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ARDMS AB-Abdomen Prep & test bundle, AB-Abdomen Exam Cram pdf,

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ARDMS Abdomen Sonography Examination Sample Questions (Q131-Q136):

NEW QUESTION # 131
Which technique is best for demonstrating the characteristic of the small hepatic lesion identified by the arrow on this image?

A. Move the transducer focus
B. Scan in upright position
C. Decrease depth
D. Use a standoff pad

Answer: D

Explanation:
The image shows a small hepatic lesion located very close to the anterior liver capsule, as indicated by the arrow. When imaging very superficial or near-field structures like subcapsular hepatic lesions, using a standoff pad is the most effective technique for optimizing visualization.
A standoff pad (also known as an acoustic stand-off or gel pad) helps increase the distance between the transducer and the superficial target. This improves the focus and beam shape for near-field imaging and minimizes reverberation and ring-down artifacts. It allows better evaluation of superficial lesions by positioning them within the focal zone of the transducer, which is usually set a few millimeters below the probe surface.
Differentiation from other options:
* A. Decrease depth: While reducing depth can help center deeper lesions in the field of view, it does not address issues with near-field resolution.
* B. Scan in upright position: This may help in gallbladder or fluid positioning but is not optimal for improving visualization of superficial liver lesions.
* C. Move the transducer focus: Adjusting focus deeper into the image won't enhance resolution of very superficial structures unless a standoff is used to bring the lesion into the focal zone.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Liver, pp. 80-84.
Kremkau FW. Sonography: Principles and Instruments. 9th Edition. Elsevier, 2015. Chapter: Image Formation and Optimization, pp. 114-117.
AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum, 2020.

NEW QUESTION # 132
Which parameter is most likely increased distal to a renal artery stenosis?

A. Acceleration time
B. Spectral broadening
C. Pulsatility index
D. Resistive index

Answer: A

Explanation:
Downstream from a significant renal artery stenosis, the acceleration time is prolonged due to delayed systolic upstroke ("tardus-parvus waveform"). This is a sensitive Doppler parameter for detecting hemodynamically significant stenosis. Spectral broadening usually occurs at the stenotic site, not distal to it.
According to Zwiebel's Introduction to Vascular Ultrasound:
"Prolonged acceleration time and reduced acceleration index characterize tardus-parvus waveforms distal to renal artery stenosis." Reference:
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.
AIUM Practice Parameter for Renal Artery Duplex Doppler Ultrasound, 2020.

NEW QUESTION # 133
Which vessel lies anterior to the uncinate process?

A. Portal vein
B. Left renal vein
C. Superior mesenteric vein
D. Inferior vena cava

Answer: C

Explanation:
The superior mesenteric vein (SMV) lies directly anterior to the uncinate process of the pancreas. The uncinate process wraps around the posterior aspect of the SMV and SMA. The portal vein and IVC lie more posteriorly in relation to the pancreatic head.
According to Moore's Clinically Oriented Anatomy:
"The superior mesenteric vein crosses anterior to the uncinate process of the pancreas." Reference:
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.
Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
-

NEW QUESTION # 134
Which renal condition is commonly associated with pyuria and leukocytosis?

A. Staghorn calculus
B. Renal cell carcinoma
C. Nephrocalcinosis
D. Acute pyelonephritis

Answer: D

Explanation:
Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Classic clinical findings include fever, flank pain, leukocytosis (elevated white blood cells), and pyuria (white blood cells in urine). Ultrasound may demonstrate renal enlargement, decreased echogenicity, and loss of corticomedullary differentiation.
* Nephrocalcinosis (A) involves calcium deposition without infection.
* Staghorn calculus (B) may lead to infection but is primarily characterized by obstructive uropathy.
* Renal cell carcinoma (C) presents with hematuria and mass formation rather than infection symptoms.
Reference Extracts:
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
Chapter: Kidneys.
* Middleton WD, Kurtz AB, Hertzberg BS.Ultrasound: The Requisites. 3rd ed. Elsevier, 2015.
-

NEW QUESTION # 135
In which segment is the solid mass located in this transverse image of the liver?

A. Right anterior
B. Left lateral
C. Left medial
D. Right posterior

Answer: D

Explanation:
The transverse ultrasound image of the liver shows a solid, hypoechoic mass located in the posterior aspect of the right lobe of the liver. In this view:
* The anterior aspect of the liver is at the top of the image (near the transducer).
* The posterior aspect is at the bottom (deeper).
* The right lobe occupies the majority of the screen on transverse imaging when the probe is placed in the epigastrium or right upper quadrant.
Anatomically, the right lobe of the liver is divided into anterior and posterior segments by the right hepatic vein in the coronal plane. In transverse imaging:
* The right anterior segment lies closer to the anterior abdominal wall.
* The right posterior segment lies deeper (posteriorly).
Given that the mass is seen deep within the liver on the right side of the image, it is best localized to the right posterior segment (Segment VI or VII depending on the exact craniocaudal level).
Comparison of answer choices:
* A. Left lateral is located far to the left of the image and typically appears higher and more anterior on transverse scans.
* B. Left medial lies near the midline and would appear adjacent to the ligamentum teres or falciform ligament.
* C. Right anterior lies closer to the transducer (top of the image), not posteriorly.
* D. Right posterior - Correct. This is the segment shown deep in the right lobe of the liver.
References:
Couinaud C. Liver anatomy: portal (and hepatic) segmentation. Trans Assoc Am Physicians. 1957.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.

NEW QUESTION # 136
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