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ARDMS AB-Abdomen Certification Dump | Clear AB-Abdomen Exam

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ARDMS Abdomen Sonography Examination Sample Questions (Q77-Q82):

NEW QUESTION # 77
During a renal artery Doppler study, which vessel should also be sampled to verify patency?

A. Inferior vena cava
B. Iliac vein
C. Main renal vein
D. Portal vein

Answer: C

Explanation:
The main renal vein should be assessed in addition to the renal arteries during renal Doppler exams. Venous thrombosis may coexist with arterial abnormalities and can impact renal perfusion. Evaluation of both arterial inflow and venous outflow ensures a comprehensive assessment of renal vascular patency.
According to Zwiebel's Introduction to Vascular Ultrasound:
"Renal vein assessment should be performed during renal artery Doppler studies to exclude venous thrombosis or outflow obstruction." Reference:
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.
AIUM Practice Parameter for Renal Artery Duplex Sonography, 2020.
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NEW QUESTION # 78
Elevation of alpha-fetoprotein levels is a characteristic finding in which tumor?

A. Hepatoma
B. Focal nodular hyperplasia
C. Adenoma
D. Cholangiocarcinoma

Answer: A

Explanation:
Alpha-fetoprotein (AFP) is commonly elevated in patients with hepatocellular carcinoma (hepatoma), particularly in those with underlying cirrhosis or chronic hepatitis B/C. AFP is not typically elevated in adenomas, cholangiocarcinoma, or FNH.
According to Rumack's Diagnostic Ultrasound:
"Serum AFP levels are elevated in 50-70% of patients with hepatocellular carcinoma." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AASLD Guidelines for HCC Surveillance, 2018.
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NEW QUESTION # 79
Where in the neck are most thyroid cancer recurrences found?

A. Contralateral
B. Subauricular
C. Ipsilateral
D. Bilateral

Answer: C

Explanation:
Most thyroid cancer recurrences are found in the ipsilateral neck-particularly in the central (level VI) or lateral (levels II-V) compartments on the same side as the original malignancy.
According to AIUM Practice Parameters:
"Post-thyroidectomy recurrence most frequently occurs ipsilateral to the original tumor, commonly involving regional lymph nodes." Reference:
AIUM Practice Parameter for Thyroid and Neck Ultrasound, 2020.
American Thyroid Association (ATA) Guidelines for Thyroid Cancer Management, 2015.

NEW QUESTION # 80
Which finding is most likely demonstrated in this image?

A. Ascites
B. Hemoperitoneum
C. Bowel obstruction
D. Hydropic gallbladder

Answer: A

Explanation:
The ultrasound image shows an anechoic (black) fluid collection in the perihepatic and perirenal spaces. The fluid outlines the liver (LIV) and right kidney (RK), which is characteristic of free fluid in the peritoneal cavity - consistent with ascites.
Sonographic features of ascites:
* Anechoic (or hypoechoic) fluid in dependent areas of the abdomen
* Seen surrounding the liver, spleen, and intestines
* Can be free-flowing or loculated
* Bowel loops may be floating or displaced centrally
This image is consistent with a typical finding of ascites: free fluid in Morison's pouch (hepatorenal recess), a common site for fluid accumulation.
Differentiation from other options:
* A. Hydropic gallbladder: Refers to an enlarged gallbladder filled with clear bile; not visible in this image.
* B. Hemoperitoneum: May appear similar to ascites, but usually has complex echogenicity or layering if acute; clinical context (trauma, bleeding) is essential for diagnosis.
* C. Bowel obstruction: Would show dilated, fluid-filled bowel loops with peristalsis or to-and-fro motion, not evident here.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Peritoneal Cavity and Abdominal Trauma, pp. 125-130.
American Institute of Ultrasound in Medicine (AIUM). Practice Parameter for the Performance of a Focused Assessment with Sonography for Trauma (FAST) Examination, 2020.
Radiopaedia.org. Ascites (ultrasound): https://radiopaedia.org/articles/ascites-ultrasound

NEW QUESTION # 81
In which segment is the solid mass located in this transverse image of the liver?

A. Right anterior
B. Left medial
C. Right posterior
D. Left lateral

Answer: C

Explanation:
The transverse ultrasound image of the liver shows a solid, hypoechoic mass located in the posterior aspect of the right lobe of the liver. In this view:
* The anterior aspect of the liver is at the top of the image (near the transducer).
* The posterior aspect is at the bottom (deeper).
* The right lobe occupies the majority of the screen on transverse imaging when the probe is placed in the epigastrium or right upper quadrant.
Anatomically, the right lobe of the liver is divided into anterior and posterior segments by the right hepatic vein in the coronal plane. In transverse imaging:
* The right anterior segment lies closer to the anterior abdominal wall.
* The right posterior segment lies deeper (posteriorly).
Given that the mass is seen deep within the liver on the right side of the image, it is best localized to the right posterior segment (Segment VI or VII depending on the exact craniocaudal level).
Comparison of answer choices:
* A. Left lateral is located far to the left of the image and typically appears higher and more anterior on transverse scans.
* B. Left medial lies near the midline and would appear adjacent to the ligamentum teres or falciform ligament.
* C. Right anterior lies closer to the transducer (top of the image), not posteriorly.
* D. Right posterior - Correct. This is the segment shown deep in the right lobe of the liver.
References:
Couinaud C. Liver anatomy: portal (and hepatic) segmentation. Trans Assoc Am Physicians. 1957.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.

NEW QUESTION # 82
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