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ARDMS Abdomen Sonography Examination Sample Questions (Q66-Q71):

NEW QUESTION # 66
Which complication is of greatest concern with undescended testis?

A. Hydrocele
B. Hernia
C. Torsion
D. Seminoma

Answer: D

Explanation:
The most serious long-term complication of undescended testis (cryptorchidism) is an increased risk of testicular malignancy, especially seminoma. Although torsion and hernia may also occur, seminoma is the most concerning complication due to its life-threatening potential.
According to Rumack's Diagnostic Ultrasound:
"Cryptorchidism is associated with a significantly increased risk of seminoma, the most common malignancy in undescended testes." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
American Urological Association (AUA) Guidelines, 2019.
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NEW QUESTION # 67
Which of the following must be sterile for a percutaneous procedure?

A. Machine controls
B. Transducer cover
C. Transducer
D. Gel within transducer cover

Answer: D

Explanation:
In percutaneous procedures such as biopsies or drainages, maintaining a sterile field is critical to avoid introducing infection. While the transducer is covered by a sterile cover, the gel placed inside this cover (between the probe and the cover) must also be sterile, as it contacts the sterile field. The transducer itself and machine controls are not sterile but are handled appropriately to avoid field contamination.
According to the AIUM Guidelines:
"Sterile coupling gel must be used inside the sterile probe cover during all invasive or percutaneous procedures." (AIUM Guidelines for Cleaning and Preparing Ultrasound Transducers, 2021).
Reference:
AIUM Guidelines for Cleaning and Preparing Ultrasound Transducers and Equipment for Reuse, 2021.
ACR Practice Parameter for Performing Ultrasound-Guided Procedures, 2020.
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NEW QUESTION # 68
Which technique best differentiates a bladder mass from a hematoma?

A. Obtain post-void image
B. Change patient position
C. Use harmonic imaging
D. Fill the bladder

Answer: B

Explanation:
Changing the patient's position allows evaluation of lesion mobility. Blood clots and hematomas are often mobile, while true bladder wall masses remain fixed. This technique helps differentiate between solid masses and non-adherent debris.
According to Rumack's Diagnostic Ultrasound:
"Changing patient position may distinguish between mobile blood clots and fixed bladder wall masses." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Bladder Ultrasound, 2020.

NEW QUESTION # 69
Which finding is indicated by the arrow in this image of the right upper quadrant?

A. Mirror image
B. Pleural effusion
C. Ascites
D. Retroperitoneal hemorrhage

Answer: B

Explanation:
The image provided is a right upper quadrant (RUQ) ultrasound-typically performed during a FAST (Focused Assessment with Sonography in Trauma) exam or for abdominal assessment. The arrow points to an anechoic (black) fluid collection seen above the diaphragm and posterior to the liver.
This fluid collection lies within the thoracic cavity, confirming the diagnosis of a pleural effusion. Pleural effusions are seen sonographically as an anechoic or hypoechoic area superior to the diaphragm in the thoracic cavity and often appear triangular or crescent-shaped. The diaphragm is visualized as a curvilinear echogenic structure separating the liver (or spleen) below from the lung space above.
Comparison of answer choices:
* A. Retroperitoneal hemorrhage would be seen in the posterior abdomen, not above the diaphragm.
* B. Pleural effusion is correct-anechoic fluid above the diaphragm is classic for this condition.
* C. Mirror image artifact occurs when liver echoes are mirrored across the diaphragm and lung-this is not a mirror artifact.
* D. Ascites collects inferior to the diaphragm and around the abdominal organs, not in the thoracic cavity.
References:
Ma OJ, Mateer JR, Blaivas M. Emergency Ultrasound, 3rd ed. McGraw-Hill; 2014.
Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749-757.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.

NEW QUESTION # 70
Which vessel is typically seen with an echogenic ring of fat when imaging the upper abdominal mesenteric circulation?

A. Superior mesenteric artery
B. Splenic artery
C. Common hepatic artery
D. Gastroduodenal artery

Answer: A

Explanation:
The superior mesenteric artery (SMA) is typically visualized surrounded by an echogenic fat pad in the mesentery, producing a characteristic "echogenic ring" appearance on ultrasound. This is a helpful landmark for identifying the SMA in the transverse abdominal aortic plane.
According to Rumack's Diagnostic Ultrasound:
"The superior mesenteric artery is often seen as a round anechoic structure surrounded by echogenic fat at its origin from the anterior aorta." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
Moore KL, Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.

NEW QUESTION # 71
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