ARDMS ABDOMEN MOCK EXAM LATEST REAL EXAM 400
QUESTIONS AND CORRECT ANSWERS AGRADE 2025 LATEST
UPDATED
Question 1
A patient presents with jaundice and a history of pancreatic carcinoma. Ultrasound reveals
dilated intrahepatic ducts. As the biliary obstruction progresses, which of the following
changes to the portal venous system is most likely to occur?
A) Thrombosis of the main portal vein.
B) Flattening or compression of the portal veins.
C) Aneurysmal dilation of the portal veins.
D) Reversal of flow in the right portal vein only.
E) Calcification of the portal vein walls.
Correct Answer: B) Flattening or compression of the portal veins.
Rationale: As biliary obstruction progresses, the intrahepatic bile ducts dilate significantly
(often referred to as the "double-barrel" or "shotgun" sign). Because the bile ducts and
portal veins run parallel to each other within the portal triads (along with the hepatic
arteries), the expanding fluid-filled bile ducts exert pressure on the adjacent portal veins.
This external pressure flattens or compresses the portal veins, making them difficult to
visualize or causing them to appear irregular.
Question 2
You are performing a right upper quadrant ultrasound on a fasting patient. When
measuring the anterior gallbladder wall, a thickness exceeding which measurement is
considered abnormal?
A) 1 mm
B) 2 mm
C) 3 mm
D) 5 mm
E) 7 mm
Correct Answer: C) 3 mm
Rationale: In a strictly fasting patient (NPO for 6-8 hours), the normal gallbladder wall
should measure 3 mm or less. A wall thickness greater than 3 mm is considered abnormal
and may indicate cholecystitis, adenomyomatosis, gallbladder carcinoma, or systemic
conditions such as congestive heart failure, hypoalbuminemia, or hepatitis. If the patient
has eaten, the gallbladder contracts, naturally thickening the wall, rendering the
measurement unreliable.
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Question 3
During a vascular assessment of the groin following a catheterization procedure, you
identify a cystic structure adjacent to the common femoral artery. Color Doppler
demonstrates a swirling "yin-yang" appearance, and spectral Doppler in the neck of the
mass shows a "to-and-fro" waveform. What is the most likely diagnosis?
A) Arteriovenous fistula.
B) Deep vein thrombosis.
C) Pseudoaneurysm.
D) Hematoma.
E) Lymphocele.
Correct Answer: C) Pseudoaneurysm.
Rationale: A pseudoaneurysm (false aneurysm) is caused by a hole in the arterial wall,
allowing blood to escape into the surrounding tissue, contained only by a fibrous capsule.
The classic sonographic signs include the "yin-yang" sign (turbulent, swirling red and blue
color flow) within the sac and a "to-and-fro" spectral waveform at the neck (blood flows
out during systole and back into the artery during diastole).
Question 4
A patient presents with sudden, severe epigastric pain. Ultrasound evaluation of the
stomach reveals prominent, thickened rugae folds. These findings are most suspicious for:
A) Gastric carcinoma.
B) Gastric bezoar.
C) Gastritis.
D) Pyloric stenosis.
E) Leiomyoma.
Correct Answer: C) Gastritis.
Rationale: Gastritis involves inflammation of the lining of the stomach. Sonographically,
this often presents as diffuse thickening of the gastric wall and prominence of the stomach
rugae (folds). While gastric carcinoma can cause wall thickening, prominent rugae in the
context of acute pain is highly suggestive of gastritis or peptic ulcer disease.
Question 5
A patient is admitted with acute pancreatitis. Which of the following is a known potential
complication of this condition that may affect the gastrointestinal tract?
A) Esophageal varices.
B) Duodenal obstruction.
C) Pyloric spasm.
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D) Intussusception.
E) Diverticulitis.
Correct Answer: B) Duodenal obstruction.
Rationale: The head of the pancreas sits within the C-loop of the duodenum. In severe
acute pancreatitis, significant edema, inflammation, or the formation of a phlegmon in the
pancreatic head can physically compress the duodenum, leading to partial or complete
duodenal obstruction. Other complications include pseudocysts, abscesses, and
hemorrhage.
Question 6
A 65-year-old male presents with painless hematuria. Ultrasound of the bladder reveals a
vascular, non-mobile, echogenic mass projecting from the posterior bladder wall into the
lumen. What is the most likely diagnosis?
A) Bladder diverticulum.
B) Cystitis.
C) Transitional Cell Carcinoma (TCC).
D) Blood clot.
E) Ureterocele.
Correct Answer: C) Transitional Cell Carcinoma (TCC).
Rationale: Transitional Cell Carcinoma is the most common primary bladder malignancy.
It typically appears as a focal, non-mobile mass arising from the bladder wall. The presence
of internal vascularity (demonstrated by Color Doppler) distinguishes a tumor from a
blood clot, which would be non-vascular and often mobile.
Question 7
While scanning the porta hepatis in a sagittal plane, you note a tubular structure anterior
to the portal vein that measures 9 mm in diameter. This finding is indicative of:
A) Portal vein thrombosis.
B) Hepatic artery aneurysm.
C) Dilated common bile duct (CBD).
D) Enlarged lymph node.
E) Normal anatomy.
Correct Answer: C) Dilated common bile duct (CBD).
Rationale: In the porta hepatis, the Common Bile Duct (CBD) lies anterior and lateral to
the portal vein. A normal CBD measurement is typically up to 6 mm (though up to 10 mm
can be normal in post-cholecystectomy patients). A measurement of 9 mm in a patient with
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a gallbladder indicates dilation, possibly due to obstruction (such as a stone or pancreatic
mass).
Question 8
A patient with a history of chronic pancreatitis presents with a palpable abdominal mass.
Ultrasound reveals a well-defined, anechoic fluid collection with posterior enhancement
located posterior to the stomach and anterior to the pancreas. This is most likely a:
A) Pancreatic Abscess.
B) Pancreatic Pseudocyst.
C) Phlegmon.
D) Cystadenoma.
E) Gastric duplication cyst.
Correct Answer: B) Pancreatic Pseudocyst.
Rationale: Pseudocysts are the most common complication of pancreatitis. They are
encapsulated collections of pancreatic juice, blood, and necrotic debris. They are termed
"pseudo" because they lack a true epithelial lining. The lesser sac (posterior to the stomach
and anterior to the pancreas) is the most common location for a pseudocyst.
Question 9
A transverse sonogram of the pancreas demonstrates multiple hyperechoic foci with
posterior shadowing within the main pancreatic duct. The duct is noted to be dilated. What
is the diagnosis?
A) Chronic pancreatitis with calcifications/stones.
B) Acute pancreatitis.
C) Pancreatic adenocarcinoma.
D) Islet cell tumor.
E) Pneumobilia.
Correct Answer: A) Chronic pancreatitis with calcifications/stones.
Rationale: Chronic pancreatitis results in irreversible destruction of the pancreatic
parenchyma. Sonographic hallmarks include a heterogeneous, atrophic gland, dilation of
the Duct of Wirsung (main pancreatic duct), and the presence of intraductal calculi (stones)
or parenchymal calcifications.
Question 10
A patient is referred for a thyroid ultrasound due to symptoms of hypothyroidism. Which
of the following clinical symptoms would you expect this patient to report?
QUESTIONS AND CORRECT ANSWERS AGRADE 2025 LATEST
UPDATED
Question 1
A patient presents with jaundice and a history of pancreatic carcinoma. Ultrasound reveals
dilated intrahepatic ducts. As the biliary obstruction progresses, which of the following
changes to the portal venous system is most likely to occur?
A) Thrombosis of the main portal vein.
B) Flattening or compression of the portal veins.
C) Aneurysmal dilation of the portal veins.
D) Reversal of flow in the right portal vein only.
E) Calcification of the portal vein walls.
Correct Answer: B) Flattening or compression of the portal veins.
Rationale: As biliary obstruction progresses, the intrahepatic bile ducts dilate significantly
(often referred to as the "double-barrel" or "shotgun" sign). Because the bile ducts and
portal veins run parallel to each other within the portal triads (along with the hepatic
arteries), the expanding fluid-filled bile ducts exert pressure on the adjacent portal veins.
This external pressure flattens or compresses the portal veins, making them difficult to
visualize or causing them to appear irregular.
Question 2
You are performing a right upper quadrant ultrasound on a fasting patient. When
measuring the anterior gallbladder wall, a thickness exceeding which measurement is
considered abnormal?
A) 1 mm
B) 2 mm
C) 3 mm
D) 5 mm
E) 7 mm
Correct Answer: C) 3 mm
Rationale: In a strictly fasting patient (NPO for 6-8 hours), the normal gallbladder wall
should measure 3 mm or less. A wall thickness greater than 3 mm is considered abnormal
and may indicate cholecystitis, adenomyomatosis, gallbladder carcinoma, or systemic
conditions such as congestive heart failure, hypoalbuminemia, or hepatitis. If the patient
has eaten, the gallbladder contracts, naturally thickening the wall, rendering the
measurement unreliable.
,[Type here]
Question 3
During a vascular assessment of the groin following a catheterization procedure, you
identify a cystic structure adjacent to the common femoral artery. Color Doppler
demonstrates a swirling "yin-yang" appearance, and spectral Doppler in the neck of the
mass shows a "to-and-fro" waveform. What is the most likely diagnosis?
A) Arteriovenous fistula.
B) Deep vein thrombosis.
C) Pseudoaneurysm.
D) Hematoma.
E) Lymphocele.
Correct Answer: C) Pseudoaneurysm.
Rationale: A pseudoaneurysm (false aneurysm) is caused by a hole in the arterial wall,
allowing blood to escape into the surrounding tissue, contained only by a fibrous capsule.
The classic sonographic signs include the "yin-yang" sign (turbulent, swirling red and blue
color flow) within the sac and a "to-and-fro" spectral waveform at the neck (blood flows
out during systole and back into the artery during diastole).
Question 4
A patient presents with sudden, severe epigastric pain. Ultrasound evaluation of the
stomach reveals prominent, thickened rugae folds. These findings are most suspicious for:
A) Gastric carcinoma.
B) Gastric bezoar.
C) Gastritis.
D) Pyloric stenosis.
E) Leiomyoma.
Correct Answer: C) Gastritis.
Rationale: Gastritis involves inflammation of the lining of the stomach. Sonographically,
this often presents as diffuse thickening of the gastric wall and prominence of the stomach
rugae (folds). While gastric carcinoma can cause wall thickening, prominent rugae in the
context of acute pain is highly suggestive of gastritis or peptic ulcer disease.
Question 5
A patient is admitted with acute pancreatitis. Which of the following is a known potential
complication of this condition that may affect the gastrointestinal tract?
A) Esophageal varices.
B) Duodenal obstruction.
C) Pyloric spasm.
,[Type here]
D) Intussusception.
E) Diverticulitis.
Correct Answer: B) Duodenal obstruction.
Rationale: The head of the pancreas sits within the C-loop of the duodenum. In severe
acute pancreatitis, significant edema, inflammation, or the formation of a phlegmon in the
pancreatic head can physically compress the duodenum, leading to partial or complete
duodenal obstruction. Other complications include pseudocysts, abscesses, and
hemorrhage.
Question 6
A 65-year-old male presents with painless hematuria. Ultrasound of the bladder reveals a
vascular, non-mobile, echogenic mass projecting from the posterior bladder wall into the
lumen. What is the most likely diagnosis?
A) Bladder diverticulum.
B) Cystitis.
C) Transitional Cell Carcinoma (TCC).
D) Blood clot.
E) Ureterocele.
Correct Answer: C) Transitional Cell Carcinoma (TCC).
Rationale: Transitional Cell Carcinoma is the most common primary bladder malignancy.
It typically appears as a focal, non-mobile mass arising from the bladder wall. The presence
of internal vascularity (demonstrated by Color Doppler) distinguishes a tumor from a
blood clot, which would be non-vascular and often mobile.
Question 7
While scanning the porta hepatis in a sagittal plane, you note a tubular structure anterior
to the portal vein that measures 9 mm in diameter. This finding is indicative of:
A) Portal vein thrombosis.
B) Hepatic artery aneurysm.
C) Dilated common bile duct (CBD).
D) Enlarged lymph node.
E) Normal anatomy.
Correct Answer: C) Dilated common bile duct (CBD).
Rationale: In the porta hepatis, the Common Bile Duct (CBD) lies anterior and lateral to
the portal vein. A normal CBD measurement is typically up to 6 mm (though up to 10 mm
can be normal in post-cholecystectomy patients). A measurement of 9 mm in a patient with
, [Type here]
a gallbladder indicates dilation, possibly due to obstruction (such as a stone or pancreatic
mass).
Question 8
A patient with a history of chronic pancreatitis presents with a palpable abdominal mass.
Ultrasound reveals a well-defined, anechoic fluid collection with posterior enhancement
located posterior to the stomach and anterior to the pancreas. This is most likely a:
A) Pancreatic Abscess.
B) Pancreatic Pseudocyst.
C) Phlegmon.
D) Cystadenoma.
E) Gastric duplication cyst.
Correct Answer: B) Pancreatic Pseudocyst.
Rationale: Pseudocysts are the most common complication of pancreatitis. They are
encapsulated collections of pancreatic juice, blood, and necrotic debris. They are termed
"pseudo" because they lack a true epithelial lining. The lesser sac (posterior to the stomach
and anterior to the pancreas) is the most common location for a pseudocyst.
Question 9
A transverse sonogram of the pancreas demonstrates multiple hyperechoic foci with
posterior shadowing within the main pancreatic duct. The duct is noted to be dilated. What
is the diagnosis?
A) Chronic pancreatitis with calcifications/stones.
B) Acute pancreatitis.
C) Pancreatic adenocarcinoma.
D) Islet cell tumor.
E) Pneumobilia.
Correct Answer: A) Chronic pancreatitis with calcifications/stones.
Rationale: Chronic pancreatitis results in irreversible destruction of the pancreatic
parenchyma. Sonographic hallmarks include a heterogeneous, atrophic gland, dilation of
the Duct of Wirsung (main pancreatic duct), and the presence of intraductal calculi (stones)
or parenchymal calcifications.
Question 10
A patient is referred for a thyroid ultrasound due to symptoms of hypothyroidism. Which
of the following clinical symptoms would you expect this patient to report?
