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ARDMS Abdomen Sonography Examination Sample Questions (Q10-Q15):
NEW QUESTION # 10
Elevation of alpha-fetoprotein levels is a characteristic finding in which tumor?
- A. Hepatoma
- B. Focal nodular hyperplasia
- C. Cholangiocarcinoma
- D. Adenoma
Answer: A
Explanation:
Alpha-fetoprotein (AFP) is commonly elevated in patients with hepatocellular carcinoma (hepatoma), particularly in those with underlying cirrhosis or chronic hepatitis B/C. AFP is not typically elevated in adenomas, cholangiocarcinoma, or FNH.
According to Rumack's Diagnostic Ultrasound:
"Serum AFP levels are elevated in 50-70% of patients with hepatocellular carcinoma." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AASLD Guidelines for HCC Surveillance, 2018.
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NEW QUESTION # 11
Which condition is most likely associated with a common bile duct measuring 5 mm?
- A. Sclerosis
- B. Obstruction
- C. Stricture
- D. Normal
Answer: D
Explanation:
A common bile duct (CBD) measuring up to 5 mm is considered normal in most patients under age 60. Some references allow for up to 6 mm, especially post-cholecystectomy or in older individuals. Significant dilation (suggestive of obstruction) typically exceeds these measurements.
According to Rumack's Diagnostic Ultrasound:
"The normal common bile duct measures up to 5-6 mm, with slight increases considered normal after cholecystectomy or with advancing age." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Abdominal Ultrasound, 2020.
NEW QUESTION # 12
Which finding is helpful to differentiate postsurgical breast scarring from a recurrent tumor?
- A. Associated skin thickening
- B. Architectural distortion
- C. Absent Doppler signal
- D. Irregular hypoechoic area
Answer: C
Explanation:
Postsurgical breast scarring may appear hypoechoic and irregular but typically shows no internal vascularity on Doppler imaging. In contrast, recurrent tumors generally exhibit increased internal vascular flow due to neovascularization. Therefore, absent Doppler signal helps suggest scar tissue rather than malignancy.
According to Stavros' Breast Ultrasound:
"The absence of internal Doppler flow favors scar tissue, whereas recurrent malignancy typically demonstrates internal vascularity." Reference:
Stavros AT. Breast Ultrasound. Lippincott Williams & Wilkins, 2004.
AIUM Practice Parameter for Breast Ultrasound, 2020.
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NEW QUESTION # 13
Which technique may provide better visualization of the common bile duct in a patient with hepatic steatosis?
- A. Decrease transducer frequency
- B. Scan patient after a fatty meal
- C. Decrease overall gain
- D. Increase dynamic range
Answer: A
Explanation:
In hepatic steatosis (fatty liver), increased echogenicity can obscure visualization of deeper structures like the common bile duct. Lowering the transducer frequency increases sound wave penetration, allowing better visualization of deep structures despite increased liver echogenicity. Decreasing gain or increasing dynamic range primarily adjusts image brightness and contrast but does not improve penetration.
According to Rumack's Diagnostic Ultrasound:
"Lower frequency transducers are used to improve penetration and visualization of deeper structures in patients with fatty liver." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of Abdominal Ultrasound Examinations, 2020.
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NEW QUESTION # 14
Which structures converge to form the inferior vena cava?
- A. Right, left, and middle hepatic veins
- B. Right atrium and superior vena cava
- C. Superior mesenteric and splenic veins
- D. Right and left common iliac veins
Answer: D
Explanation:
The inferior vena cava (IVC) is formed by the confluence of the right and left common iliac veins at the level of approximately L5. The hepatic veins drain into the IVC superiorly but do not form it. The superior mesenteric and splenic veins join to form the portal vein, not the IVC.
According to Moore's Clinically Oriented Anatomy:
"The IVC begins at the level of L5 by the union of the right and left common iliac veins." Reference:
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.
Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
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NEW QUESTION # 15
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