ARDMS AB-ABDOMEN SAMPLE QUESTIONS PDF, TEST AB-ABDOMEN ANSWERS

ARDMS AB-Abdomen Sample Questions Pdf, Test AB-Abdomen Answers

ARDMS AB-Abdomen Sample Questions Pdf, Test AB-Abdomen Answers

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ARDMS Abdomen Sonography Examination Sample Questions (Q157-Q162):

NEW QUESTION # 157
Which type of choledochal cyst is the most common?

  • A. Type III: Duodenal choledochocele
  • B. Type I: Fusiform dilatation of the common bile duct
  • C. Type II: Diverticula extending off of the common bile duct
  • D. Type IV: Multiple cystic dilatations of the hepatic ducts

Answer: B

Explanation:
Type I choledochal cyst, characterized by fusiform dilatation of the common bile duct, is the most common form, accounting for 80-90% of cases. Other types are much less frequent.
According to Rumack's Diagnostic Ultrasound:
"Type I fusiform dilatation of the extrahepatic bile duct is the most common type of choledochal cyst." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Hepatobiliary Ultrasound, 2020.
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NEW QUESTION # 158
Which clinical indication is most consistent with the finding depicted in this image?

  • A. Decreased range of motion
  • B. Trauma
  • C. Palpable abnormality
  • D. Focal pain

Answer: B

Explanation:
The ultrasound image shows disruption of the normal fibrillar echotexture of a muscle or tendon, consistent with a soft tissue injury such as a muscle or tendon tear. There is likely hypoechoic fluid consistent with a hematoma or edema, which commonly results from blunt or direct trauma.
This image is typical of a traumatic injury (e.g., partial or complete tendon rupture or muscle strain/tear).
These findings are frequently encountered in athletic injuries or blunt force trauma and correlate strongly with the clinical history of trauma.
Key sonographic features suggestive of trauma:
* Discontinuity or heterogeneity of normal striated muscle or tendon pattern
* Hypoechoic or anechoic area representing hematoma or fluid collection
* Retraction of muscle or tendon ends (in full-thickness tears)
* Surrounding soft tissue edema
Differentiation from other options:
* B. Focal pain: While pain may be a symptom, trauma is the more definitive and primary clinical indication for the findings shown.
* C. Palpable abnormality: May suggest a mass or cystic lesion (e.g., lipoma, abscess), not typically the appearance shown here.
* D. Decreased range of motion: May be present secondarily, but not the most consistent or primary clinical indication in this case.
References:
Bianchi S, Martinoli C. Ultrasound of the Musculoskeletal System. Springer, 2007. Chapters on Muscle and Tendon Injuries.
American Institute of Ultrasound in Medicine (AIUM) Practice Parameter for the Performance of a Musculoskeletal Ultrasound Examination, 2020.
Radiopaedia.org. Muscle tear (ultrasound):https://radiopaedia.org/articles/muscle-tear-ultrasound


NEW QUESTION # 159
Which condition is most likely associated with this image of the common bile duct?

  • A. Pancreatic head mass
  • B. Liver mass
  • C. Gallbladder stones
  • D. Cystic duct stone

Answer: A

Explanation:
The ultrasound image demonstrates a dilated common bile duct (CBD), measuring approximately 7.7 mm in diameter. A normal CBD should generally measure less than 6 mm in a patient under 60 years old and may increase approximately 1 mm per decade thereafter or after cholecystectomy.
In the absence of gallstones within the CBD, one of the most concerning causes of CBD dilation is distal obstruction due to an extrinsic compressive lesion. The most common and clinically significant cause of distal CBD obstruction is a mass at the head of the pancreas.
A pancreatic head mass (e.g., adenocarcinoma) may compress the distal CBD and pancreatic duct simultaneously, resulting in the "double duct sign" - dilation of both the CBD and pancreatic duct. This is a classic finding in pancreatic cancer.
Comparison of answer choices:
* A. Liver mass - unlikely to cause isolated CBD dilation unless invading the porta hepatis.
* B. Cystic duct stone - may cause gallbladder hydrops but typically not CBD dilation unless Mirizzi syndrome is present.
* C. Pancreatic head mass - Correct. This is the most likely cause of painless progressive CBD dilation without visible intraductal stones.
* D. Gallbladder stones - These may be associated with biliary colic or cholecystitis but typically do not cause CBD dilation unless the stone has migrated and obstructed the distal duct.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Lee JK, Sagel SS, Stanley RJ.Computed Body Tomography with MRI Correlation, 4th ed. Lippincott Williams & Wilkins; 2006.
ACR Appropriateness Criteria Right Upper Quadrant Pain (2021).


NEW QUESTION # 160
Which diagnosis is most consistent with this image from a patient with acute scrotal pain?

  • A. Testicular torsion
  • B. Epididymitis
  • C. Testicular rupture
  • D. Scrotal abscess

Answer: A

Explanation:
The grayscale ultrasound image demonstrates a uniformly enlarged, hypoechoic (dark), and heterogeneous testis without signs of surrounding scrotal wall thickening or a discrete fluid collection. This pattern is highly suggestive of testicular torsion in the setting of acute scrotal pain.
Sonographic features of testicular torsion on grayscale imaging:
* Enlarged testis
* Diffusely hypoechoic parenchyma
* Loss of normal homogeneity
* Absence of internal vascular flow on Doppler imaging (not shown here but critical in confirming diagnosis) Testicular torsion occurs due to twisting of the spermatic cord, leading to vascular compromise and eventual infarction if not promptly corrected. It is a surgical emergency and typically presents in adolescent males with sudden-onset, severe unilateral testicular pain.
Comparison of answer choices:
* A. Scrotal abscess appears as a complex fluid collection with irregular margins and posterior enhancement.
* B. Testicular rupture would show discontinuity of the tunica albuginea, heterogeneous texture, and often a hematocele.
* C. Testicular torsion - Correct. The enlarged, hypoechoic, heterogeneous testis is characteristic, particularly in the acute phase.
* D. Epididymitis typically shows an enlarged, hypervascular epididymis and may extend to the testis (epididymo-orchitis), but vascularity is usually increased rather than absent.
References:
Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology. 2003;227(1):18-36.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
AIUM Practice Parameter for the Performance of a Scrotal Ultrasound Examination (2021).


NEW QUESTION # 161
Which term best describes the common bile duct measured in this image of a postcholecystectomy patient?

  • A. Normal
  • B. Dilated
  • C. Atretic
  • D. Inflamed

Answer: A

Explanation:
The ultrasound image shows a measured common bile duct (CBD) diameter of 7.9 mm in a postcholecystectomy patient. In patients who have undergone cholecystectomy, mild dilation of the CBD is considered normal and is a well-recognized post-surgical change.
Normal upper limits for CBD diameter:
* In patients with a gallbladder: #6 mm is generally considered normal.
* In postcholecystectomy patients: up to 10 mm is considered within normal limits, as the CBD compensates for the absence of the gallbladder and slightly enlarges over time.
* With aging, the CBD may enlarge by approximately 1 mm per decade after age 60.
Therefore, a CBD diameter of 7.9 mm in a patient without a gallbladder is considered normal.
Differentiation from other options:
* B. Dilated: This would typically refer to a CBD diameter >10 mm in postcholecystectomy patients, or
>6 mm in patients with an intact gallbladder.
* C. Inflamed: Inflammation refers to wall thickening or hyperemia, which is not evaluated simply by measuring diameter.
* D. Atretic: Describes a congenitally absent or severely narrowed duct - not applicable here.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Biliary System, pp. 143-146.
American Institute of Ultrasound in Medicine (AIUM) Practice Parameter for the Performance of a Hepatobiliary Ultrasound Examination, 2020.
Radiopaedia.org. Common bile duct: https://radiopaedia.org/articles/common-bile-duct


NEW QUESTION # 162
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