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ARDMS Abdomen Sonography Examination Sample Questions (Q137-Q142):
NEW QUESTION # 137
Which normal anatomical structure is also known as the accessory pancreatic duct?
Answer: A
Explanation:
The Duct of Santorini is the accessory pancreatic duct that drains the superior portion of the pancreatic head into the minor duodenal papilla. The main pancreatic duct (Duct of Wirsung) drains into the major papilla, often joining the common bile duct at the Ampulla of Vater.
According to Moore's Clinically Oriented Anatomy:
"The accessory pancreatic duct (Duct of Santorini) may be present and drains into the minor duodenal papilla." 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 # 138
What is the most common location of a pancreatic pseudocyst?
Answer: B
Explanation:
Pancreatic pseudocysts most commonly develop in the lesser sac, which lies between the posterior wall of the stomach and the anterior surface of the pancreas. This space allows for the accumulation of pancreatic fluid collections following pancreatitis or pancreatic ductal disruption.
* The left anterior pararenal space (B) is a secondary location.
* The right subdiaphragmatic space (C) and left pericolic gutter (D) are less common sites.
Reference Extracts:
* Mortele KJ, Wiesner W, et al."Pancreatic pseudocysts: imaging features and diagnostic difficulties." Radiographics. 2004;24(4):1005-1020.
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
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NEW QUESTION # 139
Which vascular condition is most commonly associated with a wandering spleen?
Answer: B
Explanation:
A wandering spleen occurs when the spleen is not adequately anchored by its supporting ligaments, allowing it to move freely within the abdomen. This increases the risk of splenic torsion, which compromises vascular supply and may result in infarction if not corrected.
According to Rumack's Diagnostic Ultrasound:
"The most serious complication of a wandering spleen is torsion, which may result in splenic infarction." 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.
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NEW QUESTION # 140
In which segment is the solid mass located in this transverse image of the liver?
Answer: D
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 # 141
Which finding is expected in the contralateral kidney given the pathology depicted in this image?
Answer: D
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 # 142
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