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ARDMS Abdomen Sonography Examination Sample Questions (Q17-Q22):
NEW QUESTION # 17
Which arterial branches lie at the base of the renal pyramids?
Answer: B
Explanation:
The arcuate arteries are located at the corticomedullary junction, arching over the base of the renal pyramids.
They form as the interlobar arteries reach the boundary between the cortex and medulla. The arcuate arteries give rise to the interlobular arteries, which supply the renal cortex.
* Segmental arteries (A) branch directly from the renal artery.
* Interlobar arteries (B) course between the renal pyramids.
* Interlobular arteries (D) extend into the cortex from the arcuate arteries.
Reference Extracts:
* Moore KL, Dalley AF, Agur AM. Clinically Oriented Anatomy. 7th ed. Lippincott Williams & Wilkins, 2013.
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
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NEW QUESTION # 18
In which position should a patient be placed when internal echoes are seen within a fluid-filled bladder?
Answer: D
Explanation:
Lateral decubitus positioning allows shifting of internal echoes within the bladder, helping differentiate mobile debris (such as blood clots or sediment) from adherent masses like tumors. This technique is helpful in evaluating questionable bladder filling defects.
According to Rumack's Diagnostic Ultrasound:
"Changing the patient's position, such as turning to the lateral decubitus, can help distinguish mobile debris from attached bladder wall lesions." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Bladder Ultrasound, 2020.
NEW QUESTION # 19
Which condition is demonstrated in this image of a febrile patient with breast redness and tenderness?
Answer: B
Explanation:
The ultrasound image demonstrates an irregular, complex fluid collection in the subareolar region of the breast with internal echoes, septations, and poorly defined margins. These sonographic findings are classic for a breast abscess, particularly in a patient presenting with clinical signs of infection-fever, redness, and localized tenderness.
A breast abscess is typically seen as:
* A hypoechoic or anechoic area with thick walls
* Presence of internal debris, septations, or floating echoes
* Posterior acoustic enhancement
* Increased peripheral vascularity on Doppler (surrounding inflammation)
* Surrounding hyperechoic fat due to cellulitis
This clinical and imaging profile strongly supports the diagnosis of a breast abscess, most commonly seen in lactating women (puerperal mastitis) or in non-lactating women with chronic infection.
Comparison of answer choices:
* A. Ductal ectasia usually presents with dilated ducts and minimal inflammatory changes, often asymptomatic or causing nipple discharge.
* B. Abscess - Correct. The irregular fluid collection with complex echoes and clinical signs of infection supports this.
* C. Sebaceous cysts are typically superficial, round, and well-defined with a punctum.
* D. Galactocele appears as a well-circumscribed, fat-fluid level-containing lesion in lactating women but lacks surrounding inflammation.
References:
Mendelson EB, Bohm-Velez M, Berg WA.ACR BI-RADS Atlas: Ultrasound. American College of Radiology; 2013.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
AIUM Practice Parameter for the Performance of Diagnostic and Screening Ultrasound of the Breast (2021).
NEW QUESTION # 20
What is the most common ultrasound appearance of the pancreas in mild acute pancreatitis?
Answer: B
Explanation:
In mild acute pancreatitis, the pancreas often appears diffusely enlarged and slightly hypoechoic due to edema and inflammation. However, in very early or mild cases, the pancreas may still appear normal. Heterogeneous echotexture may develop in more severe or necrotizing pancreatitis.
According to Rumack's Diagnostic Ultrasound:
"In mild pancreatitis, the pancreas is commonly enlarged and hypoechoic due to inflammatory edema." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen, 2020.
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NEW QUESTION # 21
Which structures converge to form the inferior vena cava?
Answer: A
Explanation:
The inferior vena cava (IVC) is formed by the confluence of the right and left common iliac veins at the level of approximately L5. The hepatic veins drain into the IVC superiorly but do not form it. The superior mesenteric and splenic veins join to form the portal vein, not the IVC.
According to Moore's Clinically Oriented Anatomy:
"The IVC begins at the level of L5 by the union of the right and left common iliac veins." Reference:
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.
Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
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NEW QUESTION # 22
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