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[General] Free PDF ARDMS - Updated AB-Abdomen - Reliable Abdomen Sonography Examination Te

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【General】 Free PDF ARDMS - Updated AB-Abdomen - Reliable Abdomen Sonography Examination Te

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ARDMS Abdomen Sonography Examination Sample Questions (Q62-Q67):NEW QUESTION # 62
Which scanning technique is most beneficial when imaging the appendix?
  • A. Image in the longitudinal plane around the iliac vessels
  • B. Image small bowel transversely to evaluate for peristalsis
  • C. Apply light pressure around the patient's area of pain
  • D. Apply graded compression around the patient's area of pain
Answer: D
Explanation:
Graded compression technique is the gold standard for ultrasound evaluation of the appendix. It displaces gas and compresses overlying bowel loops to visualize the noncompressible, blind-ending tubular appendix directly at the point of maximal tenderness.
According to Rumack's Diagnostic Ultrasound:
"Graded compression using steady, increasing pressure displaces gas and bowel to optimize visualization of the appendix." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen, 2020.
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NEW QUESTION # 63
Which condition is most consistent with the sonographic appearance in this image of the abdominal wall?

  • A. Lipoma
  • B. Fibroma
  • C. Metastasis
  • D. Desmoid
Answer: A
Explanation:
The ultrasound image demonstrates a well-defined, ovoid, hypoechoic to isoechoic mass within the subcutaneous tissue of the abdominal wall. The lesion appears compressible and shows linear striations parallel to the skin surface - a classic appearance of a lipoma.
Lipomas are the most common benign soft tissue tumors and frequently arise in the subcutaneous tissue. They are composed of mature adipose tissue and are typically asymptomatic unless large or compressing adjacent structures.
Sonographic features of a lipoma:
* Isoechoic to mildly hyperechoic or hypoechoic relative to subcutaneous fat
* Oval or elliptical in shape with well-defined margins
* Internal linear striations or "feathered" echotexture
* Compressible and non-vascular on Doppler imaging
* Located in subcutaneous fat plane parallel to the skin surface
Differentiation from other options:
* B. Fibroma: Typically appears as a homogeneous, hypoechoic mass but is far less common in the abdominal wall.
* C. Desmoid: Appears as an ill-defined or infiltrative mass within deeper soft tissues; more heterogeneous and may distort surrounding tissue planes.
* D. Metastasis: Often more irregular, heterogeneous, and may show increased vascularity or invasion into adjacent structures.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Musculoskeletal and Soft Tissue Ultrasound, pp. 1448-1450.
American Institute of Ultrasound in Medicine (AIUM) Practice Parameter for the Performance of a Diagnostic Ultrasound Examination of Soft Tissue Structures, 2020.
Radiopaedia.org. Lipoma (ultrasound): https://radiopaedia.org/articles/lipoma-ultrasound

NEW QUESTION # 64
Which condition is characterized by abnormal dilatation of veins of the pampiniform plexus and most commonly affects the left testicle?
  • A. Hydrocele
  • B. Hematocele
  • C. Spermatocele
  • D. Varicocele
Answer: D
Explanation:
A varicocele is an abnormal dilatation of the pampiniform plexus veins, usually seen on the left side due to the perpendicular insertion of the left testicular vein into the left renal vein, making it more susceptible to elevated venous pressure. Sonographically, varicoceles appear as multiple serpiginous anechoic tubular structures that show venous flow on color Doppler, often accentuated with Valsalva maneuver.
Hydrocele (A) is a fluid collection surrounding the testis.
Hematocele (C) is blood within the tunica vaginalis.
Spermatocele (D) is a cystic lesion arising from the epididymis.
Reference Extracts:
Dogra VS, Bhatt S. "Sonographic evaluation of testicular varicoceles." Journal of Ultrasound in Medicine.
2004;23(6): 829-838.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
-

NEW QUESTION # 65
What is the location of the left lobe of the thyroid gland?
  • A. Posterior to the longus colli muscle
  • B. Anterolateral to the esophagus
  • C. Anterior to the left jugular vein
  • D. Anterior to the trachea
Answer: B
Explanation:
The left lobe of the thyroid is located anterolateral to the esophagus. On transverse ultrasound imaging, the esophagus can often be seen posterior to the left thyroid lobe as a circular structure with echogenic mucosa and hypoechoic muscular layer. The longus colli muscle lies posterior to the thyroid. The thyroid is anterior to the trachea but this refers more to the isthmus or midline portion.
According to Rumack's Diagnostic Ultrasound:
"The esophagus is seen as a target-shaped structure posterior to the left thyroid lobe; thus, the thyroid lobe is anterolateral to the esophagus." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Thyroid Ultrasound, 2020.
-

NEW QUESTION # 66
Which sonographic appearance of the bile ducts is demonstrated in this image?

  • A. Dilated intrahepatic
  • B. Dilated common hepatic
  • C. Dilated common bile
  • D. Normal intrahepatic
Answer: A
Explanation:
The image shows a transverse view of the left lobe of the liver with the portal triads clearly visible. The
"parallel channel" or "double barrel" sign is observed-where dilated intrahepatic bile ducts run alongside the portal veins, creating a characteristic sonographic pattern of paired anechoic (black) tubular structures.
This sonographic feature is diagnostic for dilated intrahepatic bile ducts and is typically seen in obstructive jaundice or biliary obstruction from conditions such as:
* Choledocholithiasis (stone in the common bile duct)
* Stricture or mass compressing the bile ducts
* Cholangiocarcinoma
The intrahepatic bile ducts normally are too small to visualize clearly unless dilated. Their dilation gives the liver a "too many tubes" appearance, where bile ducts become as prominent as the portal veins.
Comparison of answer choices:
* A. Normal intrahepatic ducts are not usually seen this clearly or prominently on ultrasound.
* B. Dilated intrahepatic - Correct. The parallel channel sign supports this diagnosis.
* C. Dilated common bile duct would be visualized extrahepatically, typically anterior to the portal vein near the head of the pancreas.
* D. Dilated common hepatic duct is also extrahepatic and seen in the porta hepatis, not within the liver parenchyma.
References:
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.
Taylor KJW, Burns PN, Wells PNT. Clinical Applications of Doppler Ultrasound. Raven Press; 1990.

NEW QUESTION # 67
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