ARDMS Abdomen MOCK exam| 251 | QUESTIONS &
ANSWERS | ALREADY GRADED A+
Progression of which of the following abnormalities flattens the portal veins?
Biliary obstruction
The wall thickness in a normal fasting gallbladder should not exceed
3 mm
This color Doppler sonogram is most likely demonstrating which of the following abnormalities?
Pseudoaneurysm
This color Doppler image demonstrates turbulent swirling blood flow within a fluid collection, classic
sonographic findings of a common femoral artery pseudoaneurysm.
A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence
in the stomach rugae. These findings are most suspicious for which of the following conditions?
Gastritis
Prominence of the stomach rugae in a patient with upper abdominal pain is most suspicious for
gastritis. Hypervascular, thick gastric walls are sonographic findings associated with gastric ulcers.
Which of the following is a complication of acute pancreatitis?
Duodenal obstruction
Complications of acute pancreatitis may include abscess formation, duodenal obstruction,
hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute
pancreatitis.
A patient presents with a history of hematuria. The findings in this duplex image are most suspicious
for which of the following pathologies?
Carcinoma
A vascular echogenic mass is identified protruding from the posterior wall of the urinary bladder.
Bladder carcinoma commonly presents with a history of painless hematuria. Based on the clinical
history, the sonographic findings are suspicious for a malignant mass.
A sagittal sonogram medial to the porta hepatis is demonstrating which of the following
abnormalities?
Dilated common bile duct
A hypoechoic mass identified by the calipers is obstructing the common bile duct resulting in
dilatation. The mass is most likely a malignancy in the head of the pancreas.
The pathology in this sonogram is most likely a/an
Pseudocyst
A complex fluid collection is identified posterior to the tail of the pancreas. This is most likely a
pancreatic pseudocyst. Phlegmons and islet cell tumors appear as hypoechoic masses on ultrasound.
A pancreatic hemorrhage is a differential consideration but not the most likely pathology.
,Which of the following abnormalities is demonstrated in this transverse sonogram?
Stones in the duct of Wirsung
Multiple stones are located in main pancreatic duct (duct of Wirsung).
Which of the following is a clinical symptom of hypothyroidism?
Muscle cramps
Muscles cramping is a symptom of hypothyroidism. Other symptoms may include weight gain, mental
and physical lethargy, arthritis, skin dryness, feeling cold, slow metabolic rate, and decreased heart
rate. Symptoms commonly associated with hyperthyroidism include weight loss, palpitations,
nervousness, exophthalmos, constant hunger, tremors, increased heart rate, and intolerance to heat.
A 20-year-old patient presents with a palpable left scrotal mass. The sonographic findings are most
suspicious for which of the following pathologies?
Malignant neoplasm
A malignant neoplasm is the most likely diagnosis in a young adult demonstrating a hypoechoic
intratesticular mass. The patient is afebrile excluding a testicular abscess from the differential
considerations.
A patient presents with a history of a palpable neck mass. Which of the following terms best describes
the sonographic findings?
Heterogeneous thyroid gland
The sonographer's technical report should describe the right thyroid lobe as demonstrating an
irregular and heterogeneous echo texture.
A patient presents with a history of cirrhosis. The arrows are identifying the
coronary ligament
A hyperechoic linear structure is identified dividing the right subphrenic space from the subhepatic
space. This is consistent with the right coronary ligament. The right coronary ligament serves as a
barrier between these two peritoneal spaces.
This color Doppler sonogram is most likely demonstrating which of the following abnormalities?
Patent umbilical vein
The sonogram is demonstrating a patent paraumbilical vein. Note the liver parenchyma of the left
lobe superior to the patent umbilical vein. Gastric varices are generally located to the left of midline.
Splenomegaly is a consistent finding in which of the following pathologies?
Portal hypertension
Splenomegaly is a consistent finding in cases of portal hypertension.
A duplex image of the splenic vein is demonstrating
retrograde flow.
,That's correct! The splenic vein normally flows toward the transducer, displaying a waveform above
the baseline (antegrade). In this case, the blood is flowing away from the transducer back toward the
spleen (retrograde).
Which of the following structures separates the subphrenic space into two compartments?
Falciform ligament
The falciform ligament divides the subphrenic space into right and left compartments. The left
coronary ligament suspends the left lobe of the liver from the diaphragm.
An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical
history, the sonogram most likely demonstrates
fatty infiltration
Fatty infiltration is the most likely diagnosis in an asymptomatic patient demonstrating diffusely
echogenic liver parenchyma. In addition, the portal veins are still clearly visible, consistent with fatty
infiltration.
The subhepatic space communicates with the lesser sac through the foramen of
Winslow
The foramen of Winslow allows communication between the subhepatic space and lesser sac.
Which vascular structure courses posterior to the superior mesenteric artery and anterior to the
abdominal aorta?
Left renal vein
The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal
aorta.
The celiac axis is located at
superior to the body of the pancreas
The celiac axis is located superior to the body of the pancreas, superior mesenteric artery, and splenic
vein; posterior to the left gastric vein; inferior to the gastroesophageal junction.
A postsurgical patient presents with abdominal tenderness and leukocytosis. A sonogram
demonstrates a superficial, ill-defined mass beneath the surgical incision. Based on the clinical history,
the sonographic findings are most suspicious for
abscess
An ill-defined superficial mass beneath a recent surgical incision in a patient with leukocytosis most
likely represents a postsurgical abscess.
Secretion of thyroid-stimulating hormone is controlled by the
pituitary gland
The anterior pituitary gland controls secretion of thyroid-stimulating hormone.
, The coronary vein enters the venous system near the
superior border of the portosplenic confluence
The coronary vein enters the superior border of the portosplenic confluence and may be a collateral
source in cases of portal hypertension. The inferior mesenteric vein enters the inferior border of the
portosplenic confluence.
A complication generally occurring within days of a renal transplant is
renal vein thrombosis
Renal vein thrombosis generally occurs within days of a renal transplant. Renal artery stenosis
typically occurs months to years after transplantation.
The sonogram is most suspicious for which of the following abnormalities?
Varicocele
Multiple anechoic tubular structures are identified posterior to the left testicle, most suspicious for a
varicocele. Duplex imaging of these tubular structures should be included in this examination.
The solitary echogenic focus most likely represents a(n)
floating gallstone
Multiple small stones are present in the dependent portion of the gallbladder. The solitary focus most
likely represents a floating gallstone.
Clinical findings associated with an ileus may include all of the following EXCEPT
hyperactive bowel sounds
Clinical findings in cases of ileus or bowel obstruction may include absent or hypoechoic bowel
sounds, fever, constipation, abdominal pain, nausea, and vomiting.
A cake kidney is generally located in which of the following regions?
Pelvis
A cake kidney is a variant of a horseshoe kidney. The entire medial aspects of the kidneys are fused. A
cake kidney is typically located in the pelvis.
Focal dilatation of the anterior wall of the abdominal aorta describes a
saccular aneurysm
Focal outpouching of one arterial wall is characteristic of a saccular aneurysm. They are often a result
of trauma or infection.
Which of the following structures is most likely mistaken for the splenic artery?
Pancreatic duct
The pancreatic duct and the splenic artery are most likely to be confused with each other. Color
Doppler imaging is a quick method of verifying a vascular structure.
ANSWERS | ALREADY GRADED A+
Progression of which of the following abnormalities flattens the portal veins?
Biliary obstruction
The wall thickness in a normal fasting gallbladder should not exceed
3 mm
This color Doppler sonogram is most likely demonstrating which of the following abnormalities?
Pseudoaneurysm
This color Doppler image demonstrates turbulent swirling blood flow within a fluid collection, classic
sonographic findings of a common femoral artery pseudoaneurysm.
A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence
in the stomach rugae. These findings are most suspicious for which of the following conditions?
Gastritis
Prominence of the stomach rugae in a patient with upper abdominal pain is most suspicious for
gastritis. Hypervascular, thick gastric walls are sonographic findings associated with gastric ulcers.
Which of the following is a complication of acute pancreatitis?
Duodenal obstruction
Complications of acute pancreatitis may include abscess formation, duodenal obstruction,
hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute
pancreatitis.
A patient presents with a history of hematuria. The findings in this duplex image are most suspicious
for which of the following pathologies?
Carcinoma
A vascular echogenic mass is identified protruding from the posterior wall of the urinary bladder.
Bladder carcinoma commonly presents with a history of painless hematuria. Based on the clinical
history, the sonographic findings are suspicious for a malignant mass.
A sagittal sonogram medial to the porta hepatis is demonstrating which of the following
abnormalities?
Dilated common bile duct
A hypoechoic mass identified by the calipers is obstructing the common bile duct resulting in
dilatation. The mass is most likely a malignancy in the head of the pancreas.
The pathology in this sonogram is most likely a/an
Pseudocyst
A complex fluid collection is identified posterior to the tail of the pancreas. This is most likely a
pancreatic pseudocyst. Phlegmons and islet cell tumors appear as hypoechoic masses on ultrasound.
A pancreatic hemorrhage is a differential consideration but not the most likely pathology.
,Which of the following abnormalities is demonstrated in this transverse sonogram?
Stones in the duct of Wirsung
Multiple stones are located in main pancreatic duct (duct of Wirsung).
Which of the following is a clinical symptom of hypothyroidism?
Muscle cramps
Muscles cramping is a symptom of hypothyroidism. Other symptoms may include weight gain, mental
and physical lethargy, arthritis, skin dryness, feeling cold, slow metabolic rate, and decreased heart
rate. Symptoms commonly associated with hyperthyroidism include weight loss, palpitations,
nervousness, exophthalmos, constant hunger, tremors, increased heart rate, and intolerance to heat.
A 20-year-old patient presents with a palpable left scrotal mass. The sonographic findings are most
suspicious for which of the following pathologies?
Malignant neoplasm
A malignant neoplasm is the most likely diagnosis in a young adult demonstrating a hypoechoic
intratesticular mass. The patient is afebrile excluding a testicular abscess from the differential
considerations.
A patient presents with a history of a palpable neck mass. Which of the following terms best describes
the sonographic findings?
Heterogeneous thyroid gland
The sonographer's technical report should describe the right thyroid lobe as demonstrating an
irregular and heterogeneous echo texture.
A patient presents with a history of cirrhosis. The arrows are identifying the
coronary ligament
A hyperechoic linear structure is identified dividing the right subphrenic space from the subhepatic
space. This is consistent with the right coronary ligament. The right coronary ligament serves as a
barrier between these two peritoneal spaces.
This color Doppler sonogram is most likely demonstrating which of the following abnormalities?
Patent umbilical vein
The sonogram is demonstrating a patent paraumbilical vein. Note the liver parenchyma of the left
lobe superior to the patent umbilical vein. Gastric varices are generally located to the left of midline.
Splenomegaly is a consistent finding in which of the following pathologies?
Portal hypertension
Splenomegaly is a consistent finding in cases of portal hypertension.
A duplex image of the splenic vein is demonstrating
retrograde flow.
,That's correct! The splenic vein normally flows toward the transducer, displaying a waveform above
the baseline (antegrade). In this case, the blood is flowing away from the transducer back toward the
spleen (retrograde).
Which of the following structures separates the subphrenic space into two compartments?
Falciform ligament
The falciform ligament divides the subphrenic space into right and left compartments. The left
coronary ligament suspends the left lobe of the liver from the diaphragm.
An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical
history, the sonogram most likely demonstrates
fatty infiltration
Fatty infiltration is the most likely diagnosis in an asymptomatic patient demonstrating diffusely
echogenic liver parenchyma. In addition, the portal veins are still clearly visible, consistent with fatty
infiltration.
The subhepatic space communicates with the lesser sac through the foramen of
Winslow
The foramen of Winslow allows communication between the subhepatic space and lesser sac.
Which vascular structure courses posterior to the superior mesenteric artery and anterior to the
abdominal aorta?
Left renal vein
The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal
aorta.
The celiac axis is located at
superior to the body of the pancreas
The celiac axis is located superior to the body of the pancreas, superior mesenteric artery, and splenic
vein; posterior to the left gastric vein; inferior to the gastroesophageal junction.
A postsurgical patient presents with abdominal tenderness and leukocytosis. A sonogram
demonstrates a superficial, ill-defined mass beneath the surgical incision. Based on the clinical history,
the sonographic findings are most suspicious for
abscess
An ill-defined superficial mass beneath a recent surgical incision in a patient with leukocytosis most
likely represents a postsurgical abscess.
Secretion of thyroid-stimulating hormone is controlled by the
pituitary gland
The anterior pituitary gland controls secretion of thyroid-stimulating hormone.
, The coronary vein enters the venous system near the
superior border of the portosplenic confluence
The coronary vein enters the superior border of the portosplenic confluence and may be a collateral
source in cases of portal hypertension. The inferior mesenteric vein enters the inferior border of the
portosplenic confluence.
A complication generally occurring within days of a renal transplant is
renal vein thrombosis
Renal vein thrombosis generally occurs within days of a renal transplant. Renal artery stenosis
typically occurs months to years after transplantation.
The sonogram is most suspicious for which of the following abnormalities?
Varicocele
Multiple anechoic tubular structures are identified posterior to the left testicle, most suspicious for a
varicocele. Duplex imaging of these tubular structures should be included in this examination.
The solitary echogenic focus most likely represents a(n)
floating gallstone
Multiple small stones are present in the dependent portion of the gallbladder. The solitary focus most
likely represents a floating gallstone.
Clinical findings associated with an ileus may include all of the following EXCEPT
hyperactive bowel sounds
Clinical findings in cases of ileus or bowel obstruction may include absent or hypoechoic bowel
sounds, fever, constipation, abdominal pain, nausea, and vomiting.
A cake kidney is generally located in which of the following regions?
Pelvis
A cake kidney is a variant of a horseshoe kidney. The entire medial aspects of the kidneys are fused. A
cake kidney is typically located in the pelvis.
Focal dilatation of the anterior wall of the abdominal aorta describes a
saccular aneurysm
Focal outpouching of one arterial wall is characteristic of a saccular aneurysm. They are often a result
of trauma or infection.
Which of the following structures is most likely mistaken for the splenic artery?
Pancreatic duct
The pancreatic duct and the splenic artery are most likely to be confused with each other. Color
Doppler imaging is a quick method of verifying a vascular structure.
