QUESTIONS WITH VERIFIED CORRECT ANSWERS AND
RATIONALE/A+ GRADE/APRIL 2023
Progression of which of the following abnormalities flattens the portal veins? -
ANSWER: Biliary obstruction
The wall thickness in a normal fasting gallbladder should not exceed - ANSWER: 3
mm
This color Doppler sonogram is most likely demonstrating which of the following
abnormalities? - ANSWER: 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? - ANSWER: 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? - ANSWER: 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? - ANSWER: 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? - ANSWER: 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 - ANSWER: 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? -
ANSWER: 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? - ANSWER: 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? - ANSWER:
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? - ANSWER: 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 -
ANSWER: 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? - ANSWER: 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? -
ANSWER: Portal hypertension
Splenomegaly is a consistent finding in cases of portal hypertension.
A duplex image of the splenic vein is demonstrating - ANSWER: 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? - ANSWER: 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 - ANSWER:
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 -
ANSWER: 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? - ANSWER: 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 - ANSWER: 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 -
ANSWER: 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 - ANSWER: pituitary
gland
The anterior pituitary gland controls secretion of thyroid-stimulating hormone.
The coronary vein enters the venous system near the - ANSWER: 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 - ANSWER:
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? -
ANSWER: 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) - ANSWER: 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 -
ANSWER: 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.