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2025 - 2026 ARDMS ABDOMEN MOCK EXAM|
ACTUAL 250 QUESTIONS AND ANSWERS WITH
RATIONALES|ALREADY GRADED A+
A complex fluid collection is identified posterior to the tail of the pancreas. This is most likely a pancreatic pseudocyst. Phlegmons and islet cell tumors appear as hypoechoic masses on ultrasound. A pancreatic hemorrhage is a differential consideration but not the most likely pathology. Which of the following abnormalities is demonstrated in this transverse sonogram? - **ANS:-
Stones** in the duct of Wirsung RATIONALE: Multiple stones are located in main pancreatic duct (duct of Wirsung). Which of the following is a clinical symptom of hypothyroidism? - ANS:->>>Muscle cramps RATIONALE: Muscles cramping is a symptom of hypothyroidism. Other symptoms may include weight gain, mental and physical lethargy, arthritis, skin dryness, feeling cold, slow metabolic rate, and decreased heart rate. Symptoms commonly associated with hyperthyroidism include weight loss, palpitations, nervousness, exophthalmos, constant hunger, tremors, increased heart rate, and intolerance to heat. A 20-year-old patient presents with a palpable left scrotal mass. The sonographic findings are most suspicious for which of the following pathologies? - ANS:->>>Malignant neoplasm RATIONALE: A malignant neoplasm is the most likely diagnosis in a young adult demonstrating a hypoechoic intratesticular mass. The patient is afebrile excluding a testicular abscess from the differential considerations.
A patient presents with a history of a palpable neck mass. Which of the following terms best describes the sonographic findings? - ANS:->>>Heterogeneous thyroid gland RATIONALE: The sonographer's technical report should describe the right thyroid lobe as demonstrating an irregular and heterogeneous echo texture. A patient presents with a history of cirrhosis. The arrows are identifying the - ANS:-
coronary ligament RATIONALE: A hyper echoic linear structure is identified dividing the right subphrenic space from the sub hepatic space. This is consistent with the right coronary ligament. The right coronary ligament serves as a barrier between these two peritoneal spaces. This color Doppler sonogram is most likely demonstrating which of the following abnormalities? - ANS:->>>Patent umbilical vein RATIONALE: The sonogram is demonstrating a patent paraumbilical vein. Note the liver parenchyma of the left lobe superior to the patent umbilical vein. Gastric varices are generally located to the left of midline. Splenomegaly is a consistent finding in which of the following pathologies? - ANS:->>>Portal hypertension Splenomegaly is a consistent finding in cases of portal hypertension. A duplex image of the splenic vein is demonstrating - ANS:->>>retrograde flow.
RATIONALE: The wall thickness in a normal fasting gallbladder should not exceed - ANS:-
3 mm This color Doppler sonogram is most likely demonstrating which of the following abnormalities? - ANS:->>>Pseudoaneurysm RATIONALE: This color Doppler image demonstrates turbulent swirling blood flow within a fluid collection, classic sonographic findings of a common femoral artery pseudoaneurysm. A patient presents with sudden onset of upper abdominal pain. Ultrasound demonstrates prominence in the stomach rugae. These findings are most suspicious for which of the following conditions? - ANS:->>>Gastritis RATIONALE: Prominence of the stomach rugae in a patient with upper abdominal pain is most suspicious for gastritis. Hypervascular, thick gastric walls are sonographic findings associated with gastric ulcers. Which of the following is a complication of acute pancreatitis? - ANS:->>>Duodenal obstruction RATIONALE: Complications of acute pancreatitis may include abscess formation, duodenal obstruction, hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute pancreatitis. A patient presents with a history of hematuria. The findings in this duplex image are most suspicious for which of the following pathologies? - ANS:->>>Carcinoma RATIONALE: A vascular echogenic mass is identified protruding from the posterior wall of the
urinary bladder. Bladder carcinoma commonly presents with a history of painless hematuria. Based on the clinical history, the sonographic findings are suspicious for a malignant mass. A sagittal sonogram medial to the porta hepatis is demonstrating which of the following abnormalities? - ANS:->>>Dilated common bile duct A hypoechoic mass identified by the calipers is obstructing the common bile duct resulting in dilatation. The mass is most likely a malignancy in the head of the pancreas. The pathology in this sonogram is most likely a/an - ANS:->>>Pseudocyst Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? - ANS:->>>Left renal vein The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal aorta. The celiac axis is located at - ANS:->>>superior to the body of the pancreas The celiac axis is located superior to the body of the pancreas, superior mesenteric artery, and splenic vein; posterior to the left gastric vein; inferior to the gastroesophageal junction. A postsurgical patient presents with abdominal tenderness and leukocytosis. A sonogram demonstrates a superficial, ill-defined mass beneath the surgical incision. Based on the clinical history, the sonographic findings are most suspicious for - ANS:->>>abscess
The solitary echogenic focus most likely represents a(n) - ANS:->>>floating gallstone Multiple small stones are present in the dependent portion of the gallbladder. The solitary focus most likely represents a floating gallstone. Clinical findings associated with an ileus may include all of the following EXCEPT - ANS:-
hyperactive bowel sounds Clinical findings in cases of ileus or bowel obstruction may include absent or hypoechoic bowel sounds, fever, constipation, abdominal pain, nausea, and vomiting. A cake kidney is generally located in which of the following regions? - ANS:->>>Pelvis A cake kidney is a variant of a horseshoe kidney. The entire medial aspects of the kidneys are fused. A cake kidney is typically located in the pelvis. Focal dilatation of the anterior wall of the abdominal aorta describes a - ANS:->>>saccular aneurysm Focal outpouching of one arterial wall is characteristic of a saccular aneurysm. They are often a result of trauma or infection. Which of the following structures is most likely mistaken for the splenic artery? - ANS:- Pancreatic duct
The pancreatic duct and the splenic artery are most likely to be confused with each other. Color Doppler imaging is a quick method of verifying a vascular structure. This transverse sonogram of the right testicle is most likely demonstrating which of the following abnormalities? - ANS:->>>Intratesticular calcifications Multiple small hyperechoic foci (microcalcifications) are demonstrated in the right testis. Intratesticular calcifications may be idiopathic or associated with chronic orchitis. The pathology in this sonogram is most consistent with - ANS:->>>metastatic lesions
carotid artery. This is most consistent with the internal jugular vein. The external jugular vein is located in the lateral neck. Bile pigments are produced by the - ANS:->>>liver The liver breaks down red blood cells, producing bile pigments. Which of the following anatomic variants involves the fundus of the gallbladder? - ANS:-
Phrygian cap Folding of the gallbladder fundus describes a phrygian cap. Hartmann pouch and junctional fold are anatomic variants in the region of the gallbladder neck. A multiseptated gallbladder is a congenital anomaly and fetal lobulation involves the kidney. Renal dialysis patients have an increased risk of developing a renal - ANS:->>>carcinoma Renal dialysis patients have an increased risk of developing a renal carcinoma, cyst, or adenoma. This sonogram of the right kidney is most likely demonstrating - ANS:->>>junctional parenchymal defect. A triangular, echogenic cortical defect present in the anterior wall of the right kidney most likely represents a junctional parenchymal defect. An angiomyolipoma is a differential consideration but is not as likely the diagnosis. An endocrine function of the pancreas includes secretion of - ANS:->>>glucagon
Endocrine functions of the pancreas include secretion of glucagon, insulin, and somatostatin. Exocrine functions include secretion of amylase, lipase, and trypsin. Which of the following demonstrates diffuse enlargement of the abdominal aorta without distal tapering? - ANS:->>>Arteriomegaly Arteriomegaly (aortic ectasia) demonstrates as a diffuse enlargement of the abdominal aorta without distal tapering on ultrasound. A patient presents with a history of severe upper abdominal pain increasing in intensity over the last 12 hours. Based on this clinical history, the sonogram is most likely demonstrating - ANS:->>>acute pancreatitis. An enlarged hypoechoic pancreas in a patient with severe upper abdominal pain is most consistent with acute pancreatitis. Laboratory values will likely demonstrate elevation in serum amylase and lipase levels. A round anechoic mass adjacent to the renal pelvis is most likely a(n) - ANS:->>>parapelvic cyst A round anechoic mass (cyst) adjacent to the renal pelvis is most likely a parapelvic cyst. An extrarenal pelvis and renal vein demonstrate an oval contour medial to the renal pelvis. A small hyperechoic pancreas is most suspicious for which of the following abnormalities? - ANS:->>>Chronic pancreatitis
anomalies? - ANS:->>>Renal duplication Two individual renal sinuses are present. The lower sinus demonstrates pelviectasis (Grade 1 hydronephrosis). This is most suspicious for renal duplication. Hypertrophied column of Bertin is a common anatomic variants. The arrow is identifying which of the following vascular structures? - ANS:->>>Common hepatic artery The arrow identifies a structure branching from the celiac axis and coursing toward the liver. This is most consistent with the common hepatic artery. The common hepatic artery becomes the proper hepatic artery after the origin of the gastroduodenal artery.
Cases of gallbladder carcinoma frequently demonstrate coexisting - ANS:->>>cholelithiasis In approximately 90 percent of cases, cholelithiasis coexists with gallbladder carcinoma Sonographic findings associated with pyelonephritis include - ANS:->>>well-defined renal pyramids. Generalized or focal swelling of the kidney demonstrating well-defined renal pyramids is the typical sonographic finding associated with pyelonephritis. Which benign liver neoplasm is composed of large, blood-filled cystic spaces? - ANS:-
Cavernous hemangioma The cavernous hemangioma is composed of large, blood-filled cystic spaces and is the most common benign hepatic neoplasm. Which of the following arteries are termed the hypogastric arteries? - ANS:->>>Internal iliac arteries The internal iliac arteries are also known as the hypogastric arteries. A transverse image of the urinary bladder is demonstrating which of the following? - ANS:- Ureteroceles
A 25 - year-old female patient presents with a history of mild right upper quadrant pain and normal liver function tests. Based on the sonogram, the sonographer should ask the patient
- ANS:->>>Do you use oral contraceptives? A 25-year-old female demonstrating a hypoechoic liver mass and a peripheral hypoechoic halo is suspicious for a hepatic adenoma. The sonographer should inquire whether the patient is taking oral contraceptives. The "water lily" sign is associated with which of the following abnormalities? - ANS:-
Echinococcal cyst The "water lily" sign describes a collapsed cyst within a cyst, characteristic of an echinococcal cyst. This sagittal image of the left kidney is most likely demonstrating - ANS:->>>a normal neonatal kidney. A 5.0 cm kidney (using sidebar measurements) inferior to the spleen demonstrates an echogenic renal cortex, anechoic medullary pyramids, and a discrete renal sinus. This is most consistent with a normal neonatal kidney. Which of the following most accurately describes the location of the adrenal glands? - ANS:- Medial to the kidneys
The adrenal glands are located anterior, medial, and superior to each kidney and lateral to the crura of the diaphragm. Cryptorchism is a predisposing risk factor for developing which of the following abnormalities?
- ANS:->>>Malignancy Undescended testis (cryptorchism) is a risk factor for developing testicular torsion, malignancy, and infertility. The hyperechoic structure in this sonogram represents - ANS:->>>a hepatic stent The hyperechoic structure in the right portal vein is most consistent with a hepatic stent. Patients with cirrhosis may require a hepatic stent or shunt to decrease pressure within the portosplenic venous system. Recanalization demonstrates as an echogenic thickening to the intraluminal hepatic walls. Which of the following vascular structures normally demonstrates this waveform?
Laboratory values associated with Addison disease demonstrate an elevation in serum potassium and a decrease in serum sodium and glucose. Which of the following structures divides the left lobe into two segments? - ANS:->>>Left hepatic vein and ligamentum of Teres The left hepatic vein and ligamentum of Teres divide the left lobe of the liver into left and right segments. The left lobe is separated from the right lobe by the middle hepatic vein and the main lobar fissure. A contracted gallbladder is a common sonographic finding in which of the following conditions? - ANS:->>>Chronic cholecystitis
A small or contracted gallbladder is a common sonographic finding in cases of chronic cholecystitis. Cholesterolosis, adenomyomatosis, and metastatic gallbladder disease demonstrate as intraluminal masses Which of the following laboratory values is associated with malignancy in the elderly population? - ANS:->>>Alpha-fetoprotein Alpha-fetoprotein is an abnormal finding associated with an underlying malignancy in nonpregnant patients. A patient with a history of splenomegaly demonstrates multiple tubular structures posterior to the left lobe of the liver. These tubular structures are most suspicious for - ANS:->>>gastric varices. Splenomegaly is associated with portal hypertension. Multiple anechoic tubular structures in the epigastric region are most suspicious for gastric varices. The sonographic findings are most consistent with which of the following abnormalities?
- ANS:->>>Cholelithiasis Multiple small echogenic foci layer in the dependent portion of the gallbladder. Attenuation of sound by these foci produces posterior acoustic shadowing. Which of the following abnormalities is demonstrated in this color Doppler image? - ANS:-
Fatty infiltration with focal fat sparing
