Get ARDMS AB-Abdomen Exam Practice Questions - Real and Updated

Answer : B

An accessory spleen (splenule) is a congenital variant, commonly located near the splenic hilum, and has identical echogenicity to the native spleen. This finding is benign and often incidental.

According to Rumack's Diagnostic Ultrasound:

''Accessory spleens are typically found near the splenic hilum and are isoechoic to the normal splenic parenchyma.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

AIUM Practice Parameter for Abdominal Ultrasound, 2020.

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Answer : B

The arrow in this Doppler ultrasound image of the kidney is pointing to vessels located at the corticomedullary junction, arching over the bases of the medullary pyramids. This vascular pattern is characteristic of the arcuate arteries.

Renal arterial anatomy follows a specific branching hierarchy:

Segmental arteries branch off the main renal artery.

Interlobar arteries travel between renal pyramids.

Arcuate arteries arch over the base of the pyramids at the corticomedullary junction.

Interlobular arteries extend into the cortex from the arcuate arteries.

Key characteristics of arcuate arteries on ultrasound:

Located at the corticomedullary junction (between the medullary pyramids and renal cortex).

Run perpendicular to the long axis of the kidney, often forming an arching or curving pattern.

Commonly targeted in Doppler studies to assess resistive index (RI) in renal perfusion studies.

Comparison of answer choices:

A . Interlobular arteries are smaller vessels that extend perpendicularly from the arcuate arteries into the cortex---not visible at this level.

B . Arcuate --- Correct. The arrow is indicating these vessels arching over the medullary pyramids.

C . Segmental arteries are larger and deeper, branching off the renal artery near the hilum.

D . Interlobar arteries course between the pyramids but do not arch along their base.

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.

AIUM Practice Parameter for the Performance of a Renal Artery Duplex Sonogram (2020).

Answer : C

The ultrasound image shown is a transverse endorectal (transrectal) ultrasound, commonly used to evaluate the prostate and adjacent structures. The two hypoechoic (dark) oval-shaped structures seen superior and posterior to the prostate are characteristic of the seminal vesicles.

The seminal vesicles are paired, elongated glands located superior and posterior to the base of the prostate and are best visualized in transverse planes on endorectal imaging. They appear as hypoechoic or anechoic structures with internal septations, depending on the degree of fluid content.

In contrast:

The urethra appears as a central echogenic linear structure within the prostate.

The prostate base is more inferior in the scan and is visualized just above the urethra.

The ejaculatory ducts are usually not as prominently visualized and are located medial to the seminal vesicles, entering the prostate near the verumontanum.

This image most clearly demonstrates the bilateral seminal vesicles.

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.

ACR--AIUM--SRU Practice Parameter for the Performance of an Ultrasound Examination of the Prostate (2021).

Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.

Answer : C

Pancreatic ductal adenocarcinoma is by far the most common pancreatic malignancy, accounting for approximately 85--90% of pancreatic cancers. It typically arises from the exocrine portion of the pancreas, most frequently in the pancreatic head. Islet cell (neuroendocrine) tumors and cystic neoplasms (e.g., mucinous cystadenocarcinoma) are far less common.

According to Rumack's Diagnostic Ultrasound:

''Adenocarcinoma is the most common malignant neoplasm of the pancreas, representing the vast majority of pancreatic cancers.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

WHO Classification of Digestive System Tumors, 5th ed., IARC, 2019.

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Answer : C

An intimal flap in the aorta is a hallmark ultrasound finding of aortic dissection, which can present with tearing chest/abdominal pain and differential blood pressures between arms. The flap represents separation of the intimal and medial layers of the aortic wall.

According to Rumack's Diagnostic Ultrasound:

''An intimal flap visualized within the aorta is diagnostic of an aortic dissection.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

American Heart Association (AHA) Guidelines for Aortic Disease, 2020.

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