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[General] AB-Abdomen Exam Tutorial - AB-Abdomen Certification

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【General】 AB-Abdomen Exam Tutorial - AB-Abdomen Certification

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ARDMS AB-Abdomen Exam Syllabus Topics:
TopicDetails
Topic 1
  • Abdominal Physics: This section of the exam measures the knowledge of ultrasound technicians in applying imaging physics principles to abdominal sonography. It includes understanding how to optimize ultrasound equipment settings for the best image quality and how to identify and correct imaging artifacts that can distort interpretation. Candidates should demonstrate technical proficiency in handling transducers, adjusting frequency, and managing depth and gain to obtain clear, diagnostic-quality images while minimizing errors caused by acoustic artifacts.
Topic 2
  • Anatomy, Perfusion, and Function: This section of the exam measures the skills of abdominal sonographers and focuses on evaluating the physical characteristics, blood flow, and overall function of abdominal structures. Candidates must understand how to assess organs such as the liver, kidneys, pancreas, and spleen for size, shape, and movement. It also involves analyzing perfusion to determine how effectively blood circulates through these organs. The goal is to ensure accurate interpretation of both normal and abnormal functions within the abdominal cavity using sonographic imaging.
Topic 3
  • Clinical Care, Practice, and Quality Assurance: This section of the exam tests the competencies of clinical ultrasound specialists and focuses on integrating patient care standards, clinical data, and procedural accuracy in abdominal imaging. It assesses the candidate ability to follow established medical guidelines, ensure correct measurements, and provide assistance during interventional or diagnostic procedures. Additionally, this domain emphasizes maintaining high-quality imaging practices and ensuring patient safety. Effective communication, adherence to protocols, and continuous quality improvement are key aspects of this section.
Topic 4
  • Pathology, Vascular Abnormalities, Trauma, and Postoperative Anatomy: This section of the exam evaluates the abilities of diagnostic medical sonographers and covers the detection and analysis of diseases, vascular issues, trauma-related damage, and surgical alterations in abdominal anatomy. Candidates are expected to identify abnormal growths, inflammations, obstructions, or vascular irregularities that may affect abdominal organs. They must also recognize post-surgical changes and assess healing or complications through imaging. The emphasis is on correlating pathological findings with clinical data to produce precise diagnostic reports that guide further medical management.

ARDMS Abdomen Sonography Examination Sample Questions (Q47-Q52):NEW QUESTION # 47
Which vascular condition is most consistent with patent cutaneous para-umbilical channels and portal hypertension?
  • A. Coronary vein varices
  • B. Caput medusae
  • C. Esophageal varices
  • D. Splenic vein varices
Answer: B
Explanation:
Caput medusae refers to dilated paraumbilical veins due to portal hypertension. When portal venous pressure rises, collateral channels may open along the ligamentum teres and recanalized paraumbilical vein, resulting in visible dilated veins radiating from the umbilicus.
* Esophageal varices (B) are gastroesophageal collaterals.
* Coronary vein varices (C) involve gastric veins.
* Splenic vein varices (D) are typically localized to the splenic hilum.
Reference Extracts:
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
* Gore RM, Levine MS. Textbook of Gastrointestinal Radiology. 4th ed. Saunders, 2015.
-

NEW QUESTION # 48
Which finding is indicated by the arrow in this image of the right upper quadrant?

  • A. Ascites
  • B. Mirror image
  • C. Pleural effusion
  • D. Retroperitoneal hemorrhage
Answer: C
Explanation:
The image provided is a right upper quadrant (RUQ) ultrasound-typically performed during a FAST (Focused Assessment with Sonography in Trauma) exam or for abdominal assessment. The arrow points to an anechoic (black) fluid collection seen above the diaphragm and posterior to the liver.
This fluid collection lies within the thoracic cavity, confirming the diagnosis of a pleural effusion. Pleural effusions are seen sonographically as an anechoic or hypoechoic area superior to the diaphragm in the thoracic cavity and often appear triangular or crescent-shaped. The diaphragm is visualized as a curvilinear echogenic structure separating the liver (or spleen) below from the lung space above.
Comparison of answer choices:
* A. Retroperitoneal hemorrhage would be seen in the posterior abdomen, not above the diaphragm.
* B. Pleural effusion is correct-anechoic fluid above the diaphragm is classic for this condition.
* C. Mirror image artifact occurs when liver echoes are mirrored across the diaphragm and lung-this is not a mirror artifact.
* D. Ascites collects inferior to the diaphragm and around the abdominal organs, not in the thoracic cavity.
References:
Ma OJ, Mateer JR, Blaivas M. Emergency Ultrasound, 3rd ed. McGraw-Hill; 2014.
Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749-757.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.

NEW QUESTION # 49
Identify the region where Doppler sampling should be performed in a young woman with severe postprandial pain.

Answer:
Explanation:

Explanation:
A ultrasound image of a person's body AI-generated content may be incorrect.

The origin of the superior mesenteric artery (SMA)
The image provided is a color Doppler ultrasound scan of the abdominal aorta and its major branches. In the center of the image, just anterior to the aorta, we see the superior mesenteric artery (SMA) arising in the sagittal plane. This is the critical area for Doppler sampling in a patient with symptoms suggestive of mesenteric ischemia.
Severe postprandial pain in a young woman may be a manifestation of median arcuate ligament syndrome (MALS) or chronic mesenteric ischemia. Both of these conditions are assessed via Doppler sampling of mesenteric vessels, specifically:
* The origin and proximal segment of the SMA
* The celiac artery (especially for MALS)
Doppler waveform analysis should assess:
* Peak systolic velocity (PSV): >275 cm/s suggests #70% SMA stenosis
* Angle correction should be aligned properly
* Sampling must be performed at the narrowest origin point (as shown in the image) This type of Doppler interrogation is typically done in both fasting and postprandial states to evaluate changes in flow and symptom correlation.
Why this area?
* The SMA is anterior to the aorta and travels inferiorly into the mesentery.
* The site shown in the image is ideal for measuring PSV and evaluating for stenosis or extrinsic compression.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Moneta GL, et al. Duplex ultrasound criteria for diagnosis of mesenteric artery stenosis. J Vasc Surg. 1991.
AIUM Practice Parameter for the Performance of a Mesenteric Artery Duplex Ultrasound Examination (2020).

NEW QUESTION # 50
Which clinical indication is most consistent with the finding depicted in this image?

  • A. Trauma
  • B. Focal pain
  • C. Decreased range of motion
  • D. Palpable abnormality
Answer: A
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 # 51
Identify the congenital anomaly.
Using your mouse, place the cursor on the appropriate region of the image and then left-click the mouse button to indicate your selection.

Answer:
Explanation:

Explanation:
An ultrasound of a fetus AI-generated content may be incorrect.

The ultrasound image shows a transverse (axial) view of the fetal abdomen. Notably, there is abnormal continuity of renal parenchyma across the midline anterior to the aorta, forming a U- or horseshoe-shaped structure. This is characteristic of a congenital anomaly known as a horseshoe kidney.
Horseshoe kidney is the most common fusion anomaly of the kidneys, occurring in approximately 1 in 400-
600 live births. It results from fusion of the lower poles of both kidneys during fetal development. On prenatal ultrasound, this anomaly can be suspected when the kidneys appear closer to the midline than usual and are connected by an isthmus of renal tissue or fibrous band that crosses anterior to the spine and great vessels.
Typical sonographic findings include:
* Abnormally located kidneys, often lower than expected
* Renal fusion across the midline (usually at the lower poles)
* Possible associated hydronephrosis or malrotation
Comparison to other anomalies:
* This is not consistent with polycystic kidney disease (which would show diffusely echogenic kidneys with poor corticomedullary differentiation).
* Duplex kidney would show duplicated collecting systems but not fusion across the midline.
* Renal agenesis would demonstrate absence of renal tissue.
* Posterior urethral valves would show a distended bladder with bilateral hydronephrosis, not midline fusion.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Callen PW. Ultrasonography in Obstetrics and Gynecology, 6th ed. Elsevier; 2016.
Nyberg DA, McGahan JP, Pretorius DH, Pilu G. Diagnostic Imaging of Fetal Anomalies. Lippincott Williams
& Wilkins; 2003.

NEW QUESTION # 52
......
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