AB-ABDOMEN PDF FREE - LATEST AB-ABDOMEN EXAM PATTERN

AB-Abdomen Pdf Free - Latest AB-Abdomen Exam Pattern

AB-Abdomen Pdf Free - Latest AB-Abdomen Exam Pattern

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ARDMS Abdomen Sonography Examination Sample Questions (Q75-Q80):

NEW QUESTION # 75
Which condition is most likely in a patient presenting with weight loss and fatigue along with elevated liver enzymes, elevated potassium, and decreased sodium?

  • A. Acute pancreatitis
  • B. Addison disease
  • C. Conn syndrome
  • D. Hepatocellular carcinoma

Answer: B

Explanation:
Addison disease (primary adrenal insufficiency) results in insufficient production of cortisol and aldosterone.
The hallmark laboratory findings include:
* Hyponatremia (low sodium)
* Hyperkalemia (high potassium)
* Elevated liver enzymes (due to nonspecific hepatic involvement)
* Fatigue, weight loss, and hypotension are common clinical features.
* Conn syndrome (B) causes hyperaldosteronism, leading to hypokalemia (not hyperkalemia).
* Acute pancreatitis (C) would typically show elevated amylase/lipase.
* Hepatocellular carcinoma (D) may present with elevated liver enzymes but not the electrolyte pattern described.
Reference Extracts:
* Nieman LK. "Diagnosis and Treatment of Primary Adrenal Insufficiency." J Clin Endocrinol Metab.
2011;96(7):1957-1966.
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
-


NEW QUESTION # 76
Which diagnosis is most accurate based on the findings in this image from an adult patient?

  • A. Renal cell carcinoma
  • B. Nephroblastoma
  • C. Clear cell carcinoma
  • D. Transitional cell carcinoma

Answer: A

Explanation:
The ultrasound images (sagittal and transverse views of the left kidney) demonstrate a large, well-defined, heterogeneous mass within the renal parenchyma. This is highly characteristic of renal cell carcinoma (RCC), the most common primary renal malignancy in adults.
Renal cell carcinoma accounts for approximately 85% of all malignant renal tumors in adults. RCC often appears as:
* A solid, heterogeneous, hypoechoic to isoechoic mass within the kidney
* May contain areas of necrosis or hemorrhage (seen as mixed echogenicity)
* Distortion of the normal renal contour
* May have internal vascularity on Doppler imaging
Clear cell carcinoma (choice B) is the most common histological subtype of RCC but is not a separate diagnosis from RCC in imaging terms. Therefore, the most accurate answer is choice C: Renal cell carcinoma.
Differentiation from other options:
* A. Nephroblastoma (Wilms tumor): A pediatric renal tumor, typically seen in children under 5 years of age-not applicable in adults.
* B. Clear cell carcinoma: Histological subtype of RCC, not a distinct radiologic diagnosis.
* D. Transitional cell carcinoma: Arises from the renal pelvis or ureter, typically appears as a central or collecting system mass rather than a cortical/parenchymal one.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Kidneys, pp. 215-222.
Radiopaedia.org. Renal cell carcinoma: https://radiopaedia.org/articles/renal-cell-carcinoma American College of Radiology (ACR) Appropriateness Criteria - Hematuria, 2022.


NEW QUESTION # 77
Identify the region where Doppler sampling should be performed in a young woman with severe postprandial pain.

Answer:

Explanation:

Explanation:
A ultrasound image of a person's body AI-generated content may be incorrect.

The origin of the superior mesenteric artery (SMA)
The image provided is a color Doppler ultrasound scan of the abdominal aorta and its major branches. In the center of the image, just anterior to the aorta, we see the superior mesenteric artery (SMA) arising in the sagittal plane. This is the critical area for Doppler sampling in a patient with symptoms suggestive of mesenteric ischemia.
Severe postprandial pain in a young woman may be a manifestation of median arcuate ligament syndrome (MALS) or chronic mesenteric ischemia. Both of these conditions are assessed via Doppler sampling of mesenteric vessels, specifically:
* The origin and proximal segment of the SMA
* The celiac artery (especially for MALS)
Doppler waveform analysis should assess:
* Peak systolic velocity (PSV): >275 cm/s suggests #70% SMA stenosis
* Angle correction should be aligned properly
* Sampling must be performed at the narrowest origin point (as shown in the image) This type of Doppler interrogation is typically done in both fasting and postprandial states to evaluate changes in flow and symptom correlation.
Why this area?
* The SMA is anterior to the aorta and travels inferiorly into the mesentery.
* The site shown in the image is ideal for measuring PSV and evaluating for stenosis or extrinsic compression.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Moneta GL, et al. Duplex ultrasound criteria for diagnosis of mesenteric artery stenosis. J Vasc Surg. 1991.
AIUM Practice Parameter for the Performance of a Mesenteric Artery Duplex Ultrasound Examination (2020).


NEW QUESTION # 78
Which finding is indicated by the arrow in this image of the right upper quadrant?

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

Answer: C

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 # 79
Which finding is expected in the contralateral kidney given the pathology depicted in this image?

  • A. Atrophic kidney
  • B. Polycystic kidney
  • C. Duplicated collecting system
  • D. Parapelvic cysts

Answer: B

Explanation:
The ultrasound image shows a sagittal view of the right kidney with multiple anechoic (black), non- communicating cysts of varying sizes distributed throughout the renal parenchyma, consistent with autosomal dominant polycystic kidney disease (ADPKD).
ADPKD is a hereditary disorder characterized by the progressive development of multiple bilateral renal cysts, which leads to renal enlargement and eventual loss of function. This condition typically affects both kidneys, making bilateral polycystic involvement expected. Therefore, the same cystic appearance is anticipated in the contralateral (left) kidney as well.
Comparison of answer choices:
* A. Duplicated collecting system: This is a congenital anomaly but does not result in diffusely cystic kidneys.
* B. Polycystic kidney: Correct. Bilateral renal involvement is the hallmark of ADPKD.
* C. Parapelvic cysts: These are simple cysts located in the renal sinus and do not exhibit the diffuse pattern seen here.
* D. Atrophic kidney: Not typical in the contralateral side in ADPKD; the disease affects both kidneys symmetrically.
References:
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.
Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet. 2007;369(9569):
1287-1301.


NEW QUESTION # 80
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