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A comprehensive overview of the abdomen ardms exam 2024, covering a wide range of topics related to abdominal ultrasound. It includes precise answers to various questions on abnormalities, organ measurements, color doppler findings, and other sonographic features. The document delves into the identification and interpretation of various pathologies, such as biliary obstruction, gallbladder carcinoma, pyelonephritis, liver neoplasms, and more. It also covers important anatomical landmarks, laboratory values, and procedural techniques. This resource is designed to equip students and professionals with the knowledge and skills necessary to excel in the abdomen ardms exam 2024, providing them with a valuable tool for preparation and review.
Typology: Exams
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Progression of which of the following abnormalities flattens the portal veins? - Precise Answer ✔✔Biliary obstruction The wall thickness in a normal fasting gallbladder should not exceed - Precise Answer ✔✔3 mm This color Doppler sonogram is most likely demonstrating which of the following abnormalities? - Precise Answer ✔✔Pseudoaneurysm 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? - Precise Answer ✔✔Gastritis 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? - Precise Answer ✔✔Duodenal obstruction
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? - Precise Answer ✔✔Carcinoma 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? - Precise Answer ✔✔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 - Precise Answer ✔✔Pseudocyst 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? - Precise Answer ✔✔Stones in the duct of Wirsung Multiple stones are located in main pancreatic duct (duct of Wirsung). Which of the following is a clinical symptom of hypothyroidism? - Precise Answer ✔✔Muscle cramps 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? - Precise Answer ✔✔Malignant neoplasm 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? - Precise Answer ✔✔Heterogeneous thyroid gland 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 - Precise Answer ✔✔coronary ligament A hyperechoic linear structure is identified dividing the right subphrenic space from the subhepatic 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? - Precise Answer ✔✔Patent umbilical vein 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? - Precise Answer ✔✔Portal hypertension Splenomegaly is a consistent finding in cases of portal hypertension. A duplex image of the splenic vein is demonstrating - Precise Answer ✔✔retrograde flow. That's correct! The splenic vein normally flows toward the transducer, displaying a waveform above the baseline (antegrade). In this case, the blood is flowing away from the transducer back toward the spleen (retrograde).
Which of the following structures separates the subphrenic space into two compartments? - Precise Answer ✔✔Falciform ligament The falciform ligament divides the subphrenic space into right and left compartments. The left coronary ligament suspends the left lobe of the liver from the diaphragm. An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical history, the sonogram most likely demonstrates - Precise Answer ✔✔fatty infiltration Fatty infiltration is the most likely diagnosis in an asymptomatic patient demonstrating diffusely echogenic liver parenchyma. In addition, the portal veins are still clearly visible, consistent with fatty infiltration. The subhepatic space communicates with the lesser sac through the foramen of - Precise Answer ✔✔Winslow The foramen of Winslow allows communication between the subhepatic space and lesser sac. Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? - Precise Answer ✔✔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 - Precise Answer ✔✔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 - Precise Answer ✔✔abscess An ill-defined superficial mass beneath a recent surgical incision in a patient with leukocytosis most likely represents a postsurgical abscess. Secretion of thyroid-stimulating hormone is controlled by the - Precise Answer ✔✔pituitary gland The anterior pituitary gland controls secretion of thyroid-stimulating hormone. The coronary vein enters the venous system near the - Precise Answer ✔✔superior border of the portosplenic confluence The coronary vein enters the superior border of the portosplenic confluence and may be a collateral source in cases of portal hypertension. The inferior mesenteric vein enters the inferior border of the portosplenic confluence.
A complication generally occurring within days of a renal transplant is - Precise Answer ✔✔renal vein thrombosis Renal vein thrombosis generally occurs within days of a renal transplant. Renal artery stenosis typically occurs months to years after transplantation. The sonogram is most suspicious for which of the following abnormalities? - Precise Answer ✔✔Varicocele Multiple anechoic tubular structures are identified posterior to the left testicle, most suspicious for a varicocele. Duplex imaging of these tubular structures should be included in this examination. The solitary echogenic focus most likely represents a(n) - Precise Answer ✔✔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 - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔metastatic lesions
The liver demonstrates a heterogenous parenchyma most suspicious for metastatic lesions. A palpable buttock mass identified is most consistent with which of the following?
The anechoic structure is located lateral to the thyroid lobe and anterior to the common 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 - Precise Answer ✔✔liver The liver breaks down red blood cells, producing bile pigments. Which of the following anatomic variants involves the fundus of the gallbladder? - Precise Answer ✔✔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 - Precise Answer ✔✔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 - Precise Answer ✔✔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 - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔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) - Precise Answer ✔✔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? - Precise Answer ✔✔Chronic pancreatitis Chronic pancreatitis is associated with atrophy of the pancreas and demonstrates a hyperechoic parenchyma. Fatty infiltration generally does not affect the size of the pancreas. An 11-year-old presents with a history a palpable thyroid gland, fatigue, and dysphagia. Based on this clinical history, the color Doppler image of the right thyroid lobe is most likely demonstrating - Precise Answer ✔✔thyroiditis The duplex sonogram is demonstrating a hypervascular, hypoechoic enlarged thyroid gland, most suspicious for thyroiditis. Clinical symptoms of thyroiditis may include fatigue, fever, leukocytosis, neck pain, dysphagia, and hyperthyroidism followed by hypothyroidism. A patient presents with a history of a painful lump on her posterior wrist. Based on this clinical history, the sonogram is most likely demonstrating which of the following abnormalities? - Precise Answer ✔✔Ganglion cyst An anechoic smooth walled mass is identified in the area of concern. This most likely represents a ganglion cyst. A Baker cyst is located in the posterior medial portion of the knee joint. The anechoic structure is most likely arising from which of the following structures? - Precise Answer ✔✔Kidney The cyst is most likely arising from the renal parenchyma. Possible differential considerations include hepatic or adrenal cyst.
The sonographic findings in this infant kidney are most consistent with which of the following anomalies? - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔cholelithiasis In approximately 90 percent of cases, cholelithiasis coexists with gallbladder carcinoma Sonographic findings associated with pyelonephritis include - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔Ureteroceles Bilateral hyperechoic septations within the posterior bladder wall are most consistent with ureteroceles. Ureteroceles are focal dilatations of the distal ureter expanding as urine enters the bladder. Normal sonographic findings of a renal transplant include - Precise Answer ✔✔prominent renal pyramids. Normal sonographic findings in a renal transplant include prominent renal pyramids, hyperechoic renal sinus, and hypoechoic renal cortex. Which of the following structures aids in locating the gallbladder fossa? - Precise Answer ✔✔Main lobar fissure
The main lobar fissure is a sonographic landmark used in locating the gallbladder fossa. The right hepatic vein divides the right lobe of the liver into anterior and posterior segments. 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 - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔Malignancy Undescended testis (cryptorchism) is a risk factor for developing testicular torsion, malignancy, and infertility. The hyperechoic structure in this sonogram represents - Precise Answer ✔✔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? A. Portal vein B. Hepatic vein C. Splenic vein D. Superior mesenteric vein - Precise Answer ✔✔Hepatic vein Pulsatile bidirectional venous flow is characteristic of a normal hepatic vein.
A 6-week-old female infant presents with a history of left hip clicking. Based on this clinical history, the sonogram is most likely demonstrating a - Precise Answer ✔✔dysplastic hip. The Graf alpha angle is abnormal. To be considered within normal limits the alpha angle should be 60 degrees or greater. The alpha angle in this case measures 46 degrees. The beta angle is normal measuring under 55 degrees ( 48 degrees). This is consistent with developmental dysplasia of the hip. In addition the femoral head is too lateral but still partially lies within the acetabulum consistent with subluxation. The sonographic findings are most suspicious for a(n) - Precise Answer ✔✔angiomyolipoma A well-defined hyperechoic mass is present in the anterior cortex. Angiomyolipomas are common incidental findings. Which of the following laboratory values increases in Addison disease? - Precise Answer ✔✔Serum potassium 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? - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔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 - Precise Answer ✔✔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? - Precise Answer ✔✔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? - Precise Answer ✔✔Fatty infiltration with focal fat sparing The liver parenchyma demonstrates a diffuse increase in echogenicity (fatty infiltration). Hypoechoic areas are identified anterior and posterior to a hepatic vessel (fat sparing). Incidentally the right renal cortex has a scalloped appearance typical of fetal lobulation. What is the first step in a sterile procedure technique? - Precise Answer ✔✔Wash your hands thoroughly The first step in a sterile procedure technique is to wash your hands thoroughly, followed by placing a sterile wrapped package on a clean and stable surface. Hemochromatosis is a rare disorder that may lead to - Precise Answer ✔✔cirrhosis Hemochromatosis is characterized by excessive iron deposits throughout the body and may cause cirrhosis. Which of the following abnormalities is present in this sagittal sonogram? - Precise Answer ✔✔Adenomyomatosis Immobile hyperechoic foci demonstrating a "comet-tail" reverberation artifact are characteristic findings of adenomyomatosis. The gastroduodenal artery arises from which of the following arteries? - Precise Answer ✔✔Hepatic artery
The gastroduodenal artery arises from the common hepatic artery. The common hepatic artery is a branch of the celiac axis. Which of the following liver pathologies is associated with glycogen storage disease? - Precise Answer ✔✔Adenoma Glycogen storage disease is an autosomal recessive disorder resulting in excessive deposition of glycogen in the liver, kidneys, and gastrointestinal tract. It is associated with development of a hepatic adenoma, focal nodular hyperplasia, and nephromegaly. Regulation of serum electrolytes is a function of the - Precise Answer ✔✔kidneys The urinary system regulates serum electrolytes. Which of the following abnormalities are demonstrated in this sonogram? - Precise Answer ✔✔Hydrocele and complex epididymal cyst An anechoic fluid collection is identified in the right scrotal sac. The scrotal wall appears thin. This is most consistent with a hydrocele. A complex cyst is also identified in the head of the epididymis. The arrow is identifying which of the following structures? - Precise Answer ✔✔Falciform ligament
A hyperechoic linear structure extends anterior to the left lobe of the liver consistent with the falciform ligament. The falciform attaches the liver to the anterior abdominal wall and separates the subphrenic space into right and left compartments. Elevation in creatinine levels is associated with - Precise Answer ✔✔renal failure, chronic nephritis, or urinary obstruction Elevation in creatinine levels is associated with renal failure, chronic nephritis, or urinary obstruction. Prominence of the portal veins is a sonographic characteristic of which of the following abnormalities? - Precise Answer ✔✔Hepatitis The contour of the liver is generally unaffected in cases of acute hepatitis. Acute hepatitis may demonstrate a hypoechoic liver parenchyma, hepatomegaly, associated splenomegaly, and prominence of the portal veins (star effect). A positive Phalen's sign is associated with an abnormality of which of the following joints? - Precise Answer ✔✔Wrist A positive Phalen's and/or Tinel's sign is associated with carpal tunnel syndrome (wrist). The arrow is identifying which of the following structures? - Precise Answer ✔✔Right renal artery
The right renal artery coursing posterior to the inferior vena cava is a common sonographic landmark. The main lobar fissure is a sonographic landmark used for locating the - Precise Answer ✔✔gallbladder fossa The main lobar fissure is a sonographic landmark used to locate the gallbladder fossa. Dehydration increases the risk for developing - Precise Answer ✔✔renal vein thrombosis Dehydration increases the risk for developing renal vein thrombosis Spectral analysis of the suprarenal portion of the abdominal aorta should demonstrate a - Precise Answer ✔✔high resistance waveform with a low diastolic component The abdominal aorta demonstrates a high resistance waveform with a low diastolic component proximal to the renal arteries. A triphasic waveform is found distal to the renal arteries. Which of the following ligaments is present in this image of the liver? - Precise Answer ✔✔Venosum The sonogram demonstrates the left and caudate lobes of the liver separated by the hyperechoic ligament of venosum.
Glisson's capsule surrounds which of the following organs? - Precise Answer ✔✔Liver Glisson's capsule surrounds the liver and Gerota's fascia surrounds the kidneys. A patient presents with abdominal pain and fever following an appendectomy. Based on this clinical history, the sonographic findings are most suspicious for a(n)
The normal lymph node demonstrates a smooth, hypoechoic, oval shape and a hyperechoic fatty center on ultrasound. This sonogram is most likely demonstrating which of the following? - Precise Answer ✔✔Gallbladder adenoma An immobile (decubitus position), nonshadowing, echogenic intraluminal focus is most consistent with a gallbladder adenoma (polyp). Which of the following pathologies is more commonly associated with severe abdominal pain? - Precise Answer ✔✔Portal vein thrombosis Severe abdominal pain is more commonly associated with portal vein thrombosis. The color Doppler image is most suspicious for which of the following abnormalities? A. Epididymitis B. Testicular torsion C. Testicular abscess D. Testicular carcinoma - Precise Answer ✔✔Testicular torsion The color Doppler image demonstrates an absence of testicular flow in the right testicle and the presence of blood flow within the left testicle. This is most suspicious for testicular torsion. The sonographic appearance of candidiasis is described as - Precise Answer ✔✔uniform hypoechoic masses
Candidiasis is a fungal infection associated with immune-suppressed patients. Sonographic findings include uniform hypoechoic masses, hyperechoic masses demonstrating posterior shadowing, or target lesions. Which laboratory value reveals cell injury or damage? - Precise Answer ✔✔Aspartate aminotransferase Aspartate aminotransferase (AST) is an enzyme present in many kinds of tissues releasing when cells are injured or damaged. Levels are proportional to the amount of damage and the time between cell injury and testing An ultrasound is requested to rule out Budd-Chiari syndrome. The sonographer should thoroughly evaluate which of the following abdominal veins? - Precise Answer ✔✔Hepatic veins Budd-Chiari syndrome is a life-threatening condition associated with thrombosis of the hepatic veins. The sonographer should thoroughly evaluate the liver vasculature. In this case which of the following laboratory values would be of benefit? - Precise Answer ✔✔Hematocrit A fluid-fluid level is demonstrated within the liver parenchyma most suspicious for a hematoma. Hematocrit levels would aid in determining internal bleeding. A patient presents with a history of abdominal pain. A sonogram of the liver is most likely demonstrating - Precise Answer ✔✔polycystic liver disease