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ARDMS Abdomen Sonography Examination Sample Questions (Q127-Q132):

NEW QUESTION # 127
Which description is associated with the normal sonographic appearance of a tendon?

A. Cord-like hyperechoic linear structure
B. Hyperechoic with posterior shadowing
C. Thin hypoechoic structure
D. Hypoechoic with enhancement

Answer: A

Explanation:
On ultrasound, tendons appear as cord-like hyperechoic structures with linear fibrillar echotexture when imaged in long axis. The fibrils are highly reflective, creating the typical hyperechoic appearance. Posterior shadowing is not typical unless there is calcification.
According to Rumack's Diagnostic Ultrasound:
"Tendons have a highly organized hyperechoic linear fibrillar pattern when examined along their long axis." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Musculoskeletal Ultrasound, 2020.
-

NEW QUESTION # 128
Which sonographic finding is most consistent with scrotal inflammation?

A. Granuloma
B. Abscess
C. Hyperemia
D. Hydrocele

Answer: C

Explanation:
Scrotal inflammation, such as epididymitis or orchitis, typically presents with increased blood flow (hyperemia) on color Doppler sonography. This finding reflects the inflammatory process and vascular dilation. Abscesses, granulomas, or hydroceles may be present but are not as consistent or specific for inflammation.
According to AIUM Practice Parameters and Rumack's Diagnostic Ultrasound:
"In acute inflammation, color Doppler ultrasound demonstrates prominent hyperemia of the epididymis or testis." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Scrotal Ultrasound, 2020.
-

NEW QUESTION # 129
Which sonographic finding distinguishes focal nodular hyperplasia from hepatic adenoma?

A. Target pattern
B. Stellate area within the central portion of the mass
C. Thin peripheral hypoechoic halo
D. Central calcifications

Answer: B

Explanation:
The hallmark feature of focal nodular hyperplasia (FNH) is a central stellate scar seen on imaging. This fibrous scar may not always be seen on ultrasound but is a classic distinguishing feature from hepatic adenomas, which usually lack a central scar.
According to Rumack's Diagnostic Ultrasound:
"Focal nodular hyperplasia often demonstrates a central stellate scar, which may be echogenic or isoechoic." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
WHO Classification of Digestive System Tumors, 5th ed., IARC, 2019.
-

NEW QUESTION # 130
In which position should a patient be placed when internal echoes are seen within a fluid-filled bladder?

A. Erect
B. Trendelenburg
C. Fowler
D. Lateral decubitus

Answer: D

Explanation:
Lateral decubitus positioning allows shifting of internal echoes within the bladder, helping differentiate mobile debris (such as blood clots or sediment) from adherent masses like tumors. This technique is helpful in evaluating questionable bladder filling defects.
According to Rumack's Diagnostic Ultrasound:
"Changing the patient's position, such as turning to the lateral decubitus, can help distinguish mobile debris from attached bladder wall lesions." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Bladder Ultrasound, 2020.

NEW QUESTION # 131
A patient with hepatocellular carcinoma presents for a paracentesis. Which lab value is the most pertinent to the procedure?

A. Alpha fetoprotein
B. Alanine aminotransferase
C. International normalized ratio
D. Total bilirubin

Answer: C

Explanation:
Before performing a paracentesis, assessment of the patient's coagulation status is crucial to minimize bleeding risk. The International Normalized Ratio (INR) is the standard lab value used to assess coagulation.
Elevated INR may increase the risk of bleeding complications during the procedure. ALT, AFP, and bilirubin levels evaluate liver function or cancer progression but are not directly relevant to bleeding risk for this procedure.
As per AASLD and SIR guidelines:
"An INR and platelet count should be evaluated before paracentesis to assess bleeding risk. Minor elevations in INR (<1.5) may not contraindicate the procedure." (AASLD Practice Guidance, 2021; SIR Consensus Guidelines, 2019).
Reference:
American Association for the Study of Liver Diseases (AASLD), Management of Ascites, 2021.
Society of Interventional Radiology (SIR) Consensus Guidelines for Coagulation Parameters in Image- Guided Procedures, 2019.

NEW QUESTION # 132
......

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