Abdomen ARDMS _ MOCK Exam 2024-2025. Questions and Correct Verified Answers. Graded A, Exams of Physical Activity and Sport Sciences

Download Abdomen ARDMS _ MOCK Exam 2024-2025. Questions and Correct Verified Answers. Graded A and more Exams Physical Activity and Sport Sciences in PDF only on Docsity! Abdomen ARDMS _ MOCK Exam 2024-2025. Questions and Correct Verified Answers. Graded A A "time out" is best described as A. verifying the proper equipment and medication are available for a specific invasive procedure. B. time set aside for the patient to ask questions about the invasive procedure being performed. C. time after the procedure is performed to evaluate the patient and document the area of needle path for any evidence of post procedural bleeding. D. verifying with the patient the correct invasive procedure is being performed, on the correct patient and at the correct site. - ANSVerifying with the patient the correct invasive procedure is being performed, on the correct patient and at the correct site. "time out" is performed before beginning the invasive procedure to verify with the patient the site of procedure, the correct invasive procedure is being performed, and the patient's name and birthdate A 20-year-old patient presents with a palpable left scrotal mass. The sonographic findings are most suspicious for which of the following pathologies? - ANSMalignant 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 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 - ANSDo 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. 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: A. Are you diabetic? B. Do you use oral contraceptives? C. Are you taking medication for hypertension? D. Have you undergone any abdominal surgery - ANSDo 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. Renal vein thrombosis generally occurs within days of a renal transplant. Renal artery stenosis typically occurs months to years after transplantation. A contracted gallbladder is a common sonographic finding in which of the following conditions? A. Cholesterolosis B. Metastatic gallbladder disease C. Portal hypertension D. Chronic cholecystitis - ANSChronic 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 A contracted gallbladder is a common sonographic finding in which of the following conditions? - ANSChronic 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 A decrease in serum amylase levels can be associated with A. cirrhosis. B. pancreatic carcinoma. C. biliary obstruction. D. peptic ulcer disease - ANScirrhosis Decreases in serum amylase may occur in cases of cirrhosis or hepatitis. Elevation in serum amylase is associated with acute pancreatitis and peptic ulcer disease. A duplex image of the splenic vein is demonstrating - ANSretrograde 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). A hepatic abscess is most likely to develop within the - ANSright lobe Hepatic abscesses form within the right lobe in approximately 80 percent of cases. A Klatskin tumor is located near which of the following structures? A. Adrenal gland B. Hepatic hilum C. Head of the pancreas D. Gastroesophageal junction - ANSHepatic hilum A Klatskin tumor is a malignant neoplasm located at the junction of the right and left hepatic ducts near the hepatic hilum. A Klatskin tumor is located near which of the following structures? - ANSHepatic hilum A Klatskin tumor is a malignant neoplasm located at the junction of the right and left hepatic ducts near the hepatic hilum. A metabolic disorder resulting from excessive production of cortisol describes A. Conn syndrome. B. Addison disease. C. Marfan syndrome. D. Cushing syndrome - ANSCushing syndrome The cortex of the adrenal gland secretes cortisol. Cushing disease is associated with an excessive production of cortisol. Partial or complete failure of the adrenocortical function is associated with Addison disease. Conn syndrome is associated with elevated aldosterone levels. A normal lymph node will likely demonstrate - ANSa hyperechoic fatty center The normal lymph node demonstrates a smooth, hypoechoic, oval shape and a hyperechoic fatty center on ultrasound. A palpable buttock mass identified is most consistent with which of the following? - ANSLipoma C. echinococcal cyst. D. hepatocellular carcinoma. - ANSechinococcal cyst A cystic structure within a cystic structure (honeycomb appearance) in a patient recently returning from an overseas vacation is characteristic of an echinococcal cyst. A hepatic abscess demonstrates as a heterogeneous complex mass. 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 - ANSacute 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 patient presents with a history of vague right upper quadrant pain. Laboratory values are within normal limits. The sonogram is most likely demonstrating a(n) A. hepatoma. B. metastatic lesion. C. angiomyolipoma. D. cavernous hemangioma - ANScavernous hemangioma. A well-defined hyperechoic mass is present in a patient with normal laboratory values. This is most consistent with a cavernous hemangioma. 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) - ANSabscess An irregular bordered, complex hepatic mass is present in a febrile post appendectomy patient most likely representing a hepatic abscess. 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? - ANSGastritis 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. A patient with a history of cirrhosis presents with a history of a painful supraumbilical mass. Based on this clinical history, the sonogram is most suspicious for which of the following abnormalities? A. Abdominal wall hematoma B. Meckel diverticulum C. Abdominal wall hernia D. Recanalized paraumbilical vein - ANSAbdominal wall hernia A small defect is demonstrated in the anterior abdominal wall with extension of the omentum through the defect. 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 - ANSgastric varices. Splenomegaly is associated with portal hypertension. Multiple anechoic tubular structures in the epigastric region are most suspicious for gastric varices. A positive Phalen's sign is associated with an abnormality of which of the following joints? A. Knee B. Ankle C. Wrist D. Shoulder - ANSA positive Phalen's and/or Tinel's sign is associated with carpal tunnel syndrome (wrist). A positive Phalen's sign is associated with an abnormality of which of the following joints? - ANSWrist A positive Phalen's and/or Tinel's sign is associated with carpal tunnel syndrome (wrist). 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 A complex solid mass is identified inferior to the spleen. A normal left kidney is not identified. In a toddler the most likely diagnosis would be nephroblastoma. Differential consideration may include neuroblastoma if a normal left kidney is identified. An adrenal adenoma appears as a hypoechoic homogeneous mass. A transjugular intrahepatic portosystemic shunt (TIPS) generally connects which of the following? A. Right portal vein and the inferior vena cava B. Right hepatic vein and right portal vein C. Middle hepatic vein and the left portal vein D. Left hepatic vein and left portal vein - ANSRight hepatic vein and right portal vein TIPS generally connects the right hepatic vein and right portal vein. A transjugular intrahepatic portosystemic shunt (TIPS) generally connects which of the following? A. Right portal vein and the inferior vena cava B. Right hepatic vein and right portal vein C. Middle hepatic vein and the left portal vein D. Left hepatic vein and left portal vein - ANSRight hepatic vein and right portal vein TIPS generally connects the right hepatic vein and right portal vein. A transplanted kidney is commonly placed in the A. right flank. B. left iliac fossa. C. right iliac fossa. D. paraumbilical region - ANSA renal transplant is commonly placed in the anterior right iliac fossa. A transplanted kidney is commonly placed in the - ANSright iliac fossa A renal transplant is commonly placed in the anterior right iliac fossa. A transverse image of the urinary bladder is demonstrating which of the following? - ANSUreteroceles 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. A transverse sonogram of the liver is likely demonstrating which of the following? A. Hepatomegaly resulting from biliary dilatation B. Hepatic vein thrombosis and biliary dilatation C. Prominent portal veins resulting from hepatitis D. Biliary dilatation secondary to metastatic disease - ANSBiliary dilatation secondary to metastatic disease The most likely diagnosis of this sonogram is biliary dilatation resulting from metastatic disease. Multiple discrete masses are present in the liver parenchyma. A true abdominal aortic aneurysm is defined as dilatation of the aorta A. inferior to the renal arteries. B. when compared with a previous study. C. with a diameter measuring 3 cm or greater. D. when compared with a proximal segment. - ANSwith a diameter measuring 3 cm or greater. A true abdominal aortic aneurysm (AAA) measures 3 cm or greater in diameter. The majority of AAA are located inferior to the renal arteries. A true abdominal aortic aneurysm is defined as dilatation of the aorta A. inferior to the renal arteries. B. when compared with a previous study. C. with a diameter measuring 3 cm or greater. D. when compared with a proximal segment - ANSwith a diameter measuring 3 cm or greater A true abdominal aortic aneurysm (AAA) measures 3 cm or greater in diameter. The majority of AAA are located inferior to the renal arteries. Acute tubular necrosis demonstrates on ultrasound as That's correct! Alkaline phosphatase is an enzyme produced primarily by the liver. A marked increase is suggestive of obstructive jaundice. An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical history, the sonogram most likely demonstrates A. hepatitis. B. cirrhosis. C. fatty infiltration. D. focal nodular hyperplasia - ANSfatty 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. An asymptomatic patient presents with a history of elevated liver function tests. Based on this clinical history, the sonogram most likely demonstrates - ANSfatty 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. An endocrine function of the pancreas includes secretion of A. lipase. B. pepsin. C. glucagon. D. amylase. - ANSglucagon Endocrine functions of the pancreas include secretion of glucagon, insulin, and somatostatin. Exocrine functions include secretion of amylase, lipase, and trypsin. An endocrine function of the pancreas includes secretion of - ANSglucagon Endocrine functions of the pancreas include secretion of glucagon, insulin, and somatostatin. Exocrine functions include secretion of amylase, lipase, and trypsin. An inward extension of the renal cortex describes a A. medullary pyramid. B. fetal lobulation. C. dromedary hump. D. column of Bertin - ANScolumn of Bertin. An inward extension of the renal cortex between the medullary pyramids describes a column of Bertin. Dromedary hump describes an outward cortical bulge. An inward extension of the renal cortex describes a A. medullary pyramid. B. fetal lobulation. C. dromedary hump. D. column of Bertin - ANScolumn of Bertin An inward extension of the renal cortex between the medullary pyramids describes a column of Bertin. Dromedary hump describes an outward cortical bulge. An obese patient presents with a history of elevated liver function tests. The arrows are identifying which of the following structures? - ANSPerinephric fat Increase in perinephric and peritoneal fat are common sonographic findings in obese patients. The arrows are identifying a thick amount of perinephric fat. An ultrasound is requested to rule out Budd-Chiari syndrome. The sonographer should thoroughly evaluate which of the following abdominal veins? - ANSHepatic veins Budd-Chiari syndrome is a life-threatening condition associated with thrombosis of the hepatic veins. The sonographer should thoroughly evaluate the liver vasculature. Bile pigments are produced by the A. liver. B. pancreas. C. gallbladder. D. biliary ducts - ANSThe liver breaks down red blood cells, producing bile pigments. B. Renal cell carcinoma C. Staghorn calculus D. Multicystic dysplasia - ANSStaghorn calculus Development of staghorn calculus is associated with chronic urinary tract infections and chronic history of kidney stones. Elevation in creatinine levels is associated with - ANSrenal failure, chronic nephritis, or urinary obstruction Elevation in creatinine levels is associated with renal failure, chronic nephritis, or urinary obstruction. Enlarged lymph nodes demonstrating smooth wall margins are most consistent with an underlying A. infection. B. obstruction. C. malignancy. D. hemorrhage - ANSinfection Lymphadenopathy demonstrating a normal oval shape with smooth wall margins is most consistent with an underlying infection. Irregular wall margins or decreases in the fatty hilum are findings suspicious for an underlying malignancy. Enlarged lymph nodes demonstrating smooth wall margins are most consistent with an underlying A. infection. B. obstruction. C. malignancy. D. hemorrhage - ANSinfection Lymphadenopathy demonstrating a normal oval shape with smooth wall margins is most consistent with an underlying infection. Irregular wall margins or decreases in the fatty hilum are findings suspicious for an underlying malignancy. Extended use of oral contraceptives is a predisposing factor in developing which of the following hepatic neoplasms? A. Adenoma B. Hepatoma C. Cystadenoma D. Cavernous hemangioma - ANSAdenoma Extended use of oral contraceptives is linked to development of liver adenomas. Cavernous hemangiomas and cystadenomas have a female prevalence but are not related to the use of oral contraceptives. Extended use of oral contraceptives is a predisposing factor in developing which of the following hepatic neoplasms? - ANSAdenoma Extended use of oral contraceptives is linked to development of liver adenomas. Cavernous hemangiomas and cystadenomas have a female prevalence but are not related to the use of oral contraceptives. Extension of the right lobe of the liver inferior and anterior to the right kidney is termed a(n) A. accessory lobe. B. Riedel's lobe. C. succenturiate lobe. D. pyramidal lobe - ANSRiedel's lobe Extension of the right lobe of the liver anterior and inferior to the kidney is termed a Riedel's lobe. This is a common finding in the female population. Extension of the right lobe of the liver inferior and anterior to the right kidney is termed a(n) A. accessory lobe. B. Riedel's lobe. C. succenturiate lobe. D. pyramidal lobe. - ANSRiedel's lobe. Extension of the right lobe of the liver anterior and inferior to the kidney is termed a Riedel's lobe. This is a common finding in the female population. Fifty percent of neuroblastomas appear prior to what age? How many centimeters below the superior mesenteric artery do the main renal arteries arise? A. 0.5 to 1.0 cm B. 1.0 to 1.5 cm C. 1.5 to 2.0 cm D. 2.0 to 2.5 cm - ANSThe main renal arteries are located 1.0 to 1.5 cm inferior to the superior mesenteric artery. Knowing this is useful when determining whether an abdominal aortic aneurysm includes the renal arteries. Hyperparathyroidism may lead to which of the following renal pathologies? A. Multicystic dysplasia B. Pyelonephritis C. Nephrolithiasis D. Acute tubular necrosis - ANSNephrolithiasis Excessive function of the parathyroid glands may lead to osteoporosis and nephrolithiasis. If cholelithiasis is discovered on an ultrasound, the sonographer must determine the A. size of the stone(s). B. contour of the stone(s). C. composition of the stone(s). D. mobility of the stone(s) - ANSmobility of the stone(s). The mobility of the gallstones must be evaluated. Lodged or immobile stones can change the patient's course of treatment. In a renal transplant patient, a lymphocele is generally located A. medial. B. lateral. C. anterior. D. posterior - ANSMedial Lymphoceles are usually found medial to a renal transplant and will frequently contain debris. In this case which of the following laboratory values would be of benefit? - ANSHematocrit A fluid-fluid level is demonstrated within the liver parenchyma most suspicious for a hematoma. Hematocrit levels would aid in determining internal bleeding. In which of the following laboratory tests is marked elevation associated with obstructive jaundice? A. Indirect bilirubin B. Alpha-fetoprotein C. Alkaline phosphatase D. Alanine aminotransferase - ANSAlkaline phosphatase Marked elevation in alkaline phosphatase is associated with obstructive jaundice. Elevation of direct or conjugated bilirubin is associated with biliary obstruction. In which of the following laboratory tests is marked elevation associated with obstructive jaundice? - ANSAlkaline phosphatase Marked elevation in alkaline phosphatase is associated with obstructive jaundice. Elevation of direct or conjugated bilirubin is associated with biliary obstruction. Inferiorly, the right hepatic lobe is separated from the left lobe by the A. right portal vein. B. left hepatic vein. C. main lobar fissure. D. middle hepatic vein - ANSMain Lobar Fissure The right hepatic lobe is separated from the left lobe by the main lobar fissure inferiorly and the middle hepatic vein superiorly. Inferiorly, the right hepatic lobe is separated from the left lobe by the A. right portal vein. B. left hepatic vein. C. main lobar fissure. D. middle hepatic vein. - ANSmain lobar fissure The presence of a ''thrill'' over a vascular structure is highly suspicious and characteristic of an arteriovenous fistula. Production of prothrombin depends on the amount of vitamin Vitamin D. Vitamin A. Vitamin K. Vitamin B. - ANSProduction of prothrombin depends on the amount of vitamin K in the circulatory system. Production of prothrombin depends on the amount of vitamin: D, A, K, B ? - ANSVitamin K Production of prothrombin depends on the amount of vitamin K in the circulatory system. Progression of which of the following abnormalities flattens the portal veins? A. Ascariasis B. Portal vein thrombosis C. Portal hypertension D. Biliary obstruction - ANSBiliary obstruction Progression of biliary obstruction will inadvertently flatten the portal venous system. Progression of which of the following abnormalities flattens the portal veins? - ANSBiliary obstruction Prominence of the portal veins is a sonographic characteristic of which of the following abnormalities? A. Hepatitis B. Candidiasis C. Hepatic steatosis D. Biliary obstruction - ANSHepatitis 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). Prominence of the portal veins is a sonographic characteristic of which of the following abnormalities? - ANSHepatitis 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). Proteinuria is a common clinical finding in which of the following conditions? A. Hydronephrosis B. Glomerulonephritis C. Nephrocalcinosis D. Medullary sponge disease - ANSGlomerulonephritis Proteinuria is a finding in cases of glomerulonephritis, nephrolithiasis, renal carcinoma, polycystic disease, hypertension, and diabetes mellitus. Prothrombin is an enzyme produced by the A. heart. B. liver. C. spleen. D. pancreas - ANSLiver The liver produces prothrombin. Elevation is associated with cirrhosis, malignancy, malabsorption of vitamin K, and clotting failure. Regulation of serum electrolytes is a function of the A. liver. B. kidneys. C. adrenal glands. D. thyroid glands - ANSkidneys The urinary system regulates serum electrolytes. Regulation of serum electrolytes is a function of the - ANSkidneys Sharp, severe flank pain radiating to the groin describes renal colic. Renal colic is associated with nephrolithiasis. Pain or burning during urination describes dysuria. Abnormal pain during sexual intercourse is termed dyspareunia. Sharp, severe flank pain, radiating to the groin describes A. dysuria. B. renal colic. C. renal failure. D. dyspareunia - ANSrenal colic Sharp, severe flank pain radiating to the groin describes renal colic. Renal colic is associated with nephrolithiasis. Pain or burning during urination describes dysuria. Abnormal pain during sexual intercourse is termed dyspareunia. Sialolithiasis most commonly occurs in which of the following salivary glands? A. Parotid B. Sublingual C. Submandibular D. Sublingual and submandibular - ANSSubmandibular 60 - 90% of cases of sialolithiasis occur in the submandibular salivary glands with 10 to 20 percent occurring in the parotid salivary glands. Sonographic findings associated with pyelonephritis include A. hydronephrosis. B. hypoechoic renal sinus. C. ill-defined renal capsule. D. well-defined renal pyramids. - ANSwell-defined renal pyramids Generalized or focal swelling of the kidney demonstrating well-defined renal pyramids is the typical sonographic finding associated with pyelonephritis. Sonographic findings associated with pyelonephritis include - ANSwell-defined renal pyramids. Generalized or focal swelling of the kidney demonstrating well-defined renal pyramids is the typical sonographic finding associated with pyelonephritis. Sonographic findings in cases of mesenteric lymphomatous are described by the A. olive sign. B. doughnut sign. C. sandwich sign. D. keyboard sign. - ANSsandwich sign Sandwich sign describes an anechoic lesion with a hyperechoic center found in mesenteric lymphomatous. This type of lesion is more frequent in non-Hodgkin's lymphoma cases. The jejunum and ileum demonstrate small folds in the wall termed the keyboard sign. The doughnut sign is a sonographic finding associated with intussusception. Sonographic findings in cases of mesenteric lymphomatous are described by the A. olive sign. B. doughnut sign. C. sandwich sign. D. keyboard sign - ANSsandwich sign Sandwich sign describes an anechoic lesion with a hyperechoic center found in mesenteric lymphomatous. This type of lesion is more frequent in non-Hodgkin's lymphoma cases. The jejunum and ileum demonstrate small folds in the wall termed the keyboard sign. The doughnut sign is a sonographic finding associated with intussusception. Spectral analysis of the suprarenal portion of the abdominal aorta should demonstrate a - ANShigh 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. Splenomegaly is a consistent finding in which of the following pathologies? A. Hepatic steatosis B. Biliary obstruction C. Portal hypertension D. Portal vein thrombosis - ANSPortal hypertension 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. The arrow is identifying which of the following structures? - ANSRight renal artery The right renal artery coursing posterior to the inferior vena cava is a common sonographic landmark. The arrow is identifying which of the following vascular structures? - ANSCommon 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. The caudate lobe is located A. medial to the lesser sac. B. anterior to the porta hepatis. C. anterior to the ligamentum venosum. D. medial to the inferior vena cava - ANSmedial to the inferior vena cava The caudate lobe lies anterior and medial to the inferior vena cava, posterior to the ligamentum venosum and porta hepatis, and lateral to the lesser sac. The caudate lobe is located A. medial to the lesser sac. B. anterior to the porta hepatis. C. anterior to the ligamentum venosum. D. medial to the inferior vena cava - ANSmedial to the inferior vena cava The caudate lobe lies anterior and medial to the inferior vena cava, posterior to the ligamentum venosum and porta hepatis, and lateral to the lesser sac. The celiac axis is located at A. anterior to the left gastric vein. B. inferior to the splenic vein. C. superior to the gastroesophageal junction. D. superior to the body of the pancreas - ANSsuperior 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. The celiac axis is located at - ANSsuperior 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. The color Doppler image is most suspicious for which of the following abnormalities? A. Epididymitis B. Testicular torsion C. Testicular abscess D. Testicular carcinoma - ANSTesticular 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 coronary vein enters the venous system near the A. medial border of the main portal vein. B. inferior border of the right hepatic vein. C. superior border of the portosplenic confluence. D. inferior border of the superior mesenteric vein - ANSsuperior 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. The coronary vein enters the venous system near the - ANSsuperior border of the portosplenic confluence 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. The inferior mesenteric artery is best visualized in which of the following body planes? A. Transverse B. Sagittal C. Coronal D. Sagittal oblique - ANSSagittal oblique That's correct! The inferior mesenteric artery is best visualized in the sagittal oblique plane, to the left of midline, approximately 1 cm superior to the abdominal aortic bifurcation. The main lobar fissure is a sonographic landmark used for locating the - ANSgallbladder fossa The main lobar fissure is a sonographic landmark used to locate the gallbladder fossa. The most common sonographic appearance of the mediastinum testis is described as a(n) A. complex linear structure. B. anechoic tortuous structure. C. hyperechoic linear structure. D. hyperechoic tubular structure. - ANShyperechoic linear structure A hyperechoic linear structure in the posterior medial aspect of the testis is the most common sonographic appearance of the mediastinum testis. The most common sonographic appearance of the mediastinum testis is described as a(n) A. complex linear structure. B. anechoic tortuous structure. C. hyperechoic linear structure. D. hyperechoic tubular structure. - ANShyperechoic linear structure A hyperechoic linear structure in the posterior medial aspect of the testis is the most common sonographic appearance of the mediastinum testis. The pathology in this sonogram is most consistent with - ANSmetastatic lesions The liver demonstrates a heterogenous parenchyma most suspicious for metastatic lesions. The pathology in this sonogram is most likely a/an - ANSPseudocyst 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. The protective connective tissue surrounding each kidney is termed A. renal fascia. B. renal capsule. C. Gerota's fascia. D. perinephric fat - ANSThe renal capsule is a protective connective tissue surrounding each kidney. Gerota's or renal fascia is the fibrous covering of tissue surrounding each kidney. The protective connective tissue surrounding each kidney is termed A. renal fascia. B. renal capsule. C. Gerota's fascia. D. perinephric fat - ANSrenal capsule The renal capsule is a protective connective tissue surrounding each kidney. Gerota's or renal fascia is the fibrous covering of tissue surrounding each kidney. The renal cortex is bound by the renal capsule and A. major calyces. B. perinephric fat. C. arcuate vessels. D. column of Bertin - ANSarcuate vessels The sonographic findings in this infant kidney are most consistent with which of the following anomalies? - ANSRenal 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 subhepatic space communicates with the lesser sac through the foramen of A. Ovale. B. Monro. C. Winslow. D. Santorini - ANSThe foramen of Winslow allows communication between the subhepatic space and lesser sac The subhepatic space communicates with the lesser sac through the foramen of - ANSWinslow The foramen of Winslow allows communication between the subhepatic space and lesser sac. The wall thickness in a normal fasting gallbladder should not exceed A. 2 mm. B. 3 mm. C. 5 mm. D. 7 mm - ANSThe normal fasting gallbladder demonstrates smooth hyperechoic walls measuring 3 mm or less. The wall thickness in a normal fasting gallbladder should not exceed - ANS3 mm This color Doppler sonogram is most likely demonstrating which of the following abnormalities? - ANSPatent 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. This color Doppler sonogram is most likely demonstrating which of the following abnormalities? - ANSPseudoaneurysm This color Doppler image demonstrates turbulent swirling blood flow within a fluid collection, classic sonographic findings of a common femoral artery pseudoaneurysm. This sagittal image of the left kidney is most likely demonstrating - ANSa 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. This sonogram is most likely demonstrating which of the following? - ANSGallbladder adenoma An immobile (decubitus position), nonshadowing, echogenic intraluminal focus is most consistent with a gallbladder adenoma (polyp). This sonogram of the right kidney is most likely demonstrating - ANSjunctional 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. This transverse sonogram of the right testicle is most likely demonstrating which of the following abnormalities? - ANSIntratesticular calcifications Multiple small hyperechoic foci (microcalcifications) are demonstrated in the right testis. Intratesticular calcifications may be idiopathic or associated with chronic orchitis. To obtain an optimal evaluation of the gallbladder, the adult patient should fast for A. 2 to 4 hours. B. 4 to 6 hours. C. 6 to 8 hours. D. 8 to 10 hours - ANS6 to 8 hours The cavernous hemangioma is composed of large, blood-filled cystic spaces and is the most common benign hepatic neoplasm. Which complication is most likely associated with an annular pancreas? A. Hepatitis B. Pancreatitis C. Bowel obstruction D. Urinary tract obstruction - ANSBowel obstruction Annular pancreas is a rare congenital anomaly where the head of the pancreas surrounds the duodenum. This anomaly may result in obstruction of the duodenum or biliary tree. Which laboratory value reveals cell injury or damage? A. Bilirubin B. Alkaline phosphatase C. Aspartate aminotransferase D. Alanine aminotransferase - ANSAspartate 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. Which laboratory value reveals cell injury or damage? - ANSAspartate 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 Which of the following abnormalities are demonstrated in this sonogram? - ANSHydrocele 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. Which of the following abnormalities is demonstrated in this color Doppler image? - ANSFatty 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. Which of the following abnormalities is demonstrated in this transverse sonogram? - ANSStones in the duct of Wirsung Multiple stones are located in main pancreatic duct (duct of Wirsung). Which of the following abnormalities is present in this sagittal sonogram? - ANSAdenomyomatosis Immobile hyperechoic foci demonstrating a "comet-tail" reverberation artifact are characteristic findings of adenomyomatosis. Which of the following accurately describes the portal veins? - ANSPortal veins are intralobar in location Portal veins are intralobar or intrasegmental in location. The portal veins supply approximately 70 to 75 percent of the liver's total blood volume. The main portal vein divides into the right and left portal veins. The walls of the portal veins contain fibrin. Which of the following accurately describes the spleen? A. The spleen is a retroperitoneal organ. B. The peritoneum completely covers the spleen. C. The spleen is located medial to the pancreas. D. The spleen lies posterior and lateral to the stomach - ANSThe spleen lies posterior and lateral to the stomach within the peritoneum. Peritoneum covers the spleen except at the hilum. Which of the following anatomic variants involves the fundus of the gallbladder? A. Junctional fold B. Phrygian cap C. Hartmann pouch D. Portal hypertension - ANSCholelithiasis Biliary disease is the most common cause of acute pancreatitis followed by alcohol abuse. Which of the following congenital anomalies demonstrates a "dipping effect" to inferior poles of the kidneys? A. Cake kidney B. Renal ptosis C. Renal duplication D. Horseshoe kidney - ANSHorseshoe kidney Demonstration of bilateral "dipping" of the inferior poles should raise suspicion of a horseshoe anomaly. Crossed fused ectopia demonstrates one single large kidney within the same quadrant. Which of the following demonstrates diffuse enlargement of the abdominal aorta without distal tapering? A. Pseudoaneurysm B. Mycotic aneurysm C. Ectatic aneurysm D. Arteriomegaly - ANSArteriomegaly (aortic ectasia) demonstrates as a diffuse enlargement of the abdominal aorta without distal tapering on ultrasound. Which of the following demonstrates diffuse enlargement of the abdominal aorta without distal tapering? - ANSArteriomegaly Arteriomegaly (aortic ectasia) demonstrates as a diffuse enlargement of the abdominal aorta without distal tapering on ultrasound. Which of the following enzymes will most likely affect blood pressure? A. Renin B. Trypsin C. Somatostatin D. Aldosterone - ANSRenin Renin, also known as angiotensinogenase, is an enzyme secreted by the kidneys to help regulate blood pressure. Which of the following gallbladder abnormalities is not always pathological in origin? - ANSBiliary sludge Biliary sludge may develop in cases of prolonged fasting or biliary disease. Which of the following is a clinical symptom of hypothyroidism? - ANSMuscle 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. Which of the following is a complication of acute pancreatitis? A. Cholecystitis B. Hepatomegaly C. Splenomegaly D. Duodenal obstruction - ANSDuodenal obstruction Complications of acute pancreatitis may include abscess formation, duodenal obstruction, hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute pancreatitis. Which of the following is a complication of acute pancreatitis? - ANSDuodenal obstruction Complications of acute pancreatitis may include abscess formation, duodenal obstruction, hemorrhage, phlegmon, and pseudocyst formation. Cholecystitis is a possible etiology of acute pancreatitis. Which of the following is an abnormal flow characteristic of the hepatic veins? - ANSHepatopetal Hepatic veins course away from the liver toward the inferior vena cava. This is termed hepatofugal flow. Hepatic veins demonstrate spontaneous multiphasic (pulsatile) flow. Which of the following laboratory values increases in Addison disease? - ANSSerum 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 laboratory values is associated with malignancy in the elderly population? A. Bilirubin B. Serum albumin C. Alpha-fetoprotein D. Alkaline phosphatase - ANSAlpha-fetoprotein is an abnormal finding associated with an underlying malignancy in nonpregnant patients. Which of the following laboratory values is associated with malignancy in the elderly population? - ANSAlpha-fetoprotein Alpha-fetoprotein is an abnormal finding associated with an underlying malignancy in nonpregnant patients. Which of the following laboratory values reflects the balance between production and excretion of bile? A. Bilirubin B. Alkaline phosphatase C. Alanine aminotransferase (ALT) D. Aspartate aminotransferase (AST) - ANSBilirubin Bilirubin reflects the balance between production and excretion of bile. Serum albumin evaluates protein synthesis. Which of the following laboratory values reflects the balance between production and excretion of bile? A. Bilirubin B. Alkaline phosphatase C. Alanine aminotransferase (ALT) D. Aspartate aminotransferase (AST) - ANSBilirubin Bilirubin reflects the balance between production and excretion of bile. Serum albumin evaluates protein synthesis. Which of the following ligaments forms the anterior border of the epiploic foramen? A. Falciform ligament B. Coronary ligament C. Gastrohepatic ligament D. Hepatoduodenal ligament - ANSHepatoduodenal ligament The hepatoduodenal ligament surrounds the portal triad just proximal to the porta hepatis and forms the anterior border of the epiploic foramen. Which of the following ligaments forms the anterior border of the epiploic foramen? - ANSHepatoduodenal ligament The hepatoduodenal ligament surrounds the portal triad just proximal to the porta hepatis and forms the anterior border of the epiploic foramen. Which of the following ligaments is present in this image of the liver? - ANSVenosum The sonogram demonstrates the left and caudate lobes of the liver separated by the hyperechoic ligament of venosum. Which of the following liver pathologies is associated with glycogen storage disease? A. Hepatitis B. Adenoma C. Hepatoma D. Cavernous hemangioma - ANSAdenoma 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. B. Cirrhosis C. Hepatoma D. Portal vein thrombosis - ANSPortal vein thrombosis Severe abdominal pain is more commonly associated with portal vein thrombosis. Which of the following pathologies is more commonly associated with severe abdominal pain? - ANSPortal vein thrombosis Severe abdominal pain is more commonly associated with portal vein thrombosis. Which of the following pathologies is most consistent with these sonographic findings? - ANSPortal vein thrombosis Altered blood flow within the portal vein, in conjunction with a hypoechoic intraluminal mass, is most suspicious for portal vein thrombosis. Severe abdominal pain and loss of appetite are common clinical symptoms connected with thrombosis of the portal venous system. Which of the following pathologies is most likely demonstrated in this sonogram? - ANSHepatitis An increase in echogenicity in the walls of the portal veins is a sonographic finding associated with hepatitis (star effect). Biliary obstruction demonstrates parallel channeling and flattening of the portal veins. Which of the following pathologies is most likely identified in this sonogram of the liver? A. Abscess B. Adenoma C. Hepatoma D. Cavernous hemangioma - ANSHepatoma A solitary, smooth walled, hypoechoic mass is identified in the left lobe of the liver most suspicious for a hepatoma. The mass does not demonstrate a hypoechoic halo characteristic of a hepatic adenoma or irregular wall margins characteristic of an abscess. Which of the following should be included in a kidney ultrasound protocol when hydronephrosis is encountered? A. Color Doppler imaging of the renal artery and vein B. Pre and post void bladder volumes C. Color Doppler imaging of the ureteral jet(s) D. Gray-scale images of the liver and spleen - ANSColor Doppler imaging of the ureteral jet(s) When hydronephrosis is encountered, color Doppler imaging of the ureteral jets should be included in the examination protocol. Which of the following structures aids in locating the gallbladder fossa? - ANSMain 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. Which of the following structures are included in an ultrasound protocol of the pancreas? A. Liver and spleen B. Liver and biliary system C. Inferior vena cava and abdominal aorta D. Liver and right kidney - ANSLiver and biliary system Due to the association of the liver and biliary tree with the pancreas, sagital and transverse images of these structures should be included in an ultrasound protocol of the pancreas. Which of the following structures divides the left lobe into two segments? - ANSLeft 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. Which of the following structures is located posterior to the superior mesenteric vein and anterior to the aorta? A. Splenic vein B. Uncinate process Which of the following vascular structures is located directly posterior to the neck of the pancreas? A. Inferior vena cava B. Gastroduodenal artery C. Superior mesenteric vein D. Superior mesenteric artery - ANSSuperior mesenteric vein The superior mesenteric vein and portosplenic confluence lie directly posterior to the neck of the pancreas. Which of the following vascular structures is the arrow identifying? - ANSInternal jugular vein 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. Which of the following vascular structures normally demonstrates this waveform? A. Portal vein B. Hepatic vein C. Splenic vein D. Superior mesenteric vein - ANSHepatic vein Pulsatile bidirectional venous flow is characteristic of a normal hepatic vein. Which of the following vessels receives blood from the gallbladder, pancreas, spleen, and gastrointestinal tract? A. Hepatic veins B. Main portal vein C. Inferior vena cava D. Superior mesenteric vein - ANSThe main portal vein receives blood from the gastrointestinal tract, gallbladder, pancreas, and spleen. Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? A. Splenic vein B. Left renal vein C. Left gastric artery D. Superior mesenteric vein - ANSLeft renal vein The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal aorta. Which vascular structure courses posterior to the superior mesenteric artery and anterior to the abdominal aorta? - ANSLeft renal vein The left renal vein courses posterior to the superior mesenteric artery and anterior to the abdominal aorta.