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ARDMS AB-Abdomen Exam Syllabus Topics:

Topic
Details

Topic 1

• 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 2

• 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 3

• 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.

Topic 4

• 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’s 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.

 

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ARDMS Abdomen Sonography Examination Sample Questions (Q23-Q28):

NEW QUESTION # 23
Which hernia characteristic is demonstrated in these images?

• A. Reducible
• B. Strangulated
• C. Fat only
• D. Incarcerated

Answer: A

Explanation:
The ultrasound images show two views of the same groin region - one without compression (left image labeled "W/O COMPRESSION") and one with graded probe compression (right image labeled "W/ COMPRESSION").
In the non-compression image, a hypoechoic mass-like structure is visible protruding through the abdominal wall, consistent with a hernia sac. On the compression image, the herniated content is no longer visible, indicating that the contents have been pushed back into the abdominal cavity. This is the hallmark feature of a reducible hernia.
Key characteristics of a reducible hernia on ultrasound:
* Herniated contents are visible without pressure.
* Contents disappear or reduce back into the abdomen with graded probe compression or Valsalva release.
* Typically includes omental fat or bowel, but reduction confirms lack of incarceration or strangulation.
Comparison of answer choices:
* A. Fat only refers to the hernia content type, not the behavior or reducibility shown here.
* B. Reducible - Correct. The change in hernia appearance between images demonstrates successful reduction with compression.
* C. Incarcerated hernia would remain visible and not compressible or reducible.
* D. Strangulated hernia would show signs of ischemia (bowel wall thickening, absent perfusion, hyperechoic mesentery), and would also not reduce with compression.
References:
Radswiki. Ultrasound evaluation of hernia. Radiopaedia.org
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
AIUM Practice Parameter for the Performance of a Focused Ultrasound Examination for Hernia (2021)

 

NEW QUESTION # 24
Which sonographic finding is associated with normal postprocedural Doppler of a transjugular intrahepatic portosystemic shunt (TIPS)?

• A. Triphasic flow throughout stent
• B. Low-velocity flow throughout stent
• C. Hepatofugal flow in the intrahepatic portal venous branches
• D. Hepatopetal flow in the intrahepatic portal venous branches

Answer: D

Explanation:
After successful TIPS placement, the intrahepatic portal venous branches continue to exhibit hepatopetal (toward the liver) flow, while the stent itself shows continuous, relatively high-velocity monophasic flow.
Hepatofugal flow in intrahepatic branches may indicate shunt dysfunction.
According to Zwiebel's Introduction to Vascular Ultrasound:
"Normal post-TIPS Doppler shows hepatopetal flow in the intrahepatic portal veins and continuous high- velocity flow within the stent." Reference:
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.
AIUM Practice Parameter for the Performance of Portal Venous Ultrasound, 2020.
-

 

NEW QUESTION # 25
What is the location of the left lobe of the thyroid gland?

• A. Anterolateral to the esophagus
• B. Anterior to the trachea
• C. Posterior to the longus colli muscle
• D. Anterior to the left jugular vein

Answer: A

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 # 26
Which renal anomaly is demonstrated on this image?

• A. Duplicated collecting system
• B. Pelvic kidney
• C. Crossed renal ectopia
• D. Horseshoe kidney

Answer: D

Explanation:
The ultrasound image labeled "SAG RUQ KIDNEY" demonstrates a midline sagittal view showing a renal parenchymal structure that extends across the midline anterior to the aorta and vertebral bodies, suggesting the presence of a horseshoe kidney.
A horseshoe kidney is a congenital renal anomaly in which the lower poles of both kidneys are fused across the midline by a parenchymal or fibrous isthmus. This isthmus typically lies anterior to the aorta and inferior vena cava and can be seen as a hypoechoic band of tissue crossing the midline on ultrasound.
Ultrasound findings characteristic of a horseshoe kidney:
* Abnormally low position of the kidneys in the abdomen
* Renal tissue (isthmus) bridging the lower poles anterior to the great vessels
* Renal axes may be more horizontal than usual
* Kidneys may appear closer together or "kissing" the spine anteriorly
Differentiation from other options:
* A. Duplicated collecting system: Manifests as two separate collecting systems within one kidney, often with a central renal sinus split into two - not typically midline bridging.
* B. Crossed renal ectopia: Involves one kidney crossing midline and fusing with the other on the opposite side, but they do not form a midline isthmus.
* D. Pelvic kidney: A single kidney located in the pelvis due to failed ascent - it does not appear as midline fusion of two kidneys.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Urinary Tract, pp. 215-218.
American Institute of Ultrasound in Medicine (AIUM). Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum. 2020.
Radiopaedia.org. Horseshoe kidney: https://radiopaedia.org/articles/horseshoe-kidney

 

NEW QUESTION # 27
Which condition is associated with multiple pancreatic cysts?

• A. Von Hippel Lindau syndrome
• B. Beckwith Wiedemann syndrome
• C. Autosomal recessive polycystic kidney disease
• D. Cystic fibrosis

Answer: A

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 # 28
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