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Pass Guaranteed Quiz ARDMS - AB-Abdomen - Abdomen Sonography ExaminationโValid Study Dumps
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ARDMS Abdomen Sonography Examination Sample Questions (Q56-Q61):
NEW QUESTION # 56
Which sonographic finding is commonly associated with transitional cell cancer of urinary bladder?
- A. Diffuse wall thickening
- B. Flat sessile lesion
- C. Polypoidal non-mobile focal mass
- D. Ulcerated solid infiltrative lesion
Answer: C
Explanation:
Transitional cell carcinoma (TCC) typically presents as a non-mobile, polypoidal, focal intraluminal mass projecting from the bladder wall. Mobility of the lesion helps differentiate TCC from blood clots or debris.
According to Rumack's Diagnostic Ultrasound:
"Bladder TCC most often appears as a non-mobile, polypoid mass attached to the bladder wall." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Bladder Ultrasound, 2020.
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NEW QUESTION # 57
A patient presents with right lower quadrant pain and fever. Which condition is most likely indicated by the arrow on this image?
- A. Intussusception
- B. Ruptured appendix
- C. Bowel obstruction
- D. Enlarged lymph node
Answer: B
Explanation:
The ultrasound image demonstrates a tubular, non-compressible, blind-ending structure located in the right lower quadrant (RLQ) with associated echogenic periappendiceal fat and possibly adjacent fluid or phlegmon.
These features are consistent with appendicitis. Given the clinical history of fever and RLQ pain, along with the irregular borders and complex periappendiceal findings, the diagnosis of a ruptured appendix is most likely.
Key sonographic features of ruptured appendicitis include:
* Non-visualization or distortion of the normal appendiceal wall architecture
* Periappendiceal fluid collection or abscess
* Disruption of the echogenic submucosal layer
* Surrounding fat stranding (hyperechoic inflammatory changes)
* Clinical correlation with fever and peritonitis
Comparison of answer choices:
* A. Bowel obstruction typically shows dilated bowel loops with air-fluid levels, not a tubular structure like the appendix.
* B. Intussusception presents with a target or "donut" sign in a transverse view, not a linear tubular structure.
* C. Enlarged lymph nodes are usually round or oval and hypoechoic with a central echogenic hilum, without a tubular appearance.
* D. Ruptured appendix - Correct. The ultrasound features and clinical presentation match.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Jeffrey RB, Laing FC, Townsend RR. Acute appendicitis: sonographic criteria based on 250 cases. Radiology.
1988;167(2):327-329.
American Institute of Ultrasound in Medicine (AIUM) Practice Parameter for the Performance of the Ultrasound Examination for Appendicitis (2020).
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NEW QUESTION # 58
Which technique is used to demonstrate the finding in this video?
- A. Valsalva
- B. Compression
- C. Exhalation
- D. Deep inspiration
Answer: B
Explanation:
The technique shown in the video is compression. In ultrasound imaging-especially of soft tissue masses, the bowel, or venous structures-compression is used to evaluate the compressibility of structures. The image demonstrates a classic grayscale ultrasound view of a lesion or structure being compressed with the probe.
Compression sonography is particularly important in:
* Evaluating venous patency (e.g., for deep vein thrombosis)
* Differentiating cystic from solid structures
* Evaluating bowel wall abnormalities or intussusception
* Assessing lymph nodes and soft tissue masses (as shown here)
When a structure compresses easily under probe pressure, it suggests that the lesion is fluid-filled or soft. In contrast, incompressibility may indicate a solid mass or thrombus.
Differentiation from other options:
* B. Valsalva: Involves forced expiration against a closed airway, used primarily to assess venous reflux or inguinal hernias-not what is demonstrated here.
* C. Exhalation: A respiratory maneuver that passively alters thoracoabdominal pressure, not actively performed by the operator or causing focal structural change.
* D. Deep inspiration: Used to improve visualization of the liver, diaphragm, or gallbladder-not to evaluate the compressibility of soft tissue.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Ultrasound Technique and Physics, pp. 35-39.
AIUM Practice Parameter for the Performance of a Diagnostic Ultrasound Examination, 2020.
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NEW QUESTION # 59
Which congenital anomaly is characterized by the failure of the dorsal and ventral pancreatic buds to fuse?
- A. Annular pancreas
- B. Pancreatic agenesis
- C. Pancreas divisum
- D. Ectopic pancreas
Answer: C
Explanation:
Pancreas divisum occurs when the dorsal and ventral pancreatic ducts fail to fuse during embryologic development. This results in most pancreatic secretions draining through the minor papilla via the dorsal duct (duct of Santorini).
According to Rumack's Diagnostic Ultrasound:
"In pancreas divisum, the dorsal and ventral pancreatic ducts fail to fuse, resulting in separate drainage systems." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
Moore KL, Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.
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NEW QUESTION # 60
Which condition is associated with multiple pancreatic cysts?
- A. Cystic fibrosis
- B. Von Hippel Lindau syndrome
- C. Autosomal recessive polycystic kidney disease
- D. Beckwith Wiedemann syndrome
Answer: B
Explanation:
Von Hippel-Lindau (VHL) syndrome is a genetic disorder associated with multiple pancreatic cysts, pancreatic neuroendocrine tumors, and other systemic neoplasms. While cystic fibrosis can produce thickened pancreatic secretions, it rarely causes true pancreatic cysts.
According to Rumack's Diagnostic Ultrasound:
"Multiple pancreatic cysts are strongly associated with Von Hippel Lindau syndrome." 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.
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NEW QUESTION # 61
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