach rugae in a patient with upper abdominal pain is
mostsuspiciousforgastritis.Hypervascular,thickgastricwallsaresonographicfindingsa
ssociatedwith gastric ulcers.
5. Whichofthefollowingisacomplicationofacutepancreatitis?
(Answer)Duodenalobstruction
Complications of acute pancreatitis may include abscess formation,
duodenalobstruction,hemorrhage,phlegmon,andpseudocystformation.Cholecystitisi
sapossibleetiology of acute pancreatitis.
6. Apatientpresentswithahistoryofhematuria.Thefindingsinthisdupleximagea
remostsuspiciousforwhichofthefollowingpathologies?(Answer)Carcino-ma
A vascular echogenic mass is identified protruding from the posterior wall of
theurinarybladder.Bladdercarcinomacommonlypresentswithahistoryofpainlesshem
aturia. Based on the clinical history, the sonographic findings are suspiciousfora
malignant mass.
7. A sagittal sonogram medial to the portahepatis is demonstrating
whichofthe following abnormalities?(Answer)Dilated common
bileduct
,Ahypoechoicmassidentifiedbythecalipersisobstructingthecommonbileductresulting
in dilatation. The mass is most likely a malignancy in the head of thepancreas.
,8. Thepathology inthis sonogramis mostlikely a/an(Answer)Pseudocyst
A complex fluid collection is identified posterior to the tail of the pancreas. Thisis
most likely a pancreatic pseudocyst. Phlegmons and islet cell tumors
appearashypoechoicmassesonultrasound.Apancreatichemorrhageisadifferentialc
onsiderationbutnotthemostlikelypathology.
9. Whichofthefollowingabnormalitiesisdemonstratedinthistransversesonog
ram?(Answer)Stones in the duct ofWirsung
Multiple stones are located in main pancreatic duct (duct ofWirsung).
10. Whichofthefollowingisaclinicalsymptomofhypothyroidism?
(Answer)Musclecramps
Musclescrampingisasymptomofhypothyroidism.Othersymptomsmayincludeweightg
ain,mentalandphysicallethargy,arthritis,skindryness,feelingcold,slowmetabolic rate,
and decreased heart rate. Symptoms commonly associated withhyperthyroidism
include weight loss, palpitations, nervousness,
exophthalmos,constanthunger,tremors,increasedheartrate,andintolerancetoheat.
11. A 20-year-old patient presents with a palpable left scrotal mass.
Thesonographicfindingsaremostsuspiciousforwhichofthefollowingpatholo-
gies?(Answer)Malignant neoplasm
Amalignantneoplasmisthemostlikelydiagnosisinayoungadultdemonstratinga
hypoechoicintratesticular mass. The patient is afebrile excluding a
testicularabscessfrom the differentialconsiderations.
12. Apatientpresentswithahistory of a palpableneck
mass.Which ofthefollowing terms best describes the
sonographic findings? (Answer)Heterogeneousthyroidgland
The sonographer's technical report should describe the right thyroid lobe
asdemonstratinganirregular andheterogeneousecho texture.
13. Apatientpresentswithahistory ofcirrhosis.The
arrowsare identifyingthe(Answer)coronary ligament
Ahyperechoiclinearstructureisidentifieddividingtherightsubphrenicspacefromthesu
bhepaticspace.Thisisconsistentwiththerightcoronaryligament.Therightcoronary
ligament serves asa barrier between thesetwo peritoneal spaces.
, 14. ThiscolorDopplersonogramismostlikelydemonstratingwhichofthefollowi
ngabnormalities?(Answer)Patent umbilicalvein
The sonogram is demonstrating a patent paraumbilical vein. Note the
liverparenchymaoftheleftlobesuperiortothepatentumbilicalvein.Gastricvaricesarege
nerally located to the left of midline.
15. Splenomegalyisaconsistentfindinginwhichofthefollowingpatholo-gies?
(Answer)Portal hypertension
Splenomegalyisaconsistentfindingincasesofportalhypertension.
16. Adupleximageofthesplenicveinisdemonstrating(Answer)retrogradeflow.
That'scorrect!
Thesplenicveinnormallyflowstowardthetransducer,displayingawaveform above the
baseline (antegrade). In this case, the blood is flowing awayfromthetransducer
backtowardthe spleen(retrograde).
17. Whichofthefollowingstructuresseparatesthesubphrenicspaceintotwoco
mpartments?(Answer)Falciform ligament
The falciformligament divides the subphrenic space into right and left compart-
ments. The left coronary ligament suspends the left lobe of the liver from
thediaphragm.
18. Anasymptomaticpatientpresentswithahistoryofelevatedliverfunctiontests.
Basedonthisclinicalhistory,thesonogrammostlikelydemonstrates-
(Answer)fattyinfiltration
Fatty infiltration is the most likely diagnosis in an asymptomatic patient demon-
stratingdiffuselyechogenicliverparenchyma.Inaddition,theportalveinsarestillclearly
visible, consistentwith fatty infiltration.
19. Thesubhepaticspacecommunicateswiththelessersacthroughtheforame
nof(Answer)Winslow
TheforamenofWinslowallowscommunicationbetweenthesubhepaticspaceandlesser
sac.
20. Whichvascularstructurecoursesposteriortothesuperiormesentericartery
and anterior to the abdominalaorta?(Answer)Left renal vein
